Stellenwert der präoperativen Computertomografie für die Prädiktion einer optimalen Zytoreduktion beim fortgeschrittenen Ovarialkarzinom

2021 ◽  
Vol 42 (01) ◽  
pp. 53-61
Author(s):  
Angrit Stachs ◽  
Karen Engel ◽  
Johannes Stubert ◽  
Toralf Reimer ◽  
Bernd Gerber ◽  
...  
Keyword(s):  
Retrospektive Studie ◽  
Ct Scans ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Omentum Majus ◽  
Stadium I

Zusammenfassung Einleitung Eine optimale Zytoreduktion ist der wichtigste Prognosefaktor beim fortgeschrittenen Ovarialkarzinom. Obwohl Stadieneinteilung und Einschätzung der Operabilität durch Explorativ-Operation erfolgen, gilt die präoperative Computertomografie (CT) des Abdomens als Standard. Ziel dieser Studie ist die Überprüfung verschiedener CT-Parameter hinsichtlich der Prädiktion einer optimalen Zytoreduktion. Patienten und Methoden In die retrospektive Studie wurden 131 Patientinnen mit zwischen 2010 bis 2014 neu diagnostiziertem Ovarialkarzinom aufgenommen. Davon wurden n = 36 im FIGO-Stadium I bis IIB aus der Studie ausgeschlossen. Von den 95 Patientinnen mit FIGO-Stadium IIC bis IV lagen bei n = 75 präoperative CT-Abdomen vor. Die CT-Scans wurden einem verblindeten Review unterzogen. Die evaluierten 11 CT-Parameter wurden mittels χ2-Test und logistischer Regressionsanalyse hinsichtlich der Endpunkte makroskopischer Tumorrest sowie Tumorrest > 1 cm überprüft. Überlebensanalysen erfolgten mittels Kaplan-Meier-Methode und Log-Rank-Test. Ergebnisse Von 75 Patientinnen hatten 28 (37,3 %) eine vollständige Tumorresektion und 26 (34,7 %) Tumorreste ≤ 1 cm. Tumorreste > 1 cm fanden sich bei 21 Patientinnen (28 %), davon waren 5 nicht resektabel. Das Gesamtüberleben bei Tumorrest > 1 cm unterschied sich signifikant von der Gruppe mit makroskopischer Tumorfreiheit (p = 0,003) bzw. Tumorrest ≤ 1 cm (p = 0,04). Die CT-Parameter Tumorherde am Diaphragma, Mesokolon, Omentum majus, Peritoneum sowie Aszites korrelierten mit makroskopischem Tumorrest. In der multivariaten logistischen Regressionsanalyse war lediglich hinsichtlich der Prädiktion einer suboptimalen Tumorresektion (> 1 cm) der CT-Parameter intraparenchymatöse Lebermetastase statistisch signifikant (OR 8,04; 95 %-KI 1,57–42,4; p = 0,0134). Sensitivität, Spezifität, PPV und NPV betragen 37,5, 89,7, 66,7 und 72,2 %. Schlussfolgerung Obwohl mittels CT Abdomen Risikoparameter für suboptimale Tumorreduktion identifizierbar sind, ist wegen der geringen diagnostischen Genauigkeit die chirurgische Exploration mit histologischer Diagnosesicherung unverzichtbar.

Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽  
2000 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Knoefel ◽  
Brunken ◽  
Neumann ◽  
Gundlach ◽  
Rogiers ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

scholarly journals Sarcomas de alto grau: estudo retrospectivo de 131 casos

2008 ◽  
Vol 35 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Wilmar José Manoel ◽  
Bruno José de Queiroz Sarmento ◽  
Luiz de Paula Silveira Júnior ◽  
Deidimar Cássia Batista de Abreu ◽  
Iron Pires de Abreu Neto ◽  
...  
Keyword(s):  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier

OBJETIVO: Relatar as características clínicas dos sarcomas de partes moles de alto grau e apresentar a experiência do Hospital Araújo Jorge no tratamento destes sarcomas. MÉTODO: Análise retrospectiva dos casos de sarcoma de alto grau em adultos admitidos no Hospital Araújo Jorge (HAJ) entre 1996 e 2000. Idade, sexo, características anátomo-patológicas (tamanho e tipo histológico), localização, tratamentos oncológicos realizados (cirurgias de preservação de órgãos e membros, margens, quimioterapia, radioterapia), recorrência local, recorrência distante e sobrevida foram estudados. Análise descritiva, curvas de Kaplan-Meier, log-rank test e teste ÷² foram usados quando pertinentes. RESULTADOS: Foram registrados 235 pacientes com sarcomas de partes moles entre 1996 - 2000, sendo que 131 eram de alto grau. A média de idade foi de 47,2 anos. O tipo histológico não foi determinado em 23,7% dos casos. O tipo mais freqüente foi o leiomiossarcoma (13,7%), seguido do sarcoma sinovial (10,7%) e rabdomiossarcoma (9,2%). O tamanho mediano foi de 10 cm (2-48 cm). A distribuição nos estádios II,III e IV foi de 15%, 55% e 30%, respectivamente. Nos pacientes com estádios II e III, a margem cirúrgica adequada foi obtida em 51,9% dos pacientes. Radioterapia e quimioterapia adjuvantes foram indicadas em 33,7% e 26,1% dos casos, respectivamente. As recorrências locais e distantes ocorreram em 31,5% e 34,8% dos pacientes, respectivamente. A sobrevida global em 5 anos foi 61,8%. CONCLUSÃO: A maioria dos pacientes atendidos no HAJ é portadora de lesões localmente avançadas, volumosas ou com metástase ao diagnóstico. Os pacientes apresentaram evolução adversa, com altas taxas de recorrência local e distante.

P850Clinical difference of recent myocardial infarction compared with acute myocardial infarction - Insights from Tokyo CCU network multicenter registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Ito ◽  
M Takayama ◽  
J Yamashita ◽  
K Yahagi ◽  
T Shinke ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Cause Of Death ◽  
Rank Test ◽  
Mechanical Complication ◽  
Recent Myocardial Infarction ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Multicenter Registry

Abstract Background Although the patient's characteristics and outcome of acute myocardial infarction (AMI) have been sufficiently investigated and primary percutaneous coronary intervention (PCI) has been recognized as established treatment strategy, those of recent myocardial infarction (RMI) have not been fully evaluated. Purpose The purpose of the present study was to clarify clinical characteristics and in-hospital outcomes of RMI patients from the database of the Tokyo CCU network multicenter registry. Methods In Tokyo CCU network multicenter registry database from 2013 to 2016, 15788 consecutive patients were registered as AMI (within 24 hours from onset) and RMI (within 2–30 days from onset). However 1246 patients were excluded because of inadequate data. And we excluded 66 cases because of out of onset period and 129 cases that strongly suspected of involvement of vasospastic events. Therefore, remaining 14347 patients were categorized to RMI group (n=1853) and AMI group (n=12494), and analyzed. Results Compared with AMI group, average age was older (70.4±12.9 vs 68.0±13.4 years, p<0.001), male was less (72.4 vs 76.4%, p<0.001), chest pain as chief complaint was less (75.2 vs 83.6%, p<0.001), prevalence of diabetes mellitus was higher (35.9 vs 31.0%, p<0.001), multi-vessel coronary disease was more (54.7 vs 44.6%, p<0.001), patients undergoing PCI was less (79.0 vs 91.2%, p<0.001), and the incidence of mechanical complication was more in RMI group (3.0 vs 1.5%, p<0.001). Although 30-day mortality was equivalent between 2 groups (5.3 vs 5.8%, p=0.360), the major cause of death in AMI group was cardiogenic shock, while in the RMI group it was a mechanical complication. On Kaplan-Meier analysis, the 2 groups had significantly different cumulative incidence of death due to cardiogenic shock (p=0.006, Log-rank test) and mechanical complication (p=0.021, Log-rank test). Furthermore death due to mechanical complication in AMI group was plateau after about 1 week from hospitalization, whereas in RMI group it continued to increase. Kaplan-Meier analysis Conclusions RMI patients had distinctive clinical features in backgrounds and treatment strategies compared with AMI patients, and the major cause of death of RMI patients was different from that of AMI patients. Furthermore, even though treatment during hospitalization of RMI patients was well done, death due to mechanical complications continued to increase.

Survival Outcomes for Induction vs Adjuvant Chemotherapy in Squamous Cell Carcinoma of the Maxillary Sinus

2018 ◽  
Vol 160 (4) ◽  
pp. 658-663 ◽  
Author(s):  
Phoebe Kuo ◽  
Sina J. Torabi ◽  
Dennis Kraus ◽  
Benjamin L. Judson
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Maxillary Sinus ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Cox Regression ◽  
Rank Test ◽  
Controlled Clinical Trial ◽  
Log Rank Test ◽  
Kaplan Meier

Objective In advanced maxillary sinus cancers treated with surgery and radiotherapy, poor local control rates and the potential for organ preservation have prompted interest in the use of systemic therapy. Our objective was to present outcomes for induction compared to adjuvant chemotherapy in the maxillary sinus. Study Design Secondary database analysis. Setting National Cancer Database (NCDB). Subjects and Methods In total, 218 cases of squamous cell maxillary sinus cancer treated with surgery, radiation, and chemotherapy between 2004 and 2012 were identified from the NCDB and stratified into induction chemotherapy and adjuvant chemotherapy cohorts. Univariate Kaplan-Meier analyses were compared by log-rank test, and multivariate Cox regression was performed to evaluate overall survival when adjusting for other prognostic factors. Propensity score matching was also used for further comparison. Results Twenty-three patients received induction chemotherapy (10.6%) and 195 adjuvant chemotherapy (89.4%). The log-rank test comparing induction to adjuvant chemotherapy was not significant ( P = .076). In multivariate Cox regression when adjusting for age, sex, race, comorbidity, grade, insurance, and T/N stage, there was a significant mortality hazard ratio of 2.305 for adjuvant relative to induction chemotherapy (confidence interval, 1.076-4.937; P = .032). Conclusion Induction chemotherapy was associated with improved overall survival in comparison to adjuvant chemotherapy in a relatively small cohort of patients (in whom treatment choice cannot be characterized), suggesting that this question warrants further investigation in a controlled clinical trial before any recommendations are made.

scholarly journals Estudio de supervivencia de pacientes menores de 18 años de edad con diagnóstico de cáncer atendidos en el Hospital Universitario San Ignacio-Centro Javeriano de Oncología entre octubre de 2010 y marzo de 2016

2017 ◽  
Vol 58 (4) ◽  
Author(s):  
Paula Carolina Guzmán Cruz ◽  
Luis Enrique Farías Curtidor ◽  
Helena María Jiménez Villabona ◽  
Patricia Maldonado Riveros ◽  
Iliana Del Carmen De Los Reyes Valencia
Keyword(s):  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier

<p><strong>Resumen</strong></p><p><strong>Introducción: </strong>El cáncer infantil ocasiona importante mortalidad. El objetivo es caracterizar y determinar la sobrevida de un centro especializado. <strong>Métodos: </strong>Análisis de supervivencia en menores de 18 años de edad, diagnosticados con cáncer del 01/10/2010 al 31/03/2016. Se analizaron variables sociodemográficas (edad, sexo, seguridad social y zona de residencia) y clínicas (tipo de cáncer y categorización del riesgo). Se utilizó el método de Kaplan-Meier y Log-Rank Test. <strong>Resultados: </strong>135 pacientes, con una edad promedio 7,4 años (DE 4,84), la mayoría de sexo masculino y pertenecientes al régimen contributivo. Las neoplasias más frecuentes fueron leucemias y tumores de sistema nervioso central, predominancia de alto riesgo. La supervivencia global fue del 75 % y la supervivencia libre de evento fue del 60 %. Los tumores sólidos y de alto riesgo presentaron mayor mortalidad. <strong>Conclusiones: </strong>La supervivencia global a 5 años es similar a los datos internacionales. La mayoría de los tumores sólidos eran de alto riesgo, probablemente asociados a mayor tiempo de evolución.</p>

scholarly journals ANALISIS KURVA SURVIVAL KAPLAN MEIER MENGGUNAKAN UJI LOG RANK (Studi Kasus :Pasien Penyakit Jantung Koroner di RSUD Undata Palu)

2018 ◽  
Vol 7 (1) ◽  
pp. 33-42
Author(s):  
Arianti Suhartini ◽  
Rita Rahmawati ◽  
Suparti Suparti
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Survival Curve ◽  
Disease Status ◽  
Lifestyle Changes ◽  
Rank Test ◽  
Self Awareness ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Central Sulawesi

Coronary heart disease is one of the leading causes of death in the world, including Indonesia. Based on doctor-diagnosed interviews, coronary heart disease’s prevalence in Indonesia on 2013 is 0,5% and based on a doctor-diagnosed is 1,5%. Central Sulawesi is ranked first and second for prevalence based on doctor-diagnosed interviews and doctor-diagnosed. The high number of people with coronary heart disease caused by lack of self-awareness in lifestyle changes. One of the parameters used to assess the success of treatment is the probability of survival. Survival analysis is a data analysis where the outcome of the variables studied is the time until an event occurs. This study raised the problem of survival of coronary heart patients at Undata Palu Hospital which is the main referral hospital for Central Sulawesi region. This research uses nonparametric method that is Kaplan Meier and Log Rank Test based on six factors are age, gender, stadium, disease status, complication and status of anemia. Nonparametric methods do not follow a particular distribution for survival time. Kaplan Meier's survival curve will describe the patient's characteristics of survival probability and followed by a Log Rank test to see if there are differences between curves. The result of analysis and discussion based on Log Rank test result showed that the factors of age, sex and disease status differ significantly. Keywords: Coronary heart disease, RSUD Undata Palu, Kaplan Meier analysis, Log Rank test.

scholarly journals Syndecan-1, an indicator of endothelial glycocalyx degradation, predicts outcome of patients admitted to an ICU with COVID-19

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Dong Zhang ◽  
Liubing Li ◽  
Yu Chen ◽  
Jie Ma ◽  
Yanli Yang ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Endothelial Damage ◽  
Endothelial Glycocalyx ◽  
Rank Test ◽  
Inflammatory Reactions ◽  
Log Rank Test ◽  
Survivor Group ◽  
Kaplan Meier ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality. Methods The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed. Results The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan–Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors. Conclusions COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19.

scholarly journals ACTR-32. NRG ONCOLOGY RTOG 1205: RANDOMIZED PHASE II TRIAL OF CONCURRENT BEVACIZUMAB AND RE-IRRADIATION VS. BEVACIZUMAB ALONE AS TREATMENT FOR RECURRENT GLIOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi20-vi20 ◽  
Author(s):  
Christina Tsien ◽  
Stephanie Pugh ◽  
adam Dicker ◽  
Jeffrey Raizer ◽  
Martha Matuszak ◽  
...  
Keyword(s):  
Objective Response ◽  
Patient Characteristics ◽  
Recurrent Glioblastoma ◽  
Rank Test ◽  
Significance Level ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Randomized Phase Ii ◽  
Grade 3 ◽  
Recurrent Gbm

Abstract This study sought to determine whether re-irradiation (ReRT) and concurrent bevacizumab (BEV) improves overall survival (OS) compared to BEV alone in recurrent glioblastoma (GBM). Patients (pts) were randomized 1:1 to ReRT (35 Gy/10 fractions) plus BEV (IV 10 mg/kg q2 wks) vs. BEV alone. With 160 pts, there was 80% power to detect a 31% reduction in death hazard for BEV+RT at a one-sided significance level of 0.10 using a log rank test. OS and PFS were estimated by Kaplan-Meier and HRs estimated by exact binomial distribution. Objective response was assessed using MacDonald and RANO criteria. From 11/2012 to 4/2016, 182 pts were randomized, with 170 eligible, analyzable pts. 11 pts did not receive protocol treatment. Patient characteristics (age, KPS, re-resection rates) were balanced between arms. Median f/u for censored pts was 12.8 months (mos; min-max, 0.03–52.8). BEV+ReRT did not improve OS vs BEV alone, with median OS of 10.1 vs 9.7 mos, (HR=0.98, 95% CI=0.70–1.38, p=0.46). Median PFS for BEV+RT and BEV was 7.1 vs. 3.8 mos, respectively (HR=0.73, 95% CI=0.53–1.0, p=0.051). BEV+ReRT improved 6-mo PFS rate (PFS6): 54 vs. 29%, (HR=0.42, 95% CI=0.34–0.5, p=0.001). Overall, treatment was well tolerated: 5% acute and 0% delayed grade 3+ treatment-related AE. Most patients died from recurrent GBM. CONCLUSION: RTOG 1205 is the first, prospective, randomized multi-institutional study to evaluate the safety and efficacy of ReRT in recurrent GBM using modern RT techniques. Overall, ReRT was shown to be safe and well tolerated. BEV+ReRT did not demonstrate a benefit in OS but an improved PFS6, and clinically meaningful PFS improvement. Molecular correlates of response analyses are ongoing. Funded by U10CA180868, U10CA180822 from the National Cancer Institute.

scholarly journals In Vitro Fatigue Resistance of Teeth Restored With Bulk Fill versus Conventional Composite Resin

2016 ◽  
Vol 27 (4) ◽  
pp. 452-457 ◽  
Author(s):  
Gabrielle Branco Rauber ◽  
Jussara Karina Bernardon ◽  
Luiz Clovis Cardoso Vieira ◽  
Hamilton Pires Maia ◽  
Françoá Horn ◽  
...  
Keyword(s):  
Fatigue Resistance ◽  
Composite Resin ◽  
Survival Curve ◽  
Maximum Force ◽  
Lower Percentage ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Meier Survival Curve

Abstract The aim of this study was to compare the fatigue resistance of restored teeth with bulk fill composite resin, conventional composite resin with incremental insertion and unprepared sound teeth. Twenty-eight extracted maxillary premolars were selected and divided into 4 groups based on composite resin and insertion technique: control (C), conventional composite resin with incremental insertion (I) and bulk fill composite resin with three (BF3) or single increment (BF1). The restored specimens were submitted to fatigue resistance test with a 5 Hz frequency. An initial application of 5,000 sinusoidal load cycles with a minimum force of 50 N and a maximum force of 200 N was used. Next, were applied stages of 30,000 load cycles with the maximum force increasing gradually: 400, 600, 800, 1000, 1200 and 1400 N. The test was concluded when 185,000 load cycles were achieved or the specimen failed. The fatigue resistance data were recorded for comparison, using the Kaplan-Meier survival curve and analyzed by log-rank test at 0.05 significance. Fractures were classified based on the position of the failure - above or below the cementoenamel junction (CEJ). Statistical analysis of the Kaplan-Meier survival curve and log-rank test showed a significant difference between groups (p=0.001). The fracture analysis demonstrated that only 28.58% of failures were below the CEJ in group C, while for groups I, BF1 and BF3 they were 42.85%, 85.71% and 85.71%, respectively. Teeth restored with composite bulk fill in both techniques present similar fatigue resistance values compared with those restored with a conventional incremental insertion of composite, while the fatigue strength values of unprepared sound teeth were higher. Furthermore, unprepared sound teeth showed a lower percentage of fractures below the CEJ.

scholarly journals Elevated Serum IL-17 Expression at Cessation Associated with Graves’ Disease Relapse

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Jianhui Li ◽  
Xiaohua Sun ◽  
Danzhen Yao ◽  
Jinying Xia
Keyword(s):  
Risk Factors ◽  
Elevated Serum ◽  
Antithyroid Drug ◽  
Therapeutic Modality ◽  
Rank Test ◽  
Graves Disease ◽  
Interleukin 17 ◽  
High Relapse Rate ◽  
Log Rank Test ◽  
Kaplan Meier

Background. Antithyroid drug (ATD) treatment occupies the cornerstone therapeutic modality of Graves’ disease (GD) with a high relapse rate after discontinuation. This study aimed to assess potential risk factors for GD relapse especially serum interleukin-17 (IL-17) expression. Methods. Consecutive newly diagnosed GD patients who were scheduled to undergo ATD therapy from May 2011 to May 2014 were prospectively enrolled. Risk factors for GD relapse were analyzed by univariate and multivariate Cox proportional hazard analyses. The association between serum IL-17 expression at cessation and GD relapse was analyzed with relapse-free survival (RFS) by the Kaplan–Meier survival analysis and log-rank test. Results. Of the 117 patients, 72 (61.5%) maintained a remission for 12 months after ATD withdrawal and 45 (38.5%) demonstrated GD relapse. The final multivariate Cox analysis indicated elevated IL-17 expression at cessation to be an independent risk factor for GD relapse within 12 months after ATD withdrawal (HR: 3.04, 95% CI: 1.14–7.67, p=0.021). Patients with higher expressions of IL-17 (≥median value) at cessation demonstrated a significantly higher RFS than those with lower levels by the Kaplan–Meier analysis and log-rank test (p=0.028). Conclusions. This present study indicated elevated serum IL-17 expression at cessation to be a predictor for GD relapse within 12 months.

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