Synovial sarcoma disease characteristics and primary tumor sites differ between patient age groups: a report of the Cooperative Weichteilsarkom Studiengruppe (CWS)

2020 ◽  
Vol 146 (4) ◽  
pp. 953-960 ◽  
Author(s):  
Monika Scheer ◽  
◽  
Bernd Blank ◽  
Sebastian Bauer ◽  
Christian Vokuhl ◽  
...  
2021 ◽  
Vol 10 (12) ◽  
pp. 2685
Author(s):  
Andre J. Burnham ◽  
Phillip A. Burnham ◽  
Edwin M. Horwitz

Olfactory neuroblastoma (ONB) is a rare neuroepithelial-derived malignancy that usually presents in the nasal cavity. The rarity of ONB has led to conflicting reports regarding associations of patient age and ONB survival and outcome. Moreover, long-term outcomes of chemotherapy and other treatment modalities are speculated. Here, we aimed to compare survival outcomes across age groups through time and determine associations between treatment modality and survival. In this retrospective population-based study, we analyzed the SEER 2000–2016 Database for patients with ONB tumors. Using Kaplan–Meier survival analysis, a significant effect of age and cancer-specific survival (CSS) was observed; geriatric ONB patients had the lowest CSS overall. Generalized linear models and survival analyses demonstrated that CSS of the pediatric patient population was similar to the geriatric group through 100 months but plateaued thereafter and was the highest of all age groups. Radiation and surgery were associated with increased CSS, while chemotherapy was associated with decreased CSS. GLM results showed that tumor grade, stage and lymph node involvement had no CSS associations with age or treatment modality. Our results provide insight for future investigations of long-term outcomes associated with ONB patient age and treatment modality, and we conclude that survival statistics of ONB patients should be analyzed in terms of trends through time rather than fixed in time.


Author(s):  
Cenikli U ◽  
◽  
Bir LS ◽  
Degirmenci E ◽  
Ardıç FN ◽  
...  

Background: Essential Tremor (ET) is the most common movement disorder, yet the location of the primary disease substrate continues to be a matter of debate. In this study, we aimed to evaluate ocular movement abnormalities with Electrooculography (EOG) in patients with ET to find a possible location of disease pathology. Methods: Electrooculographic evaluation including saccade, tracking, optokinetic, gaze and positional tests were performed to 36 ET patients and 36 healthy subjects. Patient age on the onset of the tremor, duration of the disease, characteristics and the location of the tremor were also investigated. Fahn- Tolosa-Marin tremor rating scale was used to determine the tremor severity. Differences of abnormal test results between patient and control groups were analysed with Pearson’s and Fisher’s Exact and correlation analyses of EOG tests and clinical data were performed with Spearman’s and Pearson’s correlation tests. Results: There was not any significant difference in EOG tests between the ET patients and controls. Significant correlation was only found between EOG abnormality and patient age in correlation analyses. Conclusions: Our results showed that ET patients may not have specific EOG test abnormalities. These tests would be used especially in the different diagnosis of other movement disorders.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anthony Fryer ◽  
Sarah Hancock ◽  
Cherian George ◽  
Basil George Issa ◽  
Simon Lea ◽  
...  

Abstract It is estimated that the prevalence of adrenal incidentaloma increases with age: ~3% of those aged 50 years, rising to 10% in those >70 years (1). Given the aging population together with increased utilisation of cross-sectional imaging in the UK (eg CT urogram, MR angiogram), we explored the proportion of patients with adrenal incidentaloma by age based on current imaging trends. Furthermore, there is no information currently available on the relationship between age and pattern of endocrine referrals. We extracted data for all CT and MRI scans from Jan 2018-Oct 2019 and used key phrases in radiology reports (eg adrenal adenoma/lesion/mass/nodule/incidentaloma, incidental adrenal, indeterminate adrenal) to identify potential lesions. We also extracted data on patient age and referral patterns as identified by a logged referral or an attendance (new or follow-up) to endocrine clinic 3 months post index scan, stratified by 10 year age groups. Where possible, we excluded false hits (eg no adrenal lesion). Preliminary data showed that, of the 2604 potential lesions identified by CT and MRI scans, 78.7% were on patients aged over 60 years. The numbers of identified lesions gradually increased with age to a peak in the 71-80 year age group after which these declined. Whilst patients younger that 60 years had fewer potential lesions identified, they were more likely to be referred to endocrine services (73 out of 55 patients; 13.2%) than those in the older age group (168 out of 2049; 8.2%; p<0.001). Indeed there was a statistically significant trend towards decreasing referral with age group (Chi-squared test for trend; p<0.001). In conclusion, patients over 60 years have a higher number of potential adrenal incidentalomas. However, this group is less likely to be referred for endocrine evaluation. This is particularly concerning given the large number of scans requested and the higher prevalence of incidentalomas in this age group. This study represents preparatory work on innovations to enhance case detection, particularly in the older age groups (2). 1. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline. Eur J Endocrinol. 2016;175:G1-G34 2. Hanna FWF, Issa BG, Lea SC, George C, Golash A, Firn M, Ogunmekan S, Maddock E, Sim J, Xydopoulos G, Fordham R, Fryer AA. Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness. BMJ Open Quality. 2019;In press.


Author(s):  
Babak Alikhani ◽  
Bennet Hensen ◽  
Arne Grosser ◽  
Maria Inés Cartes Febrero ◽  
Markus von Bestenbostel ◽  
...  

Purpose To assess digital patient briefing as an alternative to conventional paper documentation. Materials and Methods 502 patients with a planned computed tomography (CT) examination were selected for digital patient briefing using the E-ConsentPro software from Thieme Compliance on an iPad by Apple (Cupertino, California, USA). For the analysis, three age groups were formed. The time required for the patient briefing, the number of open questions as well as the time needed for discussion with physicians were determined. Student’s t-test was performed to assess statistical significance. Results There was no significant difference between patient age and briefing time which was about 20 minutes on average. The number of open or unclear questions increased with patient age. While patients younger than 30 years of age had about 2 open questions, patients over 30 and 60 years had about 4 and 5 questions, respectively. The total time needed for discussion with physicians was less than 2 minutes on average. A significant difference in the time required for discussion with physicians could not be observed between the individual age groups. Conclusion Tablet-based digital briefing allows the storage of patient documents with reasonable time and effort. Furthermore, it minimizes the risk of data loss. Key Points  Citation Format


Diabetes Care ◽  
2014 ◽  
Vol 37 (5) ◽  
pp. 1312-1320 ◽  
Author(s):  
Sieta T. de Vries ◽  
Jaco Voorham ◽  
Flora M. Haaijer-Ruskamp ◽  
Petra Denig

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2531-2531 ◽  
Author(s):  
Friederike Schneider ◽  
Eva Hoster ◽  
Michael Unterhalt ◽  
Stephanie Schneider ◽  
Annika Dufour ◽  
...  

Abstract Background: Long-term survival in NK-AML is influenced by different clinical and molecular markers. Whereas the presence of a NPM-1 mutation is associated with a positive prognostic effect on long-term outcome, the presence of a FLT3-ITD mutation has a negative impact on survival. Interestingly, a significant interaction between NPM-1 and FLT3-ITD mutations has been shown. The positive prognostic impact on clinical outcome was evident predominantly in patients with NK-AML carrying NPM1 gene mutations when FLT3-internal tandem duplications (ITD) were absent. In contrast, the survival in all other groups of NPM-1 and FLT3-ITD combinations was not different so far. A clinical parameter with negative impact on all outcome parameters (OS, EFS, RFS, CR) is patient age at diagnosis. Certainly the worse prognosis in elderly patients is due to adverse patient characteristics and comorbidities. Nevertheless also disease-associated parameters reveal differences between older and younger patients with AML. Therefore we investigated the frequencies of NPM-1/FLT3-ITD mutations in different age groups. Patients and methods: Analyses were based on 803 patients with NK-AML included in the AMLCG (German AML Cooperative Group) 2000 trial until 01/2006. Patient age ranged from 17 to 85 years (median: 60 yrs). Information about the mutation status of NPM-1 and FLT3-ITD mutations at diagnosis was available in 689 patients. Patients were divided into six age groups (1: 17–30yrs; 2: 31–40yrs; 3: 41–50yrs; 4: 51–60yrs; 5: 61–70yrs; 6: 71–85yrs). The incidence of the molecular markers NPM-1 and FLT3-ITD as well as the four NPM-1 and FLT3-ITD combinations were calculated in cross tables (Pearson’s Chi Square test) in the different age groups. Results: In 689 patients with available mutations status we found a significant decrease in the frequency of the two molecular markers with higher age. Whereas the incidence of NPM-1 mutation decreased abruptly in patients >60 yrs [Group 1: 18/28 (64.3%), 2: 35/59 (59.3%), 3: 70/114 (61.4%), 4: 84/143 (58.7%), 5: 98/234 (41.9%), 6: 46/111 (41.4%); p<0.0001], the incidence of a FLT3-ITD decreased continuously with increasing age [Group 1: 14/28 (50.0%), 2: 21/59 (35.6%), 3: 36/114 (31.6%), 4: 47/143 (32.9%), 5: 60/234 (25.6%), 6: 22/111 (19.8%); p=0.013)]. Combining both markers we found a significant relative increase of NPM-1−/FLT3-ITD− patients (p<0.0001) with a sharp cut at 60 years whereas the NPM-1+/FLT3-ITD+ group diminished continuously (p=0.020). The proportion of the positive prognostic group of NPM-1+/FLT3-ITD− patients showed an increase between 40–60 years and a decrease afterwards (p=0.024) (see table 1 and figure 1). Conclusions: Our data show in a large cohort of 689 patients with NK-AML that the presence of mutations of the molecular markers NPM-1 and FLT3-ITD significantly decreases with age. Consequently the proportion of NPM-1−/FLT3-ITD− patients increases over time. This observation sheds light on the disease biology in older patients with AML. Table 1: Distribution of the NPM-1, FLT3-ITD and the 4 NPM-1/FLT3-ITD subgroups in different age groups age groups NPM-1 + % FLT3-ITD+ (%) NPM-1−/FLT3-ITD−(%) NPM-1+/FLT3-ITD+ (%) NPM-1−/FLT3-ITD+ (%) NPM-1+/FLT3-ITD− (%) 17–30 64.3 50.0 25.0 39.3 10.7 25.0 31–40 59.3 35.6 30.5 25.4 10.2 33.9 41–50 61.4 31.6 28.9 21.9 9.6 39.5 51–60 58.7 32.9 31.5 23.1 9.8 35.7 61–70 41.9 25.6 51.3 18.8 6.8 23.1 71–85 41 4 19.8 50.5 11.7 8.1 29.7 all age groups (%) 50.9 29.0 40.5 20.5 8.5 30.5 p-value < 0.0001*** 0.013* < 0.0001*** 0.020* 0.886 0.024* Figure 1: Proportions of the four NPM-1/FLT3-ITD subgroups in different age groups Figure 1:. Proportions of the four NPM-1/FLT3-ITD subgroups in different age groups


2010 ◽  
Vol 28 (14) ◽  
pp. 2452-2459 ◽  
Author(s):  
Charles M. Balch ◽  
Jeffrey E. Gershenwald ◽  
Seng-jaw Soong ◽  
John F. Thompson ◽  
Shouluan Ding ◽  
...  

Purpose To determine the survival rates and independent predictors of survival using a contemporary international cohort of patients with stage III melanoma. Patients and Methods Complete clinicopathologic and follow-up data were available for 2,313 patients with stage III disease in an updated and expanded American Joint Committee on Cancer (AJCC) melanoma staging database. Kaplan-Meier and Cox multivariate survival analyses were performed. Results Among all 2,313 patients with stage III disease, 81% had micrometastases, and 19% had clinically detectable macrometastases. The 5-year overall survival was 63%; it was 67% for patients with nodal micrometastases, and it was 43% for those with nodal macrometastases (P < .001). Tremendous heterogeneity in survival was observed, particularly in the microscopically detected nodal metastasis subset (from 23% to 87% for 5-year survival). Multivariate analysis demonstrated that in patients with nodal micrometastases, number of tumor-containing lymph nodes, primary tumor thickness, patient age, ulceration, and anatomic site of the primary independently predicted survival (all P < .01). When added to the model, primary tumor mitotic rate was the second-most powerful predictor of survival after the number of tumor-containing nodes. In contrast, for patients with nodal macrometastases, the number of tumor-containing nodes, primary ulceration, and patient age independently predicted survival (P < .01). Conclusion In this multi-institutional analysis, we demonstrated remarkable heterogeneity of prognosis among patients with stage III melanoma, especially among those with nodal micrometastases. These results should be incorporated into the design and interpretation of future clinical trials involving patients with stage III melanoma.


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