scholarly journals AB0391 LOW SERUM COMPLEMENT C3 LEVEL AS A RISK FACTOR FOR RELAPSE OF ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A RETROSPECTIVE COHORT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1224.1-1224
Author(s):  
H. Sakai ◽  
H. Yamashita ◽  
S. Nakajima ◽  
Y. Takahashi ◽  
H. Kaneko
Keyword(s):  
Overall Survival ◽  
Clinical Characteristics ◽  
Granulomatosis With Polyangiitis ◽  
Survival Rates ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Complement C3 ◽  
Serum Complement ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Low Serum

Background:The alternative pathway of complement activation has recently been recognized as a key pathogenic event in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Some previous studies have reported that low serum complement C3 level in AAV patients is associated with more severe renal disease, worse renal prognosis, or higher mortality. However, the correlation between low serum C3 level and AAV relapse remains unclear.Objectives:To analyze the clinical characteristics and outcomes of AAV patients with low serum C3 levels at the time of diagnosis.Methods:We conducted a retrospective observational cohort study including 83 consecutive patients diagnosed with AAV in our hospital from January 1999 to December 2020. Serum C3 levels were measured at diagnosis. AAV included microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA); patients with ANCA-negative AAV were excluded. Patients were divided into low- and high-C3 groups (C3 < 100 and ≥ 100 mg/dL, respectively). We compared the clinical characteristics, and relapse-free and overall survival rates, of the two groups, and identified predictors of AAV relapse.Results:Of the 83 patients (MPA, n = 61; GPA, n = 18; EGPA, n = 4), 20 (24%) were in the low-C3 group. We found no significant group difference in sex, body mass index, disease type, ANCA subtype, Birmingham Vasculitis Activity Score (BVAS), or treatment. The low-C3 group patients were older (p=0.01), and had a higher Five Factor Score (FFS) (p=0.01) and a lower remission rate (p=0.02), than the high-C3 group. The generalized Wilcoxon test revealed that the relapse-free survival time was significantly shorter in the low-C3 group (29 months; 95% confidence interval [CI]: 15–49) than in the high-C3 group (82 months; 95% CI: 61–NA; p=0.01) (Figure 1A). The overall survival was also shorter in the low-C3 group (83 months; 95% CI: 8-121) than in the high-C3 group (112 months; 95% CI: 77-NA; p=0.03) (Figure 1B). In the Cox proportional hazards model, a low C3 level (< 100 mg/dL) (hazard ratio [HR], 3.01; 95% CI: 1.29–7.04], p=0.01) and GPA (HR, 3.04; 95% CI: 1.32–7.01; p=0.01) were independent predictors of AAV relapse.Figure 1.Kaplan-Meier estimates of the relapse-free (A) and overall (B) survival rates of AAV patients by baseline serum C3 levels. Eight patients who did not show remission were excluded in the relapse-free survival analysis. Black line: high-C3 group (≥ 100 mg/dL); red line: low-C3 group (< 100 mg/dL).Conclusion:AAV patients with low C3 levels at diagnosis were at higher risk of relapse. Larger prospective studies are required to confirm these findings.Disclosure of Interests:None declared

scholarly journals Efficacy of perioperative chemotherapy for synovial sarcoma: a retrospective analysis of a Nationwide database in Japan

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gang Xu ◽  
Hisaki Aiba ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Synovial Sarcoma ◽  
Survival Rates ◽  
Surgical Margin ◽  
Oncologic Outcomes ◽  
Wide Resection ◽  
Perioperative Chemotherapy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Relapse

Abstract Background Synovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of perioperative chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan. Methods This study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. Moreover, the effects of perioperative chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive chemotherapy were compared (cx + and cx-). Results Multivariate analysis revealed significant correlations of age (over 40, hazard ratio [HR] = 0.61, p = 0.043), margin status (marginal resection, HR = 0.18, p < 0.001 and intralesional resection, HR = 0.30, p = 0.013 versus wide resection) with overall survival; surgical margin type (marginal resection, HR = 0.14, p = 0.001 and intralesional resection, HR = 0.09, p = 0.035 versus wide resection) with local recurrence; and postoperative local recurrence (HR = 0.30, p = 0.027) and surgical margin (marginal resection, HR = 0.31, p = 0.023 versus wide resection) with distant relapse-free survival. Before propensity score matching, perioperative chemotherapy was mainly administered for young patients and patients with deeper tumor locations, larger tumors, more advanced-stage disease, and trunk location. The 3-year overall survival, local control, and distant relapse-free survival rates were 79.8%/89.3% (HR = 0.64, p = 0.114), 89.6%/93.0% (HR = 0.37, p = 0.171) and 71.4%/84.5% (HR = 0.60, p = 0.089) in the cx+/cx- groups, respectively. After propensity score matching, 152 patients were selected such that the patient demographics were nearly identical in both groups. The 3-year overall survival, local control, and distant relapse-free survival rates were 71.5%/86.0% (HR = 0.48, p = 0.055), 92.5%/93.3% (HR = 0.51, p = 0.436) and 68.4%/83.9% (HR = 0.47, p = 0.046) in the cx+/cx- groups, respectively. Conclusion This large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of perioperative chemotherapy for survival outcomes in synovial sarcoma patients was not proven in this Japanese database analysis.

scholarly journals Evaluating Outcomes of Adult Patients with Acute Lymphoblastic Leukemia Treated on the GMALL Protocol

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 28-29
Author(s):  
Danielle Fredman ◽  
Yulia Volchek ◽  
Gabriel Heering ◽  
Keren Shichrur ◽  
Ronit Yerushalmi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Research Funding ◽  
Blood Donors ◽  
Lymphoblastic Leukemia ◽  
Survival Rates ◽  
Disease Relapse ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Car T ◽  
Matched Sibling

Background Chemotherapy based approaches still constitute an essential feature in the treatment paradigm of adult acute lymphoblastic leukemia (ALL). The German Multicenter Study Group (GMALL) is a well-established and commonly used protocol for ALL (Gökbuget 2012). Over the years evolving versions of the protocol have been developed with the aim of improving patient outcome (Apel 2014). In view of the recent advancements in the treatment of adult ALL we now analyzed our more recent data. Aims Assess the clinical outcomes of adult ALL patients treated on the GMALL protocol in real world settings, and establish prognostic parameters associated with long term survival and risk of relapse. Methods Retrospective analysis of all adult ALL patients who were treated with GMALL in our institution between the years 2008-2020. Demographic, clinical, cytogenetic, treatment, and transplant related data were collected using our institution's electronic medical records system. Baseline characteristics were evaluated by Fisher's exact test and Wilcoxon rank sum tests. Kaplan-Meier estimates were used to estimate overall survival (OS) and relapse-free survival (RFS). Hazard ratios and 95% confidence intervals were generated using a Cox proportional hazards model. Results The analysis comprised 81 evaluable patients with a median age of 36 years (range 18-73), 36% were adolescents and young adults (AYA). Forty-three were B-ALL (53%), 12 (15%) patients were Philadelphia chromosome positive ALL (Ph+ ALL), and 26 (32%) were T-ALL. Median duration of follow-up was 24.4 months (range 0.7-112.1 months), at the time of data analysis 51 patients (63.8%) were alive. Seventy patients (88%) attained a first remission (CR1) and 4 (5%) died during the first two induction phases. The 2-year and 5-year overall survival rates were 62% and 44%, respectively. Estimated 2-year and 5-year leukemia-free survival rates were 52% and 35%, respectively. Overall, disease relapse (31%), lethal infection (28%), and graft-versus-host disease (14%) accounted for most patient deaths. Of patients achieving CR1, 20 (29%) eventually relapsed after a median time of 9.8 months (range 1.1-69.3). Fifty-five patients (68%) underwent an allogeneic stem cell transplantation using matched sibling (47%), matched unrelated (31%), haploidentical (7%), partially mismatched (12%), and cord blood donors (3%). Of the 50 patients transplanted in CR1, 15 relapsed (30%) after a median time of 10.9 months (range 3.8-32.8). Multivariate analysis revealed that in terms of overall survival, increasing patient age was associated with inferior outcome [Hazard ratio (HR)=1.026, confidence interval (CI) 95%, 1.002-1.05, p=0.035) as was outcome for patients whose baseline cytogenetic analysis detected a higher number of clones (HR=2.69, CI 95%, 1.57-4.62, p=0.0002). T-ALL patients experienced longer survival compared with B-ALL (87 months versus 56 months, p=0.019) while patients transplanted using cord blood donors had inferior survival, 12.8 months, compared with matched sibling donors, 71.3 months, and fully matched unrelated donors, 73.4 months (p=0.001, and p=0.003, respectively). Relapse-free survival was significantly better in patients with T-ALL compared with B-ALL (90 months vs. 50 months, p=0.039), and in patients without t(12;21)(p13;q22) (75 months vs. 11.7 months, p=0.034). Gender, AYA status, extramedullary disease at diagnosis, initial white blood cell count, treatment delays, presence of MLL rearrangement, specific measurable residual disease modality used, GMALL risk category, and cytogenetic hyperdiploidy did not significantly impact on survival or disease relapse. Treatments for relapse following GMALL included blinatumomab (6), inotuzumab (3), nelarabine (3), and CAR-T (2). Conclusions While results are improving for patients treated on GMALL, a substantial patient segment still experiences relapse. It is conceivable that in the near future new novel therapeutic modalities for adult ALL involving the use of monoclonal antibodies and CAR-T cell therapy will help reduce relapse rates and further improve the current outcomes of patients treated on the GMALL protocol. Disclosures Avigdor: Takeda, Gilead, Pfizer: Consultancy, Honoraria; Janssen, BMS: Research Funding. Canaani:Abbvie: Consultancy, Honoraria, Research Funding.

Title: Efficacy of Tacrolimus as Maintenance Therapy after Cyclophosphamide for Treating Antineutrophil Cytoplasmic Antibody-associated Vasculitis

2021 ◽  
Author(s):  
Jung Yoon Pyo ◽  
Lucy Eunju Lee ◽  
Sung Soo Ahn ◽  
Jason Jungsik Song ◽  
Yong-Beom Park ◽  
...  
Keyword(s):  
Survival Rate ◽  
Maintenance Therapy ◽  
End Stage Renal Disease ◽  
Medical Records ◽  
Survival Rates ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: Azathioprine, methotrexate, or rituximab is used for the maintenance therapy of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Although the efficacy of tacrolimus (TAC) in various autoimmune diseases has been demonstrated, there have been few reports on the efficacy of TAC in AAV. We investigated the efficacy of TAC as maintenance therapy for AAV and compared its efficacy with that of AZA.Methods: We retrospectively analyzed the medical records of 81 AAV patients who received cyclophosphamide (CYC) as induction therapy and AZA or TAC as maintenance therapy. All-cause death, relapse, and progression to end-stage renal disease (ESRD) were analyzed.Results: Among 81 AAV patients, 69 patients received AZA alone, 6 patients received TAC alone, and 6 patients received TAC after AZA for maintenance therapy. Overall, 11 patients (13.6%) died, 30 patients (37.0%) experienced relapse, and 16 patients (19.8%) progressed to ESRD during a median of 33.8 months. No significant differences were observed in cumulative patients’, relapse-free, and ESRD-free survival rates between patients administered AZA alone and TAC alone. There were no significant differences in the cumulative patients’ and relapse-free survival rate between patients who received AZA alone and TAC after AZA. However, the cumulative ESRD-free survival rate was lower in patients who received TAC after AZA than in those who received AZA alone (P = 0.027). Conclusions: Patients who received TAC as maintenance therapy showed a higher incidence of ESRD than those who received AZA, but this might be attributed to the lack of efficacy of AZA rather than the low ESRD prevention effect of TAC.

scholarly journals Impact of gender on the prognosis of carotid body tumor after surgical resection

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Huanrui Hu ◽  
Yuwei Xiang ◽  
Bin Huang ◽  
Ding Yuan ◽  
Yi Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Carotid Body ◽  
Tumor Size ◽  
Survival Rates ◽  
Carotid Body Tumor ◽  
Overall Survival Rate ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Shamblin Classification

Abstract Background Carotid body tumors (CBTs) are rare neuroendocrine neoplasms, but the prognosis of patients with resected CBTs has seldom been elucidated. This study was conducted to investigate the association between variables, especially sex, and the prognosis of carotid body tumor resection. Methods This was a large-volume single-center retrospective cohort study. Patients who were diagnosed with CBTs between 2009 and 2020 at our center were analyzed retrospectively. Their preoperative, surgical, and follow-up data were collected, and the association between variables and outcomes of CBT resection was assessed by correlation analysis, multivariate logistic regression, and multivariate Cox regression as appropriate. Results A total of 326 patients (66.6% were females) were included. Males developed larger CBTs than females (4.3 ± 1.8 cm vs. 3.8 ± 1.4 cm, P = .003). Males were more likely to develop succinate dehydrogenase B (SDHB) mutations (P = .019) and had worse relapse-free survival rates (P = .024). Although tumor size and Shamblin classification had positive relationships with neurological complications and intraoperative blood loss, they did not affect the overall survival rate of patients, which was only influenced by remote metastasis (P = .007) and local recurrence (P = .008). Conclusions Compared to females, males with CBT resection were found to have more SDHB mutations and worse relapse-free survival rates, which may lead to the deterioration of prognosis. Tumor size and Shamblin classification cannot predict the overall survival rate of patients with excised CBTs. Graphical abstract

scholarly journals Clinical impact of subgrouping ANCA-associated vasculitis according to antibody specificity beyond the clinicopathological classification

Rheumatology ◽  
2019 ◽  
Vol 58 (10) ◽  
pp. 1731-1739 ◽  
Author(s):  
Samuel Deshayes ◽  
Nicolas Martin Silva ◽  
Kathy Khoy ◽  
Seydou Yameogo ◽  
Delphine Mariotte ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Survival Rates ◽  
Clinical Manifestations ◽  
University Hospital ◽  
European Medicines Agency ◽  
Renal Survival ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Anca Associated Vasculitis ◽  
Additional Value

Abstract Objectives In ANCA-associated vasculitis (AAV), classifications have emerged to individualize homogeneous clinical and outcomes patterns, including the recently defined anti-MPO granulomatosis with polyangiitis (GPA) subgroup. This study aimed to retrospectively evaluate the impacts of re-classification based on clinicopathological criteria and/or ANCA specificity. Methods A retrospective monocentric study conducted at Caen University Hospital led to the identification of PR3 or MPO-ANCA AAV patients from January 2000 or September 2011, respectively, to June 2016. Eosinophilic GPA patients were excluded. AAVs were thereby also classified either as GPA or microscopic polyangiitis (MPA) according to the European Medicines Agency vasculitis algorithm. Results A total of 150 AAV patients were included (94 GPA, 56 MPA; 87 anti-PR3 and 63 anti-MPO patients). GPA patients exhibited a worse relapse-free survival but a better renal survival (P &lt; 0.001 and P = 0.021, respectively) than MPA patients. Overall, relapse-free and renal survival rates were similar between anti-PR3 and anti-MPO patients (P = 0.35, 0.17 and 0.15, respectively). Similarly, the prognosis was identical between anti-MPO MPA patients and anti-PR3 MPA patients (P = 0.33, 0.19 and 0.65, respectively), and between anti-MPO GPA patients and anti-PR3 GPA patients (P = 0.06, 0.99 and 0.64, respectively). Moreover, anti-PR3 GPA and anti-MPO GPA patients exhibited no differences in clinical manifestations or BVAS score. Conclusion Clinicopathological classification appeared to be the strongest criterion for distinguishing among homogeneous prognoses of AAV. Individualizing the anti-MPO GPA subgroup does not appear to bring additional value to clinical practice, but multicentre studies are required to confirm this trend.

Does lymphadenectomy improve survival in patients with intermediate risk endometrial cancer? A multicentric study from the FRANCOGYN Research Group

2018 ◽  
Vol 29 (2) ◽  
pp. 282-289
Author(s):  
Lilia Bougherara ◽  
Henri Azaïs ◽  
Hélène Béhal ◽  
Geoffroy Canlorbe ◽  
Marcos Ballester ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Survival Rates ◽  
Intermediate Risk ◽  
Nodal Staging ◽  
Relapse Free Survival ◽  
Multicentric Study ◽  
Free Survival ◽  
The Impact

ObjectiveThe role of lymphadenectomy in intermediate risk endometrial cancer remains uncertain. We evaluated the impact of lymphadenectomy on overall survival and relapse-free survival for patients with intermediate risk endometrial cancer.MethodsWe retrospectively reviewed patients from the FRANCOGYN database with intermediate risk endometrial cancer, based on pre-operative and post-operative criteria (type 1, grade 1–2 tumors with deep (> 50%) myometrial invasion and no lymphovascular space invasion), who received primary surgical treatment between November 2002 and August 2013. We compared overall survival and relapse-free survival between staged and unstaged patients.ResultsFrom 1235 screened patients, we selected 108 patients with intermediate risk endometrial cancer. Eighty-two (75.9%) patients underwent nodal staging (consisting of pelvic +/- para-aortic lymphadenectomy). Among them, 35 (32.4%) had lymph node disease. The median follow-up was 25 months (range 0.4 to 155.0). The overall survival rates were 82.5% for patients staged (CI 64.2 to 91.9) vs 77.9 % for unstaged patients (CI 35.4 to 94.2) (P = 0.73). The relapse-free survival rates were 68.9% for staged patients (CI 51.2 to 81.3) vs 68.8% for unstaged patients (CI 29.1 to 89.3) (P=0.67).ConclusionSystematic nodal staging does not appear to improve overall survival and relapse-free survival for patients with IR EC but could provide information to tailor adjuvant therapy. Sentinel lymph node dissection may be an effective and less invasive alternative staging technique and should provide a future alternative for this population.

scholarly journals Efficacy of Neoadjuvant Chemotherapy for Synovial Sarcoma: Retrospective Analysis of a Nationwide Database in Japan

2020 ◽  
Author(s):  
Gang Xu ◽  
Hisaki Aiba ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Synovial Sarcoma ◽  
Survival Rates ◽  
Surgical Margin ◽  
Oncologic Outcomes ◽  
Wide Resection ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Relapse

Abstract BackgroundSynovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of neoadjuvant chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan.MethodsThis study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. The effects of neoadjuvant chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive neoadjuvant chemotherapy were compared (cx+ and cx-).ResultsMultivariate analysis revealed significant correlations of distant postoperative metastasis (hazard ratio [HR] = 0.01, p<0.001) with overall survival; surgical margin type (marginal resection, HR=0.12, p=0.011 and intralesional resection, HR=0.08, p=0.022 versus wide resection) with local recurrence; and postoperative local recurrence (HR=0.30, p=0.027) and surgical margin (marginal resection, HR=0.31, p=0.023 versus wide resection) with distant relapse-free survival. Before propensity score matching, neoadjuvant chemotherapy was mainly administered for the patients with younger age, deeper tumor locations, larger tumors, more advanced-stage disease, and monophasic-type disease. The 3-year overall survival rates, local control rates and distant relapse-free survival rates were 82.9% / 80.7% (HR = 0.79, p = 0.102), 91.2% / 89.8% (HR = 1.04, p = 0.837) and 76.6% / 75.0% (HR = 0.76, p = 0.307) in the cx+/cx- groups, respectively. After propensity score matching, 172 patients were selected such that the patient demographics were nearly identical for both the groups. The 3-year overall survival rates, local control rates and distant relapse-free survival rates were 80.8% / 81.4% (HR = 0.83, p = 0.563), 93.2% / 89.4% (HR = 0.83, p = 0.491) and 76.9% / 78.7% (HR = 1.01, p = 0.982) in the cx+ and cx- group, respectively.ConclusionThis large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of neoadjuvant chemotherapy for survival outcomes in synovial sarcoma patients was not proven.

scholarly journals Primary tumour ulceration in cutaneous melanoma: its role on TNM stages.

2020 ◽  
Author(s):  
Faruk Tas ◽  
Kayhan Erturk
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Primary Tumour ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Poor Prognostic Factor ◽  
Free Survival ◽  
Melanoma Patients ◽  
Overall Survival Rates ◽  
Unfavourable Prognostic Factor

Abstract Background Tumour ulceration has unfavourable prognostic factor in stage I–II melanoma. The aim of this study was to question whether tumour ulceration might predict relapse and survival in melanomas of all stages. Methods A total of 911 melanoma patients were analysed. Results The 5-year relapse-free survival rates were 50.0% for ulcerated melanomas and 75.8% for all non-ulcerated melanomas (P = 0.0001). Ulcerated melanomas had lower relapse-free survival rates than non-ulcerated melanomas in all T-stages (P = 0.0001). The relapse-free survival rates were statistically significant for T1 (P = 0.02), T3 (P = 0.01) and T4 (P = 0.004); however, T2 (P = 0.07). There were significant differences between ulcerated melanomas and non-ulcerated melanomas regarding relapse-free survival rates for both N0 (P = 0.0001) and N1 (P = 0.01) patients; poor relapse-free survival rates were found to be in association with ulcerated melanomas (P = 0.06 for N1, P = 0.04 for N2 and P = 0.8 for N3 disease). The 5- year overall survival rates were 55.3 and 81.5% for ulcerated melanomas and non-ulcerated melanomas, respectively (P = 0.0001). Ulcerated melanomas had lower overall survival rates than non-ulcerated melanomas in all T-stages; they were statistically significant for T1 (P = 0.01), T2 (P = 0.03) and T4 (P = 0.006), but not for T3 (P = 0.3). Ulceration predicted poor survival in N0 patients; however, it was not found significant although its overall survival rate was lower in node-positive patients (P = 0.09), and ulceration was a significantly poor prognostic factor only for N3 patients (P = 0.03), but not for N1 (P = 0.9) and N2 patients (P = 0.2). Furthermore, non-metastatic patients with ulcerated melanomas survived significantly less (P = 0.0001), but there were no differences in survivals between ulcerated melanoma and non-ulcerated melanoma metastatic melanoma patients (P = 0.1). Conclusion Primary tumour ulceration has been considered as a poor prognostic factor in local melanomas, but it might also have a potential for predicting survival in loco-regional and advanced melanomas.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

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