scholarly journals Sex differences in disease presentation, surgical and oncological outcome of liver resection for primary and metastatic liver tumors—A retrospective multicenter study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243539
Author(s):  
Eva Braunwarth ◽  
Benedikt Rumpf ◽  
Florian Primavesi ◽  
David Pereyra ◽  
Margarethe Hochleitner ◽  
...  
Keyword(s):  
Overall Survival ◽  
Sex Differences ◽  
Liver Tumors ◽  
Univariate Analysis ◽  
Oncological Outcome ◽  
Long Term Outcome ◽  
Entire Cohort ◽  
The Impact ◽  
Disease Free

Background Sex differences are becoming of rising interest in many fields of medicine. It remains unknown whether sex has a role in postoperative and long-term outcome after hepatic resection (HR). The aim of this study was to investigate sex differences in disease presentation, surgical and oncological outcome after curative HR. Methods Retrospective analysis of 1010 patients who underwent HR between 2005 and 2018 at two tertiary hospitals in Austria. Demographics and survival data were obtained from a prospectively maintained database. Univariate analysis was used to identify sex differences for the entire cohort and for sub-cohorts. Disease-free- and overall survival was assessed by the Kaplan-Meier estimate and results were compared by log-rank tests. Results 436 females and 574 males were analyzed. Women were younger (p<0.001), had less liver cirrhosis (p<0.001), cardiac comorbidities (p<0.001), diabetes (28 (p<0.001) and obesity (p<0.001). Type of HR and surgical management did not vary by sex. Ninety-day morbidity (p = 0.179) and -mortality (p = 0.888) were comparable. In patients with malignant disease, no differences in disease-free- and overall survival was observed, neither for the entire cohort nor for the subgroups according to tumor entity or type of resection. Only in HCC patients, females showed an inferior OS (p = 0.029). Conclusion This study delivers new insights on the impact of sex differences in liver surgery. Despite the fact that male patients have a higher incidence of preoperative morbidities, we did not observe specific disparities in terms of immediate postoperative as well as long term oncological outcome between sexes.

Growth rate and site of pulmonary metastasis to predict lung relapse and overall survival in patients affected by bone and soft tissue sarcomas (B-STS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11571-11571
Author(s):  
Lorenzo D'ambrosio ◽  
Francesco Tolomeo ◽  
Maria Cristina Bruna ◽  
Sandra Aliberti ◽  
Alessandra Merlini ◽  
...  
Keyword(s):  
Growth Rate ◽  
Overall Survival ◽  
Univariate Analysis ◽  
External Validation ◽  
Anatomical Site ◽  
Tumor Doubling Time ◽  
Nodule Number ◽  
The Impact ◽  
Disease Free ◽  
Pleural Involvement

11571 Background: Despite surgically resectable pulmonary metastases may lead to cure patients with B-STS (Chudgar NP 2017), a substantial proportion of patients will eventually relapse. Presently, patient selection is based on unique organ involvement, number of metastases, interval between previous surgery and pulmonary progression or relapse. We assessed the impact of anatomical site of metastasis into the lung (as if the pleural site might ease further tumor spreading) and nodule growth rate as additional predictive/prognostic factors of lung progression-free survival (L-PFS) and overall survival (OS). Methods: In our prospectively collected database, we retrospectively evaluated patients operated for B-STS pulmonary progression at 3 different centers from 2005 to 2019. Beyond patients’ clinical features at both baseline and disease progression in the lungs, we focused on whether the relapse occurred into the parenchyma or nearby the pleura (Welter S 2012); secondly, we estimated lung metastasis growth rate, defined as tumor doubling time (TDT) (Nakamura T 2011). Statistical analyses were carried out with IBM SPSS (v. 20.0). Survival outcomes were estimated by Kaplan-Meier method. Hazard ratios (HR) were estimated by Cox regression. Multivariate analysis was performed for both L-PFS and OS according to Cox proportional hazard model. All tests were 2-sided with their corresponding 95% confidence intervals (CI95%). Results: We identified 138 patients who underwent lung metastasectomy [(F=66 (48%); median age at surgery 50 (14-78)]. Median PFS and L-PFS were 8.7 months (CI95% 6.6-10.9) and 8.6 months (CI95% 6.2-11.0), respectively. Median OS was 40.6 months (CI 95% 32.8-48.5). Univariate analysis showed a statistically significant impact of the following variables for both L-PFS and OS: ECOG 0, nodule number <3, being disease-free after first-line treatment, no pleural involvement, and TDT >40 days. Disease-free interval ≤ 24 months and absence of metastases at diagnosis showed significant correlation with L-PFS and OS, respectively. At multivariate analyses the following variables retained statistical significance for L-PFS: TDT >40 days (HR 0.53, CI95% 0.31-0.93, p=0.028); nodule number <3 (HR 0.54, 95%CI 0.29-0.99, p=0.048), no pleural involvement (HR 0.39, CI95% 0.22-0.70, p=0.001); and for OS: TDT >40 days (HR 0.36, CI95% 0.18-0.72, p=0.004), nodule number <3 (HR 0.35, 95%CI 0.18-0.71, p=0.004), no pleural involvement (HR 0.49, CI95% 0.24-0.98, p=0.045), and ECOG 0 (HR 0.29, 95%CI 0.14-0.59, p=0.001). Conclusions: Acknowledging its retrospective nature and the need for an external validation, our series highlights the key-role of the anatomical site of relapse within the lung and the impact of tumor growth rate. If confirmed, these two clinical parameters should be factored in the decision making on performing pulmonary metastasectomy.

Early Mortality of Newly Diagnosed Adult Acute Promyelocytic Leukemia Treated with the AIDA Protocol.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4617-4617
Author(s):  
George Gortzolidis ◽  
Athanasios Zomas ◽  
Theodore Marinakis ◽  
Evridiki Michalis ◽  
Athanasios Galanopoulos ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Early Mortality ◽  
Induction Phase ◽  
Molecular Remission ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

Abstract APL represents a particular subtype of acute myeloid leukemia with characteristic clinical features, as well as specific immunophenotypic, cytogenetic and molecular findings owing to the chromosomal translocation t(15;17). Anthracycline-based chemotherapy and All-Trans Retinoid Acid (ATRA) became the cornerstone of APL treatment by improving significantly the long term outcome of patients, even though there is some controversy regarding the impact of this combination on the mortality of the induction phase. Herein, we analysed retrospectively the outcome of 16 consecutive adult APL patients who were diagnosed and treated in our Unit from 12/1998 to 10/2004. The analysis focuses more on the parameters of treatment-related mortality, cause of death and disease-free survival post AIDA chemotherapy. All patients were suffering from the classical form of APL and were homogeneously treated as follows: induction consisted of ATRA p.o. and idarubicin i.v. at conventional doses of 45mg/m2/d, from D1 to CR and 12mg/m2/d, D2,4,6,8 (total of 4 infusions), respectively. Dose modifications for elderly individuals were not allowed. Complete remitters were consolidated with 3 courses of chemotherapy without ATRA, where as non-remitters were taken off protocol and received other therapy. Patients in continuing hematological and molecular remission at the end of consolidation were administered maintenance therapy for 2 years with oral 6-MP at 90mg/m2/d, oral MTX weekly at 15mg/m2 and ATRA for 15 days every 3 months. In all cases, the morphological diagnosis of APL was confirmed by chromosome and immunophenotypic analysis of blasts in addition to molecular studies. The median age of our cohort was 55 years (range 31–78) and the male/female ratio was 12/4. Three patients (3/16, 19%) were ≥ 65 years at diagnosis. Two cases (2/16, 12%) presented with a leukocyte count of ≥10 x 103/mm3 while the median Wbc at presentation was 6.5 x 103/mm3. All cases had either clinical (haemorrhagic) or laboratory evidence of disseminated intravascular coagulation. Six patients (6/16, 37%) deceased during the induction phase from pulmonary bleeding (2 cases,days 8 and 13 respectively), intracerebral bleeding (1 case,day 6), myocardial infarction-cardiac arrest (1 case,day 5), respiratory distress syndrome secondary to ATRA syndrome (1 case, day 17), and sepsis-induced hemophagocytosis syndrome (1 case, day 38). All ten out of the 16 (63%) surviving patients achieved hematological and molecular CR and remain to date relapse-free in excellent clinical condition. The median overall survival and disease-free survival for the whole group is 25 months but the same parameters for the surviving patients is better at 42 months. Our results corroborate that in APL the AIDA protocol together with maintenance treatment is highly effective in producing sustained haematological and molecular remission. Despite this excellent antileukaemic activity, early mortality (37% in our cohort) caused chiefly by fatal bleeding and thrombotic events (four patients) limits considerably patient survival and deserves further research in order to improve long-term outcome.

scholarly journals RTHP-33. A SINGLE INSTITUTION RETROSPECTIVE ANALYSIS ON SURVIVAL BASED ON TREATMENT PARADIGMS FOR PATIENTS WITH ANAPLASTIC OLIGODENDROGLIOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi216-vi217
Author(s):  
Jacob Young ◽  
Yalan Zhang ◽  
Annette Molinaro ◽  
Jennie Taylor ◽  
Jennifer Clarke ◽  
...  
Keyword(s):  
Overall Survival ◽  
Surgical Resection ◽  
Univariate Analysis ◽  
Anaplastic Oligodendroglioma ◽  
Radiation Toxicity ◽  
Single Institution ◽  
Current Standard ◽  
Entire Cohort ◽  
Significant Difference

Abstract Anaplastic oligodendrogliomas are a type of high grade glioma defined molecularly by the 1p19q co-deletion. Currently, there is no curative therapy, and some studies have estimated median survival is estimated to be approximately 5 years. Current standard of care includes surgical resection followed by radiation and chemotherapy. However, the benefit of up-front radiation with chemotherapy compared to chemotherapy alone following surgical resection has not been shown in a randomized control trial. Given the long-term cognitive consequences of radiation therapy and the high percentage of patients who lives beyond 15 years with AO, there is an effort to balance longevity with radiation toxicity. As such we performed a retrospective single institution analysis of survival of patients with anaplastic oligodendroglioma over 20 years. 159 patients were identified as diagnosed with an anaplastic oligodendroglioma between 1996–2016. Of those, 57 patients were found to have anaplastic olidodendroglioma at original diagnosis and had long term follow-up. Sixty-six percent of patients were between the ages of 30–50 and mean KPS was 87.3. At the time of analysis, 33% of patients had died. In this cohort, 60% of patients were initially treated with radiation and chemotherapy (either temozolomide or CCNU) at diagnosis and 40% were treated with chemotherapy alone. Median overall survival for the entire cohort was 142 months. The related risk of progression in the upfront chemotherapy only group is approximately 5.87 times higher than the patients who received radiation and chemotherapy (Hazard ratio=5.87, 1.92–17.90, p=0.002). However, there was no significant difference in overall survival in patients treated with upfront chemotherapy compared to patients treated upfront with chemotherapy and radiation (p=0.14). On univariate analysis, there was no association between age, KPS, EOR, or upfront vs. delayed radiation and survival. As such initial treatment with chemotherapy alone may be an option for some patients with anaplastic oligodendroglioma.

P159 THE IMPACT OF POSTOPERATIVE COMPLICATIONS ON LONG-TERM SURVIVAL AND DISEASE RECURRENCE FOLLOWING OESOPHAGO-GASTRIC CANCER RESECTION

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
J H Saunders ◽  
F Yanni ◽  
M S Dorrington ◽  
C R Bowman ◽  
R S Vohra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Postoperative Complications ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival ◽  
The Impact ◽  
Disease Free

Abstract Aim Postoperative complications following the resection of oesophago-gastric carcinoma can result in considerable early morbidity and mortality, however the long-term effects are less clear. Literature reports are mixed, so it remains unclear if complications reduce survival, as has been demonstrated in colorectal cancer. Background & Methods Some 1100 patients who underwent oesophago-gastric resection between 2006-16 were stratified by complication severity to determine the effect of leak and severe non-leak related complications on overall survival, recurrence and disease free survival. Results The median age was 69 years, 48% had stage III disease, with cancer recurrence in 39%. Clavien-Dindo (CD) complications ≥ III occurred in 22.2% of patients. The most common complications were pulmonary (30%), with a 13% incidence of pneumonia, 10% atrial dysrhythmia and 9.6% anastomotic leak. In comparison to CD 0-I complication free patients, those with CD III-IV leak did not suffer a significantly reduced survival. However patients with CD III-IV non-leak related complications were associated with a significant reduction in median overall survival (19.7 vs. 42.7 months) and disease free survival (18.4 vs. 36.4 months). Cox regression revealed age, stage, resection margin, and CD III-IV non-leak complications as independently associated with poor overall and disease free survival. Conclusion This cohort demonstrates that whilst leak does not affect long-term survival, other severe postoperative complications do significantly reduce overall survival and disease recurrence. A reduction in these complications, such as pneumonia, seen with adoption of hybrid / minimally invasive surgery may help change this pattern of disease recurrence and reduced survival.

scholarly journals Prospective Evaluation of Sarcopenia in Head and Neck Cancer Patients Treated with Radiotherapy or Radiochemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 753
Author(s):  
Sébastien Thureau ◽  
Lucie Lebret ◽  
Justine Lequesne ◽  
Marine Cabourg ◽  
Simon Dandoy ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck ◽  
Squamous Cell ◽  
Nutritional Support ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Curative Intent ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

Highlights: Sarcopenia is frequent in patients treated with radiation therapy (RT) or radiochemotherapy (RTCT) for head and neck squamous cell carcinomas. Sarcopenia is associated with poor disease-free survival and overall survival outcomes. Sarcopenia is not associated with a higher rate of treatment-related toxicity. Background: Sarcopenia occurs frequently with the diagnosis of head and neck squamous cell carcinoma (HNSCC). We aimed to assess the impact of sarcopenia on survival among HNSCC patients treated with radiotherapy (RT) or radiochemotherapy (RTCT). Methods: Patients treated between 2014 and 2018 by RT or RTCT with curative intent were prospectively included (NCT02900963). Optimal nutritional support follow-up, including weekly consultation with a dietician and an oncologist and daily weight monitoring, was performed. Sarcopenia was determined by measuring the skeletal muscles at the L3 vertebra on the planning CT scan for radiotherapy. For each treatment group (RT or RTCT), we assessed the prognostic value of sarcopenia for disease-free survival (DFS) and overall survival (OS) and its impact on treatment-related toxicity. Results: Two hundred forty-three HNSCC patients were included: 116 were treated by RT and 127 were treated by RTCT. Before radiotherapy, eight (3.3%) patients were considered malnourished according to albumin, whereas 88 (36.7%) patients were sarcopenic. Overall, sarcopenia was associated with OS and DFS in a multivariate analysis (HR 1.9 [1.1–3.25] and 1.7 [1.06–2.71], respectively). It was similar for patients treated with RT (HR 2.49 [1.26–4.9] for DFS and 2.24 [1.03–4.86] for OS), whereas for patients treated with RTCT sarcopenia was significantly associated with OS and DFS in univariate analysis only. Sarcopenia was not related to higher treatment-related toxicity. Conclusions: Pretherapeutic sarcopenia remains frequent and predicts OS and DFS for non-frail patients treated with curative intent and adequate nutritional support.

scholarly journals Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients

Blood ◽  
2011 ◽  
Vol 117 (11) ◽  
pp. 3025-3031 ◽  
Author(s):  
Francesca Gay ◽  
Alessandra Larocca ◽  
Pierre Wijermans ◽  
Federica Cavallo ◽  
Davide Rossi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Progression Free Survival ◽  
Complete Response ◽  
Hazard Ratio ◽  
Novel Agents ◽  
Maximal Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact

AbstractComplete response (CR) was an uncommon event in elderly myeloma patients until novel agents were combined with standard oral melphalan-prednisone. This analysis assesses the impact of treatment response on progression-free survival (PFS) and overall survival (OS). We retrospectively analyzed 1175 newly diagnosed myeloma patients, enrolled in 3 multicenter trials, treated with melphalan-prednisone alone (n = 332), melphalan-prednisone-thalidomide (n = 332), melphalan-prednisone-bortezomib (n = 257), or melphalan-prednisone-bortezomib-thalidomide (n = 254). After a median follow-up of 29 months, the 3-year PFS and OS were 67% and 27% (hazard ratio = 0.16; P < .001), and 91% and 70% (hazard ratio = 0.15; P < .001) in patients who obtained CR and in those who achieved very good partial response, respectively. Similar results were observed in patients older than 75 years. Multivariate analysis confirmed that the achievement of CR was an independent predictor of longer PFS and OS, regardless of age, International Staging System stage, and treatment. These findings highlight a significant association between the achievement of CR and long-term outcome, and support the use of novel agents to achieve maximal response in elderly patients, including those more than 75 years. This trial was registered at www.clinicaltrials.gov as #NCT00232934, #ISRCTN 90692740, and #NCT01063179.

Does 30-Day Readmission Affect Long-term Outcome Among Glioblastoma Patients?

Neurosurgery ◽  
2013 ◽  
Vol 74 (2) ◽  
pp. 196-205 ◽  
Author(s):  
Miriam Nuño ◽  
Diana Ly ◽  
Alicia Ortega ◽  
J.Manuel Sarmiento ◽  
Debraj Mukherjee ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hazard Ratio ◽  
Newly Diagnosed ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Newly Diagnosed Glioblastoma ◽  
Index Hospital ◽  
Medicare Database ◽  
The Impact

Abstract BACKGROUND: Research on readmissions has focused mainly on the economic and resource burden it places on hospitals. OBJECTIVE: To evaluate the effect of 30-day readmission on overall survival among newly diagnosed glioblastoma multiforme (GBM) patients. METHODS: A nationwide cohort of GBM patients diagnosed between 1991 and 2007 was studied using the Surveillance, Epidemiology and End Results Medicare database. Multivariate models were used to determine factors associated with readmission and overall survival. Odds ratio, hazard ratio, 95% confidence interval, and P values were reported. Complete case and multiple imputation analyses were performed. RESULTS: Among the 2774 newly diagnosed GBM patients undergoing surgery at 442 hospitals nationwide, 437 (15.8%) were readmitted within 30 days of the index hospitalization. Although 63% of readmitted patients returned to the index hospital where surgery was performed, a significant portion (37%) were readmitted to nonindex hospitals. The median overall survival for readmitted patients (6.0 months) was significantly shorter than for nonreadmitted (7.6 months; P &lt; .001). In a confounder-adjusted imputed model, 30-day readmission increased the hazard of mortality by 30% (hazard ratio, 1.3; P &lt; .001). Neurological symptoms (30.2%), thromboembolic complications (19.7%), and infections (17.6%) were the leading reasons for readmission. CONCLUSION: Prior studies that have reported only the readmissions back to index hospitals are likely underestimating the true 30-day readmission rate. GBM patients who were readmitted within 30 days had significantly shorter survival than nonreadmitted patients. Future studies that attempt to decrease readmissions and evaluate the impact of reducing readmissions on patient outcomes are needed.

GAMBARAN PENGETAHUAN SISWA TENTANG PERILAKU SEKS BEBAS DI SMA/SMK KOTA LUBUKLINGGAU TAHUN 2016

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Rini Mayasari Rini Mayasari
Keyword(s):  
High School ◽  
Univariate Analysis ◽  
Good Knowledge ◽  
Sex Behavior ◽  
School Class ◽  
Sufficient Knowledge ◽  
High School Class ◽  
Study Population ◽  
The Impact ◽  
Disease Free

ABSTRACT   Free sex is a relationship that is done by men and women without matrimony. Various forms of sexual behavior, such as intimate dating, courtship, to have sexual contact. Factors associated with sex behavior among others, is the lack of knowledge about free sex, free sex impact, forms of promiscuity, perversion LGBT, and disease-free sex. This study design is the technique of sampling using quantitative indirectly using a questionnaire tools shaped questionnaires. Be knew overview of students' knowledge about sex in high school / vocational Lubuk Linggau Year 2016. The study population was high school class XII students in schools in the city Lubuklingga 2016. The sample in this study is the high school class XII students in 9 schools there in Lubuklinggau of 167 people. Results of univariate analysis showed respondent knowledge about free sex amounted to 48 people (28,74%), students with sufficient knowledge of 54 people (32,33%), and students with less knowledge of 65 people (38, 93%). Students with a good knowledge about the impact of free sex amounted to 57 (34,13%), students with sufficient knowledge of 69 people (41,31%), and students with less knowledge 41 (24,56%). Students with a good knowledge about the form of free sex amounted to 58 students (34,73%), students with sufficient knowledge totaled 49 peoples (29,34%), and students with less knowledge of 60 people (35,93%). Students with a good knowledge about LGBT amounted to 54 (32,34%), students with sufficient knowledge amounted to 68 peoples (40.71%), and students with less knowledge amounted 45 peoples (26,95%). Students with a good knowledge about the disease free sex amounted to 22 peoples (13,17%), students with sufficient knowledge of 39 peoples (23,35%), and students with less knowledge amounted to 106 peoples (63,48%).     ABSTRAK   Seks bebas merupakan hubungan yang dilakukan oleh laki-laki dan perempuan tanpa adanya ikatan perkawinan. Berbagai bentuk tingkah laku seksual, seperti berkencan intim, bercumbu, sampai melakukan kontak seksual. Faktor-faktor yang berhubungan dengan perilaku seks bebas antara lain adalah kurangnya pengetahuan tentang seks bebas, dampak seks bebas, bentuk-bentuk seks bebas, penyimpangan LGBT, dan penyakit seks bebas. Desain penelitian ini adalah teknik pengambilan sampel menggunakan teknik kuantitatif yaitu secara tidak langsung menggunakan alat bantu angket berbentuk kuisener. Di ketahuinya gambaran pengetahuan siswa tentang seks bebas di SMA/SMK Kota Lubuk Linggau Tahun 2016. Populasi penelitian ini adalah siswa kelas XII SMA di sekolah yang ada di Kota Lubuklingga tahun 2016. Sampel pada penelitian ini adalah siswa kelas XII SMA di 9 sekolah yang ada di Kota Lubuklinggau yang berjumlah 167 orang. Hasil analisis univariat menunjukan respondent pengetahuan tentang seks bebas berjumlah 48 orang (28,74%), siswa dengan pengetahuan cukup 54 orang (32,33%), dan siswa dengan pengetahuan kurang 65 orang (38,93%). Siswa dengan pengetahuan baik tentang dampak perilaku seks bebas berjumlah 57 orang (34,13%), siswa dengan pengetahuan cukup 69 orang (41,31%), dan siswa dengan pengetahuan kurang 41 orang (24, 56%). Siswa dengan pengetahuan baik tentang bentuk perilaku seks bebas  berjumlah 58 siswa (34,73%), siswa dengan pengetahuan cukup  berjumlah 49orang (29,34%), dan siswa dengan pengetahuan kurang berjumlah 60 orang  (35,93%). Siswa dengan  pengetahuan baik tentang LGBT berjumlah 54 orang (32,34%), siswa dengan pengetahuan cukup berjumlah 68 orang (40,71%), dan siswa dengan  pengetahuan kurang berjumlah 45orang (26,95%). Siswa dengan pengetahuan baik tentang penyakit seks bebas berjumlah 22 orang (13,17%), siswa dengan pengetahuan cukup 39 orang (23,35%), dan siswa dengan pengetahuan kurang berjumlah 106 orang (63,48%).  

scholarly journals A Positive Dermcidin Expression Is an Unfavorable Prognostic Marker for Extramammary Paget’s Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1086
Author(s):  
Shun Ohmori ◽  
Yu Sawada ◽  
Natsuko Saito-Sasaki ◽  
Sayaka Sato ◽  
Yoko Minokawa ◽  
...  
Keyword(s):  
Overall Survival ◽  
Therapeutic Option ◽  
Univariate Analysis ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Positive Staining ◽  
Extramammary Paget’S Disease ◽  
Potential Biomarker ◽  
The Impact ◽  
Extramammary Paget's Disease

Extramammary Paget’s disease is recognized as an apocrine-origin cutaneous tumor and is localized in the intraepithelial skin lesion. However, its advanced form is intractable, and there is currently no therapeutic option with a satisfactory level of clinical outcome. Therefore, it is of great importance to identify a potential biomarker to estimate tumor advancement in extramammary Paget’s disease. Dermcidin is an antimicrobial peptide derived from the eccrine gland and is identified as a biomarker in various malignancies. To investigate the potential of dermcidin in extramammary Paget’s disease, we investigated dermcidin expression in tumors using the immunostaining technique. Although previous studies have reported that extramammary Paget’s disease has no positive staining against dermcidin, 14 out of 60 patients showed positive staining of dermcidin in our study. To clarify the characteristics of positive dermcidin in extramammary Paget’s disease, we investigated the clinical characteristics of positive dermcidin extramammary Paget’s disease patients. Positive dermcidin patients showed a significantly high frequency of lymph node metastasis. We next investigated the impact of positive dermcidin on overall survival. Univariate analysis identified that positive dermcidin showed a significantly increased hazard ratio in overall survival, suggesting that dermcidin might be a prognostic factor for extramammary Paget’s disease.

scholarly journals Predictors of Postoperative Seizure Recurrence: A Longitudinal Study of Temporal and Extratemporal Resections

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hai Chen ◽  
Pradeep N. Modur ◽  
Niravkumar Barot ◽  
Paul C. Van Ness ◽  
Mark A. Agostini ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Intractable Epilepsy ◽  
Seizure Recurrence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Longitudinal Outcome ◽  
Ictal Eeg ◽  
Multiple Variables ◽  
Postoperative Seizure

Objective. We investigated the longitudinal outcome of resective epilepsy surgery to identify the predictors of seizure recurrence. Materials and Methods. We retrospectively analyzed patients who underwent resections for intractable epilepsy over a period of 7 years. Multiple variables were investigated as potential predictors of seizure recurrence. The time to first postoperative seizure was evaluated using survival analysis and univariate analysis at annual intervals. Results. Among 70 patients, 54 (77%) had temporal and 16 (23%) had extratemporal resections. At last follow-up (mean 48 months; range 24–87 months), the outcome was Engel class I in 84% (n=59) of patients. Seizure recurrence followed two patterns: recurrence was “early” (within 2 years) in 82% of patients, of whom 83% continued to have seizures despite optimum medical therapy; recurrence was “late” (after 2 years) in 18%, of whom 25% continued to have seizures subsequently. Among the variables of interest, only resection site and ictal EEG remained as independent predictors of seizure recurrence over the long term (p<0.05). Extratemporal resection and discordance between ictal EEG and resection area were associated with 4.2-fold and 5.6-fold higher risk of seizure recurrence, respectively. Conclusions. Extratemporal epilepsy and uncertainty in ictal EEG localization are independent predictors of unfavorable outcome. Seizure recurrence within two years of surgery indicates poor long-term outcome.

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