scholarly journals OS11 - 165 Brain Cancer Survival and Conditional Survival Rates in Canada (1992-2008)

Author(s):  
F. G. Davis ◽  
Y. Yuan ◽  
Q. Shi ◽  
C. Nagamuthu ◽  
E. Andres ◽  
...  

To investigate patterns of survival and estimate conditional survival rates among brain cancer patients in Canada. METHODS: Canadian Cancer Registry data were obtained for all patients with primary brain cancer diagnosed between 1992 and 2008 (n=38,095). Follow-up ended with patient death or December 31, 2008, whichever occurred first. Crude Kaplan-Meier estimates were calculated at one, two, and five years post-diagnosis and also used to estimate conditional survival (restricted to 2000-2008). Age group, sex, residence and microscopic confirmation were considered in estimating rates for major histology types using multivariate models. RESULTS: The overall five-year survival rate was 27%. Oligodendrogliomas had the highest 5-year survival rate (65%, 95% CI: 62.5-67.4%) and glioblastomas the lowest (4.0%, 95% CI: 3.7-4.3%). Compared to Ontario, the age- and sex-adjusted 5-year glioblastoma survival estimates were lower in British Columbia, Alberta and Manitoba-Saskatchewan, lower in all other regions for diffuse astrocytoma, and lower in Manitoba-Saskatchewan for anaplastic astrocytomas. Estimates were significantly higher for oligodendrogliomas in Alberta, and for anaplastic oligodendrogliomas in Alberta and Quebec (P<0.05). Longer term conditional survival rates (surviving an additional 2 years 1-4 years after diagnosis) varied by histologic group. CONCLUSION: There is a need to further explore the underlying reasons for the observed variation in survival rates by region in an effort to improve the prognosis of brain cancer in the Canadian patient population. Conditional survival information has value for clinicians as they plan the course of treatment and follow-up for individual patients.

2017 ◽  
Vol 24 (5) ◽  
pp. 341 ◽  
Author(s):  
Y. Yuan ◽  
J. Ross ◽  
Q. Shi ◽  
F.G. Davis

Background “Conditional survival probability” is defined as the probability that a patient will survive an additional time, given that the patient has already survived a defined period of time after diagnosis. Such estimates might be more relevant for clinicians and patients during post-diagnosis care, because survival probability projections are based on the patient’s survival to date. Here, we provides the first population-based estimates of conditional survival probabilities by histology for brain cancer in Canada.Methods Canadian Cancer Registry data were accessed for patients diagnosed with primary brain cancers during 2000–2008. Kaplan–Meier survival probabilities were estimated by histology. Conditional survival probabilities at 6 months (short-term, denoted scs) and 2 years (long-term, denoted lcs) were derived from the Kaplan–Meier survival estimates for a range of time periods.Results Among the 20,875 patients who met the study criteria, scs increased by a margin of 16–18 percentage points from 6-month survivors to 2-year survivors for the three most aggressive brain cancers. The lcs for 2-year survivors was 66% or greater for all tumour groups except glioblastoma. The lcs for 4-year survivors was 62% or greater for all histologies. For glioblastoma and diffuse astrocytoma, the lcs increased each year after diagnosis. For all other histologies, the lcs first increased and then plateaued from 2 years after diagnosis. The lcs and scs both worsened with increasing older age at diagnosis.Summary We report histologically specific conditional survival probabilities that can have value for clinicians practicing in Canada as they plan the course of follow-up for individual patients with brain cancer.


2020 ◽  
Vol 9 (12) ◽  
pp. 3943
Author(s):  
João Caramês ◽  
Ana Catarina Pinto ◽  
Gonçalo Caramês ◽  
Helena Francisco ◽  
Joana Fialho ◽  
...  

This retrospective study evaluated the survival rate of short, sandblasted acid-etched surfaced implants with 6 and 8 mm lengths with at least 120 days of follow-up. Data concerning patient, implant and surgery characteristics were retrieved from clinical records. Sandblasted and acid-etched (SLA)-surfaced tissue-level 6 mm (TL6) or 8 mm (TL8) implants or bone-level tapered 8 mm (BLT8) implants were used. Absolute and relative frequency distributions were calculated for qualitative variables and mean values and standard deviations for quantitative variables. A Cox regression model was performed to verify whether type, length and/or width influence the implant survival. The cumulative implant survival rate was assessed by time-to-event analyses (Kaplan–Meier estimator). In all, 513 patients with a mean age of 58.00 ± 12.44 years received 1008 dental implants with a mean follow-up of 21.57 ± 10.77 months. Most implants (78.17%) presented a 4.1 mm diameter, and the most frequent indication was a partially edentulous arch (44.15%). The most frequent locations were the posterior mandible (53.97%) and the posterior maxilla (31.55%). No significant differences were found in survival rates between groups of type, length and width of implant with the cumulative rate being 97.7% ± 0.5%. Within the limitations of this study, the evaluated short implants are a predictable option with high survival rates during the follow-up without statistical differences between the appraised types, lengths and widths.


2020 ◽  
Vol 27 (1) ◽  
pp. 1-9
Author(s):  
Jelena Rascon ◽  
Giedrė Smailytė

Background. Population-based EUROCARE-5 studies demonstrated that childhood cancer survival rates in Lithuania were 10–20% lower than the European mean. We aimed to analyse the change in the outcome of treatment of paediatric malignancies in Lithuania over 30 years. Methods. A single-centre retrospective analysis of children below 18 years of age treated for cancer at Vilnius University Hospital Santaros Klinikos between 1982 and 2011 was carried out. The minimal requirement of 5-year follow-up after diagnosis was specified for survival estimation. The vital status was assessed using data from the population-based Lithuanian Cancer Registry. To evaluate changes over time, the entire cohort was split into three groups according to the time of diagnosis: 1982–1991, 1992–2001, and 2002–2011. Results. A total of 1268 children met the inclusion criteria. The shortest median follow-up was 8.9 (IQR 6.4–11.5) years for patients treated in the third decade. The 5-year overall survival of the entire cohort increased from 37.3% (95% CI 30.2–44.3) in 1982–1991 to 70.7% (95% CI 66.4–74.1) in 2002–2011 (p < 0.0001). The same trend was evident when calculated separately for leukaemia (p < 0.0001), lymphoma (p < 0.0005), and solid tumours (p < 0.004). The percentage of cure rose from zero in the early years of the period analysed to 80% in 2010 and 2011. The improvement in the treatment outcome was attributable to the reduction of treatment-related mortality from 45.8% in 1982–1991 to 12.4% in 2002–2011 and disease recurrence from 30.4% to 19.6% for the same periods, respectively. Conclusions. Significant progress in the cure rate of children treated for cancer at our institution was observed over 30 years. Collaborative national and international clinical and research efforts are crucial to ensure further advances in care and cure.


Author(s):  
Mary E. Gordinier ◽  
Carol L. Hanchette

From 1995-2005, ovarian cancer accounted for 2.7% of new cancer cases diagnosed among women in Kentucky and was responsible for 4.7% of female cancer deaths in the state. The five-year survival rate for ovarian cancer is 45% for all stages combined. Multiple studies document a survival advantage for women with gynecologic malignancies when treated by a gynecologic oncologist. The authors used Kentucky Cancer Registry data for the years 1995-2005, geocoded to 5-digit ZIP code, to examine the hypothesis that ovarian cancer survival is higher among patients receiving treatment in areas where gynecologic oncologists practice. Their hypothesis was confirmed. A secondary goal of the study was to identify geographic areas of the state with lower overall access to care. Contrary to the expected pattern of low access to care in the Appalachian region of the state, their analysis indicated that access to successful treatment is a greater issue in the western portion of Kentucky.


Pained ◽  
2020 ◽  
pp. 245-246
Author(s):  
Michael D. Stein ◽  
Sandro Galea

This chapter discusses how the 5-year survival rates for the most common cancers in the United States improved by nearly 20% since the 1970s. While promising overall, low survival rates persist for pancreatic, liver, lung, esophageal, brain, and many other cancers. Meanwhile, 5-year survival for uterine and cervical cancers worsened. Pancreatic cancer has the lowest 5-year survival rate at 8.2%. In contrast, prostate cancer had the greatest 5-year survival increase from 67.8% to 98.6%, most likely reflecting a substantial uptick in prostate cancer screening and early detection. Five-year survival with leukemia also improved significantly, from 34.2% to 60.6%, likely resulting from improved treatments. As such, in both detection and treatment, the United States is making progress. For the millions of Americans who face a cancer diagnosis, this is cause for hope.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Seok Hui Kang ◽  
Jong Won Park ◽  
Kyu Hynag Cho ◽  
Jun Young Do

Abstract Background and Aims Successful PD requires timely peritoneal dialysis catheter (PDC) insertion and management of PDC related complications. Some societies have recently made an effort to increase PD and PDC insertion by nephrologists is an important issue. The aim of the present study was to evaluate comparative analysis of PDC insertion between blind and surgical methods by nephrologists. Method We reviewed medical records at a tertiary medical center in Korea and identified 249 adults who underwent first-time PDC insertion. All PDC insertions were performed using the blind or surgical methods. In our hospital during study period, two of three nephrologists performed the blind method routinely in all of eligible patients (blind group, n = 144). One of three nephrologists performed the surgical method in all of eligible patients (surgical group, n = 105). During follow-up, we collected data regarding peritoneal dialysis peritonitis (PDP), exit site and/or tunnel infection (ESI/TI). Catheter survivor was defined as maintaining of PD at July 2019 or PDC removal by PDC unrelated problems such as patient death due to PDC unrelated factors, kidney transplantation, patient demand, inadequate PD, improved renal function, poor oral intake due to abdominal distension, and colon cancer. Catheter non-survivor and/or PDC associated removal was defined as PDC removal by PDC related problems such as PDP, ESI/TI or PDC malfunction. Intervention-free non-survivor was defined as PDC revision, removal, or exchange by PDC related problems. Results Mean age at the PDC insertion in blind and surgical groups were 57.5 ± 13.7 and 56.3 ± 12.9 years, respectively (P = 0.640). There were no significant differences in age, sex, body mass index, underlying disease of ESRD, and Davies comorbidity index between the 2 groups. Mean follow-up durations were 37.0 ± 26.3 and 32.6 ± 23.4 months in the blind and surgical groups, respectively (P = 0.172). Total numbers of patients with one or more PDP events during follow-up period were 72 (50.0%) and 42 (40.0%) in blind and surgical groups (P = 0.118). Total numbers of PDP episodes were 157 and 100, respectively. Total numbers of patients with one or more ESI/TI events during follow-up period were 14 (9.7%) and 7 (6.7%) in blind and surgical groups (P = 0.392). Total numbers of ESI/TI episodes were 27 and 8, respectively. The 5-year PDC survival rates were 87.0% and 91.1% in the blind and surgical groups, respectively (P = 0.995, Figure 1). The 5-year intervention-free survival rates were 79.6% and 77.0% in the blind and surgical groups, respectively (P = 0.723). The leading cause of PDC removal was patient death. There was no significant difference in the distributions of cause of PDC removal in the 2 groups (P = 0.335). PDC associated removal rates in blind and surgical groups were 14 (18.4%) and 9 (16.4%), respectively (P = 0.760). Conclusion Our study shows that catheter outcomes including infectious and mechanical complications and catheter survival are similar between blind and surgical insertion techniques by nephrologists.


Author(s):  
Clemens Raabe ◽  
Michael M. Bornstein ◽  
Julien Ducommun ◽  
Pedram Sendi ◽  
Thomas von Arx ◽  
...  

Abstract Objectives To assess survival rates and frequency of complications for immature and mature autotransplanted teeth after at least 1 year in function. Materials and methods All consecutive patients who had undergone tooth autotransplantation between 2000 and 2018 were invited to a clinical and radiographic follow-up examination. First, survival rates were calculated on the basis of a phone inquiry. A clinical follow-up examination allowed for the calculation of the success rate, i.e., absence of any potentially adverse clinical and radiographic findings of the autotransplanted teeth. Moreover, the effect of demographic, dental, and surgical variables on survival/success was analyzed statistically. Results Thirty-eight teeth in 35 patients were transplanted during the study period. Three teeth in 3 patients were excluded due to missing records. All other patients were successfully contacted and interviewed by phone. Out of these 35 transplants, 32 were still in function, and 3 had been extracted, yielding a 91.4% survival probability after a median follow-up of 3.4 years. Of the 32 teeth qualifying for the success analysis, 20 (62.5%) showed absence of potentially adverse findings, while 3 (9.4%) required root canal treatment (RCT). Out of the 9 mature, root-end resected transplants, 4 exhibited ongoing pulp canal obliteration, all with a single root canal. Postoperative and potentially adverse findings or failures were found more frequently in the group of mature transplants (55.6%) than immature transplants (30.4%) and for molars (72.7%) than premolars (17.6%) or canines (25%). None of the potential predictors had a statistically significant effect on survival or success. Conclusion Autotransplanted teeth yielded a satisfying midterm survival rate regardless of their stage of development. An additional, extraoral root-end resection of mature transplants may lead to rates of revascularization and postoperative pulp canal obliteration higher than the data reported on unmodified mature transplants. Clinical relevance Extraoral root-end resection of mature teeth shows promising outcomes for transplants especially with a single root canal and uncomplicated root morphology.


2020 ◽  
Vol 35 (5) ◽  
pp. 1019-1028
Author(s):  
Motoharu Ohno ◽  
Atsushi Tanaka ◽  
Motoi Nagayoshi ◽  
Takashi Yamaguchi ◽  
Youichi Takemoto ◽  
...  

Abstract STUDY QUESTION What technique can be used to successfully cryopreserve three or fewer ejaculated spermatozoa from cryptozoospermic men and is the physical and cognitive development of children born after this technique normal? SUMMARY ANSWER The modified cryopreservation method for three or fewer human spermatozoa from cryptozoospermic men showed a recovery rate above 95% and a survival rate just under 90%, and the physical and cognitive abilities of the children born after ICSI were comparable to those born after natural conception. WHAT IS KNOWN ALREADY Clinical outcomes of ICSI using cryptozoospermic men’s ejaculated spermatozoa are considered to be inferior to that using testicular spermatozoa from microsurgical testicular sperm extraction (Micro-TESE), possibly because the DNA fragmentation rate is higher in ejaculated spermatozoa than in testicular spermatozoa from Micro-TESE. STUDY DESIGN, SIZE, DURATION Evaluation of the efficiency of cryopreservation of three or fewer spermatozoa was conducted retrospectively at St. Mother Clinic. The physical and cognitive development of children born after this method was studied between 2011 and 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included 28 cryptozoospermic men who had three or fewer morphologically normal and motile spermatozoa in their ejaculate after centrifugation and who preferred using cryopreserved spermatozoa to Micro-TESE. Control subjects were 31 cryptozoospermic patients using fresh spermatozoa from their ejaculates and 20 non-obstructive azoospermic patients with fewer than 10 spermatozoa obtained by TESE and vitrified. Clinical outcomes among three groups, vitrified spermatozoa from the ejaculate, fresh spermatozoa from the ejaculate and vitrified spermatozoa from the testis, were statistically analysed. For the 7-year follow up study of the 14 children born after ICSI using the ejaculated vitrified spermatozoa, the Japanese government-issued Boshi Kenko Techo (Mother-Child Handbook) and Kinder Infant Development Scale (KIDS scale) were used to determine whether their physical and cognitive development was comparable to that of naturally conceived children. MAIN RESULTS AND THE ROLE OF CHANCE Recovery and survival rates were 97.8% (510/521) and 87.1% (444/510) for vitrified spermatozoa from the ejaculate and 92.7% (152/164) and 60.5% (92/152) for vitrified spermatozoa from the testis. Clinical pregnancies (%), miscarriages (%) and live birth rates (%), respectively, among the three groups were as follows: vitrified spermatozoa from the ejaculate: 15(25.0), 2(13.3), 13(21.7); fresh spermatozoa from the ejaculate: 26(24.3), 5(19.2), 20(18.7); and vitrified spermatozoa from the testis: 3(16.7), 0(0.0), 3(16.7). Among the groups, there were no statistically significant differences except for the sperm survival rate and the oocyte fertilisation rate, which were lower for vitrified spermatozoa from the testis compared with vitrified spermatozoa from the ejaculate. The 7-year follow-up study showed that the physical and cognitive development of 14 children born after ICSI using vitrified ejaculated spermatozoa from the ejaculate was comparable to that of naturally conceived children. LIMITATIONS, REASONS FOR CAUTIONS The maximum number of spermatozoa to which this method can be applied successfully is about 10. When the number of aspirated spermatozoa is over 10, some of them change direction after colliding with each other inside the aspiration pipette and reach the mineral oil, and once this happens, they cannot be expelled out of the pipette. Even though we did not find evidence of DNA fragmentation, further studies with larger participant numbers and longer time periods are necessary. WIDER IMPLICATIONS OF THE FINDINGS This technique is very useful for the cryopreservation of very small numbers of testicular spermatozoa (fewer than 10) in order to avoid or reduce Micro-TESE interventions. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received to undertake this study. There are no competing interests. TRIAL REGISTRATION NUMBER N/A


Author(s):  
J. Ross ◽  
Q. Shi ◽  
Y. Yuan ◽  
F.G. Davis

Disparities in cancer survival rates have been identified for rural patients in Canada and are thought to be due to inequities in access to care. The objective was to perform the first examination of urban and rural brain cancer survival in Canada. Methods: A population-based retrospective cohort study was performed using Canadian Cancer Registry data for patients diagnosed with a primary brain cancer from 1996-2008. Seven major brain cancer histology groups used were glioblastoma, diffuse astrocytoma, glioma (not otherwise specified), oligodendroglioma, anaplastic astrocytoma, oligoastrocytic tumours, and anaplastic oligodendroglioma as categorized by the Central Brain Tumor Registry of the United States (CBTRUS). Kaplan-Meier (KM) survival estimates and Cox Proportional Hazards Regression were performed, adjusting for sex, histology, age group, region, and urban-rural residence. Rural residence was defined using Statistics Canada’s “Rural and Small Town” definition of living in a region with a population of less than 10,000 people. Results: No significant difference between urban and rural residence was identified in crude KM survival estimates. Though not significant, 5-year survival was generally better among rural residents than urban residents, except for rural residents with anaplastic astrocytoma. There remained no significant difference for Cox hazard ratios after adjustment for age, sex, or region. Conclusions: This is the first study to examine the effect of urban-rural residence on brain cancer survival. No significant differences for any histology were found, indicating equitable access to care for brain cancer patients in Canada, regardless of their location of residence.


2009 ◽  
Vol 29 (4) ◽  
pp. 450-457 ◽  
Author(s):  
Chih-Chung Shiao ◽  
Tze-Wah Kao ◽  
Kuan-Yu Hung ◽  
Yin-Cheng Chen ◽  
Ming-Shiou Wu ◽  
...  

Background There are no Taiwanese publications and only a few Asian publications on the long-term outcome of peritoneal dialysis (PD) patients. The aim of this study was to evaluate the outcome of PD patients in Taiwan during a 7-year follow-up period. Patients and Methods This study enrolled 67 patients (23 males, mean age 46.2 ± 14.5 years) on maintenance PD. We administered the Short-Form questionnaire on 30 September 1998 and recorded major events and outcomes until 30 September 2005. We compared differences in initial parameters between groups categorized by PD patient survival and PD technique survival. Causes of mortality and transfer to hemodialysis were determined. PD patient and PD technique survival rates were measured and risk factors for patient mortality and PD technique failure were analyzed. Results Those in patient survival or PD technique survival groups had lower mean age ( p < 0.001 and 0.018 respectively) and higher serum albumin level ( p = 0.015 and 0.041 respectively) compared to those that died or failed PD. The 7-year patient survival rate was 77% and the PD technique survival rate was 58%. The independent predictors for PD technique failure included lower Mental Component Summary scores [hazard ratio (HR) = 0.85, p = 0.031] and diabetes mellitus (HR = 4.63, p < 0.001), whereas lower serum albumin level (HR = 0.22, p = 0.031), lower Physical Component Summary scores (HR = 0.67, p = 0.047), and presence of diabetes mellitus (HR = 5.123, p = 0.009) were the independent predictors for patient mortality. Conclusion For our PD patients, both patient and technique survival rates are good. Better glycemic control, adequate nutrition, and enhancement of health-related quality of life are all of potential prognostic benefit.


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