scholarly journals Clinicopathological review of epithelial ovarian tumors in young females and reproductive and survival outcome: Ten years expierence from a tertiary center

2016 ◽  
Author(s):  
Kusum Lata ◽  
Nutan Agarwal ◽  
Neerja Bhatla ◽  
Alka Kriplani
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Survival Outcome ◽  
Ovarian Tumors ◽  
Tertiary Referral Hospital ◽  
Young Females ◽  
Presenting Symptoms ◽  
Tertiary Center

Objective: To find out the prevalence of epithelial ovarian tumors in young females and correlation with reproductive and survival outcome. Design: Retrospective study. Setting: Tertiary referral hospital. Methods: A retrospective analysis of females from 9-35 year of age group treated for ovarian tumors between January 2003 to July 2013 was performed. Variables studied included age, presenting symptoms, imaging, tumor markers, surgical findings, type of surgery, histopathology reports and follow-up. Main Outcome Measures: Histopathological variant, FIGO stage, reproductive and survival outcome. Results: A total of 155 patients were found to have ovarian tumors. Mean age at time of diagnosis was 24.9 ± 1.8 years (range 9-35). Clinical presentation in majority of the cases was abdominal pain in 68 (43.8%), ascites in 13 (8.3%) mass in abdomen in 25 (16%), followed by irregular menstrual cycles in 15 (9.6%), infertility in 18 (11.6%) 12 (7.7%) were found to be incidental on ultrasound examination while 4 women were found to have virilising symptoms. There were 76 (49.1%) cases of epithelial ovarian tumors, 6 (0.03%) of borderline tumors and 30 (19.3%) were of malignant ovarian tumors while 40 (25.8%) were benign. Stage IA (N = 80), Stage I 8 (n = 2), Stage III (N = 6) and Stage IV (N = 12). Females were further subdivided into three age groups 9-15 years, 15-25 years and 25 to 35 years for determining outcome of epitheliail tumors. Reproductive and survival outcome were studied in each stage. Conclusions: Limited data exists about the histological type distribution, surgical treatment and overall survival of epithelial ovarian tumors in women aged below 35 years. Young patients have higher overall progression-free survival and a better clinical outcome than older patients. Any women presenting with pain and nonspecific symptoms should be investigated and evaluated properly.

Clinical characteristics, diagnosis, treatment, and prognosis in lung cancer patients under the age of 45.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17508-e17508
Author(s):  
Nektaria Makrilia ◽  
Alexios S Strimpakos ◽  
Ioannis Gkiozos ◽  
Kostas N Syrigos
Keyword(s):  
Lung Cancer ◽  
Chronic Hepatitis ◽  
Performance Status ◽  
Young Patients ◽  
Primary Lung Cancer ◽  
Stage Iv ◽  
Great Loss ◽  
Female Ratio ◽  
Lung Cancer Patients ◽  
Tertiary Center

e17508 Background: Lung cancer remains uncommon among young adults but it causes great loss of life expectancy in this age group. The definition of young age varies in the published studies from 40 to 50 years of age. Methods: Our aim was to assess whether patients diagnosed at young ages have unique clinicopathological and prognostic characteristics. We retrospectively reviewed records of patients aged 45 or younger who were treated for primary lung cancer at a large tertiary center between June 2003 and June 2011. Results: 2,651 patients with lung cancer were screened of whom 73 (2.8%) were aged ≤45. The male-to-female ratio was 1.6:1 and the median age at diagnosis was 42. 89% of patients were smokers. Performance status (PS) was 0, 1 and 2 in 61%, 29% and 10% of patients, respectively. The most common histological types were adenocarcinoma (47%), small-cell lung cancer (SCLC) (18%) and squamous cell carcinoma (18%). The median time elapsing between beginning of symptoms and diagnosis was 3 months. Chronic hepatitis B or C was mentioned in the medical history of 5/13 (38%) SCLC patients, whereas it was present in 4/60 NSCLC patients under 45 (p=0.008) and in 16/518 SCLC patients over the age of 45 (p<0.0001). Patients were diagnosed with stages I, II, III and IV in 2 (3%), 11 (18%), 13 (22%) and 34 (57%) of NSCLC cases, respectively, whereas 7 of 13 (54%) SCLC patients were diagnosed with limited disease. The median overall survival was 21 months and multivariate analysis indicated that PS and time until diagnosis were independent prognostic factors. Conclusions: Although more than half of young patients are at stage IV when diagnosed, prognosis does not seem as dismal as previously considered. Larger studies need to be conducted in order to elucidate the possible role of chronic hepatitis in the pathogenesis of SCLC in young patients.

scholarly journals Familial hypercholesterolemia in acute coronary syndrome patients: underdiagnosis in female and in young patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Garcia Bras ◽  
G Portugal ◽  
A Castelo ◽  
V Ferreira ◽  
R Teixeira ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Age Groups ◽  
Young Patients ◽  
Hospitalization Rate ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Gender And Age ◽  
Tertiary Center ◽  
All Cause Mortality

Abstract Introduction Familial hypercholesterolemia (FH) is often underdiagnosed, particularly in female patients (P), even during hospital admission for acute coronary syndromes (ACS). The aim of this study was to apply the Dutch Lipid Clinic Network (DLCN) Criteria in P admitted for ACS and evaluate gender and age differences. Methods Prospective evaluation of P with ACS admitted to a tertiary center from 2005 to 2019. Data including family history and laboratory tests was analysed for the application of the DLCN criteria and results were stratified according to ACS subtype, gender and age groups (20–39, 40–59, 60–79 and ≥80 years [y]). P were followed up for 30 days for hospitalization, recurring ACS and mortality. Results 3811 P were evaluated, mean age 63±13 years, 28% female and mean LDL cholesterol of 125±43 mg/dL. The admission diagnosis was unstable angina (UA) in 5%, non-ST-segment elevation myocardial infarction (NSTEMI) in 27% and ST-segment elevation MI (STEMI) in 68%. Applying the DLCN criteria, 3089 P (81%) had a score of &lt;3 (unlikely FH), 675P (17.7%) a score of 3 to 5 (possible FH), 41P (1.1%) a score of 6 to 8 (probable FH) and 1P (0.03%) a score of &gt;8 (definite FH). Stratifying according to ACS type: among UA, 31P (16%) had possible FH and 4P (2.1%) had probable FH. Among NSTEMI, 145P (14.2%) had possible FH, 9P (0.9%) probable FH and 1P (0.03%) definite FH. Finally, among STEMI P, 497P (19.1%) had possible FH and 28P (1.1%) probable FH. Regarding female P, 158P (14.7%) had possible FH and 16 P (1.5%) probable FH. Among male P, 517P (18.9%) had possible FH and 25P (0.9%) probable FH (p=0.016 for interaction). According to age groups, among P aged 20–39 y (136P), 61P (44.9%) had possible FH and 6P (4.4%) had probable FH. Concerning P aged 40–59 y (1766P), 575P (32.6%) had possible FH, 31 P (1.8%) probable FH and 1P (0.1%) definite FH. With regard to P aged 60–80 y (2122P), 80P (3.8%) had possible FH and 4P (0.2%) probable FH. Among P aged ≥80 y (1837P), only 9P (0.5%) had possible FH and no P had probable FH. In a 30-day follow-up, there was an hospitalization rate of 3.5% (134P) and recurring ACS in 1.7% (65P), while the all-cause mortality was 2% (78P) and cardiovascular (CV) death was 1.3% (49P). Female P had a significantly lower hospitalization rate (1.8% vs 3.2%, p=0.003) as well as fewer recurring ACS (0.6% vs 1.7%, p=0.001). There was no significant gender difference regarding all-cause mortality (female 1.7% vs 1.5%, p=0.552) or CV death (0.8% vs 1.1%, p=0.323). The DLCN criteria score was significantly correlated with admission for recurring ACS (OR 1.19 [95% CI 1.04–1.36], p=0.04). Conclusion Application of the DLCN criteria in female P admitted for ACS revealed 158P (14.7%) with possible FH and 16P (1.5%) with probable FH. Regarding younger ACS P (20–39y), 44.9% had criteria for possible FH and 4.4% for probable FH, prompting us to do not overlook these P subgroups in daily practice and routinely assess the likelihood of FH. FUNDunding Acknowledgement Type of funding sources: None.

Erlotinib for Advanced Non–Small-Cell Lung Cancer in the Elderly: An Analysis of the National Cancer Institute of Canada Clinical Trials Group Study BR.21

2008 ◽  
Vol 26 (14) ◽  
pp. 2350-2357 ◽  
Author(s):  
Paul Wheatley-Price ◽  
Keyue Ding ◽  
Lesley Seymour ◽  
Gary M. Clark ◽  
Frances A. Shepherd
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Elderly Patients ◽  
National Cancer Institute ◽  
Age Groups ◽  
Young Patients ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival

PurposeNational Cancer Institute of Canada Clinical Trials Group Study BR.21 established erlotinib as a standard of care in patients with non–small-cell lung cancer (NSCLC) after failure of first- or second-line chemotherapy. The current study analyzes the influence of age on outcomes in BR.21.Patients and MethodsBR.21 was a double-blind phase III trial that randomly assigned 731 patients to erlotinib 150 mg daily or placebo. End points included progression-free survival and overall survival (OS), response, quality of life (QOL), drug exposure, and toxicity, which are analyzed in this retrospective study by the following two age groups: ≥ 70 years (elderly) or less than 70 years (young).ResultsThere were 163 elderly patients (112 on erlotinib, 51 on placebo) and 568 young patients (376 on erlotinib, 192 on placebo). There was no significant difference between age groups randomly assigned to erlotinib or placebo in progression-free survival (elderly: 3.0 v 2.1 months; hazard ratio [HR] = 0.63; 95% CI, 0.44 to 0.90; P = .009; young: 2.1 v 1.8 months; HR = 0.64; 95% CI, 0.53 to 0.76; P < .0001; interaction, P = .77) or OS (elderly: 7.6 v 5.0 months; HR = 0.92; 95% CI, 0.64 to 1.34; P = .67; young: 6.4 v 4.7 months; HR = 0.73; 95% CI, 0.61 to 0.89; P = .0014; interaction, P = .31). Response rates were similar between age groups. Elderly patients, compared with young patients, had significantly more overall and severe (grade 3 and 4) toxicity (35% v 18%; P < .001), were more likely to discontinue treatment as a result of treatment-related toxicity (12% v 3%; P < .0001), and had lower relative dose-intensity (64% v 82% received > 90% planned dose; P < .001).ConclusionElderly patients treated with erlotinib gain similar survival and QOL benefits as younger patients but experience greater toxicity.

Presentation of Wegener's Granulomatosis in Young Patients

1986 ◽  
Vol 94 (3) ◽  
pp. 368-371 ◽  
Author(s):  
Lucinda A. Halstead ◽  
Collin S. Karmody ◽  
Sheldon M. Wolff
Keyword(s):  
Head And Neck ◽  
Wegener’S Granulomatosis ◽  
Medical Center ◽  
Nasal Congestion ◽  
Age Groups ◽  
Young Patients ◽  
Wegener's Granulomatosis ◽  
Upper Respiratory Tract ◽  
Presenting Symptoms ◽  
Number Of Patients

We have reviewed 50 cases of Wegener's granulomatosis, seen at the New England Medical Center Hospital between 1970 and 1984, and were impressed that 10 (20%) of these patients were under 25 years of age, with ages ranging from 13 to 23 years. Closer examination of this younger group revealed striking differences in their presenting symptoms and organ Involvement when compared to the older group of patients. The presentation of these young patients was varied, with no single predominant symptom. Patients presented with otalgia and otitis media or hearing loss, fulminant sinusitis, arthralgias, and even corneal ulcers. Only one patient had “typical” rhinitis and nasal congestion. This group also had a disproportionate number of patients with involvement of the oral cavity, skin, and trachea. Biopsy of these sites frequently demonstrated necrotizing vasculitis. Three of our 50 patients had intracranial involvement, leading to transient hemiplegia in the first, permanent hemiplegia in the second, and a seizure disorder in the third. Two of these patients were in the younger age group. The proportion of patients with limited and generalized Wegener's granulomatosis was the same in both the younger and older age groups. All the younger patients, however, had manifestations of the disease in the head and neck, while four of the older patients had no symptoms in the upper respiratory tract. The number of young patients in our study emphasizes the fact that Wegener's granulomatosis, indeed, occurs in the younger patient and with a greater frequency than previously supposed. This study suggests that in the teenager and young adult, with an unusual constellation of symptoms of the head and neck and accompanying systemic problems, a diagnosis of Wegener's granulomatosis should be seriously considered.

Differences in pathology and mutational status among colorectal cancer (CRC) patients pre-, post-, and during screening age.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3596-3596
Author(s):  
Gustavo Dos Santos Fernandes ◽  
Allan Andresson Lima Pereira ◽  
Gabriella Pereira Braga ◽  
Brenda Pires Gumz ◽  
Marcela Crosara Alves Texeira ◽  
...  
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Stage Iv ◽  
Signet Ring Cell ◽  
Screening Tests ◽  
Braf Mutations ◽  
Pathology Laboratory ◽  
Mutational Status ◽  
Mutational Profiling ◽  
Central Pathology

3596 Background: Screening protocols for CRC are broadly recommended and effective in reducing mortality. However, populations from different age groups can harbor distinct pathological and molecular profiles that can also be influenced by screening and polyp resection, especially in older ages. Methods: We retrospectively analyzed tumors from stage IV CRC patients from a central pathology laboratory in Brazil that is a reference for mutational profiling countrywide. Patients were classified into age groups as the following: pre-screening (PrSA; <45yo), screening(SA; 45-75yo) and post-screening age (PoSA; >75yo). Every tumor has been centrally reviewed by the pathologist. Groups were compared regarding clinicopathologic features and presence of RAS and BRAF mutations. Results: We included 1244 pts (164 PrSA, 919 SA and 161 PoSA). There were no difference among groups regarding sidedness(p= .68)and KRASmutations (p=.0.97). Stage IV at diagnose (p =.001), presence of signet-ring cell component (p< .001) along with poorly differentiated tumors (p= .006) were most found on young patients, while BRAFand NRASmutations where significantly more common among PosSA (table). Conclusions: PosSA and PreSA CRCs seem to present a distinct profile from SA populations, including differences in the molecular and pathologic aspects. This could impact the frequency of screening tests among different age groups. [Table: see text]

Projected future risk of leukemia and brain tumors from unnecessary brain CT scans: a multi-center study in Iran

2020 ◽  
Author(s):  
A. Asgari ◽  
A.A. Parach ◽  
F. Bouzarjomehri ◽  
F. Shirani-Takabi ◽  
A.H. Mehrparvar ◽  
...  
Keyword(s):  
Brain Cancer ◽  
Age Groups ◽  
Young Patients ◽  
Ct Scans ◽  
Brain Ct ◽  
Males And Females ◽  
And Gender ◽  
Multi Center Study ◽  
Gender Groups ◽  
Probability Of Cancer

Introduction: Computer Tomography (CT) scans can deliver a relatively high radiation dose to the patient, therefore radiation protection for this modality is paramount. The present study determined the frequency of no abnormality detected (NAD) brain CT scans and probability of cancer induction in different age groups and genders. Methods: In this study, brain CT reports were used to identify any findings as abnormality detected (AD) and others as NAD. Then probability of future leukemia and brain cancer was estimated for different age and gender groups. Results: On average, in 65% of the cases the results were NAD (56% and 76% among males and females, respectively). Among children, 79% of the reports were NAD. The total number of projected brain cancers was 1.8 and 1.3 for males and females, respectively. The number of projected leukemia cases was 0.75 and 0.7 for males and females, respectively. For pediatric patients, brain CT scans can lead to leukemia cases about 4.5 times more often than adults. Conclusion: Brain CT scans can lead to additional cases of brain cancer and leukemia. A significant fraction of brain CTs were NAD (non-pathologic) and could practically be replaced by other radiation-free imaging modalities, especially in pediatric and young patients.

Ultrasound in the follow-up of young patients with malignant ovarian tumors after conservative surgery

1994 ◽  
Vol 4 (1) ◽  
pp. 60-64 ◽  
Author(s):  
G. Zanetta ◽  
D. Trio ◽  
A. Lissoni ◽  
M. Pittelli ◽  
A. Di Lelio
Keyword(s):  
Young Patients ◽  
Conservative Surgery ◽  
Ovarian Tumors

Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

scholarly journals PATH-18. A MULTI-CENTER CASE SERIES OF ADULT K27M MUTATED DIFFUSE MIDLINE GLIOMAS REVEALING A POPULATION UNIQUE FROM PAEDIATRIC CASES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii167-ii168
Author(s):  
Alexander Yuile ◽  
Madhawa De Silva ◽  
Marina Kastelan ◽  
Veronica Cheung ◽  
Joanne Sy ◽  
...  
Keyword(s):  
Older Patients ◽  
Selection Criteria ◽  
Case Series ◽  
Progression Free Survival ◽  
Paediatric Population ◽  
Asia Pacific ◽  
Royal North Shore Hospital ◽  
Free Survival ◽  
Delay In Diagnosis ◽  
Presenting Symptoms

Abstract BACKGROUND Histone mutations in the K27M gene were first described in 2014, and incorporated into the WHO CNS tumour classification system in 2016. They are typically associated with diffuse midline gliomas (DMG). Presenting symptoms vary greatly, with some experiencing significant delay in diagnosis. Median survival is only 9-12 months for these patients. Biopsy samples are small, and in some due to location, not performed. Although data is predominately based on the paediatric population, DMGs are seen in both adolescence and adults. In this multi-site retrospective study, we describe 11 adult patients with K27M DMG gliomas across two tertiary Neuro-Oncology services in Sydney, Australia. To the authors’ knowledge we present the largest known collection of adult K27M cases in the Asia-Pacific region with correlation of treatment, clinicopathologic and radiologic features with outcomes. METHODS The glioma databases of Royal North Shore Hospital (RNSH) and Royal Prince Alfred Hospital (RPAH) between January 2009 and March 2020 were interrogated to identify patients. Selection criteria included patients aged ≥ 18 years who presented with a DMG, had undergone biopsy, and had confirmed K27M via next generation sequencing. Clinicopathologic, radiologic and treatment outcomes were extracted for correlation. RESULTS Eleven patients fitting the selection criteria were identified and reported. The median age at diagnosis was 30 years and 4 were female. Five presented with hydrocephalus, the most common presenting symptoms were headaches and nausea and/or vomiting (n= 4 and n= 2 respectively). The median progression-free survival was 13 months (4-31 months) and the median overall survival was 23 months (4-59 months). CONCLUSION This case series reports the outcomes of older patients with K27M. The clinical course demonstrated suggests a divergence from paediatric biology. Ongoing studies are required to further characterise the histopathological and clinical differences of these tumours in older patients.

Predictors of tumor progression among children with gangliogliomas

2009 ◽  
Vol 3 (6) ◽  
pp. 461-466 ◽  
Author(s):  
Mostafa El Khashab ◽  
Lynn Gargan ◽  
Linda Margraf ◽  
Korgun Koral ◽  
Farideh Nejat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tumor Progression ◽  
Cox Regression ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Initial Presentation ◽  
Subtotal Resection ◽  
Low Grade ◽  
Cox Regression Analysis ◽  
Presenting Symptoms

Object Few reports describe the outcome and prognostic factors for children with gangliogliomas. The objective of this report was to describe the progression-free survival (PFS) for children with low-grade gangliogliomas and identify risk factors for tumor progression. Methods A retrospective study was performed in children with low-grade gangliogliomas who were evaluated and treated in the neuro-oncology department between 1986 and 2006 to determine risk factors for subsequent tumor progression. Results A total of 38 children with newly diagnosed gangliogliomas were included in this report. Thirty-four children were treated with surgery alone, 3 with subtotal resection and radiation therapy, and 1 with subtotal resection and chemotherapy. The follow-up ranged from 4 months to 15.8 years (mean 5.7 ± 4.2 years [± SD]). Seven children have experienced tumor progression, and 1 child died after his tumor subsequently underwent malignant transformation. The 5-year PFS was calculated to be 81.2% using Kaplan-Meier survival analysis. Initial presentation with seizures (p = 0.004), tumor location in the cerebral hemisphere (p = 0.020), and complete tumor resection (p = 0.035) were associated with prolonged PFS. Further analysis of the above significant variables by a Cox regression model identified initial presentation with seizures as being associated with prolonged PFS (p = 0.028). Conclusions The PFS and overall survival of children with gangliogliomas are good. Tumors located in the cerebral hemispheres, the achievement of total resection, and seizures at presentation were associated with prolonged PFS. Cox regression analysis identified presenting symptoms including seizures as significant predictive factors of PFS. Prospective studies with larger numbers of children are needed to define the significant factors of tumor progression.

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