David Hodgson - Academia.edu (original) (raw)

Papers by David Hodgson

Cancer, Jan 25, 2015

Survivors of childhood cancer are at considerable risk of experiencing treatment-related adverse ... more Survivors of childhood cancer are at considerable risk of experiencing treatment-related adverse health outcomes. To provide survivors with specialized care focused on these risks during adulthood, the government of Ontario funded a provincial network of specialized survivor clinics in 1999. The aim of this study was to determine whether prior attendance at survivor clinics by adult survivors of childhood cancer was associated with rates of emergency department (ED) visits. This was a population-based, retrospective cohort study using multiple linked administrative health databases. The cohort consisted of all adult survivors of childhood cancer diagnosed between January 1, 1986 and December 31, 2005 in Ontario, Canada. A recurrent event regression model was used to evaluate the association between prior attendance at survivor clinics and the rate of ED visits; adjustments were made for individual, demographic, treatment, and provider characteristics. The study consisted of 3912 adu...

Pediatric blood & cancer, Jan 6, 2015

Childhood cancer survivors treated with anthracycline chemotherapy are at an increased risk of lo... more Childhood cancer survivors treated with anthracycline chemotherapy are at an increased risk of long-term cardiac toxicity, and guidelines recommend that exposed survivors undergo echocardiography every 1-5 years. However, it is unclear whether survivors should undergo echocardiographic screening indefinitely, or if a period of echocardiographic stability indicates that screening is no longer necessary. The objective of this study was to evaluate the outcomes of echocardiographic screening to aid in the refinement of existing guidelines. We retrospectively analyzed the results of echocardiographic screening in a cohort of adult survivors of childhood cancer treated with anthracyclines and/or cardiac radiation therapy. Interval regression analysis was performed to identify predictors of single-episode or sustained abnormal echocardiograms. The cohort constituted 333 survivors, with median follow-up time of 15.8 years post-treatment (range: 5.0-47.9), and median age at treatment of 8 y...

SEG Technical Program Expanded Abstracts 2005, 2005

Summary We have used a multipoint geostatistics algorithm called Snesim (Strebelle, 2000) to eval... more Summary We have used a multipoint geostatistics algorithm called Snesim (Strebelle, 2000) to evaluate its applicability to reservoir modeling. To test the algorithm, we used a data from a deepwater reservoir analog from outcrops in the Tanqua Karoo Basin, South Africa. Our implementation demonstrated the ability of the algorithm to efficiently and faithfully reproduce the texture of geological facies while honoring a large number (127) hard data locations plus rotation and scaling fields and soft probability fields. We have used hand- ...

British journal of haematology, Jan 22, 2015

Follicular lymphoma (FL) in young adults (YA, <40 years old) is uncommon, and the clinical cha... more Follicular lymphoma (FL) in young adults (YA, <40 years old) is uncommon, and the clinical characteristics and outcomes of this group are not well defined. We conducted a retrospective database review of 427 patients with newly diagnosed FL aged 65 years or less registered at Princess Margaret Cancer Centre between 1995 and 2010. YA (n = 61) and those 40-65 (n = 366) were compared with regards to clinical stage at diagnosis, FL International Prognostic Index (FLIPI) score, and the following clinical outcomes: time to second treatment, cause-specific survival (CSS) and overall survival (OS). At diagnosis, stage and FLIPI score were similar, as were the proportion of patients requiring therapy (YA 75% versus older adults 71%). Median follow-up was 8·1 years. Time to second therapy was similar in both age groups (5-year probability 23% YA versus 27% older adults; Gray's P-value = 0·76). Ten-year OS was significantly higher for YA (87% versus older adults 72%; P = 0·029). On mult...

Canadian journal of gastroenterology & hepatology, 2014

Postoperative surveillance following curative-intent resection of colorectal cancer (CRC) is vari... more Postoperative surveillance following curative-intent resection of colorectal cancer (CRC) is variably performed due to existing guideline differences and to the limited data supporting different strategies. To examine population-based rates of surveillance imaging and endoscopy in patients in Ontario following curative-intent resection of CRC with no evidence of recurrence, as well as patient or disease factors that may predispose certain groups to more frequent versus less frequent surveillance; to provide insight to the care patients receive in the presence of conflicting guidelines, in efforts to help improve care of CRC survivors by identifying any potential underuse or overuse of particular surveillance modalities, or inequalities in access to surveillance. A retrospective cohort study was conducted using data from the Ontario Cancer Registry and several linked databases. Ontario patients undergoing curative-intent CRC resection from 2003 to 2007 were identified, excluding pati...

Canadian family physician Médecin de famille canadien, 2012

To describe cancer screening rates for cancer survivors and compare them with those for matched c... more To describe cancer screening rates for cancer survivors and compare them with those for matched controls. Population-based, retrospective study with individuals linked across administrative databases. Ontario. Survivors of breast (n = 11 219), colorectal (n = 4348), or endometrial (n = 3473) cancer, or Hodgkin lymphoma (HL) (n = 2071) matched to general population controls. Survivors were those who had completed primary treatment and were on "well" follow-up. The study period was 4 years (1 to 5 years from the date of cancer diagnosis). Never versus ever screened (in the 4-year study period) for breast cancer, colorectal cancer (CRC), and cervical cancer and never versus ever received (during the study period) a periodic health examination; rates were compared between cancer survivors and controls. Random effects models were used to estimate odds ratios and 95% CIs. Sixty-five percent of breast cancer survivors were never screened for CRC and 40% were never screened for ce...

British Journal of Haematology, 2015

The outcome for children and adolescents with low risk Hodgkin lymphoma (HL) is excellent, with e... more The outcome for children and adolescents with low risk Hodgkin lymphoma (HL) is excellent, with event-free survival &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;85% and overall survival &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;95%. Historically, however, treatment has come at the cost of significant long-term toxicity from chemotherapy, radiation or a combination of these. Recent treatment strategies have focused on maintaining high event-free and overall survival while minimizing the use of therapy associated with late effects. The strategies used to achieve this vary greatly among paediatric cooperative groups and there is no one standard treatment for children with low risk HL. This review summaries recent clinical trials in paediatric low risk HL and addresses some of the important considerations when comparing trials, including differences in the definition of low risk HL, differences in outcome among histological subtypes and varying approaches to reduce or eliminate radiation therapy. Recommendations are provided for the treatment of children with low risk HL outside the setting of a clinical trial.

Oncology (Williston Park, N.Y.), 2013

The present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic ... more The present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic factors, and treatment options for patients with localized nodal indolent lymphoma, with an emphasis on radiation guidelines, including radiation dose, field design, and radiation techniques. Following a discussion of the current literature and available data for treatment and outcomes of patients with indolent lymphoma, several different example cases are reviewed to help physicians make appropriate treatment decisions. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) by which the panel rates the appropriateness of imaging and treatment procedu...

International Journal of Radiation Oncology*Biology*Physics, 2014

Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screenin... more Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of 50,000perquality−adjustedlifeyear(QALY).AnnualLDCTscreeningwascosteffectiveforallsmokers.AmalesmokertreatedwithmantleRTatage25achievedmaximumQALYsbyinitiatingscreening12yearspost−HL,withalifeexpectancybenefitof2.1monthsandanincrementalcostof50,000 per quality-adjusted life year (QALY). Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of 50,000perquality−adjustedlifeyear(QALY).AnnualLDCTscreeningwascosteffectiveforallsmokers.AmalesmokertreatedwithmantleRTatage25achievedmaximumQALYsbyinitiatingscreening12yearspost−HL,withalifeexpectancybenefitof2.1monthsandanincrementalcostof34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening may be cost effective for all smokers but possibly not for nonsmokers despite a small life expectancy benefit.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 28, 2014

BMC Cancer, 2014

Background: Current treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an exp... more Background: Current treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative to CHOP alone as first-line treatment of DLBCL, but it remains unclear what its real-world costs and cost-effectiveness are in routine clinical practice.

European Journal of Cancer Supplements, 2014

Keywords: Radiotherapy Chemotherapy Multiple primary malignancies or multiple primary neoplasms T... more Keywords: Radiotherapy Chemotherapy Multiple primary malignancies or multiple primary neoplasms Treatment-induced ABSTRACT Currently, 17-19% of all new primary malignancies occur in survivors of cancer, causing substantial morbidity and mortality. Research has shown that cancer treatments are important contributors to second malignant neoplasm (SMN) risk. In this paper we summarise current knowledge with regard to treatment-related SMNs and provide recommendations for future research. We address the risks associated with radiotherapy and systemic treatments, modifying factors of treatment-related risks (genetic susceptibility, lifestyle) and the potential benefits of screening and interventions. Research priorities were identified during a workshop at the 2014 Cancer Survivorship Summit organised by the European Organisation for Research and Treatment of Cancer. Recently, both systemic cancer treatments and radiotherapy approaches have evolved rapidly, with the carcinogenic potential of new treatments being unknown. Also, little knowledge is available about modifying factors of treatment-associated risk, such as genetic variants and lifestyle. Therefore, large prospective studies with biobanking, high quality treatment data (radiation dose-volume, cumulative drug doses), and data on other cancer risk factors are needed. International collaboration will be essential to have adequate statistical power for such investigations. While screening for SMNs is included in several follow-up guidelines for cancer survivors, its effectiveness in this special population has not been demonstrated. Research into the pathogenesis, tumour characteristics and survival of SMNs is essential, as well as the development of interventions to reduce SMN-related morbidity and mortality. Prediction models for SMN risk are needed to inform initial treatment decisions, balancing chances of cure and SMNs and to identify high-risk subgroups of survivors eligible for screening. Please cite this article in press as: Morton LM et al. Current knowledge and future research directions in treatment-related second primary malignancies. EJC Supplements (2014), http://dx.

Marine and Petroleum Geology, 2010

... exposed 380 m thick distal basin-plain succession that includes three major regional deformat... more ... exposed 380 m thick distal basin-plain succession that includes three major regional deformation units (DU1-3) of mass transport deposits (MTDs), is overlain by a 1 km thick basin floor fan slope shelf succession, in the SW Karoo Basin of South Africa (Van Der Merwe et al ...

... shelf-edge delta cycles shelf delta cycles mud-rich submarine fans with mass flow deposits Fi... more ... shelf-edge delta cycles shelf delta cycles mud-rich submarine fans with mass flow deposits Fig. 55.3 Schematic stratigraphic logs of the lithostratigraphy in the Tanqua (right) and Laingsburg (left) areas Page 6. 624 DM Hodgson et al. outcrop (van der Merwe et al. ...

We present seismic, core, log, and chronologic data on three early to middle Miocene sequences (m... more We present seismic, core, log, and chronologic data on three early to middle Miocene sequences (m5.8, m5.4, and m5.2; ca. 20-14.6 Ma) sampled across a transect of seismic clinothems (prograding sigmoidal sequences) in topset, foreset, and bottomset locations beneath the New Jersey shallow continental shelf (Integrated Ocean Drilling Program Expedition 313, Sites M27-M29). We recognize stratal surfaces and systems tracts by integrating seismic stratigraphy, lithofacies successions, gamma logs, and foraminiferal paleodepth trends. Our interpretations of systems tracts, particularly in the foresets where the sequences are thickest, allow us to test sequence stratigraphic models. Landward of the clinoform rollover, topsets consist of nearshore deposits above merged transgressive surfaces (TS) and sequence boundaries overlain by deepening-and fi ning-upward transgressive systems tracts (TST) and coarsening-and shallowing-upward highstand systems tracts (HST). Drilling through the foresets yields thin (<18 m thick) lowstand systems tracts (LST), thin (<26 m) TST, and thick HST (15-90 m). This contrasts with previously published seismic stratigraphic predictions of thick LST and thin to absent TST. Both HST and LST show regressive patterns in the cores. Falling stage systems tracts (FSST) are tentatively recognized by seismic downstepping, although it is possible that these are truncated HST; in either case, these seismic geometries consist of uniform sands in the cores with a blocky gamma log pattern. Parasequence boundaries (fl ooding surfaces) are recognized in LST, TST, and HST. TS are recognized as an upsection change from coarsening-to fi ning-upward successions. We fi nd little evidence for correlative conformities; even in the foresets, where sequences are thickest, there is evidence of erosion and hiatuses associated with sequence boundaries. Sequence m5.8 appears to be a single million-year-scale sequence, but sequence m5.4 is a composite of 3 ~100-k.y.-scale sequences. Sequence m5.2 may also be a composite sequence, although our resolution is insuffi cient to demonstrate this. We do not resolve the issue of fractal versus hierarchical order, but our data are consistent with arrangement into orders based on Milankovitch forcing on eccentricity (2.4 m.y., 405 and 100 k.y. cycles) and obliquity scales (1.2 m.y. and 41 k.y.).

Practical Radiation Oncology, 2014

and sharing with colleagues.

Pediatric Blood & Cancer, 2012

Children with parameningeal rhabdomyosarcoma (PM RMS) and cranial nerve palsy (CNP) are at risk f... more Children with parameningeal rhabdomyosarcoma (PM RMS) and cranial nerve palsy (CNP) are at risk for permanent neurologic dysfunction. Clinicians often consider the use of emergent therapies such as expedited radiation and/or corticosteroids; however, there is a paucity of information describing the natural history of CNP in PM RMS. We sought to describe the clinical features of patients with PM RMS plus associated CNP and to evaluate the patient, disease, and treatment-related factors that impacted neurologic recovery. We conducted a retrospective review of PM RMS cases treated at the Hospital for Sick Children between 1985 and 2010. Thirty-five children were treated for PM RMS, 19 (54%) of whom presented with CNP. Children with CNP were nine times more likely to have other high-risk features (cranial base bony erosion and/or intracranial extension) at the time of presentation than children without CNP (OR 9.6, 95% CI 1.69, 54.79, P = 0.013). In addition to commencing chemotherapy, 13 patients (68%) received expedited RT and corticosteroids, four (21%) corticosteroids alone, and two (11%) received only standard chemotherapy and RT. At last follow up of the 11 survivors, neurologic recovery was complete in five (45%), partial in five (45%), and absent in one (9%). In our cohort, recovery of PM RMS associated CNP was often incomplete despite multi-modal therapy. A larger cohort of patients is required to determine the utility of emergent initiation of radiation or corticosteroids. This study will facilitate the counseling of future families on the long-term neurologic recovery CNP in PM RMS.