Endocrine therapy with or without whole breast irradiation in low-risk breast cancer patients after breast-conserving surgery: 10-year results of the Austrian Breast and Colorectal Cancer Study Group 8A trial.

PURPOSE: To investigate long-term results of patients with hormonal receptor-positive breast cancer treated with breast-conserving surgery (BCS) and consecutive endocrine therapy (ET) with or without whole breast irradiation (WBI). METHODS AND MATERIALS: Within the 8 A trial of the Austrian Breast and Colorectal Cancer Study Group, a total of 869 patients received ET after BCS which was randomly followed by WBI (n = 439, group 1) or observation (n = 430, group 2). WBI was applied up to a mean total dosage of 50 Gy (+/- 10 Gy boost) in conventional fractionation. RESULTS: After a median follow-up of 9.89 years, 10 in-breast recurrences (IBRs) were observed in group 1 and 31 in group 2, resulting in a 10-year local recurrence-free survival (LRFS) of 97.5% and 92.4%, respectively (p = 0.004). This translated into significantly higher rates for disease-free survival (DFS): 94.5% group 1 vs 88.4% group 2, p = 0.0156. For distant metastases-free survival (DMFS) and overall survival (OS), respective 10-year rates amounted 96.7% and 86.6% for group 1 versus 96.4% and 87.6%, for group 2 (ns). WBI (hazard ratio [HR]: 0.27, p < 0.01) and tumour grading (HR: 3.76, p = 0.03) were found as significant predictors for IBR in multiple cox regression analysis. CONCLUSIONS: After a median follow-up of 10 years, WBI resulted in a better local control and DFS compared with ET alone. The omission of WBI and tumour grading, respectively, were the only negative predictors for LRFS.

The visual system of harvestmen (Opiliones, Arachnida, Chelicerata) - a re-examination.

BACKGROUND: The visual systems in chelicerates are poorly understood, even though they show strong variation in eye and visual neuropil architecture, thus may provide valuable insights for the understanding of chelicerate phylogeny and eye evolution. Comparable morphological characters are desperately sought for reconstructions of the phylogeny of Chelicerata, especially with respect to Arachnida. So far, reliable data exist only for Pycnogonida, Xiphosura, Scorpiones, and Araneae. The few earlier studies of the organisation of the visual system in harvestmen are contradictory concerning the number, morphology, and position of the visual neuropils. RESULTS: We undertook a descriptive and comparative analysis of the neuroanatomy of the visual system in several phalangid harvestmen species. Various traditional and modern methods were used that allow comparisons with previous results (cobalt fills, DiI/DiO labelling, osmium ethyl gallate procedure, and TEM). The R-cells (photoreceptor and arhabdomeric cells) in the eyes of Opiliones are linked to a first and a second visual neuropil. The first visual neuropil receives input from all R-cell axons, in the second only few R-cells terminate in the distal part. Hence, the second visual neuropil is subdivided in a part with direct R-cell input and a part without. The arcuate body is located in a subsequent position with direct contact to the second visual neuropil. CONCLUSIONS: This re-examination comes to conclusions different from those of all previous studies. The visual system of phalangid Opiliones occupies an intermediate position between Pycnogonida, Xiphosura, and Scorpiones on the one side, and Araneae on the other side. The projection of the R-cells is similar to that in the former grouping, the general neuropil arrangement to that in the latter taxon. However, more research on the visual systems in other chelicerate orders is needed in order to draw inferences on phylogeny or eye evolution.

Effects of vegetarian nutrition-A nutrition ecological perspective.

Although vegetarian nutrition is a complex issue, the multidimensionality and interrelatedness of its effects are rarely explored. This article aims to demonstrate the complexity of vegetarian nutrition by means of the nutrition ecological modeling technique NutriMod. The integrative qualitative cause-effect model, which is based on scientific literature, provides a comprehensive picture of vegetarian nutrition. The nutrition ecological perspective offers a basis for the assessment of the effects of worldwide developments concerning shifts in diets and the effects of vegetarian nutrition on global problems like climate change. Furthermore, new research areas on the complexity of vegetarian nutrition can be identified.

Austrian breast cancer patterns-of-care studies PCS93 and PCS01 versus PCS85 to identify changes in national practice.

PURPOSE: To determine the patterns of evaluation and treatment in Austrian breast cancer patients treated with surgery and radiotherapy in 1993 (PCS93) and 2001 (PCS01), and to compare these with the results of PCS85. MATERIAL AND METHODS: According to the evaluation process of the Austrian PCS85, ten randomly selected patient charts from every Austrian radiotherapy center from 1993 (n=100) as well as 2001 (n=120) were reviewed. The work-up included surgical and (histo)pathologic information, systemic therapy and detailed information on radiation therapy. RESULTS: Availability of histopathologic core data improved distinctly between 1985 and 2001. In 1985, treatment planning included fluoroscopic simulation and/or computed tomography in 55% of the cases as compared to 100% in 2001. The technical equipment in Austria changed distinctly. In 2001, 84% of the breast/chest wall fields and all regional node fields (+/- electrons) were treated by photons. Radiotherapy of the supraclavicular (77% vs. 28%), internal mammary (62% vs. 7.5%) and axillary nodes (51% vs. 5%) diminished from 1985 to 2001. A tumor bed boost was given in 34% of the patients in 1985 compared to 73% in 2001. The use of wedges (21% vs. 97%) and the number of port films (26% vs. 90%) increased substantially. CONCLUSION: Comparing both recent Austrian Patterns-of-Care surveys to the results obtained in 1985, an obvious increase in the quality level of histopathologic reporting as well as radiation treatment planning and delivery was found.