FRI0276 EARLY TREATMENT WITH ANTI-TNF IS ASSOCIATED WITH HIGHER RESPONSE RATES IN PATIENTS WITH ACTIVE AXSPA

Background:Treatment options for axial spondyloarthritis (axSpA) is currently limited, and up to 40% of the patients require biologic therapies to control symptoms. Early commencement of biologics suggested to have higher response rates but data regarding this subject is limited.Objectives:The primary aim was to investigate tumor necrosis factor inhibitor (TNFi) response and retention rates in axSpA patients who were treated in the early disease period (symptom duration (≤5 years). Our secondary aim was to identify factors predicting response to TNFi.Methods:Adult axial SpA patients who started TNFi treatments within the five years of their symptoms were identified and defined as “Group 1”. Patients whose TNFi treatments started five years after their initial symptoms served as a control group (Group 2: 5-10 years and Group3: ≥10 years). Response and survival rates at 6, 12, and 24 months were calculated. Predictors of response on TNFi survival at 24 months were also analyzed.Results:There was a total of 364 axiSpA (Group 1: 95, Group 2: 82 and Group 3: 187) patients in the study (69.8% male, 46.8±12.6 years). Group 1 patients tended to be younger, with a lower baseline CRP titers and lower HLA–B27 rate compared to the other groups. Drug survival rates were similar between the groups. This finding also remained similar when AS and nraxSpA patients analyzed separately. However, regardless of symptom duration, the drug retention rates were significantly higher in the AS group than in nraxSpA (Table 2). ASAS40 responses were higher in Group 1 than in Group 3 both at 12 and 24 months. Predictors of response based on ASAS40 at 24 months were treatment within the five years of the symptoms (OR:2.2) and age at baseline (OR:0.97) in univariate analysis. However, baseline ASDAS (OR:1.4) was the only factor in multiple regression.Conclusion:In this study we showed the following: 1) TNFi started in the early disease course resulted in a better ASAS40 response at both 12 and 24 months, 2) TNFi timing (started in the early or late disease period) seems not affecting drug retention rates, and 3) baseline disease activity is the most important predictor in achieving ASAS40 response at 24 months.Disclosure of Interests:None declared

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Tositumomab and Iodine I 131 Tositumomab (the BEXXAR® Therapeutic Regimen) Shows Efficacy in Elderly Patients (pts) with Relapsed/Refractory Low-Grade (LG), Follicular, and Transformed Non-Hodgkin’s Lymphoma (NHL).

Blood ◽

10.1182/blood.v104.11.2630.2630 ◽

2004 ◽

Vol 104 (11) ◽

pp. 2630-2630

Author(s):

Stephanie A. Gregory ◽

Andrew Zelenetz ◽

Susan J. Knox ◽

Julie Vose ◽

John P. Leonard ◽

...

Keyword(s):

Bone Marrow Involvement ◽

Response Rates ◽

Hematologic Toxicity ◽

Low Grade ◽

Age Group ◽

Prognostic Features ◽

Prior Therapy ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Objective: Pts are first diagnosed with NHL at a median age of 60 yrs. There is increasing support for the idea that physicians should evaluate older pts for cancer treatment on the basis of their health status and cognitive function rather than on chronologic age. Five core clinical trials and an expanded-access program included 995 pts with relapsed/refractory LG follicular or transformed NHL treated with BEXXAR. Data were analyzed to establish the efficacy and safety of BEXXAR as a function of age. Safety data have been presented previously (Gregory et al. Blood. 2003;102. Abstract 1485). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs. Methods: BEXXAR efficacy was analyzed by age: group 1 pts, ≤60 yrs (n=586); group 2 pts, >60–≤70 yrs (n=250); group 3 pts, >70 yrs (n=159). Median age at time of BEXXAR was 58 yrs (range, 21–88 yrs). Inclusion criteria included KPS ≥60, platelet count ≥100,000/mm3, ANC ≥1,500 cells/mm3, bone marrow involvement ≤25%, and no impaired renal, hepatic, or cardiac function. Results: All 3 pt groups had received multiple therapies for NHL before receiving BEXXAR (1–3 prior treatments, 63%–65%; ≥4 prior treatments, 34%–37%). In addition to the known poorer prognosis with older age, pts in groups 2 and 3 more frequently had other poor prognostic features, ie, transformed histology and prior radiotherapy (P <.001). Complete response rates (CR+CCR) to the most recent pre-BEXXAR therapy decreased with increasing age (group 1, 21%; group 2, 12%; group 3, 7%), and progressive disease as the initial “response” to prior therapy increased with age (group 1, 20%; group 2, 29%; group 3, 33%). Table 1 shows response rates and CR post- BEXXAR for the 3 groups. Post-BEXXAR CR+CCR rates were higher for pts in every age group compared with CR rates to prior therapy. These rates were nearly doubled for pts >60–≤70 yrs (23% vs 12%) and tripled for pts >70 yrs (23% vs 7%). Conclusions: Of all previously treated pts >60 yrs, ≥50% achieved a response post-BEXXAR. Nearly 25% of pts >60 yrs achieved a CR, with a median duration of CR of 32.3 mos. Response rates and durations of response are somewhat better in younger pts than in pts >60 yrs, but pts >60 yrs presented with poorer prognostic features (as above). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs (Gregory et al. Blood. 2003;102. Abstract 1485). BEXXAR can be administered safely and effectively to older pts with low-grade follicular or transformed NHL. Table 1 Response results to BEXXAR by age, N = 995 Age groups Overall response, % CR, % Median CR duration, mos ≤ 60 66 37 59.1 (n=586) 95% CI = 45.8, NR) 60 to ≤70 N = 250 50 23 21.8 (n=250) (95% CI = 15.7, 69.1) >70 54 23 36.4 (n=159) (95% CI = 22.6, NR)

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Comparative Analysis of Peri-Implant Bone Loss in Extra-Short, Short, and Conventional Implants. A 3-Year Retrospective Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249278 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9278

Author(s):

Daycelí Estévez-Pérez ◽

Naia Bustamante-Hernández ◽

Carlos Labaig-Rueda ◽

María Fernanda Solá-Ruíz ◽

José Amengual-Lorenzo ◽

...

Keyword(s):

Bone Loss ◽

Survival Rates ◽

Marginal Bone Loss ◽

Posterior Maxilla ◽

Group 3 ◽

Group 2 ◽

Wide Neck ◽

Implant Length ◽

Functional Loading ◽

Group 1

Objective: To evaluate the influence of implant length on marginal bone loss, comparing implants of 4 mm, 6 mm, and >8 mm, supporting two splinted crowns after 36-month functional loading. Materials and Methods: this retrospective clinical trial evaluated the peri-implant behavior of splinted crowns (two per case) on pairs of implants of the same length placed in the posterior maxilla (molar area). Implants were divided into three groups according to length (Group 1: extra-short 4 mm; Group 2: short 6 mm; Group 3: conventional length >8 mm). Marginal bone loss was analyzed using standardized periapical radiographs at the time of loading and 36 months later. Results: 24 patients (19 women and 5 men) were divided into three groups, eight rehabilitations per group, in the position of the maxillary first and second molars. The 48 Straumann® Standard Plus (Regular Neck (RN)/Wide Neck (WN)) implants were examined after 36 months of functional loading. Statistical analysis found no significant differences in bone loss between the three groups (p = 0.421). No implant suffered biological complications or implant loss. Long implants were associated with less radiographic bone loss. Conclusions: extra-short (4 mm); short (6 mm); and conventional length (>8 mm) implants in the posterior maxilla present similar peri-implant bone loss and 100% survival rates in rehabilitation, by means of two splinted crowns after 36 months of functional loading. Implants placed in posterior positions present better bone loss results than implants placed in anterior positions, regardless of the interproximal area where bone loss is measured. Conventional length (>8 mm) implants show better behavior in terms of distal bone loss than short (6 mm) and extra-short (4 mm) implants.

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Alternative therapeutic approaches after induction chemotherapy for tonsil squamous cell carcinomas

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e17010 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e17010-e17010

Author(s):

F. Huguet ◽

M. Gratacap ◽

J. Ménard ◽

S. Perie ◽

B. Angelard ◽

...

Keyword(s):

Induction Chemotherapy ◽

Predictive Factor ◽

Survival Rates ◽

Complete Response ◽

Squamous Cell Carcinomas ◽

Pathological Response ◽

Primary Site ◽

Group 3 ◽

Group 2 ◽

Group 1

e17010 Background: The role of induction chemotherapy (ICT) in the treatment of head and neck squamous cell carcinomas (SCC) remains controversial. This retrospective study aims to evaluate the outcome of patients with tonsil SCC treated with ICT followed by surgery and/or external beam radiotherapy (EBRT). Methods: Between 1997 and 2007, 103 patients (pts) with tonsil SCC received an ICT in Tenon Hospital. Most of pts (88%) received cisplatin (25 mg/m2) and 5-fluorouracil (1,000 mg/m2) for 4 days with a mean of 2.5 cycles. After ICT, 85 pts were operated. After surgery, 69 pts received a dose of 50 to 70 Gy on the primary site depending on pathological findings (Group 1). Sixteen pts with negative margins and no lymph node metastasis didn't receive any EBRT (Group 2). The remaining 17 pts were treated by EBRT without surgery (Group 3). The mean follow-up was 38 months. Results: No significant difference appears between our different groups except for the TNM stage and the tumour pathological response to ICT. After ICT, pathological complete response was observed in 18 pts (25%) for the primary site and 20 pts (34%) for lymph nodes. Clinical and radiological assessment of response after ICT was not predictive of the pathological response. The TNM stage was the only predictive factor for complete response. The 5-year disease-free survival rates were 68% for the whole population, 73% for the Group 1, 43% for the Group 2, 68% for the Group 3 (p = 0.5). A poor pathological response after ICT was the single independent predictive factor of tumour relapse (p = 0.04). In the Group 2, 6 pts had a relapse, among them 4 had EBRT in a second time. The 5-year specific survival rates were 78% for the whole population, 76% for the Group 1, 76% for the Group 2, 39% for the Group 3 (p = 0.03). The radio-clinical evaluation of response, the surgery and the pathological response were predictive factors of specific survival. Conclusions: Pts with a complete pathological response after ICT who were not irradiated had a non significant increase of the relapse rate with a specific survival identical to the group of irradiated pts. This data have to be confirmed by a prospective trial. No significant financial relationships to disclose.

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Clinical efficacy of tumor-treating fields for newly diagnosed glioblastoma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.2046 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 2046-2046

Author(s):

Yang Liu ◽

Margie Richardson ◽

Kwanza Warren ◽

Myla S. Strawderman ◽

Nimish Mohile ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Rates ◽

Extent Of Resection ◽

Newly Diagnosed ◽

Cox Models ◽

Tumor Treating Fields ◽

Group 3 ◽

Group 2 ◽

Group 1 ◽

Group Comparisons

2046 Background: Recent clinical trials have shown that adding tumor treating fields (TTF) to the Stupp protocol (SP) has increased survival after glioblastoma (GBM) diagnosis. However, whether this regimen improves population-based survival for patients with GBM remains unknown. Methods: We retrospectively identified adult patients with newly diagnosed GBM treated at our institution from January 2000 to July 2017 (n = 438, median age: 63 years).We grouped patients into three time periods for comparison: 2000-2004 (group 1, prior to SP), 2005-2013 (group 2, SP) and 2014-2017 (group 3, adding TTF to SP). The Kaplan-Meier method was used to estimate survival. Statistical analysis included unadjusted group comparisons by Chi-square and Log-rank tests and adjusted group comparisons using logistic and Cox models. Results: Thirty-seven percent (43/117) of patients with GBM in group 3 received TTF with SP therapy; when compared to those who received SP only, these patients had significant improvements in 6-month and 1-year overall survival (OS) rates (100.0% vs. 82.4%, p < 0.01; 86.0% vs. 66.2%, p < 0.05, respectively) (unadjusted for prognostic factors including sex, age, KPS and extent of resection) and an increased trend of median OS (479.0 vs. 448 days, p = 0.269). However, after adjusting for those prognostic factors, we didn’t find a statistically better survival for patients treated with TTF (OR: 6.156, p = 0.097, OR: 2.102, p = 0.185, respectively). Furthermore, multivariate Cox proportion hazards model after adjusting for those prognostic factors showed no significant survival benefits for patients treated with TTF and SP compared to those treated with SP only (HR = 0.797, p = 0.648). In addition, we didn’t find significant increases of 6-month, 1-year survival rates and median OS for patients in group 3 when compared to those in group 2 who had seen increased trends of survival trends when compared to those in group 1. Conclusions: Although adding TTF to SP appeared to benefit patients with GBM, this effect might be due to selection bias, e.g., TTF was offered to those patients with better prognostic factors. Ascertaining the long-term benefits of TTF requires further investigation.

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The pathogenicity of rmpA or aerobactin-positive Klebsiella pneumoniae in infected mice

Journal of International Medical Research ◽

10.1177/0300060519863544 ◽

2019 ◽

Vol 47 (9) ◽

pp. 4344-4352 ◽

Cited By ~ 1

Author(s):

Guili Li ◽

Shuhong Sun ◽

Zhong Yuan Zhao ◽

Yunfang Sun

Keyword(s):

Klebsiella Pneumoniae ◽

Survival Rates ◽

Gene Detection ◽

Group 4 ◽

High Virulence ◽

Bacterial Enumeration ◽

String Test ◽

Group 3 ◽

Group 2 ◽

Group 1

Objectives To investigate the pathogenicity of Klebsiella pneumoniae (KPN) possessing rmpA or the aerobactin gene in infected mice. Methods BALB/c mice were divided into four groups (n = 10 per group) and infected with: string test-positive and rmpA-positive or aerobactin-positive KPN (group 1), string test-negative but rmpA-positive KPN (group 2), string test-negative but aerobactin-positive KPN (group 3), or string test- and rmpA/aerobactin-negative KPN (group 4). Mouse survival time was compared among groups, and the infection of livers, spleens, lungs, and kidneys and KPN growth were assessed in infected mice. Results Compared with the negative group (group 4), the survival rates of mice infected with rmpA- or aerobactin-positive KPN (groups 1–3) were significantly lower, their multi-organ injuries were significantly more severe, and bacterial enumeration was significantly higher. Conclusions Despite being string test-negative, aerobactin- or rmpA-positive KPN still exhibit high virulence and anti-immune effect activity. Therefore, the combination of the string test and gene detection of aerobactin and rmpA will be helpful in screening hypervirulent KPN.

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Effect of Timing of Pulmonary Metastases Identification on Prognosis of Patients With Osteosarcoma: The Japanese Musculoskeletal Oncology Group Study

Journal of Clinical Oncology ◽

10.1200/jco.2002.11.028 ◽

2002 ◽

Vol 20 (16) ◽

pp. 3470-3477 ◽

Cited By ~ 107

Author(s):

Hiroyuki Tsuchiya ◽

Yoshimitsu Kanazawa ◽

Mohamed E. Abdel-Wanis ◽

Naohiro Asada ◽

Satoshi Abe ◽

...

Keyword(s):

Lung Metastasis ◽

Lung Metastases ◽

Survival Rates ◽

Treatment Modalities ◽

Oncology Group ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Musculoskeletal Oncology ◽

Group 1

PURPOSE: The prognostic value of the time of identification of lung metastasis was investigated in 280 patients with metastatic lung osteosarcoma as a multi-institutional study of the Japanese Musculoskeletal Oncology Group. PATIENTS AND METHODS: The 280 patients with lung metastasis were divided into four groups: group 1, patients with lung metastasis identified at initial presentation; group 2, those with lung metastasis identified during preoperative chemotherapy; group 3, those with lung metastasis identified during postoperative chemotherapy, and group 4, those with lung metastasis identified after completion of treatment. Survivals of the four groups were compared. Additionally, the effects of number of metastatic nodules, metastasectomy, and the effect of chemotherapy on the primary tumor on survival of the four groups were analyzed. RESULTS: There were 46 patients in group 1, 30 in group 2, 94 in group 3, and 110 in group 4. The overall 2-year survival rates from the time of identification of lung metastasis were 33%, 31%, 24%, and 40% for groups 1, 2, 3, and 4, respectively, whereas the 5-year survival rates were 18%, 0%, 6%, and 31%, respectively. Patients in group 4 thus demonstrated significantly better prognosis than any of the other patients (P < .0001). CONCLUSION: Time of identification of lung metastasis is an important prognostic factor. In terms of clinical behavior, groups 2 and 3 are completely different than group 4. These data ensure the need to stratify stage III osteosarcomas into subgroups according to the time of diagnosis of lung metastases. To improve the survival of osteosarcoma patients, new treatment modalities should be introduced into the treatment armamentarium for lung metastasis from osteosarcoma, especially in groups 1, 2, and 3.

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A comprehensive echocardiographic method for risk stratification in pulmonary arterial hypertension

European Respiratory Journal ◽

10.1183/13993003.00513-2020 ◽

2020 ◽

Vol 56 (3) ◽

pp. 2000513

Author(s):

Stefano Ghio ◽

Valentina Mercurio ◽

Federico Fortuni ◽

Paul R. Forfia ◽

Henning Gall ◽

...

Keyword(s):

High Risk ◽

Prognostic Value ◽

Survival Rates ◽

Intermediate Risk ◽

Chi Squared ◽

Risk Patients ◽

Pulmonary Arterial ◽

Group 3 ◽

Group 2 ◽

Group 1

Question addressedEchocardiography is not currently considered as providing sufficient prognostic information to serve as an integral part of treatment goals in pulmonary arterial hypertension (PAH). We tested the hypothesis that incorporation of multiple parameters reflecting right heart function would improve the prognostic value of this imaging modality.Methods and main resultsWe pooled individual patient data from a total of 517 patients (mean age 52±15 years, 64.8% females) included in seven observational studies conducted at five European and United States academic centres. Patients were subdivided into three groups representing progressive degrees of right ventricular dysfunction based on a combination of echocardiographic measurements, as follows. Group 1 (low risk): normal tricuspid annular plane systolic excursion (TAPSE) and nonsignificant tricuspid regurgitation (TR) (n=129); group 2 (intermediate risk): normal TAPSE and significant TR or impaired TAPSE and nondilated inferior vena cava (IVC) (n=256); group 3 (high risk): impaired TAPSE and dilated IVC (n=132). The 5-year cumulative survival rate was 82% in group 1, 63% in group 2 and 43% in group 3. Low-risk patients had better survival rates than intermediate-risk patients (log-rank Chi-squared 12.25; p<0.001) and intermediate-risk patients had better survival rates than high-risk patients (log-rank Chi-squared 26.25; p<0.001). Inclusion of other parameters such as right atrial area and pericardial effusion did not provide added prognostic value.Answer to the questionThe proposed echocardiographic approach integrating the evaluation of TAPSE, TR grade and IVC is effective in stratifying the risk for all-cause mortality in PAH patients, outperforming the prognostic parameters suggested by current guidelines.

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Comparison of Three Different Chemotherapy Regimens Containing Epirubicin in Hormone-Refractory Prostate Cancer Patients

The Scientific World JOURNAL ◽

10.1100/tsw.2008.90 ◽

2008 ◽

Vol 8 ◽

pp. 586-597 ◽

Cited By ~ 3

Author(s):

Hamit Ersoy ◽

Orhan Yigitbası ◽

Levent Sagnak ◽

Hikmet Topaloglu ◽

Ahmet Kiper

Keyword(s):

Prostate Cancer ◽

Treatment Protocol ◽

Response Rates ◽

Complete Response ◽

Survival Times ◽

Group 3 ◽

Hormone Refractory ◽

Group 2 ◽

And Performance ◽

Group 1

We compared three different chemotherapy regimens containing epirubicin in hormonerefractory prostate cancer (HRPC) patients. Sixty-nine patients with HRPC were randomized into three groups. The first group (22 patients) received 30 mg/m2/week i.v. epirubicin for 8 weeks. The second group (24 patients) received 30 mg/m2/week i.v. epirubicin for 8 weeks followed by monthly maintenance therapy for 4–6 months. The third group (23 patients) received oral estramustine phosphate (EMP) at a dose of 840 mg/day together with weekly and monthly maintenance epirubicin. The response rates, mean survival times, and toxicity were determined. Within the first 3 months, pain and performance scores were improved by at least one degree in all the groups. One patient in group two and three patients in group three had complete response. Partial response rates were 23% in group 1, 25% in group 2, and 17% in group 3. Stable disease rates were 41% in group 1, 33% in group 2, and 26% in group 3. The progression rates within the first 3 months were 36% in group 1, 38% in group 2, and 44% in group 3. None of the patients developed complications that were significant enough to terminate the treatment. Two patients in group 3 died of cardiotoxicity. The mean survival times were 10.1, 15.8, and 16.1 months in groups 1, 2, and 3, respectively. It was determined that weekly and maintenance epirubicin treatment protocol, and estramustine treatment protocol in addition to this treatment, was only meaningfully more effective against weekly epirubicin treatment in the statistical sense (0.01 < p < 0.05). However, due to the complications of EMP, which influence the quality of life, we believe that this was usable only when measures were adopted against these effects.

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Trajectory Analysis for Long-Term Mortality in Survivors of Childhood Cancer: A Korean Nationwide Observational Study

Blood ◽

10.1182/blood-2020-143461 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 5-6

Author(s):

Hyery Kim ◽

Hae Reong Kim ◽

Yu Rang Park

Keyword(s):

Childhood Cancer ◽

Trajectory Analysis ◽

Survival Rates ◽

Population Based ◽

Group 3 ◽

Group 2 ◽

Long Term Mortality ◽

Group 1

Background Survival rates of childhood cancers have improved substantially over the past four decades. However, these improvements have been accompanied by substantial long-term morbidity and premature mortality. In this study, we analyzed trajectory groups that correlate with long-term mortality in childhood cancer survivors. M ethods The National Health Insurance Service (NHIS) database is a population-based cohort covering over 95% of the population across all regions of South Korea. We used the patient-level longitudinal NHIS database which included patients who first received a cancer code ([ICD 10: C]) under the age of 20 years from 2002-2017. The onset of cancer diagnosis was defined as the time of the earliest diagnosis in patients who were prescribed any treatment excluding surgery within one month after the initial diagnosis. Claims codes for chemotherapeutic agents, radiotherapy, and transplantation were designated and analyzed in the database. For trajectory analysis, the total numbers of claimed diagnostic codes per year were used as the input variable of the group-based trajectory method. The separate trajectories were identified using the Proc Traj procedure in SAS 9.4. Results A total of 71,323 people were extracted from the NHIS database. After washing out previously diagnosed patients in 2002, 58,964 people remained from 2003-2017. We included 14,101 patients without records of any treatment for 3 years after the first diagnosis in the final analysis. Trajectory groups were generated in 14,101 and 8,119 patients who have survived more than 5 years and more than 10 years, respectively. Among the ≥ 5 years survivors, three groups were classified: Group 1 (N=5,654; 40.1%), Group 2 (N=7,027; 49.8%), and Group 3 (N=1,420, 10.1%) (Figure 1(A)). Likewise, three trajectory groups were identified in ≥ 10 years survivors: Group 1 (N=3,104; 38.2%), Group 2 (N=4,148; 51.1%), and Group 3 (N=867; 10.7%) (Figure 1(B)). Notably, the risk of death was significantly different between each trajectory group according to Cox regression analysis after being corrected for age and sex (Table 1). In patients with a follow-up of 5 years or more, mortality risk was 4.84 times higher in Group 3 compared to Group 1 (P<0.001). Also, in patients with follow-up of 10 years or more, mortality risk was 11.55 times higher in Group 3 compared with Group 1 (P<0.001). In the survival graph from the timepoints of 5 or 10 years after diagnosis, there were significant differences in overall survival between each trajectory group of the two patient cohorts (P<0.001, Figure 2). To identify characteristics associated with survival differences between trajectory groups, baseline characteristics at diagnosis and treatments were analyzed (Table 2, 3). There were significant differences in age at time of diagnosis in three trajectory groups: in both cohorts, age at diagnosis was significantly younger in Group 3 of the lowest survival rates than other groups. For initial diagnosis, there were increasing trends of Lymphoid leukemia and brain tumors in Group 3 of both cohorts. For types of treatment, the proportions of patients who received only chemotherapy or radiotherapy decreased from Group 1 to Group 3. However, the proportions of patients who received combined treatment with any stem cell transplantation increased from Group 1 to Group 3. The follow-up periods were significantly lower in Group 3, which corresponded to the survival probabilities. Whereas the numbers of prescribed codes for any treatment were significantly higher in Group 3, indicating that patients in Group 3 received more frequent and condensed treatments within shorter periods than those in Group 2, and this relationship was also seen between Group 2 and Group 1. Conclusions This study is the first trajectory analysis conducted in childhood cancer survivors using population-based longitudinal data. In this study, unlike previous trajectory analyses based on characteristics at the time of diagnosis, trajectories were classified based on the burden of diagnosis during periods, which resulted in differences in long-term mortality, and then the differences in characteristics between each group were analyzed. Our findings indicate that that long-term mortality is related to age at diagnosis and concentration of treatment relative to total follow-up duration rather than the absolute duration or intensity of treatment. Disclosures No relevant conflicts of interest to declare.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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