Characteristics and outcomes of Embolic Stroke of Undetermined Source according to stroke severity

Background and aims Patients with embolic strokes of undetermined source (ESUS) usually present with mild symptoms. We aimed to compare the baseline characteristics between mild and severe ESUS, identify predictors for severe ESUS, and assess outcomes of patients with severe ESUS. Methods In the AF-ESUS (AF-ESUS) dataset, we stratified ESUS severity using the median National Institutes of Health Stroke Scale (NIHSS) score on admission as cut-off. We performed multivariable stepwise regression analyses to identify independent predictors of severe ESUS and to assess the association between ESUS severity and stroke recurrence, death, and new incident atrial fibrillation (AF) on follow-up. The 10-year cumulative probabilities of outcome incidence were estimated by the Kaplan–Meier product limit method. Results In 772 patients (median NIHSS: 6 (interquartile range: 3–12)), 414 (53.6%) patients had severe ESUS (i.e. NIHSS ≥6). Female sex was the only independent predictor for severe ESUS (odds ratio: 1.72 (1.27–2.33)). The rates of recurrence (3.3%/year vs. 3.4%/year, adjusted-hazard ratio: 1.09 (0.73–1.62)) and new incident AF (13.5% vs. 17.0%, adjusted odds ratio: 0.67 (0.44–1.03)) were similar between severe and mild ESUS, but mortality was higher (5.4%/year vs. 3.7%/year, adjusted-hazard ratio: 1.51 (1.05–2.16)) in severe ESUS. The 10-year cumulative probability for stroke recurrence was similar between severe and mild ESUS (38.1% (29.2–48.6) vs. 36.6% (27.8–47.0), log-rank test: 0.01, p = 0.920). The 10-year cumulative probability of death was higher in patients with severe ESUS compared with mild ESUS (40.5% (32.5–50.0) vs. 34.0% (26.0–43.6) respectively; log-rank test: 4.54, p = 0.033). Conclusions Women have more severe ESUS compared with men. Patients with severe ESUS have similar rates of stroke recurrence and new incident AF, but higher mortality compared with mild ESUS.

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Hipoalbuminemia pada Pasien Usia Lanjut dengan Pneumonia Komunitas: Prevalensi dan Pengaruhnya Terhadap Kesintasan

Jurnal Penyakit Dalam Indonesia ◽

10.7454/jpdi.v1i2.48 ◽

2017 ◽

Vol 1 (2) ◽

pp. 79

Author(s):

Wawan Kurniawan ◽

C Martin Rumende ◽

Kuntjoro Harimurti

Keyword(s):

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Rank Test ◽

Proportional Hazard ◽

Hazard Regression ◽

Log Rank Test ◽

Kaplan Meier

Pendahuluan. Hipoalbuminemia merupakan salah satu penanda risiko mortalitas, tetapi belum banyak yang mempertimbangkan faktor waktu (seberapa cepat terjadinya mortalitas). Penelitian ini mengevaluasi pengaruh hipoalbuminemia terhadap kecepatan terjadinya mortalitas pada pasien usia lanjut dengan pneumonia komunitas. Penelitian ini bertujuan untuk mengetahui prevalensi hipoalbuminemia dan pengaruhnya terhadap kesintasan pasien usia lanjut yang dirawat dengan pneumonia komunitas.Metode. Penelitian dengan disain kohort retrospektif dilakukan terhadap 142 pasien usia lanjut dengan pneumonia komunitas yang dirawat di RSCM pada kurun waktu Januari-Oktober 2010. Data klinis dan laboratoris diambil dalam 24 jam pertama kedatangan (data sekunder) dan kemudian diikuti dalam 30 hari untuk melihat status mortalitasnya. Perbedaan kesintasan hipoalbuminemia ditampilkan dalam kurva Kaplan Meier dan perbedaan kesintasan diantara dua atau lebih kelompok akan diuji dengan Log-rank test, dengan batas kemaknaan <0.05, serta analisis multivariat dengan Cox’s proportional hazard regression untuk menghitung adjusted hazard ratio (dan interval kepercayaan 95%-nya) antara pasien usila dengan pneumonia yang mengalami hipoalbuminemia terhadap yang normoalbuminemia dengan koreksi terhadap variabel-variabel perancu.Hasil. Prevalensi hipoalbuminemia pada pasien usila dengan pneumonia komunitas sebesar 71,1% (IK95% 0,64-0,78). Rerata kesintasan pada kelompok dengan kadar albumin normal adalah 27 hari (IK95% 24,35-30,98), sedangkan pada kelompok albumin 2,5-3,4 g/dL rerata kesintasannya adalah 22 hari (IK95% 19,66-25,13) dan pada kelompok albumin kurang dari 2,5 g/dL rerata kesintasannya adalah 19 hari (IK95% 13,07-26,23). Crude hazard ratio (HR) pasien dengan kadar albumin antara 2,5-3,4 g/dL adalah 4,49 (IK95% 1,05-19,20) dan pada pasien dengan kadar albumin kurang dari 2,5 g/dL adalah 7,26 (IK95% 1,46-36,09) bila dibandingkan dengan pasien dengan kadar albumin normal (≥3,5 g/dL). Setelah penambahan variabel perancu, didapatkan fully adjusted hazard ratio sebesar 3,81 (IK95% 0,86-16,95) untuk kelompok albumin antara 2,5-3,4 g/dL dan 11,09 (IK95% 1,79-68,65) untuk kelompok albumin kurang dari 2,5 g/dL.Simpulan. Prevalensi hipoalbuminemia pada usia lanjut dengan pneumonia komunitas adalah 71,1%. Terdapat perbedaan kesintasan 30 hari pasien pneumonia usia lanjut yang mengalami hipoalbuminemia dibanding dengan yang normoalbuminemia (≥3,5 g/dL). Kesintasan pada pasien dengan keadaan hipoalbuminemia yang berat lebih buruk dibandingkan pada keadaan hipoalbuminemia ringan.

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Carotid plaques and detection of atrial fibrillation in embolic stroke of undetermined source

Neurology ◽

10.1212/wnl.0000000000007611 ◽

2019 ◽

Vol 92 (23) ◽

pp. e2644-e2652 ◽

Cited By ~ 27

Author(s):

George Ntaios ◽

Kalliopi Perlepe ◽

Gaia Sirimarco ◽

Davide Strambo ◽

Ashraf Eskandari ◽

...

Keyword(s):

Atrial Fibrillation ◽

Rank Test ◽

Lower Probability ◽

Cumulative Probability ◽

Carotid Plaques ◽

Pooled Data ◽

Log Rank Test ◽

Kaplan Meier ◽

Product Limit

ObjectiveTo investigate the association between the presence of ipsilateral nonstenotic carotid plaques and the rate of detection of atrial fibrillation (AF) during follow-up in patients with embolic strokes of undetermined source (ESUS).MethodsWe pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method.ResultsAmong 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37–0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34–0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8–47.2 vs 49.0%, 95% CI 40.4–57.6 respectively, log-rank-test: 11.8, p = 0.001).ConclusionsAF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without.Clinicaltrials.gov identifierNCT02766205.

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The Distribution of Yin-Deficient Symptoms and Their Relationship on Survival Rate in Cancer Patients with Yin-Deficiency

The American Journal of Chinese Medicine ◽

10.1142/s0192415x08006120 ◽

2008 ◽

Vol 36 (04) ◽

pp. 655-663 ◽

Cited By ~ 10

Author(s):

Shu-Chuan Lin ◽

Ming-Feng Chen ◽

Tsai-Chung Li ◽

Yu-Ho Hsieh ◽

Shwu-Jiuan Liu

Keyword(s):

Survival Rate ◽

Cancer Patients ◽

Survival Rates ◽

Rank Test ◽

Yin Deficiency ◽

Rate Analysis ◽

Log Rank Test ◽

Kaplan Meier ◽

Product Limit ◽

Cumulative Probabilities

Yin-Deficiency (YD), representing a status of the human body under lack of nutrition and fluid in traditional Chinese medicine, is commonly seen in late stage of cancer patients. It is not known whether the severity of YD related symptoms/signs can predict the survival rate of cancer patients. This study evaluated the distribution of Yin-deficiency symptoms/signs (YDS) in cancer patients with YD, and investigated whether the severity of YDS can predict the survival rate of cancer patients with YD. From 5 January 2007 to 5 May 2007, we selected 43 cancer patients with diagnosis of YD from hospitalized patients and outpatients. The severity of YD was evaluated by a questionnaire. We further estimated the cumulative probabilities of the survival rates over 4 months since the start of study by the Kaplan-Meier product-limit method, and compared the differences among groups with various severities in each symptom/sign with the use of the log-rank test. The results revealed that, the 3 most common YDS were sleeplessness with annoyance, less or non-coated tongue with or without redness and dry mouth. In the survival rate analysis, only 2 parameters, rapidly small pulse (p = 0.002) and less-or non-coated tongue with paleness (p = 0.017), were found to be related to the decrease of cancer patients with YD. This suggests that, both rapidly small pulse and less-or non-coated tongue without redness may be used as predictors for the estimation of survival rate in cancer patients with YD.

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Dementia and the Risk of Periodontitis: A Population-Based Cohort Study

Journal of Dental Research ◽

10.1177/00220345211037220 ◽

2021 ◽

pp. 002203452110372

Author(s):

K.S. Ma ◽

H. Hasturk ◽

I. Carreras ◽

A. Dedeoglu ◽

J.J. Veeravalli ◽

...

Keyword(s):

Cohort Study ◽

Relative Risk ◽

Propensity Score ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Rank Test ◽

Confounding Factors ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Log Rank Test

Dementia and Alzheimer’s disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score–matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score–matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, P < 0.0001, log-rank test P < 0.0001). The risk of PD in patients with dementia was age dependent ( P values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test P = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.

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Overall Survival (OS) of Acute Lymphoblastic Leukemia (ALL) Is Better When Initial Therapy Is Administered in Academic Hospitals (AH) Versus Non-Academic Hospitals (NAH): A Retrospective Analysis of the National Cancer Data Base (NCDB)

Blood ◽

10.1182/blood.v126.23.268.268 ◽

2015 ◽

Vol 126 (23) ◽

pp. 268-268 ◽

Cited By ~ 3

Author(s):

Roberto A. Ferro ◽

Valerie Shostrom ◽

Julie M. Vose ◽

Krishna Gundabolu ◽

Smith Giri ◽

...

Keyword(s):

Health Care ◽

Odds Ratio ◽

Cox Regression ◽

Initial Therapy ◽

Rank Test ◽

P Value ◽

Cumulative Survival ◽

Log Rank Test ◽

Kaplan Meier ◽

Academic Hospitals

Abstract Introduction During initial diagnosis and therapy, patients with ALL can develop life-threatening complications such as sepsis, leukostasis, hemorrhage, and tumor lysis syndrome. Dedicated multidisciplinary leukemia teams may be needed to provide optimal management of such complications and selection of optimal therapeutic strategy. AH are more likely to have such expertise, adequate resources, standard operating policies and clinical trials, which may influence early mortality and OS. Such trends have been noted for other malignancies, such as lung cancer (Samson, Am Thorac Surg 2015 and Luchtenborg JCO 2013). In acute myeloid leukemia, OS may be better if patients are treated in a high-volume hospital (Giri Blood 2015). Whether OS of ALL differs based on the facility type remains unclear. Methods Using the NCDB Participant User File, we extracted patient-level data of patients with ALL reported between 1998 to 2012. Hospital facilities were classified as either AH (academic/research program) or NAH (community cancer program, comprehensive community cancer program, and other, as per NCDB classification). Patients, who received all of their first course treatment or a decision not to treat made at the reporting facility, were included. Subjects with complete and known data for the variables sex, age, race, education, income, distance traveled for health care, hospital type, facility location, urban/rural location, insurance, Charlson co-morbidity score, chemotherapy use, time from diagnosis to treatment initiation, use of hematopoietic stem cell transplant, 30-day mortality, last contact, and vital status were included. These variables were analyzed in a univariate analysis. Kaplan Meier curves were drawn and compared using log rank test. Multivariate analysis was performed using logistic regression for 30-day mortality and cox regression with backward elimination approach for OS. Statistical analysis was done using PC SAS version 9.4. Results Of 9863 patients with ALL, 5710 (57.9%) were treated in AH. Patients treated at AH versus NAH were more likely to be African-Americans, uninsured and Medicaid insured, travel long distance to receive health care and receive transplant as a part of their treatment. The median OS (23 vs. 17 months) and 1-year OS (67% vs. 59%) were better in AH as compared to NAH (Figure 1). In a multivariate analysis, the 30-day mortality was significantly worse in NAH as compared to AH (odds ratio, OR 1.206; 95% confidence interval, CI 1.011-1.44; p <0.0374) (Table 1). Similarly, Cox regression showed that the OS was significantly worse in NAH as compared to AH (hazard ratio, HR 1.14; 95% CI 1.08-1.19; p <0.001) after adjusting for other covariates. Conclusion OS of patients with ALL may be improved, if patients receive initial therapy in AH. Possible explanations may include increased provider experience, enhanced multidisciplinary care, and access to clinical trials, among others. Improved understanding of such factors may provide opportunity to improve OS of patients treated at NAH. Table 1. Multivariate logistic regression of 30-day mortality Variable Odds ratio 95% confidence interval P value Academic (ref) Non-Academic 1 1.206 1.01-1.44 0.0374 Age - <60 years (ref)- > 60 years 1 2.907 2.28-3.71 <0.001 Charlson comorbidity score -0 (ref) -1- 2 or more 1 1.47 2.13 1.18-1.82 1.57-2.88 0.0005 <0.0001 Chemotherapy - Yes (ref) - No 1 2.93 1.82-4.72 <0.0001 Days until first treatment 0.927 0.91-0.94 <0.0001 High school education - 29% or more (ref) - 20%-28.9% - 14%-19.9% - Less than 14% 1 0.82 0.88 0.63 0.63-1.06 0.69-1.14 0.49-0.81 0.13 0.34 0.0004 Insurance Status - Private insurance/managed care (ref)- Not insured - Medicaid - Medicare - Other government 1 1.46 0.80 1.61 0.45 1.04-2.05 0.57-1.12 1.26-2.06 0.11-1.84 0.03 0.20 0.0002 0.26 Figure 1. Kaplan Meier curve showing cumulative survival among ALL patients treated at AH versus NAH (p value of log rank test <0.001) Figure 1. Kaplan Meier curve showing cumulative survival among ALL patients treated at AH versus NAH (p value of log rank test <0.001) Disclosures No relevant conflicts of interest to declare.

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Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽

10.1024/1023-9332.6.1.6 ◽

2000 ◽

Vol 6 (1) ◽

pp. 6-10

Author(s):

Knoefel ◽

Brunken ◽

Neumann ◽

Gundlach ◽

Rogiers ◽

...

Keyword(s):

Liver Metastases ◽

Colorectal Liver Metastases ◽

Rank Test ◽

Log Rank Test ◽

Kaplan Meier ◽

Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

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Sarcomas de alto grau: estudo retrospectivo de 131 casos

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912008000200004 ◽

2008 ◽

Vol 35 (2) ◽

pp. 83-87 ◽

Cited By ~ 1

Author(s):

Wilmar José Manoel ◽

Bruno José de Queiroz Sarmento ◽

Luiz de Paula Silveira Júnior ◽

Deidimar Cássia Batista de Abreu ◽

Iron Pires de Abreu Neto ◽

...

Keyword(s):

Rank Test ◽

Log Rank Test ◽

Kaplan Meier

OBJETIVO: Relatar as características clínicas dos sarcomas de partes moles de alto grau e apresentar a experiência do Hospital Araújo Jorge no tratamento destes sarcomas. MÉTODO: Análise retrospectiva dos casos de sarcoma de alto grau em adultos admitidos no Hospital Araújo Jorge (HAJ) entre 1996 e 2000. Idade, sexo, características anátomo-patológicas (tamanho e tipo histológico), localização, tratamentos oncológicos realizados (cirurgias de preservação de órgãos e membros, margens, quimioterapia, radioterapia), recorrência local, recorrência distante e sobrevida foram estudados. Análise descritiva, curvas de Kaplan-Meier, log-rank test e teste ÷² foram usados quando pertinentes. RESULTADOS: Foram registrados 235 pacientes com sarcomas de partes moles entre 1996 - 2000, sendo que 131 eram de alto grau. A média de idade foi de 47,2 anos. O tipo histológico não foi determinado em 23,7% dos casos. O tipo mais freqüente foi o leiomiossarcoma (13,7%), seguido do sarcoma sinovial (10,7%) e rabdomiossarcoma (9,2%). O tamanho mediano foi de 10 cm (2-48 cm). A distribuição nos estádios II,III e IV foi de 15%, 55% e 30%, respectivamente. Nos pacientes com estádios II e III, a margem cirúrgica adequada foi obtida em 51,9% dos pacientes. Radioterapia e quimioterapia adjuvantes foram indicadas em 33,7% e 26,1% dos casos, respectivamente. As recorrências locais e distantes ocorreram em 31,5% e 34,8% dos pacientes, respectivamente. A sobrevida global em 5 anos foi 61,8%. CONCLUSÃO: A maioria dos pacientes atendidos no HAJ é portadora de lesões localmente avançadas, volumosas ou com metástase ao diagnóstico. Os pacientes apresentaram evolução adversa, com altas taxas de recorrência local e distante.

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P850Clinical difference of recent myocardial infarction compared with acute myocardial infarction - Insights from Tokyo CCU network multicenter registry

European Heart Journal ◽

10.1093/eurheartj/ehz747.0448 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

R Ito ◽

M Takayama ◽

J Yamashita ◽

K Yahagi ◽

T Shinke ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiogenic Shock ◽

Cause Of Death ◽

Rank Test ◽

Mechanical Complication ◽

Recent Myocardial Infarction ◽

Log Rank Test ◽

Kaplan Meier ◽

Multicenter Registry

Abstract Background Although the patient's characteristics and outcome of acute myocardial infarction (AMI) have been sufficiently investigated and primary percutaneous coronary intervention (PCI) has been recognized as established treatment strategy, those of recent myocardial infarction (RMI) have not been fully evaluated. Purpose The purpose of the present study was to clarify clinical characteristics and in-hospital outcomes of RMI patients from the database of the Tokyo CCU network multicenter registry. Methods In Tokyo CCU network multicenter registry database from 2013 to 2016, 15788 consecutive patients were registered as AMI (within 24 hours from onset) and RMI (within 2–30 days from onset). However 1246 patients were excluded because of inadequate data. And we excluded 66 cases because of out of onset period and 129 cases that strongly suspected of involvement of vasospastic events. Therefore, remaining 14347 patients were categorized to RMI group (n=1853) and AMI group (n=12494), and analyzed. Results Compared with AMI group, average age was older (70.4±12.9 vs 68.0±13.4 years, p<0.001), male was less (72.4 vs 76.4%, p<0.001), chest pain as chief complaint was less (75.2 vs 83.6%, p<0.001), prevalence of diabetes mellitus was higher (35.9 vs 31.0%, p<0.001), multi-vessel coronary disease was more (54.7 vs 44.6%, p<0.001), patients undergoing PCI was less (79.0 vs 91.2%, p<0.001), and the incidence of mechanical complication was more in RMI group (3.0 vs 1.5%, p<0.001). Although 30-day mortality was equivalent between 2 groups (5.3 vs 5.8%, p=0.360), the major cause of death in AMI group was cardiogenic shock, while in the RMI group it was a mechanical complication. On Kaplan-Meier analysis, the 2 groups had significantly different cumulative incidence of death due to cardiogenic shock (p=0.006, Log-rank test) and mechanical complication (p=0.021, Log-rank test). Furthermore death due to mechanical complication in AMI group was plateau after about 1 week from hospitalization, whereas in RMI group it continued to increase. Kaplan-Meier analysis Conclusions RMI patients had distinctive clinical features in backgrounds and treatment strategies compared with AMI patients, and the major cause of death of RMI patients was different from that of AMI patients. Furthermore, even though treatment during hospitalization of RMI patients was well done, death due to mechanical complications continued to increase.

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Survival Outcomes for Induction vs Adjuvant Chemotherapy in Squamous Cell Carcinoma of the Maxillary Sinus

Otolaryngology ◽

10.1177/0194599818804777 ◽

2018 ◽

Vol 160 (4) ◽

pp. 658-663 ◽

Cited By ~ 4

Author(s):

Phoebe Kuo ◽

Sina J. Torabi ◽

Dennis Kraus ◽

Benjamin L. Judson

Keyword(s):

Overall Survival ◽

Adjuvant Chemotherapy ◽

Maxillary Sinus ◽

Induction Chemotherapy ◽

Squamous Cell ◽

Cox Regression ◽

Rank Test ◽

Controlled Clinical Trial ◽

Log Rank Test ◽

Kaplan Meier

Objective In advanced maxillary sinus cancers treated with surgery and radiotherapy, poor local control rates and the potential for organ preservation have prompted interest in the use of systemic therapy. Our objective was to present outcomes for induction compared to adjuvant chemotherapy in the maxillary sinus. Study Design Secondary database analysis. Setting National Cancer Database (NCDB). Subjects and Methods In total, 218 cases of squamous cell maxillary sinus cancer treated with surgery, radiation, and chemotherapy between 2004 and 2012 were identified from the NCDB and stratified into induction chemotherapy and adjuvant chemotherapy cohorts. Univariate Kaplan-Meier analyses were compared by log-rank test, and multivariate Cox regression was performed to evaluate overall survival when adjusting for other prognostic factors. Propensity score matching was also used for further comparison. Results Twenty-three patients received induction chemotherapy (10.6%) and 195 adjuvant chemotherapy (89.4%). The log-rank test comparing induction to adjuvant chemotherapy was not significant ( P = .076). In multivariate Cox regression when adjusting for age, sex, race, comorbidity, grade, insurance, and T/N stage, there was a significant mortality hazard ratio of 2.305 for adjuvant relative to induction chemotherapy (confidence interval, 1.076-4.937; P = .032). Conclusion Induction chemotherapy was associated with improved overall survival in comparison to adjuvant chemotherapy in a relatively small cohort of patients (in whom treatment choice cannot be characterized), suggesting that this question warrants further investigation in a controlled clinical trial before any recommendations are made.

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Estudio de supervivencia de pacientes menores de 18 años de edad con diagnóstico de cáncer atendidos en el Hospital Universitario San Ignacio-Centro Javeriano de Oncología entre octubre de 2010 y marzo de 2016

Universitas Médica ◽

10.11144/javeriana.umed58-4.espm ◽

2017 ◽

Vol 58 (4) ◽

Author(s):

Paula Carolina Guzmán Cruz ◽

Luis Enrique Farías Curtidor ◽

Helena María Jiménez Villabona ◽

Patricia Maldonado Riveros ◽

Iliana Del Carmen De Los Reyes Valencia

Keyword(s):

Rank Test ◽

Log Rank Test ◽

Kaplan Meier

ResumenIntroducción: El cáncer infantil ocasiona importante mortalidad. El objetivo es caracterizar y determinar la sobrevida de un centro especializado. Métodos: Análisis de supervivencia en menores de 18 años de edad, diagnosticados con cáncer del 01/10/2010 al 31/03/2016. Se analizaron variables sociodemográficas (edad, sexo, seguridad social y zona de residencia) y clínicas (tipo de cáncer y categorización del riesgo). Se utilizó el método de Kaplan-Meier y Log-Rank Test. Resultados: 135 pacientes, con una edad promedio 7,4 años (DE 4,84), la mayoría de sexo masculino y pertenecientes al régimen contributivo. Las neoplasias más frecuentes fueron leucemias y tumores de sistema nervioso central, predominancia de alto riesgo. La supervivencia global fue del 75 % y la supervivencia libre de evento fue del 60 %. Los tumores sólidos y de alto riesgo presentaron mayor mortalidad. Conclusiones: La supervivencia global a 5 años es similar a los datos internacionales. La mayoría de los tumores sólidos eran de alto riesgo, probablemente asociados a mayor tiempo de evolución.

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