Does knowledge of the primary tumour affect survival after surgery for spinal metastatic disease? A retrospective longitudinal cohort study

ObjectivesTo compare survival after surgery for patients with spinal metastatic disease with known primary tumour (KPT) versus patients with unknown primary tumour (UPT).Participants393 patients 18 years or older (270 men and 123 women, mean age 67.3 years) undergoing surgery at Uppsala University Hospital in Swedenbetween 2006 and 2016due to spinal metastatic disease . 271 patients (69%) had a KPT at the time of surgery and 122 (31%) had an UPT.InterventionsDecompressive and/or stabilising spine surgery due to spinal metastatic disease.Primary outcomeSurvival (median and mean) after surgery.ResultsThe estimated median survival time after surgery for patients with KPT was 7.4 months (95% CI 6.0 to 8.7) and mean survival time was 21.6 months (95% CI 17.2 to 26.0). For patients with UPT, the median estimated survival time after surgery was 15.6 months (95% CI 7.5 to 23.7) and the mean survival time was 48.1 months (95% CI 37.3 to 59.0) (Breslow, p=0.001). Unknown primary cancer was a positive predictor of survival after surgery (Cox regression, HR=0.58, 95% CI 0.46 to 0.73).ConclusionIn this study, patients with spinal metastasis and UPT had a longer expected survival after surgery compared with patients with KPT. This suggests that patients with UPT and spinal metastasis should not be withheld from surgery only based on the fact that the primary tumour is unknown.

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Laryngeal Neuroendocrine Carcinomas: A Retrospective Study of 14 Cases

BioMed Research International ◽

10.1155/2015/832194 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Yingying Zhu ◽

Liming Gao ◽

Yunxiao Meng ◽

Wenwen Diao ◽

Xiaoli Zhu ◽

...

Keyword(s):

Survival Time ◽

Neuroendocrine Carcinoma ◽

Clinical Manifestations ◽

Small Cell ◽

Atypical Carcinoid ◽

Small Cell Neuroendocrine Carcinoma ◽

Typical Carcinoid ◽

Mean Survival Time ◽

The Mean ◽

Neuroendocrine Carcinomas

Laryngeal neuroendocrine carcinomas (LNECs) are rare and highly heterogeneous which present a wide spectrum of pathological and clinical manifestations. Fourteen patients with histologically demonstrated LNEC were collected and analyzed retrospectively. The 14 cases were classified into 3 subtypes: typical carcinoid in 2, atypical carcinoid in 5, and small cell neuroendocrine carcinoma in 7. The mean survival time of the 14 patients in this study was 112.5 months (95% CI, 81.5–143.6). Surgeries were performed for 2 patients of typical carcinoid, and they were alive with no evidence of recurrence after 24 and 47 months of follow-ups. Patients in the atypical carcinoid group were treated with surgeries and postoperative radiotherapy. After 58.4 months of follow-ups (range: 9–144), 2 patients showed no evidence of disease and 1 was lost to follow-up after 72 months. The other 2 patients died of other unrelated diseases. In the small cell neuroendocrine carcinoma group, a combination of chemotherapy and radiotherapy was applied. The mean survival time was 79.7 months (95% CI, 37.9–121.4), and the 5-year survival rate was 53.6%. In conclusion, the clinical behaviors, treatment protocols, and prognosis are different for each subtype of LNECs.

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Prognostic Value of Metabolic Activity of the Psoas Muscle Evaluated By Preoperative 18 F- FDG PET-CT in Breast Cancer: A Retrospective Cross-Sectional Study

10.21203/rs.3.rs-561129/v1 ◽

2021 ◽

Author(s):

Keunyoung Kim ◽

In-Ju Kim ◽

Kyoungjune Pak ◽

Taewoo Kang ◽

Young Mi Seol ◽

...

Keyword(s):

Breast Cancer ◽

Metabolic Activity ◽

Cox Regression ◽

Surrogate Marker ◽

Psoas Muscle ◽

University Hospital ◽

Cox Regression Analysis ◽

Standardized Uptake Values ◽

The Mean ◽

Receptor Negativity

Abstract Background: This study aimed to evaluate the potential of metabolic activity of the psoas muscle measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography to predict treatment outcomes in patients with resectable breast cancer.Methods: The medical records of 288 patients who had undergone surgical resection for stages I–III invasive ductal carcinoma of the breast between January 2014 and December 2014 in Pusan National University Hospital were reviewed. The standardized uptake values (SUVs) of the bilateral psoas muscle were normalized using the mean SUV of the liver. SUVRmax was calculated as the ratio of the maximum SUV of the average bilateral psoas muscle to the mean SUV of the liver. SUVRmean was calculated as the ratio of the averaged bilateral psoas muscle to the mean SUV of the liver.Results: Univariate analyses identified a higher T stage, higher N stage, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor 2 positivity, triple-negative breast cancer, mastectomy (rather than breast-conserving surgery), SUVRmean > 0.464, and SUVRmax > 0.565 as significant adverse factors for progression-free survival (PFS). Multivariate Cox regression analysis revealed that N3 stage (hazard ratio [HR] = 5.347, P = 0.031) was an independent factor for recurrence. An SUVRmax > 0.565 (HR = 4.987, P = 0.050) seemed to have a correlation with shorter PFS.Conclusions: A higher SUVRmax of the psoas muscle, which could be a surrogate marker of insulin resistance, showed strong potential as an independent prognostic factor for recurrence in patients with resectable breast cancer.

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Effect of Intravenous Iron in Experimental Traumatic Shock

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1956.186.3.554 ◽

1956 ◽

Vol 186 (3) ◽

pp. 554-556

Author(s):

Donn L. Smith ◽

Irvin I. Kibbey ◽

Max E. Bierwagen ◽

J. R. Cruse

Keyword(s):

Heavy Metal ◽

Survival Time ◽

Metal Toxicity ◽

Intravenous Iron ◽

Traumatic Shock ◽

Survival Times ◽

Albino Rat ◽

Liver Iron ◽

Mean Survival Time ◽

The Mean

Intravenous administration of colloidal saccharated iron oxide prior to intestinal traumatization in the albino rat resulted in a significant reduction of the mean survival time. Sodium gold thiosulfate and colloidal manganese hydroxide employed in the same manner did not significantly alter mean survival times. ACTH and cortisone did not modify the deleterious effects of iron in experimental traumatic shock. A decrease in soluble liver iron was observed when traumatization followed the injection of iron. It was concluded that the reduction of mean survival time in iron injected, traumatized animals was due to a specific action of iron and is not the result of generalized heavy metal toxicity.

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Survival outcome differences based on treatments used and knowledge of the primary tumour site for patients with cancer of unknown and known primary in Ontario

Current Oncology ◽

10.3747/co.25.4003 ◽

2018 ◽

Vol 25 (5) ◽

Cited By ~ 1

Author(s):

C. S. Kim ◽

M. B. Hannouf ◽

S. Sarma ◽

G. B. Rodrigues ◽

P. K. Rogan ◽

...

Keyword(s):

Median Survival ◽

Cox Regression ◽

Metastatic Cancer ◽

Primary Tumour ◽

Primary Site ◽

Unknown Primary ◽

Survival Outcomes ◽

Tumour Site ◽

Ontario Health Insurance Plan ◽

Primary Tumour Site

IntroductionPatients with cancer of unknown primary (cup) have pathologically confirmed metastatic tumours with unidentifiable primary tumours. Currently, very little is known about the relationship between the treatment of patients with cup and their survival outcomes. Thus, we compared oncologic treatment and survival outcomes for patients in Ontario with cup against those for a cohort of patients with metastatic cancer of known primary site.Methods Using the Ontario Cancer Registry and the Same-Day Surgery and Discharge Abstract databases maintained by the Canadian Institute for Health Information, we identified all Ontario patients diagnosed with metastatic cancer between 1 January 2000 and 31 December 2005. Ontario Health Insurance Plan treatment records were linked to identify codes for surgery, chemotherapy, or therapeutic radiation related to oncology. Multivariable Cox regression models were constructed, adjusting for histology, age, sex, and comorbidities.Results In 45,347 patients (96.3%), the primary tumour site was identifiable, and in 1743 patients (3.7%), cup was diagnosed. Among the main tumour sites, cup ranked as the 6th largest. The mean Charlson score was significantly higher (p < 0.0001) in patients with cup (1.88) than in those with a known primary (1.42). Overall median survival was 1.9 months for patients with cup compared with 11.9 months for all patients with a known-primary cancer. Receipt of treatment was more likely for patients with a known primary site (n = 35,012, 77.2%) than for those with cup (n = 891, 51.1%). Among patients with a known primary site, median survival was significantly higher for treated than for untreated patients (19.0 months vs. 2.2 months, p < 0.0001). Among patients with cup, median survival was also higher for treated than for untreated patients (3.6 months vs. 1.1 months, p < 0.0001).Conclusions In Ontario, patients with cup experience significantly lower survival than do patients with metastatic cancer of a known primary site. Treatment is associated with significantly increased survival both for patients with cup and for those with metastatic cancer of a known primary site.

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Big End Double-Layer Stents for the Treatment of Gastric Outlet Obstruction Caused by Stomach Cancer

Gastroenterology Research and Practice ◽

10.1155/2019/8093091 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Ding Shi ◽

Dong Wu ◽

Yongpan Liu ◽

Feng Ji ◽

Yinsu Bao

Keyword(s):

Gastric Cancer ◽

Survival Time ◽

Stomach Cancer ◽

Double Layer ◽

Gastric Outlet Obstruction ◽

Outlet Obstruction ◽

Metal Stents ◽

Mean Survival Time ◽

Distal Gastric Cancer ◽

The Mean

Objectives. This study is aimed at evaluating the efficacy and safety of the big end double-layer uncovered self-expanding metal stents (SEMS) for the treatment of gastric outlet obstruction (GOO) caused by distal stomach cancer.Methods. Seventy three patients receiving big end double-layer uncovered SEMS for the treatment of GOO caused by distal gastric cancer will be included in this multicenter prospective clinical trial. The main outcome measures included the functional outcome, the complications, the reinterventional rates, the average treatment charges, and the mean survival time. Monthly telephone calls were needed to assess the food intake until the patients died.Results. The technical and the clinical success rates were 98.6%. The stent obstruction caused by tumor ingrowth was observed in one patient (1.4%). The incidence of food impaction was 2.9% (2/70) and the reinterventional rate was 4.3% (3/70). However, stent migration and obstruction caused by overgrowth were not observed. No perforation and severe bleeding were observed. The median cost of endoscopic stenting and total hospitalization (including reinterventions) for the big end double-layer uncovered SEMS in this study was $2945 and $3408, respectively. The mean survival time was 212.5 days.Conclusions. The placement of big end double-layer uncovered SEMS is a safe and effective modality and has the potential to be one of the options for the treatment of GOO caused by the distal gastric cancer.

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A Combination of UTMD-Mediated HIF-1α shRNA Transfection and TAE in the Treatment of Hepatic Cancer

BioMed Research International ◽

10.1155/2019/1937460 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yangying Liao ◽

Haibo Luo ◽

Zhizhong He ◽

Yongpei Kuang ◽

Peifen Chen ◽

...

Keyword(s):

Survival Time ◽

Western Blotting ◽

Tumor Size ◽

Statistical Difference ◽

Antitumor Effect ◽

Control Group ◽

Cancer Tissue ◽

Hepatic Cancer ◽

Mean Survival Time ◽

The Mean

To explore the antitumor effect of hypoxia-inducible factor-1α short hairpin RNA (HIF-1α shRNA) delivered by ultrasound targeted microbubble destruction (UTMD) and transcatheter arterial embolization (TAE) on rats with hepatic cancer. After the models of transplantation hepatoma were established, Wistar rats were randomly divided into 4 groups: Control group, UTMD group, TAE group, and UTMD+TAE group. Contrast-enhanced ultrasound (CEUS) was used to monitor tumor size on day 14 after four different treatments. Western blotting and immunohistochemistry were applied to measure the protein level of HIF-1α and VEGF in the hepatic cancer tissue. In comparison with UTMD+TAE group (21.25±10.68 days), the mean survival time was noticeably shorter in the Control group and TAE group (13.02±4.30 days and 15.03±7.32 days) (p<0.05, respectively). There was no statistical difference between UTMD+TAE group and UTMD group of the mean survival time (p>0.05). In addition, our results proved that the tumor sizes in UTMD+TAE group were obviously smaller than those in other groups (p<0.05, respectively). By CEUS, we clearly found that the tumor size was the smallest on day 14 in the UTMD+TAE group. The western blotting and immunohistochemistry results proved that the protein levels of HIF-1α and VEGF in UTMD+TAE group were obviously lower than those in TAE group and Control group on days 7 and 14 (p<0.05, respectively). However, there was no statistical difference between UTMD+TAE group and UTMD group (p>0.05). In this study we tried to explore the antitumor effect through a combination of UTMD-mediated HIF-1α shRNA transfection and TAE on rats with hepatic cancer. Our results showed that UTMD-mediated HIF-1α shRNA transfection and TAE can obviously silence HIF-1α and VEGF expression, thereby successfully inhibiting the growth of the tumor.

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Different effects of hypothermia on two syndromes of positive acceleration

Journal of Applied Physiology ◽

10.1152/jappl.1963.18.2.387 ◽

1963 ◽

Vol 18 (2) ◽

pp. 387-392 ◽

Cited By ~ 1

Author(s):

E. R. Stiehm

Keyword(s):

Survival Time ◽

Cardiac Failure ◽

Cerebral Circulation ◽

The Other ◽

Mean Survival Time ◽

Cardiac Syndrome ◽

Positive Acceleration ◽

The Mean

The tolerance to high positive (headward) acceleration at levels of 20–80 G was studied in normal and hypothermic rats. Normal rats have a mean survival time of 680 sec at 20 G, but this decreases to 105 sec at 30 G. Only slight decreases are noted at higher G, suggesting that 30 G is the point at which cerebral circulation is interrupted. Hypothermia at 22.5 C decreases acceleration tolerance at 20 G, but markedly increases acceleration tolerance at 30 G and above. At 40 G this effect is maximal, and the mean survival time for hypothermic rats is 252 sec, compared to 75 sec for controls, an increase of 236%. These different effects of hypothermia on acceleration tolerance suggest that there are two distinct syndromes of physiologic failure during positive acceleration. One is a “cardiac” syndrome, occurring at 20 G and below, characterized by partial maintenance of cerebral circulation until cardiac failure ensues, and the other is a “cerebral” syndrome, occurring at 30 G and above, characterized by immediate interruption of cerebral circulation and respiratory paralysis. Submitted on May 17, 1962

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Relationship Between Survival Rate and Survival-Time of Rabbits, Oryctolagus-Cuniculus (L), Challenged With Myxoma Virus

Australian Journal of Zoology ◽

10.1071/zo9950303 ◽

1995 ◽

Vol 43 (3) ◽

pp. 303 ◽

Cited By ~ 5

Author(s):

I Parer

Keyword(s):

Survival Time ◽

Small Groups ◽

Regression Line ◽

Survival Rates ◽

Myxoma Virus ◽

Survival Times ◽

Mean Survival Time ◽

The Past ◽

Survival Percentage ◽

The Mean

The mean survival times of small groups of rabbits challenged with myxoma virus have been used to estimate survival rates and to allocate virulence grades to field strains of myxoma virus. The slope of the regression Line relating survival percentage to mean survival time in days was shown to be less steep than has been previously estimated. This overestimation of the regression slope has, in the past, resulted in most field strains of myxoma virus being allocated to the Grade III level of virulence when allocation to Grade I would have been more appropriate.

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