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Frantisek Zitricky,1 Anni Koskinen,2,3 Kristina Sundquist,4– 6 Jan Sundquist,4– 6 Vaclav Liska,1,7 Asta Försti,8,9 Akseli Hemminki,10,11 Kari Hemminki1,4,12 1Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic; 2Department of Otorhinolaryngology- Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; 3Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; 4Center for Primary Health Care Research, Lund University, Malmö, Sweden; 5Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 6Center for Community-Based Healthcare Research and Education (Cohre), Department of Functional Pathology, School of Medicine, Shimane University, Shimane, Japan; 7Department of Surgery, Charles University Medical School, Pilsen, Czech Republic; 8Hopp Children’s Cancer Center (Kitz), Heidelberg, Germany; 9Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany; 10Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland; 11Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland; 12Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, GermanyCorrespondence: Kari Hemminki, Biomedical Center, Faculty of Medicine, Charles University Pilsen, Pilsen, 30605, Czech Republic, Email k.hemminki@dkfz.deIntroduction: Thyroid cancer (TC) is diagnosed in several histological types which differ in their clinical characteristics and survival. We aim to describe how they influence TC survival in Sweden.Methods: Cancer data were obtained from the Swedish cancer registry between years 1999 and 2018, and these were used to analyze relative survival.Results: Relative survival for all TC improved when analyzed in 10-year periods, and female survival improved more than male survival. Female survival advantage appeared to be present also for specific histological types, although case numbers were low for rare types. Female 5-year relative survival for TC was 100% for follicular, 95.1% for oncocytic, 93.4% for papillary, 89.7% for medullary, and 6.1% for anaplastic cancer. Among the clinical TNM classes, only T4 and M1 stages were associated with decreased survival compared to T1-3 and M0. Anaplastic cancer presented most often at high T and M1 stages, in contrast to other TC. Curiously, the diagnostic age for anaplastic M1 patients was lower than that for M0 patients. Both anaplastic and medullary cancers did not show age-dependent increases in the probability of metastases, in contrast to the main histological types. This could indicate the presence of several types of anaplastic and medullary cancers.Conclusion: The poor survival for anaplastic TC is an extreme contrast to the excellent survival of differentiated TC. As less than 20% of anaplastic cancer patients survived one year, urgent diagnosis and initiation of treatment are important. Facilitated treatment pathways have been instituted in Denmark resulting in improved survival. Anaplastic cancer should be a target of a major research focus.Keywords: prognosis, relative survival, anaplastic cancer, metastasis, trends

Guoqiao Zheng,1– 3 Kristina Sundquist,3– 5 Jan Sundquist,3– 5 Tianhui Chen,6 Asta Försti,1,4,7,8 Akseli Hemminki,9,10 Vaclav Liska,11,12 Kari Hemminki1,2,4,12 1Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, D-69120, Germany; 2Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, D-69120, Germany; 3Center for Primary Health Care Research, Lund University, Malmö, 205 02, Sweden; 4Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 5Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan; 6Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China; 7Hopp Children’s Cancer Center (KiTZ), Heidelberg, Germany; 8Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany; 9Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland; 10Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland; 11Department of Surgery, University Hospital, School of Medicine in Pilsen, Pilsen, Czech Republic; 12Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, Pilsen, 30605, Czech RepublicCorrespondence: Kari HemminkiBiomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, 30605, Czech RepublicTel +496221421800Fax +496221422203Email K.Hemminki@dkfz.deBackground: Second primary cancers (SPCs) are important clinically as they may negatively influence patient survival and they may tell about therapeutic side effects and general causes of cancer. Population-based literature concerning SPCs after hepatobiliary cancers is limited and here we assess risks of SPCs after hepatocellular cancer (HCC), and cancers of the gallbladder, bile ducts and ampulla of Vater. In reverse order, we consider the risk of hepatobiliary cancers as SPCs after any cancer.Methods: We used standardized incidence ratios (SIRs) to estimate bidirectional relative risks of subsequent cancers associated with hepatobiliary cancers. Cancer diagnoses were obtained from the Swedish Cancer Registry from years 1990 through 2015.Results: We identified 9997 primary HCCs, 1365 gallbladder cancers and 4721 bile duct cancers. After HCC, risks of four SPCs were increased: gallbladder (SIR = 4.38; 95% confidence interval 1.87– 8.67), thyroid (4.13; 1.30– 9.70), kidney (2.92; 1.66– 4.47) and squamous cell skin (1.55; 1.02– 2.26) cancers. In reverse order, HCC as SPC, in addition to the above cancers, associations included upper aerodigestive tract, esophageal, small intestinal and bladder cancers and non-Hodgkin lymphoma. For gallbladder and bile duct cancers, associations were found with small intestinal and pancreatic cancers.Conclusion: The results suggested that HCC is associated with two types of SPC, one related to shared environmental risk factors, such as alcohol, exemplified by upper aerodigestive tract and esophageal cancer, and the other related to immune dysfunction, exemplified by squamous cell skin cancer. SPCs associated with gallbladder and bile duct cancers suggest predisposition to mutations in the mismatch repair gene MLH1.Keywords: cancer incidence, relative risk, second primary cancer, cancer etiology, hepatobiliary cancer

The considerable literature discussing Walter Benjamin’s “idea of happiness” points both to the important role it plays in his thought and, in this context, to the diversity of interpretations his elliptic style has generated. The pivotal role played by the term in Benjamin’s oeuvre from his early writings on language to his Passagenwerk originates in what has been regarded as his “dialectics of happiness.” While this is certainly a plausible diagnosis, a closer look at the wording of the relevant passages in Benjamin’s oeuvre reveals more nuanced and numerous manifestations of the indirectness that characterizes his approach to happiness. Benjamin invokes the term “happiness” (Glück) at crucial crossroads in his thought. It oscillates between potentiality and inaccessibility; individual and collective experience; commemoration and utopia, Eros and emancipation, concrete phenomena and abstract ideas, and last but not least between politics and theology. Equally striking are the divergent modes of expression in which Benjamin’s notion of happiness is articulated. They range from the inexpressible (das Ausdruckslose) to the most lyrical effusions. My talk will correlate Benjamin’s seemingly incommensurable invocations of happiness with the very detours, incompletions, and indirections in his writings about this state of being.