Long-term survival after histologic transformation of low-grade follicular lymphoma.

PURPOSE To describe the course of patients following histologic transformation (HT) from low-grade follicular lymphoma to intermediate- or high-grade non-Hodgkin's lymphoma. PATIENTS AND METHODS Patients were identified from data bases in the Division of Oncology and the Department of Surgical Pathology. HT was defined as the conversion of a follicular small cleaved-cell or follicular mixed small cleaved-cell and large-cell lymphoma to a diffuse large-cell, diffuse mixed small cleaved-cell and large-cell or any high-grade lymphoma. RESULTS We analyzed the clinical course of 74 low-grade lymphoma patients with histologically proven transformation occurring from 1965 to 1988. The median time from diagnosis to HT was 66 months, and the median age at HT was 58 years. The median duration of survival after transformation was 22 months. Anatomic extent of disease at HT (limited v extensive, P = .01), prior chemotherapy (none v any, P = .01), and response to therapy (complete v partial or none, P = .005) at time of HT were identified as significant predictors of survival after HT in backward-selection Cox regression analysis. Thirty patients attained a complete response to therapy at HT. They had a median survival duration of 81 months after HT. CONCLUSION A subset of patients with HT from low-grade follicular lymphoma to intermediate- or high-grade lymphoma enjoys relatively long-term survival. Patients with limited disease and no previous exposure to chemotherapy have the most favorable prognosis.

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PO39 Long-term survival after histologic transformation from high grade B cell non-Hodgkin's lymphoma to low grade follicular lymphoma and Hodgkin's disease in the same patient

Critical Reviews in Oncology/Hematology ◽

10.1016/s1040-8428(12)70052-5 ◽

2012 ◽

Vol 82 ◽

pp. S23

Author(s):

A. Tolosa ◽

A. Escriva ◽

J. Ros ◽

A. Garcia ◽

M. Fernandez ◽

...

Keyword(s):

Follicular Lymphoma ◽

B Cell ◽

Hodgkin’S Disease ◽

Hodgkin's Lymphoma ◽

Low Grade ◽

High Grade ◽

Term Survival ◽

Long Term Survival ◽

Non Hodgkin's Lymphoma

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Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.8123 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 8123-8123

Author(s):

C. Tarella ◽

M. Zanni ◽

A. Rambaldi ◽

F. Benedetti ◽

R. Passera ◽

...

Keyword(s):

Complete Remission ◽

High Dose ◽

Low Grade ◽

High Grade ◽

Term Outcome ◽

Term Survival ◽

Long Term Outcome ◽

Long Term Survival

8123 Background: The high-dose sequential (HDS) chemotherapy approach, including early dose-intensification and autograft with peripheral blood progenitor cells (PBPC), was introduced several years ago (Gianni & Bonadonna, 1989); subsequently, it has been broadly used in the management of both non-Hodgkin s (NHL) and Hodgkin s Lymphoma (HL). The outcome of a large series of lymphoma patients treated with the HDS approach at 10 GITIL Centers is reported. Methods: Data have been collected on 1,266 patients, who received either the original or slightly modified HDS regimens. There were 213 HL and 1,053 NHL (630 intermediate/high-grade, 423 low-grade); median age was 46 yrs. Overall, 671 (53%) patients had refractory/relapsed disease, 595 (47%) were at diagnosis. Most patients were autografted with PBPC; 158 (12%) patients did not undergo autografting due to toxicity, disease progression or poor harvests. Results: Overall, 1,013 (80%) patients reached Complete Remission (CR) following HDS. As to December 2006, 93 (7%) patients died for early/late toxicities, 328 (26%) died for lymphoma, 844 are known to be alive. At a lead follow-up of 18 years, and a median follow-up of 5 yrs, the 5-yr Overall Survival (OS) projection is 64% (S.E.: 2%). The long-term survival was quite favorable in patients achieving a Complete Remission (CR), with a 5-yr OS projection of 76%. The prolonged OS in patients achieving CR was consistent in all lymphoma subtypes, i.e. both low and high-grade NHL (5-yr OS: 77% in both), and HL (5-yr OS: 72%). Patients at diagnosis had a significantly better outcome compared to patients treated for relapsed/refractory disease, again CR achievement was associated with prolonged survival in both subgroups (82% and 69%, respectively, at 5 yrs.). On multivariate Cox survival analysis, CR achievement was the most powerful predictor of long-term survival (HR 0.13, c.i.: 0.10–0.17). Lastly, achieving substantial tumor reduction before autografting had a major influence on the clinical outcome. Conclusions: 1. the HDS program is feasible in a multicenter setting; 2. the long-term outcome is well influenced by the CR status after HDS; 3. the influence of CR achievement on the long-term survival holds true in all lymphoma subtypes, including indolent lymphomas; 4. an adequate pre-autograft tumor debulking may contribute to a favorable long-term outcome. [Table: see text]

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Long-term Survival Analysis of Total Ankle Arthroplasty and Patient Risk Factor for Failure

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00297 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0029

Author(s):

Sung-Jae Kim ◽

Hwa-Jun Kang ◽

Ki Chun Kim

Keyword(s):

Regression Analysis ◽

Survival Analysis ◽

Survival Rate ◽

Revision Arthroplasty ◽

Survival Duration ◽

Term Survival ◽

Patient Risk ◽

Long Term Survival ◽

Cox Regression Analysis

Category: Ankle; Ankle Arthritis Introduction/Purpose: The aim of current study is to perform long-term survival analysis for TAA of 5619 cases, and identify patient risk for failure of TAA. Methods: Total of 7516 cases of TAA were identified from national insurance claim data of South Korea during 2007 to 2018. After exclusion of bilateral cases and cases performed on 2018, total 5619 cases of primary TAA cases were included. TAA failure was defined as case with revision arthroplasty or case with TAA implant removal and arthrodesis after primary TAA. Patient age, hospital size, comorbidities were included for survival analysis. Kaplan-Meier survival analysis was performed during study period, and Multivariable Cox regression analysis were performed. Results: During study period, five-year survival rate was 95.4%, and 10-year survival rate was 91.1%, and mean survival duration was 9.6 years. Regression analysis revealed that younger age (< 65, adjusted hazard ration (AHR), 1.812; p< 0.001), chronic pulmonary disease (AHR, 1.476; p= 0.013), diabetes (AHR, 1.443; p= 0.014), alcohol consumption (AHR, 1.524; p= 0.032) showed significant high odds ratio for TAA failure. Conclusion: Current study was performed with largest cohort with TAA procedures in literature. 10-year survival rate was 91.4%, young age and some comorbidities revealed as significant predictor for TAA failure.

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Vascular resection for locally advanced pancreatic ductal adenocarcinoma: analysis of long-term outcomes from a single-centre series

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02238-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Claudio F. Feo ◽

Giulia Deiana ◽

Chiara Ninniri ◽

Giuseppe Cherchi ◽

Paola Crivelli ◽

...

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Locally Advanced ◽

Operating Time ◽

Vascular Resection ◽

Ductal Adenocarcinoma ◽

Term Survival ◽

Aggressive Approach ◽

Long Term Survival ◽

Cox Regression Analysis

Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor prognosis. Radical surgery is the best option for cure and, nowadays, it is performed by many surgeons also in cases of vascular infiltration. Whether this aggressive approach to a locally advanced PDAC produces a survival benefit is under debate. Most data in the literature come from retrospective comparative studies; therefore, it is still unclear if such an extensive surgery for an advanced cancer is justified. Methods A retrospective review of patients with PDAC treated at our institution over a 12-year period was performed. Data concerning patients’ characteristics, operative details, postoperative course, and long-term survival were retrieved from prospective databases and analysed. Factors associated with poor survival were assessed via Cox regression analysis. Results A total of 173 patients with PDAC were included in the analysis, 41 subjects underwent pancreatectomy with vascular resection for locally advanced disease, and in 132 patients, only a pancreatic resection was undertaken. Demographics, major comorbidities, and tumour characteristics were similar between the two groups. Length of surgery (P=0.0006), intraoperative blood transfusions (P<0.0001), and overall complications (P<0.0001) were significantly higher in the vascular resection group. Length of hospital stay (P=0.684) and 90-day mortality (P=0.575) were comparable between groups. Overall median survival (P= 0.717) and survival rates at 1, 3, and 5 years (P=0.964, P=0.500, and P=0.445, respectively) did not differ significantly between groups. Age ≥70 years and postoperative complications were independent predictors of lower survival. Conclusions Our study confirms that pancreatectomy with vascular resection for a locally advanced PDAC is a complex operation associated with a significant longer operating time that may increase morbidity; however, in selected patients, R0 margins can be obtained with an acceptable long-term survival rate. Older patients are less likely to benefit from surgery.

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