scholarly journals Survival in Cystic Neoplasms of the Pancreas

2009 ◽  
Vol 23 (8) ◽  
pp. 537-542 ◽  
Author(s):  
Ali Cadili ◽  
Amy Bazzerelli ◽  
Sipi Garg ◽  
Robert Bailey
Keyword(s):  
Overall Survival ◽  
Pancreatic Cyst ◽  
Patient Survival ◽  
Survival Rates ◽  
Pancreatic Cysts ◽  
Cystic Neoplasms ◽  
Patient Age ◽  
Patient Âgé ◽  
History Of ◽  
Pancreatic Cystic Neoplasms

BACKGROUND: The natural history of pancreatic cystic neoplasms remains poorly understood despite growing evidence on the subject. Pancreatic cysts display a wide spectrum of pathological phenotypes, each associated with a different prognostic implication. Many pancreatic cysts are of undetermined malignant potential at presentation and remain so until surgically resected. While the survival rates of patients with malignant cysts are known to be poor, survival rates in patients with undetermined pancreatic cysts are unknown.OBJECTIVE: To identify the factors associated with survival in a group of patients diagnosed with a pancreatic cyst(s).METHODS: The present study was a retrospective multicentre review of pancreatic cystic neoplasms. All patients with a diagnosis of a neoplastic pancreatic cyst from 1994 to 2003 were identified at five different institutions in Edmonton, Alberta. The data collected included patient age, sex, imaging modality, cyst location, cyst size, number of cysts, comorbid illnesses, history of upper abdominal surgery, previous cancer, previous or concurrent metastases, symptoms (pain, upper gastrointestinal bleeding, signs of biliary obstruction, nausea/vomiting), remarkable radiological features, elevated amylase or lipase, type of pancreatic surgery, final pathology (benign or malignant) and overall survival. Survival models were used to assess whether any covariates were predictors of the survival time. Patient data were plotted using the Kaplan-Meier method. The resulting plot was used to calculate survival in the cohort.RESULTS: In total, 64 patients were identified as having neoplastic pancreatic cysts from 1994 to 2003 at the five institutions. The median overall patient survival time was 86 months. The median age at diagnosis for the patient population was 73 years, with 40 patients being women. Univariate analysis revealed that the risk of death was associated with patient age, sex and history of major comorbid illness. Multivariate models identified increased patient age and male sex as the factors that correlated most strongly with decreased overall survival.CONCLUSION: Overall survival in patients with neoplastic pancreatic cysts is determined by patient factors (ie, age and sex) rather than factors descriptive of the cyst such as size and morphology. No conclusions could be made regarding the relationship between cyst pathology and patient survival.

scholarly journals Survival and prognostic factors in HIV-infected adults treated with Antiretroviral Therapy in a Malaysian referral hospital: A retrospective cohort study

2019 ◽  
Author(s):  
Lee Sing Chet ◽  
Siti Azrin Ab Hamid ◽  
Norsa'adah Bachok ◽  
Suresh Kumar Chidambaram
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Antiretroviral Therapy ◽  
Haemoglobin Level ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Baseline Haemoglobin ◽  
History Of ◽  
Overall Survival Rates

Abstract Background: It is well established that antiretroviral therapy (ART) is beneficial in reducing the mortality among patients with human immunodeficiency virus (HIV). In Malaysia, there is lack of study and information regarding the overall survival rates and prognostic factors for survival in HIV-infected adults treated with ART. Therefore, this study aimed to assess and compare the survival rates as well as to identify the prognostic factors for survival among HIV adults in Malaysia.Methods: A retrospective cohort study was conducted by reviewing the medical records of HIV patients who started ART between year 2007 and 2016 at a tertiary referral hospital in Malaysia. ART-naive adults aged 15 years and above were included and those who were transferred out were excluded. After applying inclusion and exclusion criteria, there were 339 cases eligible in this study. Systematic sampling method was applied. Kaplan Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.Results: The estimated overall survival rates were 95.9%, 93.8%, 90.4%, 84.9%, and 72.8% at 6 months, 1 year, 3 years, 5 years and 10 years, respectively. The overall survival rates were significantly different according to age group (p<0.001), employment status (p<0.001), transmission mode (p=0.003), and history of illicit drug use (p=0.017), baseline CD4 cell count (p<0.001), baseline haemoglobin level (p<0.001), tuberculosis co-infection (p<0.001), hepatitis co-infection (p=0.008), first NRTI (p<0.001) and history of defaults (p=0.021). Based on multiple Cox regression, patients who were anaemic had 3.76 times (95% CI: 1.97, 7.18; p<0.001) higher hazard of death than their non-anaemic counterparts. The hazard risk was 2.09 times (95% CI: 1.10, 3.96; p=0.024) higher among HIV patients co-infected with tuberculosis compared to those who were not. Conclusion: Overall survival rates were higher than low-income countries but lower than in high-income countries, and comparable with middle-income countries. Low baseline haemoglobin level and tuberculosis co-infection were strong prognostic factors for HIV survival

scholarly journals Pancreatic Cysts

2016 ◽  
Vol 46 (2) ◽  
pp. 60-65 ◽  
Author(s):  
Timothy Meagher ◽  
Andreas Armuss
Keyword(s):  
Malignant Transformation ◽  
Abdominal Imaging ◽  
The Other ◽  
Pancreatic Cysts ◽  
Risk Selection ◽  
Optimal Management ◽  
Ongoing Debate ◽  
Cystic Neoplasms ◽  
Pancreatic Cystic Neoplasms ◽  
Benign Course

Pancreatic cysts are more common than before, largely because of widespread abdominal imaging. Pancreatic cystic neoplasms (PCN) are relevant to risk selection on 2 counts: they constitute more than 50% of all pancreatic cysts and, in contrast to the other 2 cyst types, are capable of malignant transformation. The majority of PCNs are benign at time of diagnosis and will follow a benign course. The challenge is to identify those PCNs that are malignant or will undergo malignant transformation with time. The purpose of this article is to provide pointers that can help meet this challenge while also summarizing the ongoing debate about their optimal management.

Prognosticating Traumatic Brain Injury (TBI): Analysis of CRASH, IMPACT Models and Patient Age in a Cohort of TBI Patients

Neurosurgery ◽  
2019 ◽  
Vol 84 (5) ◽  
pp. E271-E272 ◽  
Author(s):  
Conor Gillespie ◽  
Catherine McMahon
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Survival Rates ◽  
Predictive Performance ◽  
Good Survival ◽  
Post Injury ◽  
Patient Age ◽  
Patient Âgé ◽  
Significant Difference ◽  
Impact Models

Abstract INTRODUCTION Both CRASH and IMPACT models have been developed in recent years to predict the outcome of Traumatic Brain Injury (TBI). However, there is no clear evidence as to how these models perform in a modern cohort of UK-patients. There is also predictive uncertainty with regards to survival rates and functional outcome in elderly (>65 yr) patients. METHODS Patients referred to a tertiary neuroscience center from December 2014 to January 2016 with a suspected TBI were retrospectively examined. For each model, the predicted survival and overall outcome were compared to the actual outcome on admission and at 6 mo post injury, stratified by patient age (>65 yr vs ≤65 yr). RESULTS A total of 161 patients met the initial criteria; mean age 65 yr (SD = 21) and 110 male. Both CRASH and IMPACT correctly predicted 6-mo mortality rates and functional outcomes in most patients (range 61.7%-82.4%), with better predictive performance for patients not accepted to the center (range 84%-98%). There was no significant difference in the initial survival of elderly patients if accepted (78% [95% CI 50.6-104.0] vs 81% [95% CI 67.8-94.8] but were lower for those not accepted (24% [95% CI 4.2-43.7] vs 76% [95% CI 63.5-88.5], P = .027). CONCLUSION Patients >65 yr admitted to tertiary neuroscience center had good survival rates on admission and at 6 mo. The lesser ability of CRASH and IMPACT models to predict poorer outcomes when accepted suggests that acceptance to specialist centers may be able to improve outcome and suggests more optimistic treatment and acceptance of appropriate over 65 yr should be considered.

Comparison Between Immediate and Delayed Laser-Treated Implants Surface With Switching Platform: A Clinical Retrospective Study

2013 ◽  
Vol 39 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Eduardo José de Moraes ◽  
Francesco Rao Genovese
Keyword(s):  
Retrospective Study ◽  
Bone Graft ◽  
Survival Rates ◽  
Laser Surface ◽  
Patient Age ◽  
Patient Âgé ◽  
And Performance ◽  
Implant Length ◽  
Mature Bone

The aim of the present study was to compare immediate (Im) versus delayed (De) placement of laser-treated implants surface with switching platform to confirm the predictability and performance of this type of implant. The implants were placed in pos exodontia and healed sites at the incisor, canine, premolar, and molar regions of the maxilla or the mandible. A protocol was prepared in which patient age, sex, implant length, diameter, and use of bone graft were recorded. The study included 44 GEASS Srl (Udine, Italy) implants with laser surface and morse taper connection, placed in 27 patients (mean age: 56 years; range: 25–80 years).The survival rates were 100% in the Im group and in the De group. The patients were followed for a minimum of 12 months. Implants with laser surface and morse connection presented when placed in fresh sockets showed similar results to implants placed in mature bone after 12 months of follow-up.

Pancreatic cysts or pancreatic cystic neoplasms? An analysis of 145 cases.

2018 ◽  
Vol 90 (4) ◽  
pp. 1-4
Author(s):  
Aleksandra Oleśna ◽  
Michał Wlaźlak ◽  
Janusz Strzelczyk ◽  
Marian Danilewicz
Keyword(s):  
Cystic Lesion ◽  
Demographic Data ◽  
Pancreatic Cysts ◽  
Histopathological Diagnosis ◽  
Cystic Neoplasms ◽  
Pancreatic Cystic Lesion ◽  
Cystic Tumors ◽  
Mucinous Neoplasms ◽  
Risk Of Malignancy ◽  
History Of

Introduction Frequency of detection of pancreatic cystic lesions increased recent years. The majorities are pseudocysts, the remaining cysts are mainly neoplasms. Proven risk of malignancy affects intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN). Material and methods 145 patients operated on at the Department of General and Transplant Surgery in Barlicki Hospital in Lodz, Poland, in 2007-2016 due to pancreatic cystic lesion. The type of surgery, histopathological diagnosis and basic demographic data were analyzed. Results Nonneoplastic cyst (mainly pseudocysts) was found in 66.9% of patients, neoplasms were detected in 33.1%. The mean age was significantly higher in patients with neoplasms than without neoplasm (57.06 years vs. 50.88 years, p = 0.009). Neoplastic cyst occurred more frequently in women (68.75% of women, 31.25% of men, p = 0.001), Nonneoplastic cyst was found significantly more often in men (64.95% of men, 35.05% of women, p = 0.001). Malignant tumor was found in 14.58% of neoplasms cases. Pancreatic resections in neoplastic cysts were performed in 77,08%. In patients with nonneoplastic cysts drainage operations were performed most frequently (80.41%). Conclusions Neoplastic cysts are more common in women. The average age in the group of patients with neoplasms is higher than in the group with nonneoplastic cysts. In women with pancreatic cystic lesion without history for pancreatitis, the probability of neoplasms diagnosis is high. Discussion Pancreatic cystic tumors are treated radically due to the lack of sufficiently sensitive and specific pre-operative examinations. The natural history of mucinous neoplasms (IPMN and MCN) ranges from dysplasia to cancer. There are no guidelines that could be in satisfactory way used in follow up patients with pancreatic cysts.

scholarly journals Natural History of Fibroadenomas Based on the Correlation Between Size and Patient Age

1999 ◽  
Vol 29 (1) ◽  
pp. 8-10 ◽  
Author(s):  
H. Takei ◽  
Y. Iino ◽  
J. Horiguchi ◽  
M. Maemura ◽  
T. Yokoe ◽  
...  
Keyword(s):  
Natural History ◽  
Patient Age ◽  
Patient Âgé ◽  
History Of

scholarly journals Microcystic Serous Cystadenoma of Pancreas Presenting With Chronic Diarrhea

2018 ◽  
Vol 08 (03) ◽  
pp. 045-049
Author(s):  
Shravya Sudesh Kotian ◽  
Shubha P Bhat ◽  
Rajshekhar Mohan ◽  
Sajitha K.
Keyword(s):  
Imaging Techniques ◽  
Surgical Excision ◽  
Serous Cystadenoma ◽  
The Body ◽  
Cystic Neoplasms ◽  
Large Size ◽  
History Of ◽  
Serous Cystic Neoplasms ◽  
Pancreatic Cystic Neoplasms ◽  
Unnecessary Intervention

AbstractPancreatic cystic neoplasms are increasingly being recognized due to widespread use of advanced imaging techniques. The prevalence of pancreatic cystic lesions is estimated to be between 2.6% - 19.6%. Serous Cystic Neoplasms account for nearly 16% of surgically resected th th pancreatic cystic neoplasms. They commonly occur in females between 5 and 6 decade of life. These tumours are essentially benign and asymptomatic unless they attain a large size. Majority of them occur in the body and tail of pancreas. Malignant transformation is reported in 1%-3% of cases. Surgical excision is the treatment of choice. Thus, it is important to accurately diagnose this lesion to avoid unnecessary intervention in the form of chemotherapy or uncalled for surgical resection. We report a rare case of a 65 year old male who presented with a history of intermittent diarrhea.

The Outcome of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Patients with Pancreatic Cystic Neoplasms: A Systematic Review

2020 ◽  
pp. 1-6
Author(s):  
Viswanath YKS ◽  
Ahmed Mehanna ◽  
Viswanath YKS ◽  
Talvinder Gill ◽  
Anil Reddy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malignant Tumors ◽  
High Specificity ◽  
Needle Aspiration ◽  
Pancreatic Cysts ◽  
Cystic Neoplasms ◽  
Pancreatic Cystic Neoplasms ◽  
Low Sensitivity ◽  
The Uk

Introduction: Pancreatic cancer is the sixth most common cause of death from cancer in the UK. Cystic pancreatic neoplasms are being recognized more with the increase in the use of the CT scan. EUS has been increasingly used to asses and identify lesions in the pancreas, however, it can’t differentiate between benign and malignant tumors alone. The role of EUS guided FNA cytology (EUS FNAC) is still controversial in the management of pancreatic cysts where neoplastic process is questioned. Aim: This systematic review is aiming to explore the currently available evidence assessing the role of EUS guided FNA cytology (EUS FNAC) in the management of pancreatic cystic neoplasms. Methods: A total of five studies with 597 patient EUS FNAC episodes were included in this systematic review. Results: The sensitivity of the EUS FNAC in the papers was variable between 46.7% to 91.7% while the sensitivity of the test was 100% for all the papers except for 1 paper which was 82.1%. CEA level was assessed in 3 papers, however, the cut off level was different. Conclusion: The high specificity of EUS FNAC qualify it as a useful adjunct to ascertain or exclude malignancy in the pancreatic cystic lesions. EUS FNAC cannot be used alone as a method of screening, given low sensitivity. Measuring CEA in the cyst fluid can be a good aide to increase the sensitivity and an identifiable cut off level should be proposed. Well-conducted and powered studies are needed to further explore the role of EUS FNAC in patients with pancreatic cystic neoplastic lesions.

Male breast cancer: Overall survival in a single institution.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 93-93
Author(s):  
Anke Bergmann ◽  
Marcelo Adeodato Bello ◽  
Celia Regina Andrade Costa ◽  
Paulo Francisco Mascarenhas Bender ◽  
Luiz Claudio Santos Thuler
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Median Survival ◽  
Male Breast Cancer ◽  
Male Breast ◽  
Single Institution ◽  
Patient Age ◽  
Risk Of Death ◽  
Patient Âgé ◽  
Tumor Stages

93 Background: Male breast cancer is an uncommon disease and the therapy is mainly based on what is know from female breast cancer. Objective: To investigate the clinicopathologic characteristics of male breast cancer and the overall survival in a single institution. Methods: The clinical data and survival status of 75 male breast cancer treated in a Brazilian public cancer hospital from 2000 to 2009 were collected. The association with clinicopathological characteristics and overall survival was analyzed using Kaplan-Meier curves and the Cox proportional hazards regression (enter method) was used to assess survival differences after adjusting for confounders. The study was approved by National Cancer Institute Research and Ethics Committee (number 128/11). Results: The median patient age was 64 years (range 33-86). Estrogen receptor (ER) was positive in 58 (77.3%) patients, while progesterone receptor (PR) were positive in 47 (62.7%). Histology type was ductal infiltrant carcinoma for 57 (76.0%) and 51 (68.0%) patients underwent surgery. The median follow-up period was 43,1 months (range 2.7-147.8). The median survival from the diagnosis of breast cancer was 97.0 months (95%CI 53.6 -140.4) with a 61.7% 5-year overall survival (OS). In the final Cox regression model, independent factors associated with increased risk of death were metastasis at diagnosis (HR = 18.1; 95%CI: 5.9-55.2), ≥ 65 years old (HR = 4.3; 95%CI: 1.7-10.5); tumor stages ≥ IIb (HR = 3.5; 95%CI: 1.3-9.7) and smoking (HR = 1.6; 95%CI: 1.04-2.6). Conclusions: Invasive ductal carcinoma is the main pathologic type. The median survival from the diagnosis of breast cancer was 97.0 months and metastasis at diagnosis, patient age, tumor stage and smoking are independent prognostic factors.

scholarly journals Ballistic lobar trajectory outcomes in civilian firearm penetrating brain injury

2020 ◽  
pp. 1-10
Author(s):  
Georgios Alexopoulos ◽  
Nabiha Quadri ◽  
Maheen Khan ◽  
Henna Bazai ◽  
Carla Formoso Pico ◽  
...  
Keyword(s):  
Brain Injury ◽  
Parietal Lobe ◽  
Survival Rates ◽  
Trauma Patients ◽  
Retrospective Case ◽  
Potential Donor ◽  
Patient Age ◽  
Penetrating Brain Injury ◽  
Patient Âgé ◽  
Gcs Score

OBJECTIVEPenetrating brain injury (PBI) is the most lethal of all firearm injuries, with reported survival rates of less than 20%. The projectile trajectory (PT) has been shown to impact mortality, but the significant lobar tracks have not been defined. The aim of this retrospective case-control study was to test for associations between distinct ballistic trajectories, missile types, and patient outcomes.METHODSA total of 243 patients who presented with a PBI to the Saint Louis University emergency department from 2008 through 2019 were identified from the hospital registry. Conventional CT scans combined with 3D CT reconstructions and medical records were reviewed for each patient to identify distinct PTs.RESULTSA total of 65 ballistic lobar trajectories were identified. Multivariable regression models were used, and the results were compared with those in the literature. Penetrating and perforating types of PBI associated with bitemporal (t-statistic = −2.283, p = 0.023) or frontal-to-contralateral parietal (t-statistic = −2.311, p = 0.025) projectile paths were universally found to be fatal. In the group in which the Glasgow Coma Scale (GCS) score at presentation was lower than 8, a favorable penetrating missile trajectory was one that involved a single frontal lobe (adjusted OR 0.02 [95% CI 0.00–0.38], p = 0.022) or parietal lobe (adjusted OR 0.15 [95% CI 0.02–0.97], p = 0.048). Expanding or fragmenting types of projectiles carry higher mortality rates (OR 2.53 [95% CI 1.32–4.83], p < 0.001) than do nondeformable missiles. Patient age was not associated with worse outcomes when controlled by other significant predictive factors.CONCLUSIONSPatients with penetrating or perforating types of PBI associated with bitemporal or frontal-to-contralateral parietal PTs should be considered as potential donor candidates. Trauma patients with penetrating missile trajectories involving a single frontal or parietal lobe should be considered for early neurosurgical intervention, especially in the circumstances of a low GCS score (< 8). Surgeons should not base their decision-making solely on advanced patient age to defer further treatment. Patients with PBIs caused by nondeformable types of projectiles can survive multiple simultaneous intracranial missile trajectories.

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