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Mortality following a brain tumour diagnosis in patients with multiple sclerosis

Montgomery, S. and Hassan, A. and Bahmanyar, S. and Brus, O. and Hussein, O. and Hiyoshi, A. and Hillert, J. and Olsson, T. and Fall, K. (2013) Mortality following a brain tumour diagnosis in patients with multiple sclerosis. BMJ Open, 3 (11). ISSN 20446055 (ISSN)

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Objectives: As brain tumours and their treatment may theoretically have a poorer prognosis in inflammatory central nervous system diseases such as multiple sclerosis (MS), all-cause mortality following a brain tumour diagnosis was compared between patients with and without MS. The potential role of age at tumour diagnosis was also examined. Setting: Hospital inpatients in Sweden with assessment of mortality in hospital or following discharge. Participants: Swedish national registers identified 20 543 patients with an MS diagnosis (1969-2005) and they were matched individually to produce a comparison cohort of 204 163 members of the general population without MS. Everyone with a primary brain tumour diagnosis was selected for this study: 111 with MS and 907 without MS. Primary and secondary outcome measures: 5-year mortality risk following brain tumour diagnosis and age at brain tumour diagnosis. Results: A non-statistically significant lower mortality risk among patients with MS (lower for those with tumours of high-grade and uncertain-grade malignancy and no notable difference for low-grade tumours) produced an unadjusted HR (and 95% CI) of 0.75 (0.56 to 1.02). After adjustment for age at diagnosis, grade of malignancy, sex, region of residence and socioeconomic index, the HR is 0.91 (0.67-1.24). The change in estimate was largely due to adjustment for age at brain tumour diagnosis, as patients with MS were on average 4.7 years younger at brain tumour diagnosis than those in the comparison cohort (p<0.001). Conclusions: Younger age at tumour diagnosis may contribute to mortality reduction in those with highgrade and uncertain-grade brain tumours. Survival following a brain tumour is not worse in patients with MS; even after age at brain tumour diagnosis and grade of malignancy are taken into account.

Item Type: Article
Additional Information: Unmapped bibliographic data: C7 - 9 [EPrints field already has value set] LA - English [Field not mapped to EPrints] J2 - BMJ Open [Field not mapped to EPrints] AD - Clinical Epidemiology and Biostatistics, �rebro University Hospital, �rebro, Sweden [Field not mapped to EPrints] AD - School of Health and Medical Sciences, �rebro University, �rebro, Sweden [Field not mapped to EPrints] AD - Clinical Epidemiology Unit and Pharmacoepidemiology Unit, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Department of Clinical Neuroscience, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Neuroimmunology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: adult, article, astrocytoma, brain tumor, cholesteatoma, controlled study, craniopharyngioma, ependymoblastoma, ependymoma, female, germ cell tumor, hamartoma, hemangioblastoma, hemangioma, hemangiopericytoma, hospital patient, human, major clinical study, male, medulloblastoma, meningioma, mortality, multiple sclerosis, neurilemoma, neuroblastoma, neurofibroma, population, Sweden, teratoma, tumor diagnosis
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 14 Apr 2015 10:07
Last Modified: 10 May 2015 09:35
URI: http://eprints.goums.ac.ir/id/eprint/1818

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