Comparison of preoperative chemoradiation with radiation or chemotherapy alone in patients with non-metastatic, resectable retroperitoneal sarcoma

2021 ◽  
pp. 1-6
Author(s):  
Sung Jun Ma ◽  
Brian Yu ◽  
Lucas M. Serra ◽  
Austin J. Bartl ◽  
Oluwadamilola T. Oladeru ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Preoperative Chemoradiation ◽  
Retroperitoneal Sarcoma ◽  
Rank Test ◽  
Preoperative Radiation ◽  
Inclusion Criteria ◽  
Therapy Regimen ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
The Impact

Abstract Aim: Optimal preoperative therapy regimen in the treatment of resectable retroperitoneal sarcoma (RPS) remains unclear. This study compares the impact of preoperative radiation, chemoradiation and chemotherapy on overall survival (OS) in RPS patients. Materials and Methods: The National Cancer Database (NCDB) was queried for patients with non-metastatic, resectable RPS (2006–15). The primary endpoint was OS, evaluated by Kaplan–Meier method, log-rank test, Cox multivariable analysis and propensity score matching. Results: A total of 1,253 patients met the inclusion criteria, with 210 patients (17%) receiving chemoradiation, 850 patients (68%) receiving radiation and 193 patients (15%) receiving chemotherapy. On Cox multivariable analysis, when compared to preoperative chemoradiation, preoperative radiation was not associated with improved OS (hazards ratio [HR] 0·98, 95% CI 0·76–1·25, p = 0·84), while preoperative chemotherapy was associated with worse OS (HR 1·64, 95% CI 1·24–2·18, p < 0·001). Similar findings were observed in 199 and 128 matched pairs for preoperative radiation and chemotherapy, respectively, when compared to preoperative chemoradiation. Findings: Our study suggested an OS benefit in using preoperative chemoradiation compared to chemotherapy alone, but OS outcomes were comparable between preoperative chemoradiation and radiation alone.

The Efficacy of Etoposide-Based Therapy in Adult Secondary Hemophagocytic Lymphohistiocytosis

2021 ◽  
pp. 1-9
Author(s):  
Leonard Naymagon ◽  
Douglas Tremblay ◽  
John Mascarenhas
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Proportional Hazards ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Significant Difference ◽  
The Impact

Data supporting the use of etoposide-based therapy in hemophagocytic lymphohistiocytosis (HLH) arise largely from pediatric studies. There is a lack of comparable data among adult patients with secondary HLH. We conducted a retrospective study to assess the impact of etoposide-based therapy on outcomes in adult secondary HLH. The primary outcome was overall survival. The log-rank test was used to compare Kaplan-Meier distributions of time-to-event outcomes. Multivariable Cox proportional hazards modeling was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Ninety adults with secondary HLH seen between January 1, 2009, and January 6, 2020, were included. Forty-two patients (47%) received etoposide-based therapy, while 48 (53%) received treatment only for their inciting proinflammatory condition. Thirty-three patients in the etoposide group (72%) and 32 in the no-etoposide group (67%) died during follow-up. Median survival in the etoposide and no-etoposide groups was 1.04 and 1.39 months, respectively. There was no significant difference in survival between the etoposide and no-etoposide groups (log-rank <i>p</i> = 0.4146). On multivariable analysis, there was no association between treatment with etoposide and survival (HR for death with etoposide = 1.067, 95% CI: 0.633–1.799, <i>p</i> = 0.8084). Use of etoposide-based therapy was not associated with improvement in outcomes in this large cohort of adult secondary HLH patients.

scholarly journals Survival and Prognostic Factors for Outcome after Radiotherapy for T2 Glottic Carcinoma

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1319 ◽  
Author(s):  
Hendriksma ◽  
Ruler ◽  
Verbist ◽  
Jong ◽  
Langeveld ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Anterior Commissure ◽  
Rank Test ◽  
Consecutive Series ◽  
Glottic Carcinoma ◽  
Test Results ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Patients At Risk ◽  
The Impact

Background: Local recurrence after radiotherapy for T2 glottic carcinoma remains an issue and identifying patients at risk for relapse is, therefore, important. This study aimed to assess the oncological outcomes and prognostic factors in a consecutive series of patients treated with radiotherapy for T2N0 glottic carcinoma. Methods: Patients with T2N0 glottic carcinoma treated with radiotherapy were included in this retrospective study. Five- and ten-year local control (LC), overall survival (OS), disease-specific survival (DSS), and laryngeal preservation (LP) rates were calculated with the Kaplan–Meier method. The impact of prognostic variables was evaluated with the log-rank test. Results: Ninety-four patients were included for analysis. LC, OS, DSS, and LP rates were 70.5, 63.7, 86.0, and 74.7%, respectively at five years and 65.8, 41.0, 75.6, and 72.4% at 10 years. In total, 46 scans were included in the analyses. Vertical involvement of the anterior commissure on imaging showed a significant impact on LC. Conclusions: In accordance with previously described surgical risk factors, we identified vertical involvement of the anterior commissure on imaging as a prognostic factor for radiation failure.

Abstract 20470: Lower Mortality and Stent Thrombosis Rates Associated With Introduction of Potent P2Y12 Inhibitors in Patients With Acute Coronary Syndromes

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Javaid Iqbal ◽  
Rebecca Rowe ◽  
Yao-Jun Zhang ◽  
Yasir Parviz ◽  
Allison C Morton ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Acute Coronary Syndromes ◽  
Lower Mortality ◽  
Rank Test ◽  
P2y12 Inhibitors ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Confounding Variables ◽  
Coronary Syndromes ◽  
The Impact

Aims: We investigated the impact of new platelet P2Y12 inhibitors, prasugrel and ticagrelor, compared with clopidogrel, upon mortality and stent thrombosis (ST) in patients with acute coronary syndromes (ACS) in a large, single-centre, ‘all-comers’ population. Methods: Data were collected for 6742 consecutive patients attending the cardiac catheterization lab at Sheffield, UK (2009-2013) with ACS. Differences in outcomes among patients receiving different P2Y12 inhibitors were evaluated at 12 months by Kaplan-Meier curves and log-rank test in the overall and a propensity-matched population. Results: Of 6742 patients with ACS (36% STEMI, 64% NSTE-ACS), 67% (4525) received clopidogrel, 15% (1007) prasugrel and 18% (1210) ticagrelor, with aspirin for all. In the overall group, prasugrel (HR 0.78, 95% CI 0.59-1.02, p=0.07) and ticagrelor (HR 0.77, 95% CI 0.60-0.99, p=0.04) were associated with lower all-cause mortality compared with clopidogrel (Fig 1A). There was no difference in mortality between prasugrel- and ticagrelor-treated groups (HR 1.01, 95% CI 1.00-1.67, p=0.96). The incidence of definite/probable ST was 4.2% (1.5% definite, 2.7% probable) at 12 months. ST rates were nearly 2-fold higher in patients treated with either clopidogrel or prasugrel compared with ticagrelor (Fig 1B). In the STEMI subgroup, lower mortality and ST rates were observed with new P2Y12 inhibitors but no significant differences between prasugrel and ticagrelor (Fig 1C and 1D). The results for all ACS population or STEMI subgroup remained similar after adjustment for confounding variables or analysing propensity-matched cohorts. Conclusions: Both prasugrel and ticagrelor appear superior to clopidogrel for reduction in mortality in ACS in the ‘real world’. Ticagrelor was associated with the lowest mortality and ST rates in all ACS patients, whereas either prasugrel or ticagrelor appear suitable in STEMI patients without contraindications.

scholarly journals Proton Pump Inhibitor Taking Associates with Higher All-Cause Mortality and CV Events in Peritoneal Dialysis Patients

2020 ◽  
Author(s):  
Yingsi Zeng ◽  
Lingling Liu ◽  
Liya Zhu ◽  
Xiaojiang Zhan ◽  
Fenfen Peng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Proton Pump ◽  
Regression Models ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
The Impact

Abstract Background: A long period of inappropriate proton pump inhibitors (PPI) treatment have been proved to be associated with adverse prognosis in general population and hemodialysis (HD) patients. This study was conducted to clarify the impact of PPI taking on mortality and adverse cardiovascular (CV) events in peritoneal dialysis (PD) patients.Methods: This is a retrospective study. We enrolled 904 patients from two PD centers, included 211 patients on PPI treatment and 618 patients not taking PPIs. Kaplan-Meier curves were used to identify the incidence of adverse outcomes. Multivariate Cox regression models and inverse probability of treatment weighting (IPTW) were applied to analyze hazard ratios (HRs) for adverse outcomes. Results: During follow-up, 162 deaths and 102 CV events were recorded. Kaplan-Meier curve demonstrated all-cause mortality (log-rank test P=0.018) and CV events (log-rank test P=0.024) were significantly higher in PPI usage group. Multivariate COX regression models and IPTW showed that PPI taking was an indicator for all-cause mortality (HR=1.33, 95%CI=1.07-1.65, P=0.010) and CV events (HR=1.81, 95%CI=1.38-2.38, P<0.001). Conclusions: PPI usage associates with higher all-cause mortality and CV events in PD patients. Clinicians are supposed to be more careful when using PPI and need to master the indications more rigorously in patients receiving PD treatment.

scholarly journals Relationship Between Postoperative Lordosis Distribution Index And Adjacent Segment Disease Following L4-S1 Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Guoquan Zheng ◽  
Chunguo Wang ◽  
Tianhao Wang ◽  
Wenhao Hu ◽  
Quanbo Ji ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Rank Test ◽  
Adjacent Segment ◽  
Free Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Distribution Index ◽  
Lower Lumbar ◽  
The Impact

Abstract Background. ASD is an acknowledged problem of PLIF. Many studies have been reported concerning the role of LDI in spinal biomechanics. However, few reports have been published about the impact of LDI on ASD following L4-S1 PLIF. Methods. The study enrolled 200 subjects who underwent L4-S1 PLIF for degenerative spine disease from 2009 to 2014. The average follow-up term was 84 months. Several lower lumbar parameters were measured, including lower lumbar lordosis (LLL), lumbar lordosis (LL) and LDI on the pre- and postoperative radiograph. Perioperative information, comorbidities and operative data were documented. Kaplan-Meier curves were plotted for the comparisons of ASD-free survival of 3 different kinds of postoperative LDI subgroups. Results. The incidence of ASD was found to be 8.5%. LL and LLL increased by 3.96 ° (38.71 ° vs 42.67 ° , P ＜ 0.001) and 3.60 ° (26.22 ° vs 28.82 ° , P ＜ 0.001) after lower lumbar fusion surgery, respectively. Lordosis distribution index (LDI) increased by 0.03 (0.66 vs 0.69, P=0.004) postoperatively. A significant difference(P=0.001) was observed when comparing the incidence of ASD among postoperative LDI subgroups. The Kaplan-Meier curves showed a marked difference in ASD-free survival between low and moderate LDI subgroup (Log Rank test, P=0.0012) , high and moderate LDI subgroup (Log Rank test, P=0.0005) Conclusion. Patients with abnormal postoperative LDI were statistically more likely to develop ASD than those who had normal postoperative LDI. Moreover, patients with low postoperative LDI were at greater risk for developing ASD than those with high postoperative LDI over time.

Association of smoking status with p16 and cyclin D1 (CCND1) expression with clinical characteristics and overall survival (OS) in oropharyngeal squamous cell carcinoma (OSC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5551-5551
Author(s):  
Mei-Kim Ang ◽  
Siok Hoon Ang ◽  
Sai Sakktee Krishna ◽  
Wallace Jian Jun Chen ◽  
Minn Minn Myint Thu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Smoking Status ◽  
Multivariable Analysis ◽  
Rank Test ◽  
Cox Models ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Point Increase ◽  
A Cell ◽  
P16 Expression

5551 Background: Smoking-related head and neck cancer (HNC) is genetically different, with higher mutation rates compared with non-smokers (NS). Human papillomavirus (HPV)-positive (+) OSC has a superior prognosis independent of treatment. Among HPV+ patients (pt), current or prior smokers (CS) have poor OS compared with NS. Expression of p16, a known HPV surrogate, and CYD1, a cell cycle marker often dysregulated in HNC, was evaluated with respect to smoking status and OS. Methods: Expression of p16 and CYD1 was assessed by immunohistochemistry in 108 OSC pt treated between 1999-2009, using cutoffs of ≥70% (p16+) and ≥10% (CYD1+) stained tumor cells. Associations between expression, clinical characteristics and OS were evaluated by Kaplan-Meier method and compared by log rank test. Hazard ratio (HR) for death was estimated using Cox models. Results: 31 pt (28.7%) were p16+ and 80 pt (75.5%) were CYD1 negative(-). p16+ pt were younger (median age 57 v 66 yrs, p=0.002), more likely female (35.5% v 15.2%, p=0.035), NS (51.6% v 13.9%, p<0.001) with lower combined age-comorbidity score (ageCS) (p=0.003). CYD1+ pt were older (median 66 v 57 yrs, p=0.015), more likely CS (81.5% v 48.1%, p=0.002) with higher ageCS (p=0.018). At a median f/u of 65.7 months, median OS was 57.3 months. p16+ pt had better OS than p16- pt (median OS not reached (NR) v 22.3 mths, p<0.001). CYD1+ pt had poorer OS than CYD1- pt (median OS NR v 17.7 mths, p<0.001). On multivariable analysis p16 and CYD1 status were independently associated with OS (HR 0.412, p=0.045 and HR 4.06, p=0.011 respectively), independent of smoking status (HR 5.01, p=0.008), ageCS (HR 1.32 per 1 point increase, p<0.001) and stage. Strikingly, among NS, 5-year OS in p16+ compared with p16- pt was 100% vs 67% (p<0.001). In contrast, among CS, p16 status had no association with OS (HR 0.97, p=0.943), while CYD1 status and ageCS were independent predictors of death (HR 4.70, p=0.025 and HR 1.28, p<0.001 respectively). Conclusions: In OSC, NS with high p16 expression have excellent prognosis. Among CS, pt with fewer comorbidities and low CYD1 expression have better OS. p16 status was not prognostic in the latter group of patients.

The impact of nodal metastasis on survival in stage IV colon cancer: Analysis of National Cancer Database 2004-2014.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15042-e15042
Author(s):  
Sukamal Saha ◽  
Mohamed Elgamal ◽  
Meghan Cherry ◽  
Robin Buttar ◽  
David Wiese ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
Nodal Metastasis ◽  
Rank Test ◽  
National Cancer Database ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Stage Iv Disease ◽  
The Impact

e15042 Background: Lymph node (LN) metastasis (mets) is the strongest prognostic factor in colon cancer (CCa), however, its significance in Stage IV disease remains controversial. We analysed National Cancer Database (NCDB) to determine the impact of nodal mets on survival in Stage IV CCa patients (pts). Methods: From 2004-2014, NCDB pts with pathologic Stage IV CCa were divided into groups based on LN status and No. of +ve LNs. Only Stage IV CCa pts who underwent surgical resection of their primary tumor with available pathologic data as well as chemotherapy data were included. Kaplan-Meier method and log rank test were used to compare 5-year overall survival. Results: A total of 33574 pts data met the criteria of the study. Adenocarcinoma represented 82.3% of the total pts. Majority of the pts (82.61%) had +ve LN status. Mean survival was 36.3 vs 24.2 months in -ve LN vs +ve LN pts respectively. Overall 5yr survival was better in LN -ve pts ( 23.4%) versus LN +ve pts ( 10.2%) Survival for all years was inversely related to the number of +ve LN ( Table). For LN +ve or LN -ve pts, receiving any form of chemotherapy was associated with significantly improved survival when compared to no chemotherapy. Conclusions: LN status and No. of +ve LNs impact the prognosis of CCa, even in stage IV. Receiving some form of chemotherapy improves the prognosis for both pts with +ve or -ve LN status. These findings suggest that separation of Stage IV LN negative versus positive patients may be warranted in staging and treatment. 5 year survival according to LN status and No. of positive LN. [Table: see text]

scholarly journals Low-Dose Aspirin as Primary Prophylaxis for Cardiovascular Events in Rheumatoid Arthritis: An Italian Multicentre Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Daniela Iacono ◽  
Serena Fasano ◽  
Ilenia Pantano ◽  
Virginia D’Abrosca ◽  
Piero Ruscitti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Low Dose ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Primary Prophylaxis ◽  
Treated Group ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Kaplan Meier

Objective. To investigate the role of acetylsalicylic acid (ASA) in reducing the incidence of cardiovascular (CV) events in an Italian multicentre rheumatoid arthritis (RA) inception cohort. Methods. The clinical charts of RA patients consecutively admitted to 4 Italian centres for their 1st visit from November 1, 2000, to December 31, 2015, and followed up till December 2016 were retrospectively investigated for the incidence of CV events. Patients were subdivided into two groups, namely, ASA- and non-ASA-treated groups. The Kaplan–Meier curve and log-rank test were used to investigate differences in event-free survival. Cox regression analysis was carried out to identify factors associated with CV event occurrence. Results. Seven hundred forty-six consecutive RA patients were enrolled and followed up for a median of 5.6 years (range 2.9–8.9 years). The incidence rate (IR) of CV events was 8/1000 person-years (p-ys) in the overall cohort. The IR of CV events was significantly lower in the ASA-treated group with respect to the non-ASA-treated group (IR 1.7 vs. 11.8/1000 p-ys; p=0.0002). The CV event-free rate was longer in ASA-treated patients than in non-ASA-treated patients (log-rank test 12.8; p=0.0003). At multivariable analysis, arterial hypertension (HR 9.3) and hypercholesterolemia (HR 2.8) resulted to be positive predictors and ASA (HR 0.09) and hydroxychloroquine (HCQ) (HR 0.22) to be negative predictors. Conclusion. The IR of CV events in our Italian multicentre cohort was lower than that reported in other European and non-European cohorts. Low-dose ASA may have a role in the primary prophylaxis of CV events in RA patients.

Efficacy of statin on vascular access patency in diabetic hemodialysis patients

2017 ◽  
Vol 18 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Satoru Sanada ◽  
Yasunori Miyasaka ◽  
Atsuhiro Kanno ◽  
Kozo Sato ◽  
Mitsuhiro Sato ◽  
...  
Keyword(s):  
Vascular Access ◽  
Health Care Organization ◽  
Multivariable Analysis ◽  
Statin Treatment ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Care Organization ◽  
Kaplan Meier ◽  
Hemodialysis Vascular Access ◽  
The Impact

Introduction An effective approach to prevent hemodialysis vascular access dysfunction is still unclear despite previous studies, which have shown conflicting results of several drugs on vascular access outcomes. In this study, we focused on diabetic hemodialysis patients with native arteriovenous fistula and evaluated the impact of statin treatment on vascular access patency. Methods A retrospective cohort study of 268 consecutive patients who newly started hemodialysis due to diabetic nephropathy between January 2011 and December 2013 at Japan Community Health Care Organization Sendai Hospital was performed and the patients were followed for two years. The primary outcome was vascular access dysfunction. Effect of statin treatment was examined using Kaplan Meier analysis and Cox proportional hazard, after adjusting for covariates. Results The mean follow-up period was 426.7 days, and 117 (52.2%) patients developed vascular access dysfunction. The two-year patency rate was 55.0% among statin users and 36.1% in non-users. Vascular access survival period was significantly longer among statin users (log-rank test, p = 0.004). In multivariable analysis, statin treatment is significantly associated with better vascular access outcomes, in which the hazard ratio was 0.71 (95% CI, 0.52 to 0.97; p = 0.028) in the unadjusted model and 0.63 (95% CI, 0.45 to 0.88; p = 0.007) after adjustment for covariates. Conclusions Statin treatment could be associated with improved vascular access dysfunction among diabetic hemodialysis patients.

scholarly journals Factors that influence peritonitis events on patients with continuous ambulatory peritoneal dialysis in Sanglah General Hospital, Denpasar-Bali, Indonesia

2020 ◽  
Vol 3 (3) ◽  
pp. 82-86
Author(s):  
Gede Wirya Kusuma Duarsa ◽  
Oka Udrayana ◽  
Yeni Kandarini ◽  
Raka Widiana ◽  
Marleen
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Education Level ◽  
Rank Test ◽  
Inclusion Criteria ◽  
Survival Curves ◽  
Log Rank Test ◽  
Kaplan Meier

Background. To determine risk factors that influence peritonitis event on patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) in Sanglah Hospital, thus, we can prevent the occurrence of peritonitis in CRF patients with CAPD. Methods. This is a retrospective cohort study, which was conducted at the Sanglah Hospital in Denpasar from August to September 2016. All data are processed using SPSS 17.0 for Windows, data analysis by using the Kaplan Meier (K-M) curves, hypothesis using the log-rank test, while for the survival is by using the median or mean survival. The significance is determined by the value of p < 0.05 with 95% CI. Results. A total of 78 people (46 men and 32 women) who meet the inclusion criteria of this study. Thirteen people (16.7%) are experiencing peritonitis. K-M Survival Curves between in CRF patients with CAPD, with Age ≥ 50 years (51.36 months survival rates, 95% CI 44.79 until 57.93) with < 50 years (56.1 months Survival rates, 95% CI 51.41 until 60.78) with RR 2.54 log-rank p 0.084. K-M Survival Curves between in CRF patients with CAPD, with DM (mean 52.63 months survival rates, 95% CI 47.21 until 58.06) with No DM (56.88 months survival rates, 95% CI 52.89 until 60.88) with RR 4.16 and 0.037 log-rank p. Conclusion. There is a correlation between DM and the incidence of peritonitis in CRF patients with CAPD at Sanglah Hospital. However, age and education level are not related.

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