Lack of late toxicity in patients treated with cisplatin-containing combination chemotherapy for metastatic testicular cancer.

1990 ◽  
Vol 8 (1) ◽  
pp. 21-26 ◽  
Author(s):  
M Boyer ◽  
D Raghavan ◽  
P J Harris ◽  
J Lietch ◽  
A Bleasel ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Combination Chemotherapy ◽  
Late Toxicity ◽  
Smoking History ◽  
Diffusing Capacity ◽  
Peripheral Nerve Damage ◽  
Single Breath ◽  
Advanced Testicular Cancer

To date, the prevalence and nature of the late toxicity of cisplatin-based combination chemotherapy for advanced testicular cancer has been poorly documented. Thirty men with a median age of 35 years (range, 23 to 63), who had undergone such treatment were assessed with detailed investigation to determine the type and frequency of chronic toxicity. The median follow-up from the time of commencement of chemotherapy was 75 months (range, 48 to 126). The most common late toxic effects were high tone hearing loss in 23 men (77%) and electrophysiological evidence of peripheral nerve damage in 15 (50%). Both the hearing and nerve abnormalities were predominantly asymptomatic. In addition, elevation of serum cholesterol, noted in 20 patients (67%), was significant (P = .014) when compared with a control population. Hyperuricemia was present in nine patients (30%). Only one patient, with other risk factors (smoking, family history), had evidence of ischaemic heart disease while 20% (all with a smoking history) had a diminished single breath diffusing capacity for carbon monoxide (DLCO). Cisplatin-based chemotherapy is relatively free of major long-term side effects and should not be withheld for fear of late toxicity.

Abstract TP127: Mortality and Recurrence in Atherosclerotic Ischemic Stroke: Long-term Follow-up

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Miguel A Barboza ◽  
Rodrigo Uribe ◽  
Fabiola Serrano ◽  
Luis C Becerra-Pedraza ◽  
D. K Mantilla-Barbosa ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Median Time ◽  
Smoking History ◽  
Stroke Recurrence ◽  
Active Smoking ◽  
Long Term Outcome ◽  
Long Term Follow Up

Background and purpose: Atherosclerotic ischemic stroke is the second most frequent etiology of stroke in the adult population. Functional outcome, mortality and recurrence of stroke rates on the long-term follow-up are poorly studied. This study investigates long-term outcome among patients with ischemic stroke secondary to atherosclerotic causality, and identifies the main factors associated with poor outcome, recurrence, and death. Methods: We analyzed data from our consecutive acute ischemic stroke database, over a period of 25 years (1990-2015). The endpoints were: bad outcome (Modified Rankin Score ≥3), recurrence and mortality at discharge, and final follow-up. Multivariate Cox and Kaplan-Meier analysis were used to estimate the probability of death and recurrence. Results: A total of 946 consecutive atherosclerotic stroke patients were included (571 [60.4%] males, median age 65 years [interquartile range 57-73 years] for the entire population); dyslipidemia (64.2%), hypertension (63.3%), diabetes (35.0%), and active smoking history (31.8%) were the most prevalent risk factors.After a median follow-up of 38 months (IQR 12-75 months), 59.3% patients had a bad outcome at discharge. A result of 26.1% had stroke recurrence (median time until recurrence: 9 months [IQR 12-84 months], with 12.9% cases presenting ≥2 recurrences), and 24.1% were dead (median time to death: 18.5 months [IQR 11-74 months]) at the final follow-up period. After multivariate adjustment, hypertension (HR 4.2, CI 95% 2.8-6.1; p<0.001) was the strongest predictor of recurrence. Additionally, diabetes (HR 2.6, CI 95% 2.0-3.5; p<0.001), bad functional outcome after recurrence (HR 2.3, CI 95% 1.9-2.9; p<0.001), age ≥65 years (HR 2.2, CI 95% 1.7-2.9; p<0.001), and active smoking (HR 1.8, CI 95% 1.3-2.3; p<0.001) were the strongest predictors of mortality. Conclusions: Atherosclerotic ischemic stroke has a high rate of recurrence, associated mainly with hypertension. Mortality is predicted by diabetes, bad functional outcome at recurrence, and older age.

Long-term follow-up of a phase III intergroup study of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study.

1997 ◽  
Vol 15 (7) ◽  
pp. 2564-2569 ◽  
Author(s):  
S B Saxman ◽  
K J Propert ◽  
L H Einhorn ◽  
E D Crawford ◽  
I Tannock ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Combination Chemotherapy ◽  
Performance Status ◽  
Single Agent ◽  
Phase Iii ◽  
Long Term Follow Up ◽  
Intergroup Trial ◽  
Advanced Urothelial Carcinoma

PURPOSE A previously reported randomized intergroup trial demonstrated that combination chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) was superior to single-agent cisplatin in patients with advanced urothelial carcinoma. We conducted a long-term analysis of patients included in the intergroup trial to examine factors associated with long-term survival. PATIENTS AND METHODS Two-hundred fifty-five assessable patients with urothelial carcinoma were randomized to receive either single-agent cisplatin (70 mg/m2 on day 1) or combination chemotherapy with methotrexate (30 mg/m2 on days 1, 15, and 22), vinblastine (3 mg/m2 on days 2, 15, and 22), doxorubicin (30 mg/m2 on day 2), and cisplatin (70 mg/m2 on day 2). Courses were repeated every 28 days. The association between patient characteristics and survival was assessed using Cox proportional hazards models. RESULTS With long-term follow-up evaluation, survival in the M-VAC arm continues to be superior to cisplatin (P = .00015, log-rank test). Predictors of survival include performance status, histology, and the presence of liver or bone metastasis. Only 3.7% of the patients randomized to M-VAC are alive and continuously disease-free at 6 years. CONCLUSION Long-term follow-up evaluation of the intergroup trial confirms that M-VAC is superior to single-agent cisplatin in patients with advanced urothelial carcinoma; however, durable progression-free survival is rare. Patients with non-transitional-cell histology, poor performance status, and/or bone or visceral involvement fare poorly and are unlikely to benefit significantly from M-VAC chemotherapy.

scholarly journals Chronic fatigue in 812 testicular cancer survivors during long-term follow-up: increasing prevalence and risk factors

2015 ◽  
Vol 26 (10) ◽  
pp. 2133-2140 ◽  
Author(s):  
M. Sprauten ◽  
H.S. Haugnes ◽  
M. Brydøy ◽  
C. Kiserud ◽  
T. Tandstad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Testicular Cancer ◽  
Cancer Survivors ◽  
Chronic Fatigue ◽  
Long Term Follow Up ◽  
Testicular Cancer Survivors

Late toxicity of brachytherapy after female genital tract tumors treated during childhood: Prospective evaluation with a long-term follow-up

2015 ◽  
Vol 117 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Antonin Levy ◽  
Helene Martelli ◽  
Chiraz Fayech ◽  
Veronique Minard-Colin ◽  
Isabelle Dumas ◽  
...  
Keyword(s):  
Genital Tract ◽  
Female Genital Tract ◽  
Late Toxicity ◽  
Prospective Evaluation ◽  
Long Term Follow Up ◽  
Female Genital

scholarly journals Intermediate to Long Term Follow Up of Hintegra Total Ankle Replacements

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0043
Author(s):  
Andrew Walls ◽  
Gavin Heyes ◽  
Raymond McKenna ◽  
Honor Prout ◽  
R Alistair Wilson ◽  
...  
Keyword(s):  
Learning Curve ◽  
Smoking History ◽  
P Value ◽  
Ankle Arthritis ◽  
Aofas Score ◽  
Additional Surgery ◽  
Patient Reported ◽  
One Way Anova

Category: Ankle, Ankle Arthritis Introduction/Purpose: The optimal management of severe ankle arthritis is still debated. Some maintain that arthrodesis is the reference standard. However, with appropriately selected patients modern Total Ankle Replacements (TAR) can offer good to excellent patient reported outcomes. First generation TARs were highly constrained and prone to accelerated wear, loosening and subsidence and failure. Subsequent reincarnations have led to the development of reduced constraint, mobile bearing prostheses with reliance on ligamentous balancing. New generation TARs report 10-year survival of up to 89%, however many studies are from design centres and not uniformly replicated elsewhere. The largest long-term Hintegra TAR study is from a designer’s centre, reporting 84% survival at 10 years. This paper reports multicentre results on the intermediate (6 years +) outcomes of the Hintegra TAR. Methods: TARs performed by two senior consultant surgeons from 30/03/2004-18/01/2013 were reviewed. Prospective review of patients included; review of current and or new symptoms, an updated past medical history, AOFAS Hindfoot scores and radiological imaging. We used the AOFAS hindfoot score for our functional assessment as it validated and also the most frequently cited scoring system in the literature. Radiographs were reviewed for loosening and this was defined by a validated assessment method with a suitably low inter-observer variability. In our study all images were reviewed by at least two authors for a consensus opinion. The Charlson Comorbidity Index (CCI) was utilised to evaluate and risk stratify co-morbidities and their influence on other illnesses and surgical outcomes. This study was considered to be service evaluation by our local research and ethics department and approved in accordance with General Data Protection Regulation guidelines. Statistical analysis was performed using SPSS software. Results: 62 TARs were performed on 58 patients. Excluding the deceased (n=9) and patients lost to follow up (n=1), mean follow up was 12years 3months. AOFAS score did not decline with age of TAR (Spearman Rho co-efficient 0.339). During the first 4 years Hintegra TARs were performed 11/23 (48%) patients underwent additional surgery highlighting the already published learning curve with TAR. 5-year and 10-year survival was 84% (52/62) and 71% respectively (27/38). Predictors for revision included obesity with a BMI>30 versus those with a BMI of 18.5-25 (Chi-Sq P-value 0.006) and previous smoking history (Chi-Sq P-value 0.027). No association was found between CCI scores and revision (One-way ANOVA P-value 0.4). Interestingly lower ASA scores were significantly more likely to require revision (One-way ANOVA P-value 0.034). Conclusion: The Hintegra Total Ankle Replacement offers good sustained pain relief and function. 71% of implants were retained with an average AOFAS score of 78 (36-100 range) after 10 years. We do recommend caution in patients who are obese, smokers, ex-smokers and those with a high functional demand. We stress the importance of achieving correct alignment of the TAR to maximise longevity. There is a steep learning curve when performing a TAR and we would suggest operating with another experienced surgeon for at least the first 20 cases.

scholarly journals Long-Term Follow Up of the Erectile Function of Testicular Cancer Survivors

2019 ◽  
Vol 10 ◽  
Author(s):  
Francesco Pallotti ◽  
Alessandra Petrozzi ◽  
Francesco Cargnelutti ◽  
Antonio Francesco Radicioni ◽  
Andrea Lenzi ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Cancer Survivors ◽  
Erectile Function ◽  
Long Term Follow Up ◽  
Testicular Cancer Survivors

Larynx preservation after initial non-cisplatin containing combination chemotherapy plus radiotherapy, as opposed to surgical intervention with or without radiotherapy in previously untreated advanced head and neck cancer: final analysis after 12 years follow-up

1993 ◽  
Vol 107 (3) ◽  
pp. 211-216 ◽  
Author(s):  
L. A. Price ◽  
H. J. Shaw ◽  
Bridget T. Hill
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Median Overall Survival ◽  
Postoperative Radiotherapy ◽  
Local Therapy ◽  
Final Analysis ◽  
Entire Group ◽  
Larynx Preservation

After a median follow-up of 12 years, median overall survival of 73 patients with advanced squamous cell carcinoma of the larynx was 65 months. The 61 per cent of patients responding to two courses of initial schedule A combination chemotherapy, not including cisplatin, and the 81 per cent of patients achieving a final complete remission after definitive local therapy, had median overall survival figures of 95 and 97 months respectively. Overall survival and relapse-free survival in 51 patients treated with radiotherapy only with larynx preservation, were not significantly different from the 21 patients who completed their surgery with pre- or postoperative radiotherapy: median overall figures were 71 versus 65 months. These data add weight to our proposal that use of initial combination chemotherapy followed by radiotherapy may eliminate the need for radical surgery, so preserving the larynx in patients with advanced disease, and provides evidence of some long-term benefit with 32 per cent of this entire group surviving 12 years.

Sign in / Sign up

Export Citation Format

Share Document