scholarly journals Prognostic Factors Associated with Successful Salvage Surgery in Recurrent Oral Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1105
Author(s):  
Mateusz Szewczyk ◽  
Paweł Golusiński ◽  
Jakub Pazdrowski ◽  
Wojciech Golusiński
Keyword(s):  
Oral Cancer ◽  
Negative Impact ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Primary Resection ◽  
Margin Status ◽  
Factors Associated ◽  
Neck Disease ◽  
Surgical Salvage

Most patients with recurrent oral cancer are not eligible for salvage surgery. Among those who are candidates for surgical salvage, failure rates are high. Given the potential negative impact of salvage surgery on quality of life (QoL)—particularly in unsuccessful interventions—the decision to operate must be weighed carefully. However, the variables associated with successful surgical salvage in oral cancer have not been clearly established. In the present retrospective study, we sought to determine the factors associated with disease recurrence and successful salvage surgery. We evaluated the following parameters in patients (n = 261) treated for primary oral cancer at our institution from 2010 to 2017: age; T/N status; perineurial invasion; lymphovascular invasion; extranodal extension; and margin status. In total, 36 patients (33%) were considered eligible for salvage surgery. Four variables were significantly associated with suitability for salvage surgery: early primary T stage, no primary neck disease (N0), no positive margins in the primary resection, and no adjuvant radiotherapy following primary resection. The only variable significantly associated with improved salvage outcomes was negative margin status after the primary tumor resection, underscoring the importance of margin status on treatment outcomes. Additional studies are needed to identify other factors associated with successful salvage surgery in order to better stratify patients according to the likelihood of success, thus potentially avoiding the negative impact on QoL in patients who undergo unsuccessful surgery.

scholarly journals A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1474
Author(s):  
Stefan Grasl ◽  
Elisabeth Schmid ◽  
Gregor Heiduschka ◽  
Markus Brunner ◽  
Blažen Marijić ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Classification System ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Previous Treatment ◽  
Extent Of Resection ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Oral Nutrition

(1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.

scholarly journals Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic

2021 ◽  
Vol 18 (15) ◽  
pp. 7925
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olanrewaju Ibigbami ◽  
Maha El Tantawi ◽  
Brandon Brown ◽  
Nourhan M. Aly ◽  
...  
Keyword(s):  
Food Intake ◽  
Food Insecurity ◽  
Sex Education ◽  
Negative Impact ◽  
Poor Quality ◽  
People Living With Hiv ◽  
Daily Lives ◽  
Lower Odds ◽  
Factors Associated

An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.

scholarly journals Rectal metastasis from bladder urothelial carcinoma: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuki Ii ◽  
Shinya Munakata ◽  
Kumpei Honjo ◽  
Masaya Kawai ◽  
Shingo Kawano ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Small Areas ◽  
Metastatic Urothelial Carcinoma ◽  
Rare Site ◽  
Difficult Defecation ◽  
Carcinoma Of The Bladder ◽  
Transitional Cells ◽  
Rectal Metastasis

Abstract Background Urothelial carcinoma arises from transitional cells in the urothelial tract. In advanced cases, it can metastasize locally to surrounding organs or distally to organs such as the lungs, bones, or liver. Here we describe a case of rectal metastasis from urothelial carcinoma treated with multiple sessions of transurethral resection of bladder tumor (TURBT). Case presentation A 72-year-old woman presented to our department with abdominal bloating andobstructed defecation. She had undergone two sessions of TURBT for early urothelial carcinoma in another hospital at 64 and 65 months ago, respectively. Cystoscopy at 3 months after the second TURBT session had indicated disease recurrence, and thus, she had been referred to our hospital for further examination, followed by TURBT for the third time at 59 months ago and for the fourth time at 48 months ago; thereafter, she had been followed up with cystoscopy every 6 months without any recurrence. However, she returned to our hospital, complaining of difficult defecation. Subsequent colonoscopy demonstrated an obstructive tumor in the rectum, which was pathologically diagnosed as metastatic urothelial carcinoma of the bladder. Laparoscopic examination revealed two small areas of peritoneal dissemination in the pelvis. A sigmoid colostomy was performed without rectal tumor resection. She has been receiving chemotherapy and is still alive 10 months after surgery. Conclusions Rectal metastasis is a rare site of metastasis for urothelial carcinomas. It is important to consider the possibility of annular rectal constriction caused by infiltrating or metastasizing urothelial carcinoma when managing patients with urothelial carcinoma and with difficult defecation.

Vietnamese–Australian children’s language proficiency and use

2021 ◽  
pp. 136700692110345
Author(s):  
Van H Tran ◽  
Cen Wang ◽  
Sharynne McLeod ◽  
Sarah Verdon
Keyword(s):  
Language Proficiency ◽  
Associated Factors ◽  
English Language ◽  
Language Use ◽  
Language Ideologies ◽  
Negative Impact ◽  
Demographic Factors ◽  
Language Practices ◽  
Language Management ◽  
Factors Associated

Aim: To explore Vietnamese–Australian children’s proficiency and use of Vietnamese and English and identify associated factors that are related to demographics, language practices, language ideologies, and language management. Methodology: Vietnamese–Australian parents ( n = 151) completed a questionnaire (in English or Vietnamese) regarding their child’s language proficiency and use, demographic details and a range of factors as conceptualized by Spolsky’s language policy theory: language practices; language ideologies; and language management. Data and analysis: Bivariate analyses (Pearson’s correlation and analysis of variance) and multiple regression models were conducted to explore associations between language proficiency and use and associated factors and identify the most significant factors. Findings/conclusions: Factors associated with children’s Vietnamese language proficiency (oral/written) included: demographic factors; language practices; language ideologies; and language management. In contrast, children’s English language proficiency (oral/written) was linked to demographic factors and language practices. Children’s Vietnamese language use was not significantly correlated with demographics but rather with language practices, language ideologies, and language management. Children’s home language use and proficiency did not have a negative impact upon their English proficiency. Originality: This study is the first to consider factors associated with Vietnamese–Australian children’s language proficiency and use. Significance/implications: Demographic factors, language practices, language ideologies, and language management were associated with children’s language proficiency and use. The results can be used by parents, educators, policy-makers, speech–language pathologists and other professionals to support Vietnamese–Australian and multilingual children around the world to develop and maintain their home and majority languages.

Violence Against Women and Girls

2017 ◽  
Vol 5 (10) ◽  
pp. 153-176
Author(s):  
Josephine Muthami ◽  
Haniel Nyaga Gatumu ◽  
Sahaya G. Selvam ◽  
Wambui J.
Keyword(s):  
Violence Against Women ◽  
Emotional Abuse ◽  
Negative Impact ◽  
Peer Pressure ◽  
Coping Mechanism ◽  
Cross Sectional ◽  
Problem Solving Skills ◽  
Factors Associated ◽  
Women And Girls ◽  
The Government

The purpose of the study was to highlight the factors associated with violence against women and girls and how they can benefit from therapy. The study was guided by the following objectives: to establish the factors associated with the occurrence of violence, determining the effectiveness of therapy in dealing with survivors of violence, exploring factors influencing or blocking effectiveness of therapy. A cross sectional research design was used in which questionnaires, an interviewing guide, focus group discussion and psychological assessment scale were used to collect study data. A sample of 75 women and girls was purposively selected from health facilities, counselling centres, chief camps, police station, NGOs and CBOs within Kibra Constituency. All respondents were females aged 18 years and above. The findings showed that all the respondents (100%) had been exposed to violence. The respondents who reported physical abuse were 30%, sexual abuse was reported by 10%, psychological and emotional abuse was reported by 16%, financial coercion was reported by 15%, neglect of children and duty by 13%, and verbal assault was reported by 16%.  Further, the results showed that the most common victims of violence are expectant mothers and children who are under the care of irresponsible persons. The most reported people to perpetrate violence were cited to be men. The responses given by the respondents as factors that trigger violence are: Previous assaults (61%), cultural expectations (61%), alcohol abuse and other drugs (49%), poor communication skills (49%), poor problem solving skills (49%), perpetrator outstretched demands on resources (49%), infidelity(37%), unemployment (37%), peer pressure (37%), frustration emanating from blocked goals (24%), childlessness (24%) and  personality traits (12%). Violence against women and girls impact negatively on their lives. The most common negative impact mentioned are depression by 75 respondents, children suffering cited by 65 respondents, family disintegration cited by 56 respondents, non-productivity, physical injury, and anxiety respectively cited  by 46 respondents. The survivors of violence have knowledge of where they can access help in order to cope with the consequences of violence. Of the 75 respondents, 75 of them said that counselling is very helpful. Perseverance is another coping mechanism mentioned by 75 respondents. Separation and keeping quite are strategies mentioned by 65 respondents. Going to hospital is another support and help available mentioned by 56 respondents. The respondents who opted for spiritual intervention were 47 while those who opted to start a business for sustainability were 38. Those who preferred sharing with significant others as a coping mechanism were 28. Last but not least, 18 women indicated that support groups are helpful in dealing with violence. The study recommended that women and girls should be empowered financially and policies put into place to curb violence. The government and other stakeholders should partner to support women and girls to overcome violence in the society.

scholarly journals Prevalence and factors associated with erectile dysfunction among adult men in Moshi municipal, Tanzania: community-based study

2020 ◽  
Author(s):  
KENAN BOSCO NYALILE ◽  
Emmanuel HP Mushi ◽  
Epiphania Moshi ◽  
Beatrice J. Leyaro ◽  
Sia E Msuya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Erectile Dysfunction ◽  
Lifestyle Modification ◽  
Negative Impact ◽  
Screening Program ◽  
Community Based ◽  
Cross Sectional ◽  
Factors Associated ◽  
Adult Men

Abstract Background: Erectile dysfunction (ED) has a negative impact on ones’ relationships with poor quality of life as inevitable result. Men’s sexual health has been forgotten in most developing countries and therefore the burden of ED and associated risk factors are not known in these settings. This study aimed to determine the prevalence and factors associated with erectile dysfunction among adult men in Moshi municipality, northern Tanzania. Methodology: A community based cross-sectional study was conducted in July 2019. Multi stage sampling technique was used to enroll men aged 18 years and above infour wards of Moshi municipality. The 5-item version of the International Index of Erectile Function (IIEF-5) scale was used to assess erectile dysfunction. Multivariate logistic regression was done to get factors associated with ED. Results: The mean age of the 381 men was 39.6 (SD ±16.8) years. Theoverall prevalence of ED on this study was 29.7%. The severity of ED among study participants was 13.4 % (51), 9.7 % (37), 3.7 % (14), 2.9% (11) participants had mild, mild to moderate, moderate and severe erectile dysfunction respectively. Age, tobacco use, overweight, hypertension and diabetes all showed significance association with ED. However, in multivariate logistic analysis only age ≥40 years and hypertension remain statistically significant associated with ED [(OR 5.2, 95% CI 2.68-10.21, P<0.001), (OR 11.5, 95% CI 5.8-22.76, P<0.001) and (OR 2.5, 95% CI 1.06-5.86, P=0.035) ] respectively. Conclusion: About one in three men in Moshi municipal had ED. High prevalence of ED among hypertensive individuals suggest a need to establish ED screening program during their routine clinic for early detection and treatment. Furthermore, education should be given on lifestyle modification to prevent hypertension and diabetes in the community. The outcome will be improvement of patient’s quality of life. Key words: Erectile dysfunction, Diabetes mellitus, Hypertension, Physical activities, Prevalence, Predictors, Tanzania

scholarly journals Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Huapeng Sun ◽  
Yi Liu ◽  
Long Lv ◽  
Jingwen Li ◽  
Xiaofeng Liao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Curative Resection ◽  
Tumor Resection ◽  
Margin Status ◽  
High Expression ◽  
Duodenal Adenocarcinoma ◽  
Gastric Type ◽  
Duodenal Carcinoma

BackgroundTo evaluate the clinical risk factors that influence the overall survival in patients with duodenal adenocarcinoma (DA) after tumor resection.MethodsThis study retrospectively analyzed 188 patients who underwent tumor resection for DA between January 2005 and June 2020 at Xiangyang Central Hospital.ResultsThe median survival of the patients who underwent resectional operation was 54 months, longer than of those who underwent palliative surgery (20.8 months) (2,916.17; 95% CI, 916.3−9,280.5; p &lt; 0.001). Survival of non-ampullary duodenal carcinoma patients (50.3 months; 95% CI, 39.7−61.8) was similar to that of ampullary duodenal carcinoma patients (59.3 months; 95% CI, 38.6−66.7) but was significantly better than that of papillary adenocarcinoma patients (38.9 months; 95% CI, 29.8−54.8; p = 0.386). Those with intestinal-type ductal adenocarcinomas had a longer median overall survival than those with the gastric type (61.8 vs. 46.7 months; p &lt; 0.01) or pancreatic type (32.2 months; p &lt; 0.001). Clinical DA samples had significantly diverse expressions of ATG12, IRS2, and IGF2. Higher expressions of the ATG12 and IRS2 proteins were significantly correlated with worse survival. Multivariate Cox regression analysis revealed that lymph node metastasis (hazard ratio (HR), 6.44; 95% CI, 3.68−11.27; p &lt; 0.0001), margin status (HR, 4.94; 95% CI, 2.85−8.54; p &lt; 0.0001), and high expression of ATG12 (HR, 1.89; 95% CI, 1.17−3.06; p = 0.0099) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups with ampullary, non-ampullary, and papillary adenocarcinomas treated with adjuvant chemotherapy (p = 0.973).ConclusionGastric/pancreatic type, high expression of ATG12, lymph node metastases, and margin status were negative prognosticators of survival in patients with DAs than in those with tumor anatomical location. Curative resection is the best treatment option for appropriate patients.

Factors associated with delay in presentation among patients for oral cancer

2019 ◽  
Vol 8 (12) ◽  
pp. 1003-1071
Author(s):  
Xinyan Zhang ◽  
Dongling Liu ◽  
Hongmei Dong ◽  
Yuxiang Li ◽  
Ye Zhang ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Cancer Patients ◽  
Lower Risk ◽  
Cross Sectional Study ◽  
Cancer Knowledge ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing ◽  
Oral Cancer Patients

Aim: This study aimed to determine factors that influence delay in presentation among oral cancer patients. Materials & methods: A cross-sectional study with 128 Oral cancer patients receiving treatment from the Hospital of Stomatology, at Jilin University, in China, was conducted. Results: A total of 78 patients delayed seeking treatment for more than 3 weeks after noticing symptoms of oral anomaly. Patients who were male, farmers (Odds ratio [OR] = 2.617; 95% CI: 1.90–3.64), or currently smoking (OR = 4.651; 95% CI: 1.21–9.46), were more likely to delay. Patients alerted to the problem at a physical exam had much lower risk of delay than patients who discovered the disease independently (OR = 0.029; 95% CI: 0.01–0.30). Higher coping style scores (OR = 0.747; 95% CI: 0.47–1.18) and oral cancer knowledge scores (OR = 0.886; 95% CI: 0.60–2.01) were significantly correlated with shorter delays. Conclusion: Delay in presentation may be achieved through regular oral health screening and improved public education about factors influencing delay.

Sign in / Sign up

Export Citation Format

Share Document