Long-term symptom burden and orodental health of oropharyngeal cancer (OPC) survivors following treatment with chemoradiotherapy (CRT) or sequential therapy (ST).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9530-9530
Author(s):  
Sewanti Atul Limaye ◽  
Robert I. Haddad ◽  
Ann Partridge ◽  
Anne M. O'Neill ◽  
Andrea Radossi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Thermal Sensitivity ◽  
Symptom Burden ◽  
Treatment Completion ◽  
Age At Diagnosis ◽  
Term Survival ◽  
Hpv Status ◽  
Number Of Patients ◽  
Significant Difference

9530 Background: OPC treatment is associated with significant long-term toxicity. Very little is known about the long-term symptom burden and orodental health in OPC survivors >2 yrs from treatment. Methods: Survivors treated for OPC with CRT/ST (involving definitive RT) at Dana Farber Cancer Institute between 2002-2011 and >2 yrs from treatment completion, were identified by chart review and asked to complete the Vanderbilt Head and Neck Symptom Survey version 2 (VHNSS v2), National Health And Nutrition Examination Survey for Oral Health Questionnaire, health care availability survey. Results: 200 survivors were contacted, 127 responded (RR: 64%). Median age at diagnosis was 54 yrs; 85% males; 85% stage IVA/B, 13% stage III; 56% CRT, 43% ST. HPV status: 47% (+), 10% (-), 43% unknown. Median time from treatment completion: 50 mths (24-135 mths). Residual moderate to severe toxicities reported in VHNSS v2: 71% dry mouth; 59% difficulty chewing/swallowing food; 53% feeling of food becoming stuck in the throat; 53% prolonged time to eat; 31% thick mucus, 6% had difficulty sleeping secondary to this; 16% trouble speaking, 27% trouble hearing;30% limitation of neck/shoulder movement; altered taste/smell - 45%/23%; sensitivity to spicy food and dryness-57%/62%; 30% decreased desire to eat, 11% had moderate weight loss. Orodental health assessment: 13% thermal sensitivity, 21% teeth cracking and chipping, 20% loose teeth, 33% had treatment for gum disease, 42% had lost bone around teeth. 98% survivors had health insurance; only 66% had dental insurance. No statistically significant difference was noted with respect to symptoms between CRT or ST. ST did not affect long-term toxicity compared to CRT alone. Conclusions: OPC is known to correlate with HPV positivity, early age at diagnosis and high rates of long-term survival after appropriate therapy. Our study documents that the OPC survivors have substantial residual long-term head and neck and orodental symptoms directly related to the treatment that significantly impacts their quality of life. A substantial number of patients lack dental health coverage, which likely further impacts symptom burden and QOL.

Post-Discharge Outcomes After Pancreatic Necrosectomy: A Single Institution Experience Following Endoscopic vs Open Debridement

2021 ◽  
pp. 000313482110385
Author(s):  
Manuel Martinez ◽  
Steven Medeiros ◽  
James Dove ◽  
Mohsen Shabahang
Keyword(s):  
Necrotizing Pancreatitis ◽  
Long Term Results ◽  
Source Control ◽  
Tertiary Referral Hospital ◽  
Term Survival ◽  
Pancreatic Necrosectomy ◽  
Medical Comorbidities ◽  
Number Of Patients ◽  
Significant Difference

Background Pancreatic necrosectomy outcomes have been studied extensively; however, long-term results of these procedures have not been well characterized. Our study aimed to assess the outcomes at and after discharge for patients following necrosectomy. Methods Data from patients undergoing pancreatic necrosectomy at a single tertiary referral hospital from January 1, 2007, to June 1, 2019 were retrospectively analyzed. Patients were stratified into an open pancreatic necrosectomy (OPN) and an endoscopic pancreatic necrosectomy (EPN) group. Results Cohorts were composed of an OPN (n = 30) and EPN (n = 31) groups with a mean follow-up of 22 and 13.5 months, respectively. There was no statistically significant difference in the demographics or etiology of disease; however, the presence of severe sepsis and elevated BISAP scores was significantly higher in the OPN group (40% vs 13% p = .016, 37% vs 10% p = .012, respectively). There was no significant difference in discharge parameters or disposition other than a higher need for wound care in the OPN group (14% vs 0% p =< .0001). No significant difference in the number of patients who returned to baseline, 12-month ED visits, 12-month readmissions, medical comorbidities, or long-term survival was noted. Conclusions Previous studies have demonstrated that OPN patients have a higher severity of disease and higher inpatient mortality; however, this does not hold true once the acute phase of the illness has passed. Long-term medical comorbidities and survival of patients with necrotizing pancreatitis who endure the primary insult do not differ in long term, regardless of the debridement modality performed for source control.

scholarly journals Long-term clinical outcome of cardiogenic shock patients undergoing Impella CP treatment vs. standard of care

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Scherer ◽  
E Luesebrink ◽  
S Massberg ◽  
M Orban
Keyword(s):  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Vascular Complications ◽  
University Hospital ◽  
Circulatory Support ◽  
Term Survival ◽  
Long Term Outcome ◽  
Number Of Patients ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background The number of patients treated with the mechanical circulatory support device Impella Cardiac Power (CP) for cardiogenic shock is steadily increasing. The aim of this study was to investigate long-term survival and complications related to this modality. Methods Patients undergoing Impella CP treatment for cardiogenic shock were retrospectively enrolled and matched with cardiogenic shock patients not treated with mechanical circulatory support between 2010 and 2020. Data were collected from the cardiogenic shock registry of our university hospital. Results 68 patients with refractory cardiogenic shock without mechanical circulatory support were matched with 68 patients treated with Impella CP. At presentation, the mean age was 67 ± 14 years with 82% being male in the group without support and 68 ± 14 years (p = 0.65) with 77% being male (p = 0.52) in the group with Impella. There was no significant difference in the rate of cardiac arrest (57% vs. 54%, p = 0.86) and myocardial infarction was the predominant cause of cardiogenic shock in both groups (66% vs. 74%, p = 0.34). A total of 46% of patients without cardiocirculatory support and 54% of patients with Impella support died during the first month (p = 0.32). After one year, mortality rates were similar in both groups (53% in conventional vs. 59% in Impella CP group, p = 0.51) as was mortality rate at long-term 5-years follow-up (73% in conventional vs. 72% in Impella CP group, p = 0.50). The rate of clinically significant bleedings during ICU stay was much lower in the conventional group than in the Impella support group (25% vs. 42%, p = 0.03). Conclusion In this small observational and non-randomized analysis no difference in long-term outcome between patients treated with Impella CP vs. guideline directed cardiogenic shock therapy without mechanical circulatory support could be detected. Care must be taken regarding the high rate of bleeding and vascular complications when using Impella CP. Large, adequately powered studies are urgently needed to investigate the efficacy and safety of Impella CP in cardiogenic shock.

Surgery in drug use-associated infective endocarditis: long-term survival is negatively affected by recurrence

2019 ◽  
Vol 30 (4) ◽  
pp. 528-534 ◽  
Author(s):  
Vilem Rohn ◽  
Branislav Laca ◽  
Milan Horn ◽  
Lukas Vlk ◽  
Petra Antonova ◽  
...  
Keyword(s):  
Drug Use ◽  
Intravenous Drug ◽  
Long Term Outcomes ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Number Of Patients ◽  
Significant Difference

Abstract OBJECTIVES The prevalence of infectious endocarditis (IE) in intravenous drug users (IDUs) is increasing, and the number of patients who need surgery is also rising. Relatively little is known about the short-term and long-term outcomes of these operations. METHODS This study is a retrospective analysis of our institutional results, focussing on risk factors for perioperative death, major adverse events and long-term survival. A total of 50 of the 66 (75.75%) patients had postoperative follow-up, and the mean follow-up time was 53.9 ± 9.66 months. Patients were divided into 2 groups depending on whether they were having their first operation or were being reoperated for recurrent IE. RESULTS From March 2006 to December 2015, a total of 158 patients underwent surgery for IE; 72 (45.6%) of them were identified as active IDUs. The operative mortality in IDUs was 8.33% (6 patients), with no significant difference between the 2 groups (P = 0.6569). Survival rates at 1 year, at 3 years and at the end of follow-up were 92%, 72% and 64%, respectively. There was significantly worse survival of patients with recurrent IE (log-rank test, P = 0.03). CONCLUSIONS Although the short-term results of operation for IE in IDUs are good, long-term outcomes are not satisfactory. The survival of patients with recurrence of IE caused by return to intravenous drug use is significantly worse.

scholarly journals Long-Term Clinical Outcome of Cardiogenic Shock Patients Undergoing Impella CP Treatment vs. Standard of Care

2020 ◽  
Vol 9 (12) ◽  
pp. 3803
Author(s):  
Clemens Scherer ◽  
Enzo Lüsebrink ◽  
Danny Kupka ◽  
Thomas J. Stocker ◽  
Konstantin Stark ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Vascular Complications ◽  
University Hospital ◽  
Circulatory Support ◽  
Term Survival ◽  
Long Term Outcome ◽  
Number Of Patients ◽  
Significant Difference

The number of patients treated with the mechanical circulatory support device Impella Cardiac Power (CP) for cardiogenic shock is steadily increasing. The aim of this study was to investigate long-term survival and complications related to this modality. Patients undergoing Impella CP treatment for cardiogenic shock were retrospectively enrolled and matched with cardiogenic shock patients not treated with mechanical circulatory support between 2010 and 2020. Data were collected from the cardiogenic shock registry of the university hospital of Munich (DRKS00015860). 70 patients with refractory cardiogenic shock without mechanical circulatory support were matched with 70 patients treated with Impella CP. At presentation, the mean age was 67 ± 15 years with 80% being male in the group without support and 67 ± 14 years (p = 0.97) with 76% being male (p = 0.68) in the group with Impella. There was no significant difference in the rate of cardiac arrest (47% vs. 51%, p = 0.73) and myocardial infarction was the predominant cause of cardiogenic shock in both groups (70% vs. 77%). A total of 41% of patients without cardiocirculatory support and 54% of patients with Impella support died during the first month (p = 0.17). After one year, mortality rates were similar in both groups (55% in conventional vs. 59% in Impella CP group, p = 0.30) as was mortality rate at long-term 5-years follow-up (64% in conventional vs. 73% in Impella CP group, p = 0.33). The rate of clinically significant bleedings during ICU stay was lower in the conventional group than in the Impella support group (15% vs. 43%, p = 0.002). In this small observational and non-randomized analysis no difference in long-term outcome between patients treated with Impella CP vs. guideline directed cardiogenic shock therapy without mechanical circulatory support could be detected. Care must be taken regarding the high rate of bleeding and vascular complications when using Impella CP. Large, adequately powered studies are urgently needed to investigate the efficacy and safety of Impella CP in cardiogenic shock.

scholarly journals Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Retrospective Studies ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

scholarly journals Female Sex and Outcomes after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Propensity Score Matched Cohort Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 162
Author(s):  
Christian-Alexander Behrendt ◽  
Thea Kreutzburg ◽  
Jenny Kuchenbecker ◽  
Giuseppe Panuccio ◽  
Mark Dankhoff ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Propensity Score ◽  
Acute Limb Ischemia ◽  
Insurance Claims ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Abdominal Aortic ◽  
Significant Difference

Objective: Previous studies have showed a potential disadvantage of female patients who underwent abdominal aortic aneurysm (AAA) repair. The current study aims to determine sex-specific perioperative and long-term outcomes using propensity score matched unselected nationwide health insurance claims data. Methods: Insurance claims from a large German fund were used, covering around 8% of the insured German population. Patients who underwent endovascular aortic repair (EVAR) for intact AAA from 1 January 2011 to 30 April 2017 were included in the cohort. A 1:2 female to male propensity score matching was applied to adjust for confounding variables. Perioperative and long-term outcomes after 5 years were determined using matching and regression methods. Results: Among a total of 3736 patients (19.3% females, mean 75 years) undergoing EVAR for intact AAA, we identified 1863 matched patients. Before matching, females were more likely to be previously diagnosed with hypothyroidism, electrolyte disorders, rheumatoid disorders, and depression, while males were more often diabetics. In the matched sample, 23.4% of the females and 25.8% of the males died during a median follow-up of 776 and 792 days, respectively. Perioperatively, females were more likely to exhibit acute limb ischemia (5.3% vs. 3.2%, p = 0.031) and major bleeding (22.0% vs. 15.9%, p = 0.001) before they were discharged to rehabilitation (5.5% vs. 1.5%, p < 0.001) when compared to males. No statistically significant difference in perioperative (odds ratio 1.12, 95% CI 0.54–2.16) or long-term mortality (hazard ratio 0.91, 95% CI 0.76–1.08) was observed between sexes. This was also true regarding aortic reintervention rates after 1 year (2.0% vs. 2.9%) and 5 years (10.9% vs. 8.1%). Conclusion: The current retrospective matched analysis of insurance claims revealed high early access-related morbidity in females when compared to their male counterparts. Short-term or long-term survival and reintervention outcomes were similar between sexes.

Aggressive Treatment in Glioblastoma: What Determines the Survival of Patients?

2020 ◽  
Author(s):  
Lei Yu ◽  
Guozhong Zhang ◽  
Songtao Qi
Keyword(s):  
Overall Survival ◽  
Malignant Gliomas ◽  
Epidemiological Studies ◽  
Control Cohort ◽  
Poor Overall Survival ◽  
Term Survival ◽  
Significant Difference ◽  
Positive Rate ◽  
Long Term Survivors

Abstract Background and Study Aims The exact reason of long-term survival in glioblastoma (GBM) patients has remained uncertain. Molecular parameters in addition to histology to define malignant gliomas are hoped to facilitate clinical, experimental, and epidemiological studies. Material and Methods A population of GBM patients with similar clinical characteristics (especially similar resectability) was reviewed to compare the molecular variables between poor (overall survival [OS] < 18 months, control cohort) and long-term survivors (overall survival > 36 months, OS-36 cohort). Results Long-term GBM survivors were younger. In the OS-36 cohort, the positive rate of isocitrate dehydrogenase (IDH) mutation was very low (7.69%, 3/39) and there was no statistical difference in OS between IDH mutant and wild-type patients. The results of 1p/19q codeletions are similar. Besides, there were no significant difference in MGMT promoter methylation, telomerase reverse transcriptase (TERT) promoter mutation, and TP53 mutations between OS-36 cohort and control cohort. Conclusions No distinct markers consistently have been identified in long-term survivors of GBM patients, and great importance should be attached to further understand the biological characteristics of the invasive glioma cells because of the nature of diffuse tumor permeation.

scholarly journals Long-term outcome after allogeneic stem cell transplantation in multiple myeloma

2021 ◽  
Author(s):  
Sini Luoma ◽  
Raija Silvennoinen ◽  
Auvo Rauhala ◽  
Riitta Niittyvuopio ◽  
Eeva Martelin ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Relapse Group

AbstractThe role of allogeneic hematopoietic stem cell transplantation (allo-SCT) in multiple myeloma is controversial. We analyzed the results of 205 patients transplanted in one center during 2000–2017. Transplantation was performed on 75 patients without a previous autologous SCT (upfront-allo), on 74 as tandem transplant (auto-allo), and on 56 patients after relapse. Median overall survival (OS) was 9.9 years for upfront-allo, 11.2 years for auto-allo, and 3.9 years for the relapse group (p = 0.015). Progression-free survival (PFS) was 2.4, 2.4, and 0.9 years, respectively (p < 0.001). Non-relapse mortality at 5 years was 8% overall, with no significant difference between the groups. Post-relapse survival was 4.1 years for upfront-allo and auto-allo, and 2.6 years for the relapse group (p = 0.066). Survival of high-risk patients was reduced. In multivariate analysis, the auto-allo group had improved OS and chronic graft-versus-host disease was advantageous in terms of PFS, OS, and relapse incidence. Late relapses occurred in all groups. Allo-SCT resulted in long-term survival in a small subgroup of patients. Our results indicate that auto-allo-SCT is feasible and could be considered for younger patients in the upfront setting.

Sign in / Sign up

Export Citation Format

Share Document