Factors predicting outcome of G1/2 GEP NET after PRRT with Lu177-octreotate.

e14565 Background: Outcome analyses of G1/2 NEN stage IV after peptide receptor radionuclide therapy (PRRT) are still limited, especially with regard to the impact of the Ki-67 index. This study aims to establish predictors of survival. Methods: Retrospective analysis of 74 consecutive GEP NET patients undergoing PRRT with 177Lu-octreotate. Patients had unresectable metastatic disease and a G1/2 grading (33 pancreatic, 41 non-pancreatic GEP- NET), documented morphologic or clinical progression within < 12 months and/or uncontrolled disease. Response (modified SWOG criteria) was correlated with potential impact factors: origin, function, burden, and uptake of tumor, age, Ki-67-index, Karnofsky score, baseline tumor marker levels. Predictors for survival were analyzed with Kaplan-Meier curves (log-rank test) and multivariate analysis (p<0.05). Results: The response rates were 36.5% PR, 17.6% MR, 35.1% SD, and 10.8% PD for the entire cohort, 54.5% PR, 18.2% MR, 18.2% SD, and 9.1% PD for pancreatic NET, and 22.0% PR, 17.1% MR, 48.8% SD, and 12.2% PD for non-pancreatic GEP-NET. The median progression-free (PFS) and overall (OS) survival was 26 months (95% CI, 18.3 - 33.7) and 55 months (95% CI, 48.8–61.2), respectively. The only factor associated with decreased PFS was a Ki-67 index >10% (p=0.002). For OS, besides the Ki-67 index, a Karnofsky score ≤70% and a baseline NSE of >15 ng/ml independently predicted shorter survival (each p<0.005, HR 3.0 - 3.4). Patients with a Ki-67 index >10% still had a median PFS and OS of 19 and 34 months, respectively. Conclusions: This study confirms the favorable outcome of G1/2 NET after PRRT. Independent predictors of survival are the Ki-67 index, the patient‘s performance status and the baseline NSE level. Nevertheless, patients with a Ki-67 >10% may still benefit from PRRT as demonstrated by the long-term outcome.

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The Impact of Cannabis in the Early Stages of Schizophrenia: A 3-Year Longitudinal Study on Cannabis Influence on Relapse Rates

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2137 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S196-S197

Author(s):

M. Gomez Revuelta ◽

M. Juncal Ruiz ◽

O. Porta Olivares ◽

V. Gajardo Galan ◽

G. Pardo de Santayana Jenaro ◽

...

Keyword(s):

Intervention Program ◽

Response To Treatment ◽

Rank Test ◽

First Episode ◽

Term Outcome ◽

Long Term Outcome ◽

Early Stages ◽

Increased Risk ◽

The Impact

IntroductionThe first five years after the onset of a first episode of psychosis (FEP) are crucial for long term outcome. In this period, the risk of relapse is particularly high. Consequences of relapse include an increased risk of neurotoxicity, chronicity, hospitalization, decreased response to treatment, increased economic burden and functional impairment.ObjectivesTo discern the influence of cannabis on relapse as it may contribute to adopt specific measures in patients during early stages of the illness.Material and methodsPAFIP is an early intervention program for patients with a FEP. Between January 2005 and January 2011, 163 patients were recruited for this study. They were followed-up during 3 years at intervals of three months. The sample was divided into three groups: (1) those non-cannabis users neither before the FEP nor during follow-up (nn), (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences between the three groups were observed but a trend (P = 0.057) towards a more enduring survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log Rank Test results will be included in the final poster).ConclusionsCannabis has a detrimental effect on schizophrenia. The interruption of its use could contribute to improve the outcome of the disease, as the results of our study suggest.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The impact of immunohistochemical markers of Ki-67 and p53 on the long-term outcome of growth hormone-secreting pituitary adenomas: A cohort study

Asian Journal of Neurosurgery ◽

10.4103/1793-5482.142732 ◽

2014 ◽

Vol 9 (3) ◽

pp. 130 ◽

Cited By ~ 12

Author(s):

Abbas Amirjmshidi ◽

Maysam Alimohamadi ◽

Vahid Ownagh ◽

Leila Mahouzi ◽

Afshin Ostovar ◽

...

Keyword(s):

Growth Hormone ◽

Cohort Study ◽

Pituitary Adenomas ◽

Ki 67 ◽

Term Outcome ◽

Long Term Outcome ◽

Immunohistochemical Markers ◽

The Impact

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The management of Hemorrhoidal Disease by Dearterialization and Mucopexy.

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200506091306 ◽

2020 ◽

Vol 15 ◽

Author(s):

Veronica De Simone ◽

Francesco Litta ◽

Angelo Parello ◽

Paola Campennì ◽

Raffaele Orefice ◽

...

Keyword(s):

Postoperative Management ◽

Term Outcome ◽

Long Term Outcome ◽

Doppler Probe ◽

Minimally Invasive Surgical ◽

Bowel Movements ◽

Excessive Strain ◽

Life Threatening ◽

Hemorrhoidal Prolapse ◽

The Impact

: Several minimally invasive surgical procedures have been recently developed to treat hemorrhoids without any excision. About 25 years ago, a non-excisional procedure providing doppler-guided ligation of the hemorrhoidal arteries has been proposed - named “hemorrhoidal dearterialization”. The original technique has been modified over the years, and indications were expanded. In particular, a plication of the redundant and prolapsing mucosa/submucosa of the rectum (named “mucopexy”) has been introduced to treat hemorrhoidal prolapse, without excision of the hemorrhoidal piles. At present, the THD® Doppler procedure is one of the most used techniques to treat hemorrhoids. Aim of this technique is to realize a target dearterialization, using a Doppler probe with the final purpose to reduce the arterial overflow to the hemorrhoidal piles. In case of associated hemorrhoidal prolapse, a mucopexy is performed together with Doppler-guided dearterialization. The entity and circumferential extension of the hemorrhoidal prolapse guides the mucopexy, which can be considered tailored to a single patient; the dearterialization should be considered mandatory. Advantages of this surgical technique are the absence of serious and life-threatening postoperative events, chronic complications, and limited recurrence risks. The impact of the procedure on the anorectal physiology is negligible. However, a careful postoperative management is mandatory to avoid complications and to guarantee an improved long-term outcome. Therefore, regular physiologic bowel movements, excessive strain at the defecation and strong physical activity are advisable.

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Laparoscopic Revisional Surgery After Failed Heller Myotomy for Esophageal Achalasia: Long-Term Outcome at a Single Tertiary Center

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-021-05041-x ◽

2021 ◽

Author(s):

Giovanni Capovilla ◽

Renato Salvador ◽

Luca Provenzano ◽

Michele Valmasoni ◽

Lucia Moletta ◽

...

Keyword(s):

Heller Myotomy ◽

Revisional Surgery ◽

Stage Iv ◽

Postoperative Outcomes ◽

Control Group ◽

Term Outcome ◽

Long Term Outcome ◽

Eckardt Score ◽

Stage Iv Disease

Abstract Background Laparoscopic Heller myotomy (HM) has gained acceptance as the gold standard of treatment for achalasia. However, 10–20% of the patients will experience symptom recurrence, thus requiring further treatment including pneumodilations (PD) or revisional surgery. The aim of our study was to assess the long-term outcome of laparoscopic redo HM. Methods Patients who underwent redo HM at our center between 2000 and 2019 were enrolled. Postoperative outcomes of redo HM patients (redo group) were compared with that of patients who underwent primary laparoscopic HM in the same time span (control group). For the control group, we randomly selected patients matched for age, sex, FU time, Eckardt score (ES), previous PD, and radiological stage. Failure was defined as an Eckardt score > 3 or the need for re-treatment. Results Forty-nine patients underwent laparoscopic redo HM after failed primary HM. A new myotomy on the right lateral wall of the EGJ was the procedure of choice in the majority of patients (83.7%). In 36 patients (73.5%) an anti-reflux procedure was deemed necessary. Postoperative outcomes were somewhat less satisfactory, albeit comparable to the control group; the incidence of postoperative GERD was higher in the redo group (p < 0.01). At a median 5-year FU time, a good outcome was obtained in 71.4% of patients in the redo group; further 5 patients (10.2%) obtained a long-term symptom control after complementary PD, thus bringing the overall success rate to 81.6%. Stage IV disease at presentation was independently associated with a poor outcome of revisional LHD (p = 0.003). Conclusions This study reports the largest case series of laparoscopic redo HM to date. The procedure, albeit difficult, is safe and effective in relieving symptoms in this group of patients with a highly refractory disease. The failure rate, albeit not significantly, and the post-operative reflux are higher than after primary HM. Patients with stage IV disease are at high risk of esophagectomy.

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Long-term outcome of children undergoing surgery for suspected perilymph fistula

The Journal of Laryngology & Otology ◽

10.1017/s0022215108003046 ◽

2008 ◽

Vol 123 (3) ◽

pp. 298-302 ◽

Cited By ~ 2

Author(s):

R J Sim ◽

A H Jardine ◽

E J Beckenham

Keyword(s):

Hearing Loss ◽

Case Series ◽

Outcome Data ◽

Rank Test ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome ◽

Signed Rank ◽

Signed Rank Test

AbstractA number of authors have suggested that surgery for suspected perilymph fistula is effective in preventing deterioration of hearing and in improving hearing in some cases in the short term. We present long-term hearing outcome data from 35 children who underwent exploration for presumed perilymph fistula at The Children's Hospital, Sydney, Australia, between 1985 and 1992.Methods:The pre-operative audiological data (mean of 500, 1000, 2000 and 4000 Hz results) were compared with the most recently available data (range two to 15 years) and the six-month post-operative data.Results:The short-term results showed no significant change in hearing at six months, with a subsequent, statistically significant progression of hearing loss in both operated and non-operated ears (Wilcoxon signed rank test: operated ear, p < 0.017; non-operated ear, p < 0.009).Conclusion:In this case series, exploratory surgery for correction of suspected perilymph fistula did not prevent progression of long-term hearing loss.

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The impact of isolated local recurrence on long-term outcome in early-breast cancer patients after breast-conserving therapy

European Journal of Cancer ◽

10.1016/j.ejca.2021.06.018 ◽

2021 ◽

Vol 155 ◽

pp. 28-37

Author(s):

Conny Vrieling ◽

Samson Y. Assele ◽

Lotte Moser ◽

Nicolas Sauvé ◽

Saskia Litière ◽

...

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Breast Conserving Therapy ◽

Breast Cancer Patients ◽

Term Outcome ◽

Long Term Outcome ◽

Isolated Local Recurrence ◽

The Impact

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Prognostic Factors and Long-Term Outcome of Pancreatic Neuroendocrine Neoplasms: Ki-67 Index Shows a Greater Impact on Survival than Disease Stage. The Large Experience of the Spanish National Tumor Registry (RGETNE)

Neuroendocrinology ◽

10.1159/000355152 ◽

2013 ◽

Vol 98 (2) ◽

pp. 156-168 ◽

Cited By ~ 40

Author(s):

Elena Martin-Perez ◽

Jaume Capdevila ◽

Daniel Castellano ◽

Paula Jimenez-Fonseca ◽

Ramon Salazar ◽

...

Keyword(s):

Prognostic Factors ◽

Disease Stage ◽

Neuroendocrine Neoplasms ◽

Ki 67 ◽

Term Outcome ◽

Long Term Outcome ◽

Tumor Registry ◽

Pancreatic Neuroendocrine Neoplasms ◽

Impact On Survival

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Perinatal Care at the Threshold of Viability

PEDIATRICS ◽

10.1542/peds.96.5.974 ◽

1995 ◽

Vol 96 (5) ◽

pp. 974-976

Author(s):

◽

Keyword(s):

Perinatal Care ◽

Survival Rates ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Term Outcome ◽

Long Term Outcome ◽

Obstetric Management ◽

The Cost ◽

The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

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Psychological profiles derived by cluster analysis of Minnesota Multiphasic Personality Inventory and long term clinical outcome after coronary artery by pass grafting

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2012.141 ◽

2015 ◽

Vol 78 (1) ◽

Author(s):

Maddalena Modica ◽

Roberta Carabalona ◽

Rosa Spezzaferri ◽

Monica Tavanelli ◽

A. Torri ◽

...

Keyword(s):

Cluster Analysis ◽

Coronary Artery ◽

Clinical Characteristics ◽

Minnesota Multiphasic Personality Inventory ◽

Personality Inventory ◽

Psychological Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

The Impact

Background: To evaluate the psychological characteristics of coronary heart disease (CHD) patients after coronary artery bypass grafting (CABG) by cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI-2) questionnaires and to assess the impact of the profiles obtained on long-term outcome. Methods: 229 CHD patients admitted to cardiac rehabilitation filled in self-administered MMPI-2 questionnaires early after CABG. We assessed the relation between MMPI- 2 profiles derived by cluster analysis, clinical characteristics and outcome at 3-year follow-up. Results: Among the 215 patients (76% men, median age 66 years) with valid criteria in control scales, we identified 3 clusters (G) with homogenous psychological characteristics: G1 patients (N=75) presented somatoform complaints but overall minimal psychological distress. G2 patients (N=72) presented type D personality traits. G3 subjects (N=68) showed a trend to cynicism, mild increases in anger, social introversion and hostility. Clusters overlapped for clinical characteristics such as smoking (G1 21%, G2 24%, G3 24%, p ns), previous myocardial infarction (G1 43%, G2 47%, G3 49% p ns), LV ejection fraction (G1 60 [51 – 60]; G2 58 [49- 60]; G3 60 [55-60], p ns), 3-vessel-disease prevalence (G1 69%, G2 65%, G3 71%, p ns). Three-year event rates were comparable (G1 15%; G2 18%; G3 15%) and Kaplan- Meier curves overlapped among clusters (p ns). Conclusions: After CABG, the interpretation of MMPI- 2 by cluster analysis is useful for the psychological and personological diagnosis to direct psychological assistance. Conversely, results from cluster analysis of MMPI-2 do not seem helpful to the clinician to predict long term outcome.

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