Annual hazard rates of recurrence for breast cancer after primary therapy.

1996 ◽  
Vol 14 (10) ◽  
pp. 2738-2746 ◽  
Author(s):  
T Saphner ◽  
D C Tormey ◽  
R Gray
Keyword(s):  
Breast Cancer ◽  
Eastern Cooperative Oncology Group ◽  
Entire Group ◽  
Hazard Rates ◽  
Primary Therapy ◽  
Time Intervals ◽  
Differentiating Agents ◽  
The Mean ◽  
Lower Hazard

PURPOSE To determine if the long-term increase of recurrence for breast cancer is stable or slowly decreasing, or if it ever reaches zero; and to determine the effect of prognostic factors on the hazard of recurrence. METHODS All patients entered onto the seven completed and unblinded Eastern Cooperative Oncology Group (ECOG) coordinated studies of postoperative adjuvant therapy for breast cancer were analyzed in terms of annual hazard of recurrence of breast cancer. RESULTS For the entire group, the peak hazard of recurrence occurred in the interval of 1 to 2 years. The hazard decreased consistently in the interval of 2 to 5 years. Beyond 5 years, the hazard of recurrence decreased very, very slowly through year 12. The average hazard of recurrence between years 5 and 12 for the entire population was 4.3% per year. The pattern of a peak hazard of recurrence during the first 5 years with a slowly decreasing hazard of recurrence beyond 5 years was also observed to varying degrees in most subsets. Higher risk subsets such as patients with more than three nodes positive had a higher hazard of recurrence at all time intervals, while lower risk subsets such as patients with negative nodes had a lower hazard of recurrence in all time periods. CONCLUSION Patients 5 years postsurgery for breast cancer appear to have a very slowly decreasing hazard of recurrence. The mean hazard of recurrence between years 5 to 12 postsurgery is 4.3% per year. This group of patients may be well suited for trials evaluating cytostatic drugs or differentiating agents.

scholarly journals Clinical Features, Therapeutic Trends, and Outcome of Giant Prolactinomas: A Single-Center Experience Over a 12-Year Period

2020 ◽  
Vol 13 ◽  
pp. 117955142092618
Author(s):  
Mussa H Almalki ◽  
Naji Aljohani ◽  
Saad Alzahrani ◽  
Ohoud Almohareb ◽  
Maswood M Ahmad ◽  
...  
Keyword(s):  
Clinical Features ◽  
Tumor Volume ◽  
Serum Prolactin ◽  
Primary Therapy ◽  
Single Center ◽  
Retrospective Case ◽  
The Mean ◽  
Giant Prolactinomas ◽  
Epidemiological Characteristics

Background: Management of giant prolactinomas presents a different challenge than the management of traditional prolactinomas. Objective: The aim of this study was to report the largest long-term single-center study of giant prolactinomas to analyze their clinical features; define epidemiological characteristics, comorbidities, complications, treatment outcomes; and to demonstrate our experience with long-term cabergoline (CAB) treatment of these giant tumors. Methods: A retrospective case study and clinical review of patients presenting with giant prolactinomas in the pituitary clinic at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, in the period between 2006 and 2018 were included in the study. Of the charts reviewed, 33 patients (24 men; 9 women) with age of diagnosis between 18 and 63 years (mean = 37.21 years) met the selection criteria for giant prolactinomas. Result: The most common presenting features include headache (87.8%), visual defects (69.7%), and hypogonadism (51.5%). The baseline means serum prolactin (PRL) level was extremely high for both sexes (95 615.03 nmol/L), which eventually decreased by as much as 95.4% after CAB treatment. Serum PRL concentrations completely normalized in 11 patients and significantly reduced in 22 patients. The mean tumor volume at baseline was 42.87 cm3, whereas the mean posttreatment tumor volume was 3.42 cm3 (no residual tumor in 2 patients, while in others, it ranged from 0.11 to 16.7 cm3) at the last follow-up visit. The mean change in tumor volume was 88.84%. Tumor volume decreased by an average of 92% for men and 80.4% for women. One patient had no tumor size change with CAB (3.5 mg thrice a week) or radiotherapy and required surgery. The response rate (remission after medical therapy alone) in this series was 84.84%. Conclusions: Findings reinforce results from our previous study that CAB provides dramatic clinical improvements with an excellent safety profile. The CAB should, therefore, be considered as the primary therapy for giant prolactinomas.

Study of clinical outcome of Loco-Regional Recurrences in breast cancer: A prospective study

2021 ◽  
Vol 19 (3) ◽  
pp. 160-164
Author(s):  
Ganesh Thakur ◽  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Disease Free Survival ◽  
Primary Diagnosis ◽  
Entire Group ◽  
Locoregional Treatment ◽  
Tata Memorial Hospital ◽  
The Mean ◽  
A Prospective Study ◽  
Improvement In Survival

Background: Advances in the management of breast cancer led to significant improvement in survival. This has led to an increased incidence of Loco-Regional Recurrences. Objective: To report clinical outcome of patients presenting with locoregional recurrence (LRR). Material and Methods: The present prospective observational study was done at Tata Memorial Hospital, Mumbai and Advanced Center for Treatment and Education of Cancer, Navi Mumbai. A total of 100 consecutive patients of local/ regional/ Loco-regional recurrences and fulfilling the study inclusion criteria were invited to participate in this study. Statistical analysis was done using SPSS Statistics version 20.0. Survival period was defined as the period from the date of diagnosis to the development of recurrence or to the date of the last recorded clinical followup.Results: The mean and median overall survival from the time of diagnosis of primary for the entire group was 62.8 and 41.2 months (range 8.0-237.5) respectively. The mean and median disease-free survival was 53.9 and 32.7 months (range 0.33-23.3) respectively from the date of primary diagnosis. Conclusion: Multi-modal therapy comprising of optimal locoregional treatment and systemic therapy achieves durable local control.

Abstract 11655: Long Term Cardiovascular Mortality After Radiotherapy for Breast Cancer: A Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Partha Sardar ◽  
Saurav Chatterjee ◽  
Anju Nohria ◽  
Ramez Nairooz ◽  
Pascal Meier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Studies ◽  
Meta Analysis ◽  
Late Complication ◽  
Breast Cancer Radiotherapy ◽  
Cardiac Dose ◽  
The Mean ◽  
Cvd Mortality

Introduction: Cardiovascular disease (CVD) is a late complication of radiotherapy (RT); the mean cardiac dose from irradiation of a left-sided breast cancer is much higher than that for a right-sided breast cancer. However, there is limited knowledge regarding the long-term risk of RT on CVD mortality. This study sought to investigate the use of RT for breast cancer and its association with CVD mortality, in the context of the laterality of breast cancer. Hypothesis: Long term cardiac mortalty with left-sided breast cancer radiotherapy is much higher than that for a right-sided breast cancer. Methods: Databases were searched from their inception through December 2013. Studies reporting CVD mortality with left versus right sided breast RT were included. Two authors reviewed the studies, abstracted the data and checked for accuracy, quality and strength of evidence. The outcome of interest was CVD mortality. We calculated summary risk ratio (RR) and 95% confidence intervals (CI) with the random effects model. Results: The analysis included 289,109 patients from 13 observational studies. Women, who had received RT for left-sided breast cancer, had a higher risk of CVD death than those who received RT for a right-sided breast cancer (RR 1.12, 95% CI: 1.07 to 1.18). Difference in CVD mortality between left versus right breast RT was more apparent after 15 years of follow up (RR 1.23, 95% CI: 1.08 to 1.41). Conclusions: Mortality from CVD with left sided RT was significantly higher compared to right sided RT for breast cancer; this difference was more apparent after at least 15 years of follow up.

scholarly journals Evaluation of long-term sagittal lip changes using Burstone line: Pilot Study

2021 ◽  
Vol 7 (2) ◽  
pp. 32-37
Author(s):  
Rachel Sathekge ◽  
Colin Lesar
Keyword(s):  
Soft Tissue ◽  
Upper Lip ◽  
Short Term ◽  
Time Intervals ◽  
Lower Lip ◽  
Linear Distance ◽  
Long Term Follow Up ◽  
The Mean

Objective Lip position has become one of the most important soft tissue analyses as it influences the occlusion, tooth stability and facial aesthetic. Hence, the objective of this study was to compare the short-term and long-term sagittal lip positions/changes using the Burstone line (B-line).   Methods The sample consisted of 18 Caucasoid females only (14 extractions, 4 non-extractions) who were successfully treated with edgewise appliances. All the patients were evaluated before treatment (T1),at the end of active treatment (T2), and at a long-term follow-up observation (T3). The mean age at commencement was 13.2 years with the range of 10.5-19 years. The linear distance between the tip of the lips and the B-line were measured.   Results T1-T2 time intervals showed the upper lip underwent a mean change of 1.272 mm relative to the B-line (-32.8%) which was statistically significant. The lower lip showed a mean change of 1.549 mm (-22.2%), but these changes were not statistically significant. Lip protrusion relative to the B-line continued to reduce during the long term follow up period. The upper lip showed slight changes (-9.2%), whereas the lower lip demonstrated greater change (-53.8%).   Conclusion Using B-line, the sagittal soft tissue lip positions were more retrusive on the long-term follow-up records for both extraction and non-extraction cases, their values were not very different from the normal values of the untreated cases. Although the differences were not statistically significant,  upper lips were retrusive post treatment from T1-T2, while were statistically significant the lower lips were retrusive from T1-T2.

Cognitive Outcome of Long-Term Survivors of Multisystem Langerhans Cell Histiocytosis: A Single-Institution, Cross-Sectional Study

2003 ◽  
Vol 21 (15) ◽  
pp. 2961-2967 ◽  
Author(s):  
Vasanta Rao Nanduri ◽  
Leasha Lillywhite ◽  
Claire Chapman ◽  
Louise Parry ◽  
Jon Pritchard ◽  
...  
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Significant Risk ◽  
Langerhans Cell ◽  
Cognitive Outcome ◽  
Entire Group ◽  
Cns Involvement ◽  
Cranial Radiotherapy ◽  
The Mean ◽  
Long Term Survivors

Purpose: Damage to the CNS, including the cerebellum, and to the hypothalamopituitary axis, is documented in Langerhans cell histiocytosis (LCH). Neuropsychologic deficits have been recognized, but this is the first study in which cognitive function has been systematically assessed in a cohort of patients. Patients and Methods: Twenty-eight long-term survivors of multisystem LCH (mean age, 15.1 years) were investigated for intelligence, memory and learning, language, and academic attainments. Results: The mean intelligence quotient (IQ) of the entire group was not significantly different from the mean of the population (ie, mean ± SD, 100 ± 1), but there were wide ranges (Full-Scale IQ [FSIQ]: mean, 93.6; range, 61.7 to 134; Performance IQ [PIQ]: mean, 92.2; range, 46 to 136; and Verbal IQ [VIQ]: mean, 93.7; range, 64.2 to 126). CNS involvement was a significant risk factor for lower scores, but sex, diabetes insipidus, and cranial radiotherapy were not. The CNS group had lower VIQ, PIQ, and FSIQ than patients with no CNS involvement (no CNS group: mean ± SD FSIQ, 102.3 ± 15.6; CNS group: mean ± SD FSIQ, 73.6 ± 7.7; P < .001). A similar pattern of results was obtained for all other cognitive measures. Even when effects of reduction in FSIQ were taken into account, specific deficits were found in patients in the CNS group. Conclusion: Long-term survivors of multisystem LCH, particularly patients with CNS involvement, may develop significant cognitive deficits. All patients should have formal, repeated neuropsychologic assessment as part of long-term follow-up, which will enable abnormalities to be detected early so that appropriate supportive measures can be offered.

scholarly journals Mode Switching in Red Semiregular Variable Stars?

1995 ◽  
Vol 155 ◽  
pp. 405-406
Author(s):  
J. Gál ◽  
K. Szatmáry
Keyword(s):  
Variable Stars ◽  
Point Of View ◽  
Mode Switching ◽  
Radial Pulsation ◽  
Light Curve Analysis ◽  
Time Intervals ◽  
Frequency Spectra ◽  
The Mean ◽  
Semiregular Variable

AbstractLight curve analysis of the carbon variable RY Dra and the oxygen-rich variables TX Dra and AF Cyg is summarised. In each case, two shorter periods were found (which may be connected with the radial pulsation of the stars) and also a long term variation in the mean brightness. In the case of RY Dra, the amplitudes of the shorter periods both decreased while the amplitude of the long secondary variation was found to be increasing. The light curves and frequency spectra of TX Dra and AF Cyg can be interpreted as a result of mode switching. These stars pulsate with two different periods and there are time intervals when the longer period disappears and the shorter one remains dominant, and it lasts for many cycles. We concluded that the double and multi-periodic red semiregular variables may be very important from both theoretical and observational point of view, because, based on the ratio of the periods, we can identify the pulsational modes in these variables.

scholarly journals Results of organ-preserving treatment of breast cancer using intraoperative radial therapy

2021 ◽  
Vol 17 (3) ◽  
pp. 16-23
Author(s):  
I. S. Chumachenko ◽  
R. A. Murashko ◽  
A. A. Keshabyan ◽  
P. V. Krivorotko ◽  
S. N. Novikov
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Triple Negative ◽  
Breast Cancer Subtype ◽  
Luminal B ◽  
End Of Treatment ◽  
Cosmetic Effect ◽  
The Mean ◽  
Biological Subtype

Objective: to compare the immediate and long-term outcomes of patients with early breast cancer treated with intraoperative radial therapy depending on the biological subtype of breast cancer.Materials and methods. We prospectively evaluated number of recurrences, cosmetic effect and early treatment results of 104 patients with early breast cancer aged 66.72 ± 0.68 years old. The mean follow-up period was 36 months. The mean dose on the surface of applicator was 17.8 Gy, on the depth 0.5 cm – 8.8 Gy, on the depth 1.0 cm – 5 Gy. The mean time of radiation was 22.15 min ± 28.09 sec.Results. The local recurrence was in 3 patients. The first patient had triple negative breast cancer subtype, the second patient had luminal B HER2+, and the third one had luminal B HER2– subtype. Relapses occurred in 7, 14 and 20 months after the end of treatment respectively. The recurrence rate in patients with luminal B biological subtype was 10.71 %; in patients with triple negative subtype was 20 %. All recurrences were found in the area of the postoperative scar.Conclusion. The obtained results question the rationale for the use of the demonstrated method in patients with luminal B and triple negative molecular subtypes of tumors.

Ten-year follow-up study of premenopausal women with metastatic breast cancer: an Eastern Cooperative Oncology Group study.

1995 ◽  
Vol 13 (6) ◽  
pp. 1453-1458 ◽  
Author(s):  
G Falkson ◽  
C Holcroft ◽  
R S Gelman ◽  
D C Tormey ◽  
J M Wolter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Survival Time ◽  
Median Survival ◽  
Eastern Cooperative Oncology Group ◽  
Metastatic Breast ◽  
Premenopausal Women ◽  
Er Positive

PURPOSE To investigate the long-term survival of premenopausal women with previously untreated first recurrence or metastases of breast cancer entered on Eastern Cooperative Oncology Group (ECOG) study 2177 (EST 2177), which completed accrual in June 1983. MATERIALS AND METHODS One hundred forty-seven premenopausal women with metastatic breast cancer were entered onto the study. Eighty-nine patients with estrogen receptor (ER)-positive and ER-unknown disease were randomized to receive cyclophosphamide (CTX), doxorubicin (ADR), and fluorouracil (FU) (CAF) or surgical oophorectomy plus CAF (O+CAF). Fifty-eight patients with known ER-negative disease were treated with CAF. Survival time was measured from the time of study entry. Randomization was stratified by performance status (PS), dominant metastatic site, and ER status. RESULTS One hundred thirty patients were eligible. The median survival time of randomized patients was 35 months (90% confidence interval, 28.9 to 54.3), with 28% alive at 5 years. The overall median survival duration, including ER-negative patients, was 30 months. There was no significant difference in survival time between the randomized treatments (median, 42 months for O+CAF and 30 months for CAF). In models of survival time, age > or = 45 years and last menstruation within 1 month were associated with significantly longer survival (P < .004 for each). There were also three significant interactions with treatment (even after correction for multiple comparisons): age (P = .00009; O+CAF associated with longer survival in patients < 45 years, CAF associated with longer survival in patients > 45 years), PS (P = .002; O+CAF associated with consistently better survival in PS O patients), and disease-free interval (DFI). CONCLUSION Long-term follow-up data of premenopausal women with metastatic breast cancer show a longer than expected median survival time at 2.5 years overall and close to 5 years for patients treated with O+CAF who were ER-positive or had a good PS.

scholarly journals On Relation between No-Arbitrage Pricing Principle and Modigliani-Miller Propositions

2020 ◽  
Vol 9 (1) ◽  
pp. 148-174
Author(s):  
Valery Shemetov
Keyword(s):  
Firm Value ◽  
Initial Conditions ◽  
Business Environment ◽  
Time Intervals ◽  
No Arbitrage ◽  
Bankruptcy Costs ◽  
Brownian Model ◽  
The Mean ◽  
Short Time

An extension of Merton’s (1974) model (EMM) taking account of the firm’s payments and generating a new statistical distribution for the firm value is suggested. In an open log-value space, this distribution evolves from the initially normal to negatively skewed one. When payments are zero or proportional to the firm value, EMM turns into the Geometric Brownian model (GBM). We show that Modigliani-Miller Propositions (MMPs) and the no-arbitraging principle (NAP) result from the use of GBM with no payments. For a firm with payments, MMPs hold for short times and are false for time intervals exceeding a year. In contradiction with MMPs, the asset structure affects the firm value at the perfect market, and at the market with taxes, debt decreases the firm value even when there are no bankruptcy costs. NAP always holds for the entire market for short time deals. For long-term investments, the firm’s mean year returns decline in time intervals whose length depends on the firm’s initial conditions and its business environment. In these conditions, NAP does not hold for the whole market, but it temporarily holds for individual stocks as far as the mean year returns of the firms issuing them remain constant and fails when the mean year returns begin to decline.

scholarly journals Pharmacokinetics and Safety of Intravitreal Caspofungin

2014 ◽  
Vol 58 (12) ◽  
pp. 7234-7239 ◽  
Author(s):  
Ying-Cheng Shen ◽  
Chiao-Ying Liang ◽  
Chun-Yuan Wang ◽  
Keng-Hung Lin ◽  
Min-Yen Hsu ◽  
...  
Keyword(s):  
High Performance ◽  
Potential Role ◽  
Elimination Rate ◽  
Retinal Toxicity ◽  
Primary Therapy ◽  
Time Intervals ◽  
Content Type ◽  
Fungal Endophthalmitis ◽  
Time Points ◽  
The Mean

ABSTRACTCaspofungin exhibits potent antifungal activities againstCandidaandAspergillusspecies. The elimination rate and retinal toxicity of caspofungin were determined in this study to assess its pharmacokinetics and safety in the treatment of fungal endophthalmitis. Intravitreal injections of 50 μg/0.1 ml of caspofungin were administered to rabbits. Levels of caspofungin in the vitreous and aqueous humors were determined using high-performance liquid chromatography (HPLC) at selected time intervals (10 min and 1, 2, 4, 8, 16, 24, and 48 h), and the half-lives were calculated. Eyes were intravitreally injected with caspofungin to obtain concentrations of 10 μg/ml, 50 μg/ml, 100 μg/ml, and 200 μg/ml. Electroretinograms were recorded 4 weeks after injections, and the injected eyes were examined histologically. The concentrations of intravitreal caspofungin at various time points exhibited an exponential decay with a half-life of 6.28 h. The mean vitreous concentration was 6.06 ± 1.76 μg/ml 1 h after intravitreal injection, and this declined to 0.47 ± 0.15 μg/ml at 24 h. The mean aqueous concentration showed undetectable levels at all time points. There were no statistical differences in scotopica-wave andb-wave responses between control eyes and caspofungin-injected eyes. No focal necrosis or other abnormality in retinal histology was observed. Intravitreal caspofungin injection may be considered to be an alternative treatment for fungal endophthalmitis based on its antifungal activity, lower retinal toxicity, and lower elimination rate in the vitreous. More clinical data are needed to determine its potential role as primary therapy for fungal endophthalmitis.

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