NCOG-34. AN ASSESSMENT OF OVERALL SURVIVAL AND PALLIATIVE CARE USE AMONG PATIENTS WITH GLIOSARCOMA DIAGNOSED OVER A TWELVE-YEAR SPAN

Abstract Gliosarcoma (GS), a rare variant of glioblastoma, accounts for less than 5% of CNS tumors. Due to its low incidence and prevalence, very few comprehensive, large-scale studies are reported in the literature that describe prognostic elements and treatment outcomes. The objective of the study was to examine patient and treatment characteristics to identify significant predictors of survival. METHODS: Data on patients with GS, diagnosed between 2004-2016, was extracted from the National Cancer Database (NCDB). Univariate analysis and a multivariate Weibull regression model was used to determine prognostic factors of survival (months). Kaplan-Meier (KM) method with log-rank test was used to compare and estimate overall survival rates between various groups. RESULTS: There was a total of 2,656 GS patients identified in the NCDB between the years of 2004-2016 with median age of 62 years old. In multivariable Weibull regression model, increasing age (HR=1.04, p=0.000) and increasing comorbidities were independent predictors of increased hazard of death. Having 3 or more comorbidities had the strongest association with increased hazard of death (HR=1.44; P=0.001). The OS has minimally improved over the period of 2004-2016; median OS was highest among those diagnosed between 2012 and 2016 at 11.4 months followed by an OS of 10.6 months between 2004 and 2007, and 9.1 months between 2008 and 2011 (P=0.001). Although current clinical guidelines recommend chemotherapy and radiation within 30 days of surgery, there was no statistically significant difference in median OS between patients who had chemotherapy initiated within 30 days, between 30 and 60 days or later than 60 days (P=0.109). There is also no statistically significant difference in OS for time of radiation initiation categories (P=0.752). In a disease with such low OS and limited treatment options, palliative care use was found in only 45 (1.7%) patients.

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Adherence to the BCLC guidelines and impact on overall survival.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.345 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 345-345 ◽

Cited By ~ 1

Author(s):

Jesna Mathew ◽

Sasha Slipak ◽

Anil Kotru ◽

Joseph Blansfield ◽

Nicole Woll ◽

...

Keyword(s):

Overall Survival ◽

Survival Benefit ◽

Cox Regression ◽

Early Stage ◽

Univariate Analysis ◽

Tertiary Care ◽

Treatment Recommendations ◽

Rank Test ◽

P Value ◽

Significant Difference

345 Background: Multiple studies exist that validate the prognostic value of the Barcelona Clinic Liver Cancer (BCLC) staging. However, none have established a survival benefit to the treatment recommendations. The aim of this study was to evaluate the adherence to the BCLC guidelines at a rural tertiary care center, and to determine the effect of following the treatment recommendations on overall survival. Methods: A retrospective chart review was conducted for 97 patients newly diagnosed with hepatocellular carcinoma (HCC) from 2000 to 2012. The treatment choice was compared with the BCLC guidelines and percentage adherence calculated. Overall survival was estimated using the Kaplan-Meier method and the log rank test was used to test the difference between the two groups. Cox regression tests were used to determine independent effects of stage, treatment aggressiveness, and guideline adherence on survival. A p-value <0.05 was considered statistically significant. Results: Of 97 patients, 75% (n=73) were male. Median overall survival was 12.9 months. In 59.8% (n=58) of the patients, treatment was adherent to stage specific guidelines proposed by the BCLC classification. There was no significant difference in overall survival between the adherent and non-adherent groups (11.2 vs 14.1 months, p<0.98). However on stage specific survival analysis, we noted a significant survival benefit for adherence to the guidelines for early stage HCC (27.9 vs 14.1 months, p<0.05), but a decrease in survival for adherence in the end stage (20 days vs 9.3 months, p<0.01). On univariate analysis, more aggressive treatment was associated with increased survival (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.22 to 0.87; p = 0.018). Multivariate analysis revealed that adherence did not independently affect survival when stage and aggressiveness of treatment were included in the model (HR, 1.3; 95% CI, 0.76 to 2.2, p = 0.34). Conclusions: Although the BCLC guidelines serve as a practical guide to the management of patients with HCC, they are not universally practiced. These results indicate that survival of patients with hepatocellular cancer is determined by stage and aggressiveness of treatment, not adherence to BCLC guidelines.

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Analysis of the National Cancer Data Base (NCDB) on impact and trend of neoadjuvant chemotherapy in upper urinary tract urothelial cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.408 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 408-408

Author(s):

Rashad Khan ◽

Danning Huang ◽

Alina Basnet

Keyword(s):

Overall Survival ◽

Neoadjuvant Chemotherapy ◽

Private Insurance ◽

Survival Rates ◽

Rank Test ◽

P Value ◽

Perioperative Chemotherapy ◽

Cancer Specific Survival ◽

Cancer Data ◽

Significant Difference

408 Background: Five year cancer specific survival rate is between 12- 70% for pT2 and higher UUTUC tumors. Adjuvant platinum based therapies have proven to improve Overall survival (OS) in observational series. Compromised renal function after surgery, delayed recovery from surgery pose challenge for adjuvant chemotherapy (AC). Thus, neoadjuvant chemotherapy (NAC) is an appealing option. However, there is only limited evidence on the role of NAC in UUTUC. Methods: We conducted a retrospective study of UUTUC (stage I- III) who underwent complete or partial nephroureterectomy with peri-operative chemotherapy. We then compared OS outcome among NAC vs AC groups. OS was calculated using Kaplan Meier analysis. Multivariate analysis was performed with Cox proportional hazard regression model to adjust for different variables. Results: Out of 50539 UUTUC patients reported in NCDB (2004-2016), 20121 met our inclusion criteria. 360 patients received NAC, 2617 received AC and 17144 received only surgery. Patients who received NAC were more likely to be younger, treated at academic centers, have Medicare and private insurance, have clinical T3 and higher tumor, have lower Charlson-Deyo Score (CDCC) score and undergo complete nephroureterctomy. One, three and five year OS among NAC and AC is depicted in table 1. With 150 months (m) follow up, median OS was 73.89 m for NAC and 54.14 m for AC group. A log rank test with p value=0.3437 shows no significant difference in survival rates of the two groups. Though consistent upward trend is observed in the use of NAC from 2004 to 2015, significantly higher percentages of patients still undergo only surgery without perioperative chemotherapy. Conclusions: Numerically higher mOS in NAC group was not statistically significant different from AC group. Use of perioperative chemotherapy appears to be much lower in UUTUC. Limitations that exist with this registry based study include lack of randomization, differences in surgical and radiation techniques, duration of chemotherapy, and provider/patient selection bias. Overall survival among two groups. [Table: see text]

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Hepatocellular Carcinoma (HCC): Epidemiology, Risk Factors, and Survival

10.21203/rs.3.rs-506735/v1 ◽

2021 ◽

Author(s):

Sweta Soni ◽

Puneet Pareek ◽

Satya Narayan ◽

Amrita Rakesh ◽

Abhilasha Abhilasha

Keyword(s):

Hepatocellular Carcinoma ◽

Palliative Care ◽

Overall Survival ◽

Median Survival ◽

Predictive Factors ◽

Survival Curve ◽

Tumour Size ◽

Univariate Analysis ◽

Rank Test ◽

Care Group

Abstract Background: HCC is an aggressive tumour with unpredictable outcome. It is fourth most common cause of cancers in India. However, information on HCC is inadequate in India.Therefore purpose of study is to determine overall survival for patients diagnosed with hepatocellular carcinoma (HCC) and association between various predictive factors and survival. Results: The median overall survival (OS) was 5 months ranging from 0-13 months. Majority of patients were in advance stage (III/IV). All patient died by 13 months. None of the possible predictive factors were found to be significantly associated with survival (P > 0.05) by univariate analysis. However age < 59 yrs, male gender, KPS ≤ 60, AFP ≥ 400, cirrhosis, multifocality, tumour size > 10 cm, advance stage (IIIB/IV), child pugh score B/C, CLIP score ≥ 4 and raised bilirubin level had poorer survival compared to other predictive factors. Median survival was better in patient treated with TACE followed by sorafenib + palliative care group (9 month) then sorafenib + palliative care and palliative care alone group (5 and 4 months respectively). Although results were not statistically significant (p: 0.133). Amongst all possible variables, highest hazard was found with multifocal lesion (2.0577) and results were statistically significantly (p 0.0451, 95 % confidence interval : 0.9225 to 4.5900 ) as compared to unifocal lesion with median survival period of 7 vs 9.5 months by Kaplan-Meier survival curve analysis using log rank test. Conclusion: Multifocality was independent predicator for poor survival in HCC. Further clinical studies are necessary to improve the outcomes of patients with high risk features.

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NCOG-27. INCREASED OVERALL SURVIVAL AMONG RACIAL MINORITIES AND SUBOPTIMAL USE OF STANDARD OF CARE TREATMENT IN GLIOBLASTOMA MULTIFORME

Neuro-Oncology ◽

10.1093/neuonc/noaa215.565 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii134-ii135

Author(s):

Stephanie Boisclair ◽

Shenae Samuels ◽

Arjun Khunger ◽

Delia A Wietecha ◽

Alejandro Lopez Cohen ◽

...

Keyword(s):

Palliative Care ◽

Overall Survival ◽

Glioblastoma Multiforme ◽

Academic Research ◽

Surgical Techniques ◽

Standard Of Care ◽

Poor Overall Survival ◽

Asian Ethnicity ◽

Weibull Regression ◽

Significant Difference

Abstract Glioblastoma Multiforme (GBM) is the most common primary central nervous system (CNS) tumor and is always considered grade IV given its aggressive nature and poor overall survival (OS). Despite advancements in surgical techniques and cancer therapies, GBM treatment has remained the same since 2005: total resection followed by temozolomide and radiation. We hypothesized that OS has increased over the years and is similar among all races/ethnic groups without reduction of mortality based upon treatment facility. METHODS: The National Cancer Database from 2004-2016 was utilized to obtain demographic, tumor and treatment factors of GBM (excluding gliosarcomas). Multivariate Weibull regression model was used to evaluate prognostic factors for OS in months(m). RESULTS: A total of 119,496 patients were identified. There was a significant difference(P=0.000) in OS for patients diagnosed in 2012-2016 (10.2m) compared to 2008-2011 (9.2m) and 2004-2007 (8.1m). Among racial groups, the highest incidence was among whites (91.8%) whom also had the lowest OS (9.0m), followed by Blacks (10.5m), Hispanics (11.7m) and Asians (12.9m)(P=0.000). Patients with unilateral tumors (72.1%) and tumor size < 3cm (18.3%) had an increased OS (9.8m-10.2m and 11.2m, respectively) compared with patients having bilateral tumors or larger size ≥ 3cm (OS of 4.8m and 8.9m, respectively)(P=0.000). Increasing age (HR=1.03) and comorbidity score ≥ 3 (HR=1.40) were independent predictors of death (P=0.000), while female sex (HR=0.88), Asian ethnicity (HR=0.75) and treatment at an academic/research facility (HR=0.86) were independent predictors of survival(P< 0.01). Only 60.1% of patients (n=59,112) received ideal treatment (surgery, chemotherapy and radiation), while only 3.2% of all GBM patients received palliative care. DISCUSSION: Decreased OS was found among white race, large and bilateral tumors. Despite a statistically significant, although minimal, increase in OS since 2004-2007, there is notable underutilization of ideal treatment and palliative care. Further studies should focus on access inequalities and limitations to treatment.

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Characteristics of primary and repeated recurrent retroperitoneal liposarcoma: outcomes after aggressive surgeries at a single institution

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa126 ◽

2020 ◽

Vol 50 (12) ◽

pp. 1412-1418

Author(s):

Kenta Ishii ◽

Yukihiro Yokoyama ◽

Yoshihiro Nishida ◽

Hiroshi Koike ◽

Suguru Yamada ◽

...

Keyword(s):

Overall Survival ◽

Survival Rates ◽

Rank Test ◽

R0 Resection ◽

Radical Cure ◽

Recurrence Free Survival ◽

Free Survival ◽

Retroperitoneal Liposarcoma ◽

Significant Difference ◽

Overall Survival Rates

Abstract Objective This study sought to investigate the characteristics of primary and repeated recurrent retroperitoneal liposarcoma. Methods Patients treated with primary or recurrent retroperitoneal liposarcoma between 2005 and 2018 were retrospectively reviewed. Survival time analysis of recurrence-free survival and overall survival was conducted using Kaplan–Meier analysis and log-rank test. Results Fifty-two patients with primary retroperitoneal liposarcoma were analysed. Amongst them, 46 patients (88%) had undergone surgery. Histologic grades included well-differentiated (n = 21), dedifferentiated (n = 21), myxoid (n = 3) and pleomorphic (n = 1) subtypes. The patients undergoing R0 resection in the first surgery had significantly higher recurrence-free survival rates compared with the patients undergoing non-R0 resection (3-year recurrence-free survival: 80 versus 38%; 5-year recurrence-free survival: 49 versus 29%, P = 0.033). Although overall survival rates tended to be higher in the patients undergoing R0 resection compared with the non-R0 resection, it did not reach to a statistical significant difference (5-year overall survival: 93 versus 75%; 10-year overall survival: 93 versus 59%, P = 0.124). The recurrence rates were 65, 67, 73 and 100%, and the median recurrence-free survival times were 46, 20, 9 and 3 months after the first, second, third and fourth surgeries, respectively. The 5-year overall survival rates were 82, 69, 40 and 0% after the first, second, third and fourth surgeries, respectively. Conclusions With repeated recurrence and surgeries, the time to recurrence decreased and the recurrence rate increased. R0 resection in the first surgery was considered the most important for longer recurrence-free survival and radical cure.

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Impact of surgical treatment on survival in patients with primary rectal melanoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19001 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19001-19001

Author(s):

J. C. Yap ◽

G. Yang

Keyword(s):

Overall Survival ◽

Univariate Analysis ◽

Survival Rates ◽

Primary Melanoma ◽

Mantel Test ◽

Tumor Burden ◽

Pattern Of Care ◽

Significant Difference ◽

Impact On Survival ◽

Anal Lesions

19001 Background: Reports of melanoma of the lower GI tract, especially in the rectal area, were often grouped with diseases from the anal canal region. Outcome and pattern of care regarding primary melanoma of the rectum only were not well described in the literature. This review examined the utilization of surgery, radiotherapy (RT), and the potential impact on survival outcome in this subgroup of patients. Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973 to 2003) was searched. Only patients with primary melanoma of the rectum (excluding anal lesions) with recordable pathology reports were included. 79 patients were identified. 61 of them had melanoma of the rectum as the sole primary disease, and these patients were the focus of this study. Kaplan Meier estimation and Cox-Mantel test were used to calculate and compare survival rates. Results: Among the 61 patients, 20 patients did not have further surgery after biopsy. Another 20 patients had surgery, but the types of procedure were unknown. Of the remaining 21 patients eligible for analysis, eight patients had abdominoperineal resection (APR), and one of them received postoperative RT. Thirteen patients had partial proctectomy (PP), and none had RT. In univariate analysis, the 5-year overall survival rates for APR and PP groups were 12.5% and 7.7% respectively (p=0.63). There were one survivor in each group at the last follow up period with crude survival time of 15 years and 13.5 years respectively. More patients in APR group had locoregional disease (extramural and nodal) than in PP group (63% versus 0% respectively) at diagnosis. Comparing the time intervals by decade between 1973 to 1982, 1983 to 1992, and 1993 to 2003 in all 61 patients, use of postoperative RT was relatively limited at 1 in 14 cases, 1 in 19 cases, 2 in 28 cases respectively. RT was used mostly in patients who were not candidate for surgery and in patients with metastatic disease at diagnosis presumably for palliation. Conclusions: Primary melanoma of the rectum is a rare disease. Data for analysis were limited. There was no significant difference in overall survival between patients who had APR versus PP although APR group had higher tumor burden at diagnosis than PP group. Use of adjuvant RT is rare, and its role has yet to be further defined. No significant financial relationships to disclose.

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Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

Innovative Surgical Sciences ◽

10.1515/iss-2020-0030 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Andrés Moreno Roca ◽

Luciana Armijos Acurio ◽

Ruth Jimbo Sotomayor ◽

Carlos Céspedes Rivadeneira ◽

Carlos Rosero Reyes ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Survival Time ◽

Univariate Analysis ◽

Rank Test ◽

Kaplan Meier ◽

Significant Difference ◽

Icd 10 ◽

The Difference ◽

Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

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Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

International Journal of Colorectal Disease ◽

10.1007/s00384-021-04005-6 ◽

2021 ◽

Author(s):

Claudius E. Degro ◽

Richard Strozynski ◽

Florian N. Loch ◽

Christian Schineis ◽

Fiona Speichinger ◽

...

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Blood Level ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Stage I ◽

Cancer Stage ◽

Single Center ◽

Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

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Hemodialysis (HD) dose and ultrafiltration rate are associated with survival in pediatric and adolescent patients on chronic HD—a large observational study with follow-up to young adult age

Pediatric Nephrology ◽

10.1007/s00467-021-04972-6 ◽

2021 ◽

Author(s):

Verena Gotta ◽

Olivera Marsenic ◽

Andrew Atkinson ◽

Marc Pfister

Keyword(s):

Rank Test ◽

Primary Analysis ◽

Ultrafiltration Rate ◽

Dialysis Dose ◽

Dialysis Adequacy ◽

Weibull Regression ◽

Adult Age ◽

Kaplan Meier ◽

Continuous Scale ◽

Weibull Regression Model

Abstract Background Hemodialysis (HD) dose targets and ultrafiltration rate (UFR) limits for pediatric patients on chronic HD are not known and are derived from adults (spKt/V>1.4 and <13 ml/kg/h). We aimed to characterize how delivered HD dose and UFR are associated with survival in a large cohort of patients who started HD in childhood. Methods Retrospective analysis on a cohort of patients <30 years, on chronic HD since childhood (<19 years), having received thrice-weekly HD 2004–2016 in outpatient DaVita centers. Outcome: Survival while remaining on HD. Predictors: (I) primary analysis: mean delivered dialysis dose stratified as spKt/V ≤1.4/1.4–1.6/>1.6 (Kaplan–Meier analysis), (II) secondary analyses: UFR and alternative dialysis adequacy measures [eKt/V, body-surface normalized Kt/BSA] on continuous scale (Weibull regression model). Results A total of 1780 patients were included (age at the start of HD: 0–12y: n=321, >12–18y: n=1459; median spKt/V=1.55, eKt/V=1.31, Kt/BSA=31.2 L/m2, UFR=10.6 mL/kg/h). (I) spKt/V<1.4 was associated with lower survival compared to spKt/V>1.4–1.6 (P<0.001, log-rank test), and spKt/V>1.6 (P<0.001), with 10-year survival of 69.3% (59.4–80.9%) versus 83.0% (76.8–89.8%) and 84.0% (79.6–88.5%), respectively. (II) Kt/BSA was a better predictor of survival than spKt/V or eKt/V. UFR was additionally associated with survival (P<0.001), with increased mortality <10/>18 mL/kg/h. Associations did not alter significantly following adjustment for demographic characteristics (age, etiology of kidney disease, and ethnicity). Conclusions Our results suggest usefulness of targeting Kt/BSA>30 L/m2 for best long-term outcomes, corresponding to spKt/V>1.4 (>12 years) and >1.6 (<12 years). In contrast to adults, higher UFR of 10–18 ml/kg/h was not associated with greater mortality in this population.

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Sustainability Time and Its Determinant Factors of Small and Medium-scale Enterprises in East Gojjam Zone: Parametric Survival Regression Model

Global Business Review ◽

10.1177/0972150920988657 ◽

2021 ◽

pp. 097215092098865

Author(s):

Amare Wubishet Ayele ◽

Abebaw Bizuayehu Derseh

Keyword(s):

Regression Model ◽

Marketing Channel ◽

Educational Status ◽

Weibull Regression ◽

Service Sectors ◽

Weibull Regression Model ◽

Parametric Survival ◽

Prospective Study Design ◽

Significant Factors ◽

Survival Regression

The contributions of small and medium-sized enterprises (SMEs) to socio-economic development are generally recognized, but they have faced several obstacles that impede their sustainability. This manuscript seeks to identify factors for the survival of SMEs in the East Gojjam Zone, Ethiopia. The prospective study design was employed. Both descriptive and inferential statistics, particularly families of parametric survival regression models, have been used. Of the 650 enterprises included in this study, 330 (50.8%) were censored (sustained enterprises) and the remaining 320 (49.2%) were events or withdrawn enterprises. The findings of this study revealed that the incidence of termination or withdrawal of SMEs in the study area is relatively common. The results from multivariable Weibull regression model revealed that woreda, sector, manger profile (gender, age, educational status, experience (in year) and source of experience), working place, marketing channel and profitability district status of enterprise were found to be statistically significant factors for the sustainability of enterprises in the study area. The bodies concerned, in particular the enterprise administrative offices at various levels, should work with collaborative organizations to develop a strong marketing platform (network), should be able to make workplaces accessible with the required infrastructure at minimal rental costs, and should prioritize the type of sector that has the highest customer needs at the onset, for instance, agriculture and service sectors.

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