Siegal Sadetzki

Publications of Siegal Sadetzki

• The effect of hysterectomy on survival of patients with borderline ovarian tumors.

  Authors: Joseph Menczer, Angela Chetrit, Siegal Sadetzki

  Gynecologic oncology. 02/2012;

  OBJECTIVE: The classically recommended surgical treatment of borderline ovarian tumors (BOTs) includes hysterectomy in addition to bilateral adnexectomy. Possible reasons for hysterectomy might be aOBJECTIVE: The classically recommended surgical treatment of borderline ovarian tumors (BOTs) includes hysterectomy in addition to bilateral adnexectomy. Possible reasons for hysterectomy might be a high frequency of uterine involvement and its favorable effect on survival. The purpose of the present study was to assess the frequency of uterine involvement in patients with BOTs and the effect of hysterectomy on survival. METHODS: All incident cases of histological confirmed BOTs diagnosed in Israeli Jewish women between March 1 1994 and June 30 1999, were identified. Clinical and pathological characteristics were abstracted from medical records. Patients with tumors grossly confined to the ovaries (apparently stage I) were considered to have had surgical staging when at least hysterectomy, bilateral salpingooophorectomy, omentectomy and pelvic lymph node sampling were done. RESULTS: The study group comprised 225 patients. Hysterectomy was performed in 147 (65.31%) patients and uterine involvement was present in only 3 (2.0%) of them. The 13year survival of the total group of patients was 85.8% and of those in apparent stage I, 88.5%. Among patients with tumors apparently confined to the ovaries, no significant survival difference was observed between unstaged and surgically staged patients. There was also no survival difference between the overall staged and unstaged patients and between patients in stages II-III who did and did not undergo hysterectomy. CONCLUSIONS: Our data indicate that the rate of uterine involvement in BOT is low and that hysterectomy does not favorably affect survival. The necessity of hysterectomy in BOT patients is questioned.

• Association between BRCA1 and BRCA2 mutations and survival in women with invasive epithelial ovarian cancer.

  Authors: Kelly L Bolton, Georgia Chenevix-Trench, Cindy Goh, Siegal Sadetzki, Susan J Ramus, Beth Y Karlan, Diether Lambrechts, Evelyn Despierre, Daniel Barrowdale, Lesley McGuffog [......] Ilana Cass, Christine Walsh, Andrew J Li, Ronald Leuchter, Ora Gordon, Montserrat Garcia-Closas, Simon A Gayther, Stephen J Chanock, Antonis C Antoniou, Paul D P Pharoah

  JAMA : the journal of the American Medical Association. 01/2012; 307(4):382-90.

  Approximately 10% of women with invasive epithelial ovarian cancer (EOC) carry deleterious germline mutations in BRCA1 or BRCA2. A recent article suggested that BRCA2-related EOC was associated withApproximately 10% of women with invasive epithelial ovarian cancer (EOC) carry deleterious germline mutations in BRCA1 or BRCA2. A recent article suggested that BRCA2-related EOC was associated with an improved prognosis, but the effect of BRCA1 remains unclear. To characterize the survival of BRCA carriers with EOC compared with noncarriers and to determine whether BRCA1 and BRCA2 carriers show similar survival patterns. A pooled analysis of 26 observational studies on the survival of women with ovarian cancer, which included data from 1213 EOC cases with pathogenic germline mutations in BRCA1 (n = 909) or BRCA2 (n = 304) and from 2666 noncarriers recruited and followed up at variable times between 1987 and 2010 (the median year of diagnosis was 1998). Five-year overall mortality. The 5-year overall survival was 36% (95% CI, 34%-38%) for noncarriers, 44% (95% CI, 40%-48%) for BRCA1 carriers, and 52% (95% CI, 46%-58%) for BRCA2 carriers. After adjusting for study and year of diagnosis, BRCA1 and BRCA2 mutation carriers showed a more favorable survival than noncarriers (for BRCA1: hazard ratio [HR], 0.78; 95% CI, 0.68-0.89; P < .001; and for BRCA2: HR, 0.61; 95% CI, 0.50-0.76; P < .001). These survival differences remained after additional adjustment for stage, grade, histology, and age at diagnosis (for BRCA1: HR, 0.73; 95% CI, 0.64-0.84; P < .001; and for BRCA2: HR, 0.49; 95% CI, 0.39-0.61; P < .001). The BRCA1 HR estimate was significantly different from the HR estimated in the adjusted model (P for heterogeneity = .003). Among patients with invasive EOC, having a germline mutation in BRCA1 or BRCA2 was associated with improved 5-year overall survival. BRCA2 carriers had the best prognosis.

• Genome-wide high-density SNP linkage search for glioma susceptibility loci: results from the Gliogene Consortium.

  Authors: Sanjay Shete, Ching C Lau, Richard S Houlston, Elizabeth B Claus, Jill Barnholtz-Sloan, Rose Lai, Dora Il'yasova, Joellen Schildkraut, Siegal Sadetzki, Christoffer Johansen [......] Eastwood Hon-chiu Leung, Caleb Davis, Rita Cheng, Fay J Hosking, Georgina N Armstrong, Yanhong Liu, Robert K Yu, Roger Henriksson, Beatrice S Melin, Melissa L Bondy

  Cancer research. 12/2011; 71(24):7568-75.

  Gliomas, which generally have a poor prognosis, are the most common primary malignant brain tumors in adults. Recent genome-wide association studies have shown that inherited susceptibility plays aGliomas, which generally have a poor prognosis, are the most common primary malignant brain tumors in adults. Recent genome-wide association studies have shown that inherited susceptibility plays a role in the development of glioma. Although first-degree relatives of patients exhibit a two-fold increased risk of glioma, the search for susceptibility loci in familial forms of the disease has been challenging because the disease is relatively rare, fatal, and heterogeneous, making it difficult to collect sufficient biosamples from families for statistical power. To address this challenge, the Genetic Epidemiology of Glioma International Consortium (Gliogene) was formed to collect DNA samples from families with two or more cases of histologically confirmed glioma. In this study, we present results obtained from 46 U.S. families in which multipoint linkage analyses were undertaken using nonparametric (model-free) methods. After removal of high linkage disequilibrium single-nucleotide polymorphism, we obtained a maximum nonparametric linkage score (NPL) of 3.39 (P = 0.0005) at 17q12-21.32 and the Z-score of 4.20 (P = 0.000007). To replicate our findings, we genotyped 29 independent U.S. families and obtained a maximum NPL score of 1.26 (P = 0.008) and the Z-score of 1.47 (P = 0.035). Accounting for the genetic heterogeneity using the ordered subset analysis approach, the combined analyses of 75 families resulted in a maximum NPL score of 3.81 (P = 0.00001). The genomic regions we have implicated in this study may offer novel insights into glioma susceptibility, focusing future work to identify genes that cause familial glioma.

• Childhood exposure to ionizing radiation to the head and risk of schizophrenia.

  Authors: Siegal Sadetzki, Angela Chetrit, Lori Mandelzweig, Daniella Nahon, Laurence Freedman, Ezra Susser, Raz Gross

  Radiation research. 11/2011; 176(5):670-7.

  While the association between exposure to ionizing radiation and cancer is well established, its association with schizophrenia is unclear. The aim of our study was to assess risk of schizophreniaWhile the association between exposure to ionizing radiation and cancer is well established, its association with schizophrenia is unclear. The aim of our study was to assess risk of schizophrenia after childhood exposure to ionizing radiation to the head (mean dose: 1.5 Gy). The study population included an exposed group of 10,834 individuals irradiated during childhood for treatment of tinea capitis in the 1950s and two unexposed comparison groups of 5392 siblings and 10,834 subjects derived from the National Population Registry individually matched to the exposed group by age, sex (when possible), country of birth, and year of immigration to Israel. These groups were followed for a median 46 years for diagnosis of schizophrenia updated to December 2002. The Cox proportional hazards model stratified by matched sets was used to compare the risk of schizophrenia between the groups. Based on 1,217,531 person-years of follow-up, 451 cases were identified. No statistically significant association was found between radiation exposure and schizophrenia for the total group (hazard ratio per 1 Gy to the brain: 1.05, 95% confidence interval: 0.93-1.18) or within subgroups of sex, dose categories or latent period. When comparing a subgroup of subjects irradiated under 5 years of age with the matched unexposed group, the estimated hazard ratio reached 1.18 (95% confidence interval: 0.96-1.44; P = 0.1). The results of our analysis do not support an association between exposure to ionizing radiation and risk of schizophrenia. More research on possible effects of early exposure to ionizing radiation on schizophrenia specifically and brain tissue in general is needed.

• Association between very young age and adverse characteristics of breast cancer at presentation amongst Israeli women.

  Authors: Shani Paluch-Shimon, Ido Wolf, Siegal Sadetzki, Iris Gluck, Bernice Oberman, Moshe Zvi Papa, Raphael Catane, Bella Kaufman

  American journal of clinical oncology. 06/2011; 34(3):219-22.

  Up to 4% of breast cancer cases occur in women younger than 35 years. Studies have suggested an association between breast cancer at a young age, poorer outcome, and adverse clinical and pathologicUp to 4% of breast cancer cases occur in women younger than 35 years. Studies have suggested an association between breast cancer at a young age, poorer outcome, and adverse clinical and pathologic characteristics. It is unclear whether age is an independent prognostic factor. To characterize the prognostic significance of young age at diagnosis through comparison of disease characteristics of "less-young" (born between 1958-1962 and aged 37-44 years) and "very-young" (born after 1967 and aged ≤35 years) premenopausal patients. Consecutive patients with breast cancer born after 1967 treated at Sheba Medical Centre between January, 1999 and October, 2002 were identified and their files reviewed. This cohort was identified as "very-young" and was compared with a group of "less-young" patients. The clinico-pathologic characteristics and survival data were compared. Sixty-one very young and 94 less-young patients were identified. The mean age at diagnosis was 29.9 (range, 23-34 years) and 40.5 years (range, 37-44 years) for the very young and less young patients, respectively (P < 0.0001). Significantly more very young patients had metastatic disease at presentation (20% vs. 3%, respectively, P = 0.0007). The very young patients were more likely to have high grade, endocrine nonresponsive tumors than the less young patients. After controlling for stage and tumor grade, very-young age was not shown to be an independent risk factor for reduced survival. Very young age among Israeli women with breast cancer is associated with higher stage at diagnosis, adverse pathologic characteristics and adverse outcome but is not an independent prognostic factor for survival.

• Indications of possible brain-tumour risk in mobile-phone studies: should we be concerned?

  Authors: Elisabeth Cardis, Siegal Sadetzki

  Occupational and environmental medicine. 03/2011; 68(3):169-71.

• Possible interaction between ionizing radiation, smoking, and gender in the causation of meningioma.

  Authors: Pazit Flint-Richter, Lori Mandelzweig, Bernice Oberman, Siegal Sadetzki

  Neuro-oncology. 03/2011; 13(3):345-52.

  Data on the association between smoking and meningioma are inconsistent. The aim of this study was to assess the role of smoking in radiation- and non-radiation-related meningiomas. The study wasData on the association between smoking and meningioma are inconsistent. The aim of this study was to assess the role of smoking in radiation- and non-radiation-related meningiomas. The study was designed as a 4-group case-control study, balanced for irradiation, including 160 irradiated meningioma case patients, 145 irradiated control subjects, 82 nonirradiated case patients, and 135 nonirradiated control subjects. The sources of these groups included a cohort of individuals who underwent radiotherapy (mean dose, 1.5 Gy to the brain) during childhood for treatment of tinea capitis, claims filed for radiation damage in the framework of a compensation law, and the Israel Cancer Registry. All tests of statistical significance were 2-sided. A statistically significantly elevated risk of meningioma was found among men who had ever smoked, compared with those who were never smokers (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.09-4.15), increasing with smoking pack-years from 1.67 to 2.69 for <10 to >20 pack-years, respectively. Among women, an interaction between radiation and smoking was observed, expressed by a significant protective effect for meningioma (OR, 0.32; 95% CI, 0.14-0.77), with a strong dose-response association (P < .01) in non-irradiated women and a nonsignificant increased risk of meningioma among those who were irradiated (OR, 1.23; 95% CI, 0.68-2.23). Variation in the association between smoking and meningioma may be explained by effects of distinct host factors, such as past exposure to ionizing radiation and/or hormonal factors.

• [Determining health policy for sensible mobile phone use--current world status].

  Authors: Omer Itzhak Sagi, Siegal Sadetzki

  Harefuah. 03/2011; 150(3):216-20, 306.

  Mobile phones have become the leading communication system, with more than 4.5 billions users around the world. The sharp increase in the number of users, and its penetration to all populations,Mobile phones have become the leading communication system, with more than 4.5 billions users around the world. The sharp increase in the number of users, and its penetration to all populations, including children, has raised concern about possible adverse health effects, particularly cancer This article reviews the public health policies introduced in Israel and several other countries regarding mobile phone use in view of the lack of clarity concerning the safety of this new technology. The data show that most countries have adopted the precautionary principle as the leading guideline, recommending the use of simple and low-cost safety measures which could substantially reduce exposure to the brain and other body organs from mobile phones. These include the use of text messages, hands-free kits, and/or the loud-speaker mode of the phone. Accordingly, recommendations, guidelines, standards, and legislation aimed at the general population, drivers, state institutions and the industry have been formulated. For children, who are considered to be more susceptible to cancer development following exposure to carcinogens, there is widespread consensus for a stricter approach. In some countries, measures such as banning use of mobile phones in schools, prohibiting sales/advertisements targeted at young age groups, expanding warnings on phones/ packages, and encouraging educational campaigns have been adopted for this population. Regulations regarding phone use while driving have been instituted in most countries. In conclusion, many public health practitioners have moved from the theoretical level (adoption of the precautionary principle) to an active phase of introducing regulations, with specific emphasis to various populations.

• Uterine metastases in ovarian carcinoma: frequency and survival in women who underwent hysterectomy.

  Authors: Joseph Menczer, Angela Chetrit, Siegal Sadetzki

  Journal of gynecologic oncology. 09/2010; 21(3):191-5.

  Possible reasons for hysterectomy in the initial surgical management of advanced invasive epithelial ovarian carcinoma (EOC) might be a high frequency of uterine involvement and its impact onPossible reasons for hysterectomy in the initial surgical management of advanced invasive epithelial ovarian carcinoma (EOC) might be a high frequency of uterine involvement and its impact on survival. The aim of the present study was to describe the frequency of uterine involvement and its association with survival in an unselected population of EOC patients who underwent hysterectomy. All incident cases of EOC diagnosed in Israeli Jewish women between March 1994 to June 1999, were identified within the framework of a nationwide case-control epidemiological study. The target population of the present report includes all stage II-IV EOC patients who had a uterus at the time of diagnosis. Of the 822 such patients, 695 fulfilled the inclusion criterion. Excluded were 141 patients for various reasons. The present analysis is based on the remaining 554 patients. Uterine involvement was present in 291 (52.5%) of the patients and it was macroscopic in only 78 (14.1%). The serosa was the most common site of isolated metastases. Multivariate analysis showed that advanced stage significantly increased the risk for uterine involvement. The overall median survival with any uterine involvement was significantly lower compared to those with no involvement (38.9 months vs. 58.0 months; p<0.001). There is an association between uterine involvement, whether macro- or microscopic, and lower survival even after hysterectomy although residual tumor could not be included in the analysis. Further studies are required to establish whether uterine involvement itself is an unfavorable risk factor or merely a marker of other unfavorable prognostic factors.

• The tinea capitis campaign in Serbia in the 1950s.

  Authors: Shifra Shvarts, Goran Sevo, Marija Tasic, Mordechai Shani, Siegal Sadetzki

  The Lancet infectious diseases. 08/2010; 10(8):571-6.

  In this Historical Review we describe the 1950-59 UNICEF-supported campaign to eliminate tinea capitis, also known as ringworm, in Yugoslavia. Medical treatment for this infectious disease involvedIn this Historical Review we describe the 1950-59 UNICEF-supported campaign to eliminate tinea capitis, also known as ringworm, in Yugoslavia. Medical treatment for this infectious disease involved the use of ionising radiation. We discuss the possible health implications for the treated population. Data were collected from archive documents, newspapers from the 1950s, Yugoslavian scientific reports, interviews with patients who received treatment, and interviews with physicians who gave treatment during the campaign. The campaign screened 878 659 individuals and treated 49 389. On the basis of Israeli tinea capitis research, late health consequences (mainly cancer in the irradiated area) can be expected in the treated Serbian population. The discovery of treatment records for a substantial number of patients makes public-health action and further research possible. The findings are relevant to the Serbian medical community and populations in other countries that used a radiation-based technique for the treatment of tinea capitis.

• Erratum to: Survey of familial glioma and role of germline p16 ( INK4A )/p14 ( ARF ) and p53 mutation.

  Authors: Lindsay B Robertson, Georgina N Armstrong, Bianca D Olver, Amy L Lloyd, Sanjay Shete, Ching Lau, Elizabeth B Claus, Jill Barnholtz-Sloan, Rose Lai, Dora Il'yasova [......] Nicholas A Vick, Christoffer Johansen, Hanne Bødtcher, Siegal Sadetzki, Revital Bar-Sade Bruchim, Galit Hirsh Yechezkel, Ulrika Andersson, Beatrice S Melin, Melissa L Bondy, Richard S Houlston

  Familial cancer. 06/2010;

• Survey of familial glioma and role of germline p16INK4A/p14ARF and p53 mutation.

  Authors: Lindsay B Robertson, Georgina N Armstrong, Bianca D Olver, Amy L Lloyd, Sanjay Shete, Ching Lau, Elizabeth B Claus, Jill Barnholtz-Sloan, Rose Lai, Dora Il'yasova [......] Nicholas A Vick, Christoffer Johansen, Hanne Bødtcher, Siegal Sadetzki, Revital Bar-Sade Bruchim, Galit Hirsh Yechezkel, Ulrika Andersson, Beatrice S Melin, Melissa L Bondy, Richard S Houlston

  Familial cancer. 05/2010; 9(3):413-21.

  There is increasing recognition of familial propensity to glioma as a distinct clinical entity beyond a few rare syndromes; however its genetic basis is poorly understood. The role ofThere is increasing recognition of familial propensity to glioma as a distinct clinical entity beyond a few rare syndromes; however its genetic basis is poorly understood. The role of p16(INK4A)/p14(ARF) and p53 mutations in sporadic glioma provides a strong rationale for investigating germline mutations in these genes as a cause of familial glioma. To survey the familial glioma phenotype and examine the contribution of germline mutation in p16(INK4A)/p14(ARF) and p53 to the disease we have analyzed a series of 101 index familial cases collected through the GLIOGENE Consortium (http://braintumor.epigenetic.org/). There was little evidence for within family correlations for tumour histology, suggesting generic susceptibility to glial tumors. We did not detect any functional mutations in p16(INK4A) or p14(ARF). One index case with glioblastoma multiforme (GBM) diagnosed at age 54 and had a family history comprised of a paternal aunt with GBM at age 55, carried the p53 R158H mutation, which is predicted to be functional and has previously been implicated as a cause of Li-Fraumeni syndrome. Our findings provide no evidence that p16(INK4A)/p14(ARF) and p53 mutations contribute significantly to familial glioma.

• Incidence rates of cervical carcinoma among first- and second-generation women of North African origin in Israel.

  Authors: Joseph Menczer, Micha Barchana, Angela Chetrit, Irena Liphshitz, Siegal Sadetzki

  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 12/2009; 19(9):1606-9.

  OBJECTIVES: To evaluate the incidence rates of cervical cancer by ethnic origins and compare these rates between first- and second-generation women of North African origin. METHODS: Data of allOBJECTIVES: To evaluate the incidence rates of cervical cancer by ethnic origins and compare these rates between first- and second-generation women of North African origin. METHODS: Data of all cervical carcinoma of Jewish women during 2000 to 2005 were obtained from the National Cancer Registry. Standardized incidence ratios for each ethnic origin category were calculated and compared using Poisson regression. RESULTS: During the study period, 938 patients were examined. The standardized incidence ratios of North African-born women and of Israeli-born women of North African descent were significantly higher compared with those of women of other origins. CONCLUSIONS: The persistence of a higher risk of cervical cancer in Israeli Jewish women of North African descent compared with those of other origins may suggest that genetic factors are involved in the etiology of this neoplasm.

• Smoking and risk of glioma: a meta-analysis.

  Authors: Lori Mandelzweig, Ilya Novikov, Siegal Sadetzki

  Cancer causes & control : CCC. 08/2009;

  OBJECTIVE: Although causal relationships between smoking and cancer risk have been established for many sites, most studies of brain cancer have not supported an association. However, two recentOBJECTIVE: Although causal relationships between smoking and cancer risk have been established for many sites, most studies of brain cancer have not supported an association. However, two recent cohort studies showed increased risks of glioma among smokers. We quantified the association between smoking and glioma through a meta-analysis of the literature. METHODS: Of 20 eligible studies, 17 (6 cohort and 11 case-control) were included in an analysis of ever versus never smoking. Multivariate-adjusted risk estimates in the papers were pooled to calculate cumulative risk. RESULTS: The cumulative estimated risk associated with ever smoking was 1.06 (95% CI: 0.97-1.15), for all, 1.10 (95% CI: 1.01-1.20) for cohort, and 1.00 (95% CI: 0.88-1.15) for case-control studies. A significantly increased risk associated with past smoking was noted for cohort studies, OR = 1.16 (p = 0.007), while an increased risk of borderline significance was seen for all studies, OR = 1.10 (p = 0.08). In general, dose-response analysis did not support an association and was limited because very few studies included these variables and could be pooled. CONCLUSION: Overall, results of pooling of all studies suggested that smoking is not associated with risk of glioma. However, the small but significant increased risk seen for cohort studies remains to be clarified.

• Quantifying the Impact of Selection Bias Caused by Nonparticipation in a Case-Control Study of Mobile Phone Use.

  Authors: Martine Vrijheid, Lesley Richardson, Bruce K Armstrong, Anssi Auvinen, Gabriele Berg, Matthew Carroll, Angela Chetrit, Isabelle Deltour, Maria Feychting, Graham G Giles [......] Siegal Sadetzki, Tina Salminen, Marie Sanchez, Birgitte Schlehofer, Joachim Schüz, Jack Siemiatycki, Tore Tynes, Alistair Woodward, Naohito Yamaguchi, Elisabeth Cardis

  Annals of epidemiology. 02/2009; 19(1):33-41.e1.

  PURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-responsePURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. RESULTS: Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. CONCLUSIONS: Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.

• The effect of symptom duration in epithelial ovarian cancer on prognostic factors.

  Authors: Joseph Menczer, Angela Chetrit, Siegal Sadetzki

  Archives of gynecology and obstetrics. 11/2008;

  PURPOSE: To assess the association between duration of symptoms and main prognostic factors of invasive epithelial ovarian cancer (EOC). METHODS: The data of all histologically confirmed EOC patientsPURPOSE: To assess the association between duration of symptoms and main prognostic factors of invasive epithelial ovarian cancer (EOC). METHODS: The data of all histologically confirmed EOC patients diagnosed in Israel during the period 1994-1999 (n = 1,005) were retrieved from discharge summaries and admission records. Of the 371 (36.9%) patients with known presenting symptoms, the durations of 187 (50.4%) were recorded. RESULTS: The most common presenting symptoms were abdominal pain (65.2%). The percentage of patients with three or more symptoms increased significantly with stage (P = 0.001). No statistically significant association between duration of symptoms and prognostic factors was found. CONCLUSION: Our findings did not show an association between duration of symptoms and prognostic factors in EOC patients and may indicate that prognosis is not a function of delay in diagnosis.

• Brain tumor epidemiology: Consensus from the Brain Tumor Epidemiology Consortium.

  Authors: Melissa L Bondy, Michael E Scheurer, Beatrice Malmer, Jill S Barnholtz-Sloan, Faith G Davis, Dora Il'yasova, Carol Kruchko, Bridget J McCarthy, Preetha Rajaraman, Judith A Schwartzbaum, Siegal Sadetzki, Brigitte Schlehofer, Tarik Tihan, Joseph L Wiemels, Margaret Wrensch, Patricia A Buffler

  Cancer. 10/2008; 113(S7):1953-1968.

  Epidemiologists in the Brain Tumor Epidemiology Consortium (BTEC) have prioritized areas for further research. Although many risk factors have been examined over the past several decades, there areEpidemiologists in the Brain Tumor Epidemiology Consortium (BTEC) have prioritized areas for further research. Although many risk factors have been examined over the past several decades, there are few consistent findings, possibly because of small sample sizes in individual studies and differences between studies in patients, tumor types, and methods of classification. Individual studies generally have lacked samples of sufficient size to examine interactions. A major priority based on available evidence and technologies includes expanding research in genetics and molecular epidemiology of brain tumors. BTEC has taken an active role in promoting understudied groups, such as pediatric brain tumors; the etiology of rare glioma subtypes, such as oligodendroglioma; and meningioma, which, although it is not uncommon, has only recently been registered systematically in the United States. There also is a pressing need for more researchers, especially junior investigators, to study brain tumor epidemiology. However, relatively poor funding for brain tumor research has made it difficult to encourage careers in this area. In this report, BTEC epidemiologists reviewed the group's consensus on the current state of scientific findings, and they present a consensus on research priorities to identify which important areas the science should move to address. Cancer 2008;113(7 suppl):1953-68. (c) 2008 American Cancer Society.

• Epidemiology of Gliomas in Israel: A Nationwide Study.

  Authors: Siegal Sadetzki, Leor Zach, Angela Chetrit, Dvora Nass, Chen Hoffmann, Zvi Ram, Menashe Zaaroor, Felix Umansky, Zvi Harry Rappaport, Avi Cohen, Uriel Wald, Sigmund Rothman, Moshe Hadani

  Neuroepidemiology. 10/2008; 31(4):264-269.

  Background: Glial brain tumors span a wide range of neoplasms with distinct clinical and histopathological features. This report presents the descriptive epidemiology of glial tumors by histologicalBackground: Glial brain tumors span a wide range of neoplasms with distinct clinical and histopathological features. This report presents the descriptive epidemiology of glial tumors by histological subtype and tumor behavior. Methods: The study population included all incident cases of glial tumors diagnosed in Israel during March 2001 to July 2003. Age-standardized incidence rates (ASR) were calculated using the world population as a standard. Results: A total of 548 tumors were diagnosed, of which 520 had histological confirmation. The ASR of all adult (>20 years) glial tumors was 5.82/100,000 (7.11 for males; 4.75 for females, p < 0.001). The majority of tumors (78%) were classified as high grade; astrocytic tumors were the most frequent (85%), with glioblastoma multiforme accounting for 70% of them. A significant positive association was shown between age at diagnosis and grade. The highest ASR was seen for Europe- and-American-born, followed by Israeli, Asian and African-born individuals (6.78, 5.86, 4.94 and 3.84/100,000, respectively). Conclusions: In general, these results describing data of incident cases of pathologically validated glial tumors are consistent with previous reports. To enhance our understanding of these diseases, epidemiological studies should rely on well-defined histological tumor types, incorporating comprehensive information which will allow comparability between different groups of patients.

• Timing of sentinel lymph node biopsy in patients receiving neoadjuvant chemotherapy for breast cancer.

  Authors: Moshe Zvi Papa, Douglas Zippel, Bella Kaufman, Shani Shimon Paluch, Ady Yosepovich, Bernice Oberman, Siegal Sadetzki

  Journal of surgical oncology. 09/2008;

  OBJECTIVE: To address optimal timing of sentinel lymph node biopsy (SLNB) in breast cancer patients undergoing neoadjuvant treatment. METHODS: The study population included 117 patients with locallyOBJECTIVE: To address optimal timing of sentinel lymph node biopsy (SLNB) in breast cancer patients undergoing neoadjuvant treatment. METHODS: The study population included 117 patients with locally advanced cancer with clinically negative nodes treated with primary chemotherapy. Group 1 underwent SLNB and completion axillary lymph node dissection (ALND) in conjunction with lumpectomy/mastectomy, after neoadjuvant treatment (n = 31). Group 2 underwent SLNB followed by neoadjuvant therapy and subsequently surgery and completion of ALNDs (n = 58). Group 3 was treated using the same sequence as group 2, however, completion ALND was performed only for patients with positive sentinel lymph nodes (SLNs) (n = 28). RESULTS: SLN identification was lowest in group 1 compared to groups 2 and 3 (87% and 98.8% respectively; P = <0.05). The highest false negative rate was in group 1 (15.8% compared with 0% in group 2). CONCLUSION: Neoadjuvant treatment lowers the SLN identification rate, possibly due to fibrosis within the axilla, and increases the false negative rate due to downstaging. SLN biopsy prior to chemotherapy could give a more accurate evaluation of axillary status, unaffected by any previous therapeutic intervention. J. Surg. Oncol. (c) 2008 Wiley-Liss, Inc.

• Smoking and risk of parotid gland tumors: a nationwide case-control study.

  Authors: Siegal Sadetzki, Bernice Oberman, Lori Mandelzweig, Angela Chetrit, Tehila Ben-Tal, Avital Jarus-Hakak, Shay Duvdevani, Elisabeth Cardis, Michael Wolf

  Cancer. 06/2008; 112(9):1974-82.

  BACKGROUND: Because existing data regarding the relation between smoking and salivary gland tumors are sparse, tobacco is currently not classified as a salivary gland carcinogen. The objective of theBACKGROUND: Because existing data regarding the relation between smoking and salivary gland tumors are sparse, tobacco is currently not classified as a salivary gland carcinogen. The objective of the current study was to assess the association between smoking and benign and malignant parotid gland tumors (PGTs) in a nationwide study. METHODS: The sample included 459 patients with incident PGT, aged > or =18 years, who were diagnosed between 2001 and 2003 and a group of 1265 individually matched, population-based controls. Analyses of the risk of PGT associated with various smoking variables were performed by using conditional logistic regression. Data also were stratified by histologic type; statistical significance tests were 2-sided. RESULTS: Ever smoking cigarettes was associated with an odds ratio (OR) of 1.66 (95% confidence interval [95% CI], 1.31-2.11) for developing a PGT. The risk was strongest for early ages at smoking initiation, and trends of increasing risk were observed with increasing smoking intensity, pack-years, latent period, and smoking duration (P for trend <.001 for each). Analysis by histologic type indicated remarkably high risks for Warthin tumor (OR for ever cigarette smokers: 15.3; 95% CI, 6.1-38.5). For pleomorphic adenomas and malignant tumors, the risks associated with ever smoking were 1.01 (95% CI, 0.75-1.37) and 1.69 (95% CI, 0.81-3.51), respectively. CONCLUSIONS: Smoking plays an important role in the development of Warthin tumor. Although no association was observed for pleomorphic adenoma, the possible indication of increased risk of malignant tumors requires further investigation in larger studies.