scholarly journals Frequency of Surgery in Black Patients with Malignant Pleural Mesothelioma

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Emanuela Taioli ◽  
Andrea S. Wolf ◽  
Jacqueline M. Moline ◽  
Marlene Camacho-Rivera ◽  
Raja M. Flores
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Early Stage ◽  
Large Population ◽  
Multivariable Analysis ◽  
Female Gender ◽  
Population Based ◽  
Pleural Mesothelioma ◽  
Early Stage Disease ◽  
Black And White ◽  
Black Patients

Introduction. Malignant Pleural Mesothelioma (MPM) is a rare disease, even less frequently described in minority patients. We used a large population-based dataset to study the role of race in MPM presentation, treatment, and survival.Methods. All cases of pathologically proven MPM were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Age, sex, diagnosis year, stage, cancer-directed surgery, radiation, and vital status were analyzed according to self-reported race (black or white).Results. There were 13,046 white and 688 black MPM patients (incidence: 1.1 per 100,000 whites; 0.5 per 100,000 blacks; age-adjusted,p=0.01). Black patients were more likely to be female, younger, and with advanced stage and less likely to undergo cancer-directed surgery than whites, after adjustment by stage. On multivariable analysis, younger age and having surgery were associated with longer survival for both cohorts; female gender (HR 0.82 (0.77–0.88)) and early stage at diagnosis (HR 0.83 (0.76–0.90)) were predictive of longer survival in white, but not in black, patients.Conclusions. Surgery was associated with improved survival for both black and white MPM patients. However, black patients were less likely to undergo cancer-directed surgery. Increased surgical intervention in MPM black patients with early stage disease may improve their survival.

Abstract P256: Association Between Antidepressants Use and Intracerebral Hemorrhage: Florida Stroke Registry

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mithilesh Siddu ◽  
Antonio Bustillo ◽  
Carolina M Gutierrez ◽  
Kefeng Wang ◽  
Hannah Gardener ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Oral Anticoagulants ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Prior History ◽  
Stroke Registry ◽  
The Us ◽  
History Of ◽  
Antidepressant Use

Introduction: SSRIs, the most commonly prescribed antidepressants (AD) in the US, are linked to an increased intracerebral hemorrhage (ICH) risk possibly related to impaired platelet function. In the Florida Stroke Registry (FSR), we studied the proportion of cases presenting with ICH amongst AD users and the rate of SSRI prescription amongst stroke patients discharged on AD. Methods: From Jan 2010 to Dec 2019 we included 127,915 cases from FSR in whom information on AD use was available. Multivariable logistic regression was used to evaluate ICH proportions amongst AD and non-AD users and rates of prescribed SSRIs at discharge. Results: The rate of ICH amongst prior AD users (n=17,009, median age 74, IQR=19) and non-AD users (n=110,906, median age 72, IQR=21) were 11% and 14% respectively. Prior AD users were more likely to be female (17% vs. 10% male), non-Hispanic White (16% vs. 8% non-Hispanic Black vs. 12% Florida Hispanic vs. 6% Puerto Rican Hispanic), have hypertension (HTN) (14.% vs. 10%), diabetes mellitus (DM) (16% vs.12%), use oral anticoagulants (OAC) (17 % vs. 13%), antiplatelets (AP; 17% vs. 11%), and statins (17% vs. 10%) prior to hospital presentation. In multivariable analysis adjusting for age, race, prior history of HTN, DM, prior OAC, AP and statin use, AD users just as likely to present with spontaneous ICH as compared to non-AD users (OR=0.92, 95% CI 0.85, 1.01). A total of 3.4% of all ICH patients and 9% of those in whom AD information was available were discharged home on an AD (74 % SSRI, 24% other AD). Conclusion: In this large population-based study, we did not find an association between prior AD use and an increased rate of ICH. Importantly AD (mostly SSRIs) are commonly prescribed to patients with ICH in routine clinical practice. The association between types, duration, and safety of antidepressant use in ICH patients deserves further studies.

scholarly journals Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report

2021 ◽  
Vol 10 (23) ◽  
pp. 5542
Author(s):  
Stefano Bongiolatti ◽  
Francesca Mazzoni ◽  
Ottavia Salimbene ◽  
Enrico Caliman ◽  
Carlo Ammatuna ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Malignant Pleural Mesothelioma ◽  
Early Stage ◽  
Disease Free Survival ◽  
Stage I ◽  
Long Term Results ◽  
Pleural Mesothelioma ◽  
Free Survival ◽  
Therapy Regimen ◽  
Platinum Based Chemotherapy

Malignant pleural mesothelioma (MPM) is an aggressive disease with poor prognosis and the current treatment for early-stage MPM is based on a multimodality therapy regimen involving platinum-based chemotherapy preceding or following surgery. To enhance the cytoreductive role of surgery, some peri- or intra-operative intracavitary treatments have been developed, such as hyperthermic chemotherapy, but long-term results are weak. The aim of this study was to report the post-operative results and mid-term outcomes of our multimodal intention-to-treat pathway, including induction chemotherapy, followed by surgery and Hyperthermic Intraoperative THOracic Chemotherapy (HITHOC) in the treatment of early-stage epithelioid MPM. Since 2017, stage I or II epithelioid MPM patients have been inserted in a surgery-based multimodal approach comprising platinum-based induction chemotherapy, followed by pleurectomy and decortication (P/D) and HITHOC with cisplatin. The Kaplan–Meier method was used to estimate overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS). During the study period, n = 65 patients affected by MPM were evaluated by our institutional Multidisciplinary Tumour Board; n = 12 patients with stage I-II who had no progression after induction chemotherapy underwent P/D and HITHOC. Post-operative mortality was 0, and complications developed in n = 7 (58.3%) patients. The median estimated OS was 31 months with a 1-year and 3-year OS of 100% and 55%, respectively. The median PFS was 26 months with 92% of a 1-year PFS, whereas DFS was 19 months with a 1-year DFS rate of 83%. The multimodal treatment of early-stage epithelioid MPM, including induction chemotherapy followed by P/D and HITHOC, was well tolerated and feasible with promising mid-term oncological results.

scholarly journals Risk factors and survival outcomes of metachronous contralateral upper tract urothelial carcinoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kan Wu ◽  
Jiayu Liang ◽  
Yiping Lu
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Regression Model ◽  
Urothelial Carcinoma ◽  
Large Population ◽  
Multivariable Analysis ◽  
Population Based ◽  
Upper Tract Urothelial Carcinoma ◽  
Competing Risk ◽  
Upper Tract

Abstract Because population-based risk estimates for metachronous contralateral UTUC are lacking. In this study, we aimed to evaluate the risk and survival of metachronous contralateral upper tract urothelial carcinoma (UTUC) on a large population-based level. A total of 23,075 patients were identified from the Surveillance, Epidemiology, and End Results database (1973–2015), 144 (0.6%) patients developed metachronous contralateral UTUC (median of 32 months after diagnosis). The cumulative incidence at 10, 20, and 30 years of follow-up was 1.1%, 1.6%, and 2.6%, respectively. We applied Fine and Gray’s competing risk regression model to determine the risk factors of a new contralateral, metachronous UTUC. The competing risk regression model demonstrated that older age (hazard ratio [HR] 0.75; 95% CI 0.67–0.85) and larger tumor size (HR 0.61; 95% CI 0.39–0.97) were associated with a significantly decreased risk of metachronous contralateral UTUC. However, bladder cancer presence was an independent risk factor for the development of contralateral tumors (HR 2.42; 95% CI 1.73–3.37). In addition, we demonstrated developing contralateral UTUC was not associated with poor prognosis by using Kaplan–Meier and multivariable analysis. Our findings suggest that metachronous contralateral UTUC is comparatively rare, and has not impact on survival. Importantly, patients with younger age, small tumours, and the presence of bladder cancer were more likely to develop a contralateral tumor, which may provide a rationale for lifelong surveillance in high-risk patients.

Iron signature in asbestos-induced malignant pleural mesothelioma: A population-based autopsy study

2016 ◽  
Vol 79 (3) ◽  
pp. 129-141 ◽  
Author(s):  
Sergio Crovella ◽  
Anna Monica Bianco ◽  
Joseph Vuch ◽  
Luisa Zupin ◽  
Ronald Rodrigues Moura ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Population Based ◽  
Pleural Mesothelioma ◽  
Autopsy Study

scholarly journals Does size matter? —a population-based analysis of malignant pleural mesothelioma

2020 ◽  
Vol 9 (4) ◽  
pp. 1041-1052
Author(s):  
Jiaxi He ◽  
Songhui Xu ◽  
Hui Pan ◽  
Shuben Li ◽  
Jianxing He
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Population Based ◽  
Pleural Mesothelioma ◽  
Size Matter

Utilization of radiation therapy in early-stage Hodgkin disease and its impact on survival

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 8511-8511
Author(s):  
J. Rineer ◽  
D. Schreiber ◽  
A. Wortham ◽  
M. Olsheski ◽  
R. Sroufe ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Early Stage ◽  
Clinical Stage ◽  
Large Population ◽  
Population Based ◽  
Stage I ◽  
Hodgkin Disease ◽  
Entire Cohort ◽  
Treatment Paradigm ◽  
Cause Specific Survival

8511 Background: Despite numerous randomized trials confirming the benefit of consolidation radiation therapy (RT) in the management of early stage Hodgkin disease (HD), utilization of RT in this setting remains variable. We performed a population-based analysis to assess the utilization of RT and its impact on overall and cause specific survival. Methods: The surveillance, epidemiology and end results (SEER) registry was used to identify patients aged 15–75 years diagnosed between 1990–2004 with early stage (stage I-IIA/B) HD, excluding nodular lymphocyte predominant HD. Kaplan-Meier analysis was performed to evaluate the effect of RT on overall survival (OS) and cause-specific survival (CSS). Subgroup survival analyses were also performed by era of treatment (1990–1997 and 1998–2004), sex, and patient age (<30, 30–50, and >50 years). Results: A total of 9729 patients met inclusion criteria. Median age of all patients was 34 years. The majority (71.3%) had nodular sclerosis (NS) type HD. By clinical stage, 3399 (34.9%) were stage I, and 6330 (65.1%) were stage II. 5352 patients (55%) received RT. RT was more likely to be employed during the early era of treatment, in younger patients, females, non-Blacks, and in NS, mixed cellularity and lymphocyte-rich HD. For the entire cohort, RT was associated with a significant (p<0.001) improvement in OS and CSS (hazard ratio of 0.537 and 0.437, respectively). The benefit of RT for OS and CSS remained significant for all subgroups analyzed including the era of treatment, sex, and age (p≤0.001). Conclusions: In this large population-based series of early stage HD patients, the use of RT is associated with a significant OS and CSS benefit across all subgroups. Current efforts in clinical trials have aimed at decreasing the utilization of RT among this patient population. This shift in practice is reflected in the data presented here. The omission of RT from the treatment paradigm, however, appears to be related with diminished survival. No significant financial relationships to disclose.

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