umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Laurell, Göran
Alternative names
Publications (10 of 50) Show all publications
Boldrup, L., Gu, X., Coates, P. J., Norberg-Spaak, L., Fåhraeus, R., Laurell, G., . . . Nylander, K. (2017). Gene expression changes in tumor free tongue tissue adjacent to tongue squamous cell carcinoma. OncoTarget, 8(12), 19389-19402
Open this publication in new window or tab >>Gene expression changes in tumor free tongue tissue adjacent to tongue squamous cell carcinoma
Show others...
2017 (English)In: OncoTarget, ISSN 1949-2553, E-ISSN 1949-2553, Vol. 8, no 12, p. 19389-19402Article in journal (Refereed) Published
Abstract [en]

Due to the high frequency of loco-regional recurrences, which could be explained by changes in the field surrounding the tumor, patients with squamous cell carcinoma of head and neck show poor survival. Here we identified a total of 554 genes as dysregulated in clinically tumor free tongue tissue in patients with tongue tumors when compared to healthy control tongue tissue. Among the top dysregulated genes when comparing control and tumor free tissue were those involved in apoptosis (CIDEC, MUC1, ZBTB16, PRNP, ECT2), immune response (IFI27) and differentiation (KRT36). Data suggest that these are important findings which can aid in earlier diagnosis of tumor development, a relapse or a novel squamous cell carcinoma of the tongue, in the absence of histological signs of a tumor.

Keywords
tongue cancer, RNA expression, field cancerization
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-133220 (URN)10.18632/oncotarget.14288 (DOI)000396879200062 ()
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2018-06-09Bibliographically approved
Lindblom, U., Nilsson, P., Gärskog, O., Kjellen, E., Laurell, G., Wahlberg, P., . . . Levring Jäghagen, E. (2016). Aspiration as a late complication after accelerated versus conventional radiotherapy in patients with head and neck cancer. Acta Oto-Laryngologica, 136(3), 304-311
Open this publication in new window or tab >>Aspiration as a late complication after accelerated versus conventional radiotherapy in patients with head and neck cancer
Show others...
2016 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, no 3, p. 304-311Article in journal (Refereed) Published
Abstract [en]

Conclusion Neck dissection after radiotherapy increased the risk of aspiration as a late effect in a sub-sample of patients treated for head and neck cancer in the ARTSCAN study. Patients treated with accelerated fractionation (AF) developed aspiration, with or without coughing, more frequently than patients treated with conventional fractionation (CF). Objectives A long-term follow-up study was conducted to determine the frequency of aspiration as a late effect in patients with head and neck cancer treated with AF or CF. Method One-hundred and eight patients were recruited from two centres of the Swedish multi-centre study, ARTSCAN, where AF and CF were compared. Patients with positive lymph nodes were treated with neck dissection after completing radiotherapy. The follow-up was performed at a median of 65 months after initiation of radiotherapy and included an ENT and a videofluoroscopic examination. Results Aspiration was found in 51/108 (47%) and silent aspiration in 34/96 (35%) patients. Neck dissection (n = 47 patients) was significantly associated with both aspiration and silent aspiration. Aspiration was more common among patients treated with AF (34/61; 56%) compared to CF (17/47; 36%; p = 0.053). Silent aspiration was also more common after AF (24/54; 44%) than after CF (10/42; 24%; p = 0.052).

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Late effect, dysphagia, follow-up, neck dissection, sequelae, swallowing disorders, videofluoroscopy
National Category
Cancer and Oncology Otorhinolaryngology
Research subject
Oncology; Odontology; Radiology; radiofysik; Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:umu:diva-115781 (URN)10.3109/00016489.2015.1113439 (DOI)000375933300017 ()26838580 (PubMedID)
Projects
ARTSCAN
Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2018-06-07Bibliographically approved
Nyqvist, J., Fransson, P., Laurell, G., Hammerlid, E., Kjellén, E., Franzén, L., . . . Zackrisson, B. (2016). Differences in health related quality of life in the randomised ARTSCAN study; accelerated vs. conventional radiotherapy for head and neck cancer: A five year follow up. Radiotherapy and Oncology, 118(2), 335-341
Open this publication in new window or tab >>Differences in health related quality of life in the randomised ARTSCAN study; accelerated vs. conventional radiotherapy for head and neck cancer: A five year follow up
Show others...
2016 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 118, no 2, p. 335-341Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Health related quality of life (HRQoL) was assessed in the randomised, prospective ARTSCAN study comparing conventional radiotherapy (CF) with accelerated radiotherapy (AF) for head and neck cancer.

Material and methods: 750 patients with squamous cell carcinoma (of any grade and stage) in the oral cavity, oro-, or hypopharynx or larynx (except T1-2, NO glottic carcinoma) without distant metastases were randomised to either conventional fractionation (2 Gy/day, 5 days/week in 49 days, total dose 68 Gy) or accelerated fractionation (1.1 + 2.0 Gy/day, 5 days/week in 35 days, total dose 68 Gy). HRQoL was assessed with EORTC QLQ-C30, QLQ-H&N35 and HADS at baseline, at end of radiotherapy (eRT) and at 3 and 6 months and 1, 2 and 5 years after start of treatment.

Results: The AF group reported HRQoL was significantly lower at eRT and at 3 months for most symptoms, scales and functions. Few significant differences were noted between the groups at 6 months and 5 years. Scores related to functional oral intake never reached baseline.

Conclusion: In comparison to CF, AF has a stronger adverse effect on HRQoL in the acute phase.

Keywords
Health related quality of life, Accelerated radiotherapy, Head and neck cancer, Quality of life, Accelerated fractionation
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:umu:diva-120668 (URN)10.1016/j.radonc.2015.12.024 (DOI)000373420000019 ()26777124 (PubMedID)
Available from: 2016-06-16 Created: 2016-05-18 Last updated: 2018-06-07Bibliographically approved
Sgaramella, N., Lindell Jonsson, E., Boldrup, L., Califano, L., Coates, P. J., Tartaro, G., . . . Nylander, K. (2016). High expression of podoplanin in squamous cell carcinoma of the tongue occurs predominantly in patients ≤ 40 years but does not correlate with tumour spread. The Journal of Pathology: Clinical Research, 2(1), 3-8
Open this publication in new window or tab >>High expression of podoplanin in squamous cell carcinoma of the tongue occurs predominantly in patients ≤ 40 years but does not correlate with tumour spread
Show others...
2016 (English)In: The Journal of Pathology: Clinical Research, ISSN 2056-4538, Vol. 2, no 1, p. 3-8Article in journal (Refereed) Published
Abstract [en]

More than 30% of patients with squamous cell carcinoma (SCC) of the mobile tongue have clinically undetectable lymph node metastasis. Tumour cells can spread as single cells or collectively. A protein known to play a role in both processes is podoplanin, which is expressed in endothelial cells not only in lymph vessels but also in some aggressive tumours with high invasive and metastatic potential. Here we studied samples from 129 patients with primary SCC of the tongue for expression of podoplanin using immunohistochemistry. mRNA levels were analysed in another 27 cases of tongue SCC with adjacent clinically tumour-free tongue tissue and 14 tongue samples from healthy donors. Higher levels of podoplanin were seen in tumours compared to both normal tongue and clinically normal tongue in the tumour vicinity. No association was found between levels of podoplanin, presence of lymph node metastases or other clinical factors. Patients aged 40 or less were more likely to express high levels of podoplanin protein compared to older patients (p 50.027). We conclude that levels of podoplanin in primary tongue SCCs are not associated with lymph node metastases. However, tongue SCCs arising in young patients (40 years of age) are more likely to express high levels of podoplanin than tongue SCCs that arise in the more elderly. The data suggest that podoplanin has a distinctive role in young patients, who are known to have a poor prognosis: these patients may, therefore, benefit from podoplanin inhibitory therapies.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
squamous cell carcinoma, tongue, podoplanin
National Category
Cancer and Oncology Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-121097 (URN)10.1002/cjp2.28 (DOI)000410840100001 ()27499910 (PubMedID)
Available from: 2016-05-26 Created: 2016-05-26 Last updated: 2018-06-07Bibliographically approved
Salander, P., Isaksson, J., Granström, B. & Laurell, G. (2016). Motives that head and neck cancer patients have for contacting a specialist nurse: an empirical study. Journal of Clinical Nursing, 25(21-22), 3160-3166
Open this publication in new window or tab >>Motives that head and neck cancer patients have for contacting a specialist nurse: an empirical study
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 21-22, p. 3160-3166Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a speciaist nurse during two years postdiagnosis.

Background: Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer

Design: Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse.

Methods: Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included.

Results: In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make a contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals.

Conclusions: The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals.

Relevance to clinical practice: When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspectice. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
field notes, head and neck cancer, nursing intervention, qualitative study, specialist nurse
National Category
Nursing
Research subject
omvårdnadsforskning med samhällsvetenskaplig inriktning
Identifiers
urn:nbn:se:umu:diva-117429 (URN)10.1111/jocn.13283 (DOI)000388922700008 ()
Note

Acknowledgement of funding: This study was supported by grants from the Swedish Cancer Society, the Swedish Laryng Foundation and the Cancer Research Foundation in Northern Sweden.

Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2018-06-07Bibliographically approved
Loizou, C., Laurell, G., Lindquist, D., Öfverman, C., Stefansson, K., Nylander, K. & Olofsson, K. (2015). Incidence of tonsillar cancer in northern Sweden: Impact of human papilloma virus. Oncology Letters, 10(6), 3565-3572
Open this publication in new window or tab >>Incidence of tonsillar cancer in northern Sweden: Impact of human papilloma virus
Show others...
2015 (English)In: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 10, no 6, p. 3565-3572Article in journal (Refereed) Published
Abstract [en]

The incidence rate of tonsillar cancer is increasing worldwide. The current study identifies a parallel increase in the incidence of tonsillar cancer, human papilloma virus (HPV) and p16 expression among a population from northern Sweden, a sparsely populated area, confirming the strong association between p16 and HPV infection in tonsillar tissue. Data from the Swedish Cancer Registry was assessed to identify cases of tonsillar cancer in the northern territorial area of Sweden. HPV DNA was extracted from paraffin embedded diagnostic biopsies and detected by polymerase chain reaction using general primers Gp5+/6+ and CpI/IIG. Expression of p16 was identified by immunochemistry. Patients were grouped into urban or rural residence categories. A total of 214 cases were identified, comprising 155 (72.4%) men and 59 (27.6%) women, and 65 of these patients, who presented between 2000 and 2012, were analyzed. The overall median age for the analyzed patients was 58 years; 48 (74%) were males (median age, 57.5 years) and 17 (26%) were females (median age, 65 years). Of the 65 specimens, 59 (91%) were positive for HPV, and 62 (95%) expressed p16. The incidence of tonsillar cancer in the cohort demonstrated a 2-fold increase between 1990 and 2013; specifically, a 2.7-fold increase was observed in men whilst the female group exhibited only a small increase. These findings demonstrate a strong association between p16 expression and HPV infection in tonsillar malignancies. The incidence of HPV-positive tonsillar cancer has increased in recent years, even in sparsely populated regions, as demonstrated in northern Sweden.

Place, publisher, year, edition, pages
Spandidos Publications, 2015
Keywords
head and neck cancer, human papilloma virus, immunohistochemistry, incidence, p16, tonsillar cancer
National Category
Cancer and Oncology Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-114586 (URN)10.3892/ol.2015.3775 (DOI)000367232600038 ()
Available from: 2016-02-16 Created: 2016-01-25 Last updated: 2018-06-07Bibliographically approved
Loizou, C., Laurell, G., Arvidsson, A., Lindquist, D., Nylander, K. & Olofsson, K. (2015). Recurrent respiratory papillomatosis in northern Sweden: Clinical characteristics and practical guidance. Acta Oto-Laryngologica, 135(10), 1058-1064
Open this publication in new window or tab >>Recurrent respiratory papillomatosis in northern Sweden: Clinical characteristics and practical guidance
Show others...
2015 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 10, p. 1058-1064Article in journal (Refereed) Published
Abstract [en]

Conclusion: Recurrent respiratory papillomatosis (RRP) patients with high surgical treatment frequency (>= 1/year, HF) were significantly younger and had a more widespread laryngeal disease compared to a low frequency treated group (< 1 treatment/year, LF). This study confirms the existence of a clinical RRP group, not primarily related to HPV sub-type, but more care-intensive and in need of more vigilant follow-up. Objectives: RRP is associated with high morbidity due to its influence on breathing and voice. The purpose of this study was to characterize RRP patients in northern Sweden and investigate possible predictor factors affecting therapeutic needs. Method: Patients from the regional referral area (northern Sweden) were categorized for age, disease duration, juvenile or adult onset, profile of disease development, number of surgical sessions in relation to disease duration, laryngeal deposition of papilloma, gender, and HPV sub-types, in order to identify patients with increased need for frequent surgical treatment. Results: The median age of the RRP patients (n = 48) was 44.5 years; 34 (71%) were males and 14 (29%) females, most were infected with HPV 6. Patients with high surgical treatment frequency/year were significantly younger and showed more widespread papillomatous vegetation in the larynx, compared to the low frequency treated group.

Keywords
Human papilloma virus, recurrent respiratory papillomatosis, HPV vaccine, tonsillar cancer, gender, airway surgery, data analysis
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-110217 (URN)10.3109/00016489.2015.1048378 (DOI)000361294200014 ()26004132 (PubMedID)
Available from: 2015-10-16 Created: 2015-10-16 Last updated: 2018-06-07Bibliographically approved
Isaksson, J., Salander, P., Granström, B. & Laurell, G. (2014). Critical incidents reveal how patients with head and neck cancer construct their 'secure base' as a 'helping system'. Journal of psychosocial oncology, 32(3), 322-341
Open this publication in new window or tab >>Critical incidents reveal how patients with head and neck cancer construct their 'secure base' as a 'helping system'
2014 (English)In: Journal of psychosocial oncology, ISSN 0734-7332, E-ISSN 1540-7586, Vol. 32, no 3, p. 322-341Article in journal (Refereed) Published
Abstract [en]

Most studies of the psychosocial needs of patients with head and neck cancers' (HNC) use predefined categories and explicitly ask for specified needs. These studies are important but should be complemented with inductive studies based on patients' own descriptions of experiences. The present qualitative study is such a contribution. In repeated interviews positive and negative incidents were collected from 137 patients with HNC, and these experiences were categorized in dimensions expressing needs. A core category - 'being included - neglected by a helping system' - emerged from the narrated incidents and it was based on the dimensions 'engagement', 'competence' and 'information'. The findings are easily related to attachment theory by stressing the significance of establishing trustful relationships with the health care staff, as attachment figures, who respond flexibly and sensitively to the patient's needs. In the constitution of health care as a helping system, all encounters between the patient and health care staff matters. Further research should preferably focus on the creation of guidelines for the constitution of health care as a helping system, i.e. how the found factors of a helping system can be operationalized in clinical practice.

Place, publisher, year, edition, pages
Taylor & Francis, 2014
Keywords
Attachment theory, Critical incidents, Head-and neck cancer, Patient-perspective, Psychosocial needs
National Category
Social Work Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-85734 (URN)10.1080/07347332.2014.897289 (DOI)000337570500005 ()
Note

Acknowledgement of funding: This study was supported by grants from the Cancer Research Foundation in Northern Sweden and the Swedish Laryng Foundation.

Available from: 2014-02-10 Created: 2014-02-10 Last updated: 2018-06-08Bibliographically approved
Rentoft, M., Coates, P. J., Loljung, L., Wilms, T., Laurell, G. & Nylander, K. (2014). Expression of CXCL10 is associated with response to radiotherapy and overall survival in squamous cell carcinoma of the tongue. Tumor Biology, 35(5), 4191-4198
Open this publication in new window or tab >>Expression of CXCL10 is associated with response to radiotherapy and overall survival in squamous cell carcinoma of the tongue
Show others...
2014 (English)In: Tumor Biology, ISSN 1010-4283, E-ISSN 1423-0380, Vol. 35, no 5, p. 4191-4198Article in journal (Refereed) Published
Abstract [en]

Five-year survival for patients with oral cancer has been disappointingly stable during the last decades, creating a demand for new biomarkers and treatment targets. Lately, much focus has been set on immunomodulation as a possible treatment or an adjuvant increasing sensitivity to conventional treatments. The objective of this study was to evaluate the prognostic importance of response to radiotherapy in tongue carcinoma patients as well as the expression of the CXC-chemokines in correlation to radiation response in the same group of tumours. Thirty-eight patients with tongue carcinoma that had received radiotherapy followed by surgery were included. The prognostic impact of pathological response to radiotherapy, N-status, T-stage, age and gender was evaluated using Cox's regression models, Kaplan-Meier survival curves and chi-square test. The expression of 23 CXC-chemokine ligands and their receptors were evaluated in all patients using microarray and qPCR and correlated with response to treatment using logistic regression. Pathological response to radiotherapy was independently associated to overall survival with a 2-year survival probability of 81% for patients showing a complete pathological response, while patients with a non-complete response only had a probability of 42% to survive for 2 years (p = 0.016). The expression of one CXC-chemokine, CXCL10, was significantly associated with response to radiotherapy and the group of patients with the highest CXCL10 expression responded, especially poorly (p = 0.01). CXCL10 is a potential marker for response to radiotherapy and overall survival in patients with squamous cell carcinoma of the tongue.

Keywords
p63, prognosis, tongue carcinoma
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-92407 (URN)10.1007/s13277-013-1549-6 (DOI)000335759800029 ()24395654 (PubMedID)
Available from: 2014-08-26 Created: 2014-08-26 Last updated: 2018-06-13Bibliographically approved
Loljung, L., Coates, P. J., Nekulova, M., Laurell, G., Wahlgren, M., Wilms, T., . . . Nylander, K. (2014). High expression of p63 is correlated to poor prognosis in squamous cell carcinoma of the tongue. Journal of Oral Pathology & Medicine, 43(1), 14-19
Open this publication in new window or tab >>High expression of p63 is correlated to poor prognosis in squamous cell carcinoma of the tongue
Show others...
2014 (English)In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 43, no 1, p. 14-19Article in journal (Refereed) Published
Abstract [en]

Backgroundp63 proteins are important in formation of the oral mucosa. Normal oral mucosa shows a balance between the six protein isoforms, whereas an imbalance between them is seen in squamous cell carcinomas (SCC). There is controversy over the clinical impact of p63 in SCC, which may relate to different expression in different areas. In addition, p63 isoforms can act as p53-like molecules (TAp63) or can inhibit p53 functions (Np63) and expression of these isoforms varies in different tumours. Here, we chose to concentrate on the most common intra-oral sub-site, SCC of the mobile tongue. MethodsTotal p63, Np63 and TAp63 were analysed separately using immunohistochemistry. The percentage of cells and intensity of expression of different isoforms of p63 was evaluated using a quick score method and correlated with clinical data in a group of 87 patients with tongue SCC. ResultsAll tumours expressed p63 in at least 60% of the cells when using two different antibodies detecting all 6 isoforms. p63 expression correlated significantly with 2-year survival (P=0.018), with fewer patients surviving 2years if their tumours expressed p63 with strong intensity in at least 80% of the cells (quick score 18). Looking at 5-year survival, this was even more emphasized. Np63 was expressed in all tumours, whereas expression of TAp63 was seen only in 59/87 patients, usually at very low levels. ConclusionsBased on the present data, we recommend using expression of p63 as an additional factor contributing prognostic information in analysis of SCC in the tongue.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
p63, prognosis, tongue carcinoma
National Category
Dentistry Surgery
Identifiers
urn:nbn:se:umu:diva-85784 (URN)10.1111/jop.12074 (DOI)000329291500003 ()
Funder
Swedish Cancer Society, 11 0651
Available from: 2014-02-13 Created: 2014-02-10 Last updated: 2018-06-08Bibliographically approved
Organisations

Search in DiVA

Show all publications