scholarly journals Analysis of Prognostic Factors and Treatment Modes of Patients with Recurrent Endometrial Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yi Li ◽  
Dong Yang ◽  
Shuangjian Yang
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Treatment Modality ◽  
Poor Prognosis ◽  
Treatment Plan ◽  
Treatment Modalities ◽  
Factors Affecting ◽  
Multifactorial Analysis ◽  
Primary Surgery ◽  
First Choice

Objective. Recurrence of endometrial cancer after initial treatment can be complex and difficult to treat. The current main treatment modalities for patients with recurrent endometrial cancer (REC) include chemotherapy, radiotherapy, and surgery, which vary according to the individual patient. However, REC is often associated with a poor prognosis, and it is therefore important to investigate the risk factors affecting REC prognosis and to explore appropriate treatment modalities to improve the prognosis and treatment strategies for patients with REC. Methods. Totally, 100 patients with REC admitted to our hospital from January 2013 to January 2018 were chosen to be research objects. Their pathological data were analyzed, including age, disease-free interval (DFI), recurrence site, and treatment plan after relapse (definitive local therapy (DLT) and palliative chemotherapy (PC)). According to these parameters, univariate and multivariate factors affecting the prognosis of REC patients and the curative effect of PC were analyzed, and the 3-year overall survival (OS) curve and progression-free survival (PFS) curve were drawn. Results. After 3 years of follow-up, 30 patients had a poor prognosis and 70 had a good prognosis, according to which a single multifactorial analysis was performed for different prognoses, where the results of the single-factor analysis showed significant differences between patients with different prognoses in terms of pathomorphology, pathological grading, TFI, and treatment modality after relapse. Further multifactorial analysis showed that TFI and treatment modality after recurrence were independent factors affecting poor prognosis in REC patients. The 3-year OS and 3-year PFS of REC patients were 74.00% and 70.00%, respectively. Patients whose DFI was less than 12 months or treated with PC after relapse were notably associated with lower levels of 3-year OS and 3-year PFS. In addition, radiotherapy and chemotherapy, DFI, and chemotherapy plan after primary surgery were independent risk factors that affected the PC efficacy of REC patients. Conclusion. DFI and treatment mode after relapse are independent factors affecting the prognosis of REC patients. DLT can obviously improve the prognosis of REC patients. For patients who can only choose PC, chemoradiotherapy and DFI after primary surgery are helpful to predict the chemotherapy effect, and the combination of paclitaxel and platinum drugs should be the first choice for chemotherapy.

Management of Surgical Stage III and IV Endometrioid Endometrial Carcinoma: An Overview

2009 ◽  
Vol 19 (3) ◽  
pp. 431-446 ◽  
Author(s):  
F.H. van Wijk ◽  
M.E.L. van der Burg ◽  
Curt W. Burger ◽  
Ignace Vergote ◽  
H.C. van Doorn
Keyword(s):  
Endometrial Cancer ◽  
Hormone Therapy ◽  
Single Agent ◽  
Treatment Modalities ◽  
Low Grade ◽  
Ongoing Research ◽  
First Choice ◽  
Peritoneal Washings ◽  
Low Toxicity ◽  
Management Recommendations

This paper covers an overview of the literature on the management of advanced endometrial cancer, concentrating on patients with histopathologic endometrioid type of tumors. The different treatment modalities are described and management recommendations are proposed.The standard surgical procedure includes an extrafacial total hysterectomy with bilateral salpingo-oophorectomy, collection of peritoneal washings for cytology, and exploration of the intraabdominal contents. In cases of extensive disease in the abdomen, an optimal surgical cytoreduction is associated with improved survival. Further treatment with radiotherapy may be indicated based on the pathological staging information to improve loco-regional control. Primary radiotherapy is indicated in cases where surgery is contraindicated. Systemic treatment can either be hormone therapy or chemotherapy. Progesterons are the cornerstone of hormone therapy. Prognostic factors for response are the presence of high levels of progesterone and estrogen receptors and low grade histology. Paclitaxel is the most active single agent drug. The combination therapy with paclitaxel and carboplatin is adopted as first choice in patients with endometrial cancer because of the efficacy and low toxicity, although not proven in a randomized trial.The literature on the management of patients with advanced endometrial cancer is discussed in detail. Each stage of advanced disease is presented separately, and management recommendations are proposed, and alternative approaches are given.Ongoing clinical trials are described, and the focuses of ongoing research are mentioned.

scholarly journals HYPERPLASTIC PROCESSES OF ENDOMETRIUM IN WOMEN OF PERIMENOPAUSAL AGE: CLINICAL ASPECTS OF THE PROBLEM

2017 ◽  
Vol 4 (4) ◽  
pp. 201-207
Author(s):  
Dmitry V. Baburin ◽  
A. L Unanyan ◽  
I. S Sidorova ◽  
E. A Kudrina ◽  
A. I Ishchenko
Keyword(s):  
Risk Factors ◽  
Mathematical Model ◽  
Logistic Regression ◽  
Endometrial Cancer ◽  
Malignant Transformation ◽  
Polycystic Ovary ◽  
Treatment Plan ◽  
Significant Risk ◽  
Binary Logistic Regression ◽  
Clinical Aspects

The aim of the study is to identify the most significant clinical and anamnestic risk factors for the onset and progression of endometrial hyperplastic processes and the development of malignant transformation of endometrium in women of perimenopausal age, with taking into account their importance on the basis of statistical analysis. Methods. Based on Spearman’s correlation analysis and determination the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic and diagnostic risk factors (risk ratio (RR) in groups), there were obtained coefficients for a mathematical model allowing with the use of the binary logistic regression method predict the risk of the appearance of endometrial cancer. Results. The most clinically and statistically significant risk factors for the progression of the pathological process of the endometrium, having a high RR (greater than 1) and a confidence interval of 95% (p < 0.05), are (in the order of significance): recurrence of the endometrial hyperplastic process, obesity, the pronounced blood flow in Ultrasound with color Doppler mapping, polycystic ovary syndrome, abnormal ovarian formations, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and/or adenomyosis), hereditary predisposition to cancer development, hypertension, age of 50 years and older. Conclusion. The tactics of the management and treatment of patients with hyperplastic endometrial processes should be based on the detection of the degree of the risk of the progression of pathological processes and the development of the malignant transformation of the endometrium. The study of the individual prognosis of endometrial cancer in patients with hyperplastic endometrial processes currently is becoming increasingly important due to the need to construct a rational treatment plan of the management and performing the follow-up dispensary observation on the basis of a scientifically justified forecast. Results obtained during our work allowed us identify statistically significant risk factors for the development of endometrial cancer. There were obtained coefficients for the creation a reliable mathematical model. With the use of the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes at the perimenopausal age.

Implications of Treatment Modality on Chronic Opioid Use Following Treatment for Head and Neck Cancer

2020 ◽  
pp. 019459982096013
Author(s):  
Craig A. Bollig ◽  
Brian P. Kinealy ◽  
David R. Gilley ◽  
Andrew D. Clark ◽  
Tabitha L.I. Galloway ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Psychiatric Disorder ◽  
Head And Neck ◽  
Tobacco Use ◽  
Neck Cancer ◽  
Treatment Modality ◽  
Treatment Modalities ◽  
Opioid Use ◽  
Chronic Opioid Use

Objective To investigate the relationship between treatment modality and chronic opioid use in a large cohort of patients with head and neck cancer. Study Design Retrospective cohort study. Setting Single academic center. Methods There were 388 patients with head and neck cancer treated between January 2011 and December 2017 who met inclusion criteria. Clinical risk factors for opioid use at 3 and 6 months were determined with univariate and multivariate analyses. Results The prevalence of opioid use was 43.0% at 3 months and 33.2% at 6 months. On multivariate analysis, primary chemoradiation (odds ratio [OR], 4.04; 95% CI, 1.91-8.55) and surgery with adjuvant chemoradiation (OR, 2.39; 95% CI, 1.09-5.26) were associated with opioid use at 3 months. Additional risk factors at that time point included pretreatment opioid use (OR, 7.63; 95% CI, 4.09-14.21) and decreasing age (OR, 1.03; 95% CI, 1.01-1.06). At 6 months, primary chemoradiation (OR, 2.40; 95% CI, 1.34-4.28), pretreatment opioid use (OR, 5.86; 95% CI, 3.30-10.38), current tobacco use (OR, 2.00; 95% CI, 1.18-3.40), and psychiatric disorder (OR, 1.79; 95% CI, 1.02-3.14) were associated with opioid use. Conclusion Of the patients who receive different treatment modalities, those receiving primary chemoradiation are independently at highest risk for chronic opioid use. Other risk factors include pretreatment opioid use, tobacco use, and a psychiatric disorder. In an effort to reduce their risk of chronic opioid use, preventative strategies should be especially directed to these patients.

scholarly journals Analysis of Serum Interleukin-37 Level and Prognosis in Patients with ACS

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Canjun Liu ◽  
Yancui Cui ◽  
Dan Zhang ◽  
Xiao Tian ◽  
Hongyan Zhang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Poor Prognosis ◽  
Prognostic Value ◽  
Diagnostic Value ◽  
Good Prognosis ◽  
Control Group ◽  
Factors Affecting ◽  
Coronary Syndrome ◽  
Independent Risk Factors

Objective. To explore the level of serum interleukin-37 in patients with acute coronary syndrome (ACS) and its prognostic value. Methods. Altogether, 121 continuous ACS cases from September 2017 to June 2020 were selected as the research group (RG), and 107 healthy individuals during the same period were obtained as the control group (CG). ELISA was applied to test IL-37 in the serum of the CG and the RG. Chemiluminescence immunoassay was applied to test NT-pro BNP and hs-cTnI in each group and immune scattering turbidimetry to test hs-CRP. The correlation of IL-37 with serum NT-pro BNP, hs-cTnI, and CRP was analyzed, and the value of IL-37 in diagnosis and prognosis prediction of patients with ACS was tested. Logistic regression was applied to test the independent risk factors affecting poor prognosis of patients with ACS. Results. IL-37 was poorly expressed in patients with ACS, which had a high diagnostic value for ACS (sensitivity: 94.39%, specificity: 74.38%, and area under curve: 0.945). There was a negative correlation of IL-37 with serum NT-pro BNP, hs-cTnI, and CRP. IL-37 in patients with poor prognosis was markedly declined compared with that of patients with good prognosis, and the predicted AUC was 0.965. Logistic regression revealed that low IL-37, diabetes, high CRP, NT-pro BNP, and hs-cTnI in the blood were independent risk factors for poor prognosis in patients with ACS. Conclusion. IL-37 is low expressed in patients with ACS, which has a good diagnostic and prognostic value for ACS, and may be applied as an important marker for the prediction of patients with ACS.

scholarly journals Is prophylactic fixation preferable to active surveillance of the unaffected contralateral hip in unilateral slipped capital femoral epiphysis?- A Systematic Review

2021 ◽  
Vol 4 (1) ◽  
pp. 18-24
Author(s):  
Vishvas Shetty ◽  
◽  
Kash Akhtar ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Qualitative Analysis ◽  
Musculoskeletal Disorders ◽  
Active Surveillance ◽  
Treatment Modality ◽  
Slipped Capital Femoral Epiphysis ◽  
Initial Presentation ◽  
Treatment Modalities ◽  
Endocrine Disorders

Slipped capital femoral epiphysis is one of the commonest musculoskeletal disorders amongst children. Whilst its management is reasonable well established, the treatment of the unaffected contralateral hip is controversial. The incidence of subsequent contralateral slip has been reported to be between 19 and 63%. The two treatment modalities are prophylactic fixation at initial presentation or active surveillance and fixation on diagnoses of subsequent slip. Both approaches have their merits but there is no clear consensus. Known risk factors include age, sex, young age at initial presentation, endocrine disorders and obesity. Clinical, epidemiological and radiological predictors have been assessed retrospectively but have limited prospective accuracy. We performed a systematic review of the existing literature as per PRISMA guidelines to determine which treatment modality is more effective. Qualitative analysis of the literature also yielded interesting insights into different aspects of the management of the contralateral hip in unilateral SCFE.

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

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