64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
T Nishimura

Abstract   Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p < 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p < 0.05], total bilirubin value≧ 2 [HR:2.5573, p < 0.05], and presence of HCC [HR:2.2450, p < 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 61-61
Author(s):  
Tatsuro Nishimura ◽  
Takuya Iwamoto ◽  
Tsuyoshi Ishikawa ◽  
Isao Sakaida ◽  
Taro Takami

Abstract Background Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 256 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and January 2017. Among them, 143 successfully followed up. The patients’ characteristics were: mean age, 63.8 years (29–85); 97 men and 46 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The mean age in the long-term/non-long-term survival group was 62.4 ± 9.4 years/67.2 ± 10.5 years, indicating a significantly higher age in the non-long-term group (P < 0.01). Preoperative Child-Pugh score was 6.3 ± 1.2/7.5 ± 2.2 (P < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.7%/56.2% (P < 0.01), significantly higher in the non-long-term group. Additionally, regarding the treatment method, endoscopic injection sclerotherapy (EIS): endoscopic variceal ligation (EVL) alone in the groups was 50:9/41:18, suggesting a significantly higher EVL rate in the non-long-term group (P < 0.05). Recurrence of esophageal varices occurred in 33 and 22 patients in the long-term and non-long-term groups, respectively, with no significant difference between groups. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, P < 0.05], total bilirubin value≧ 2 [HR:2.5573, P < 0.05], and presence of HCC [HR:2.2450, P < 0.01] were noted as significant factors, but the recurrence of esophageal varices was not noted as significant. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio(OR) 0.3463, P < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices. Disclosure All authors have declared no conflicts of interest.


2011 ◽  
Vol 213 (3) ◽  
pp. S40
Author(s):  
Leonidas Tapias ◽  
Babatunde Oriowo ◽  
Luis F. Tapias ◽  
Juan A. Sanchez

ISRN Surgery ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Apichat Tantraworasin ◽  
Somcharoen Saeteng ◽  
Nirush Lertprasertsuke ◽  
Nuttapon Arayawudhikule ◽  
Choosak Kasemsarn ◽  
...  

Background. Although early stage non-small cell lung cancer (NSCLC) has an excellent outcome and correlated with good long-term survival, up to 15 percent of patients still relapse postoperatively and die. This study is conducted to identify prognostic factors that may affect the long-term survival in completely resected N0 NSCLC. Methods. Medical records of 124 patients with completely resected N0 NSCLC were retrospectively reviewed. Prognostic factors affecting long-term survival were analyzed by the Kaplan-Meier method and Cox proportional hazards analysis. Results. Overall five-year survival rate was 48 percent. Multivariable analysis revealed stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases as significant prognostic factors affecting long-term survival. The hazard ratio (HR) of tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases was 2.0, 2.3, 7.6, 4.1, and 8.3, respectively, and all P values were less than 0.001. Conclusions. Our study shows stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastasis, and skin metastasis as the independent prognostic factors of long-term survival in pathological N0 NSCLC. Early stage NSCLC patients without nodal involvement or presented with tumor necrosis should benefit from adjuvant chemotherapy, and sites of metastasis could predict the long-term survival as described.


2021 ◽  
Author(s):  
Kosei Doshita ◽  
Hirotsugu Kenmotsu ◽  
Shota Omori ◽  
Yuya Tabuchi ◽  
Takanori Kawabata ◽  
...  

Abstract Background. Long-term survival data of patients with limited-disease small-cell lung cancer (LD-SCLC) treated with concurrent chemoradiotherapy (CRT) have not been fully evaluated. Furthermore, the association between long-term prognosis and prognostic factors has not been sufficiently investigated.Methods. The efficacy of concurrent CRT was retrospectively evaluated in 120 patients with LD-SCLC who were planned for curative CRT using concurrent accelerated hyperfractionated radiotherapy.Results. The median patient age was 65.5 years. The majority of patients were males (73%) and had clinical stage III disease (80%). The median follow-up time for overall survival (OS) was 71.3 months. The median OS was 34.3 months; the 3- and 5-year OS rates were 52.4% and 41.8%, respectively. The median progression-free survival (PFS) was 12.2 months; the 3- and 5-year PFS rates were 37.6% and 33.6%, respectively. The 5-year OS rates of patients who achieved PFS at 12, 24, and 36 months were 70.9%, 83.6%, and 91.9%, respectively. The gradual increase in the 5-year OS rate following PFS extension and initial depression of Kaplan–Meier curves showed that disease progression frequently occurred in the first 2 years after concurrent CRT initiation. The Cox proportional hazards model revealed no significant factors that correlated with long-term survival through univariate and multivariate analyses.Conclusions. Prognostic factors associated with long-term prognosis in LD-SCLC were not identified. Nonetheless, the 5-year OS rate was 41.8%, whereas the 5-year survival rate among patients without disease progression at 2 years was 83.6%. These data suggest that the prognosis of patients with LD-SCLC was improving.


2021 ◽  
Vol 42 (6) ◽  
pp. 103070
Author(s):  
Nicholas B. Abt ◽  
Lauren E. Miller ◽  
Tara E. Mokhtari ◽  
Derrick T. Lin ◽  
Jeremy D. Richmon ◽  
...  

2007 ◽  
Vol 32 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Marcella Arru ◽  
Luca Aldrighetti ◽  
Renato Castoldi ◽  
Saverio Di Palo ◽  
Elena Orsenigo ◽  
...  

Author(s):  
Seong Kyeong Lim ◽  
Kyoungwon Jung ◽  
Moo In Park ◽  
Jae Hyun Kim ◽  
Sung Eun Kim ◽  
...  

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