Survival outcome of ampullary and duodenal adenocarcinomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14579-e14579
Author(s):  
Walid Labib Shaib ◽  
Rahul Sharma ◽  
Sungjin Kim ◽  
Zhengjia Chen ◽  
John S. Kauh ◽  
...  
Keyword(s):  
Early Stage ◽  
Rank Test ◽  
Proportional Hazard ◽  
Equal Distribution ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Survival Difference ◽  
Significant Survival ◽  
Significant Difference ◽  
Emory University

e14579 Background: Adenocarcinomas of the duodenum are divided into two locations: ampullary (AMP) and duodenal (DA). AMP represents 2% of all gastrointestinal (GI) malignancies and commonly present with tumor related obstruction of the common bile duct. DA is rare, and constitutes 0.4% of GI but 45% of small bowel malignancies. The literature regarding treatment and outcome of DA and AMP is very limited. The objective of this project is to evaluate the outcome for these cancers. Methods: After IRB approval, AMP and DA patients were identified from Emory University database. A chart review from July 1995 to July 2012 was conducted. Data was collected for demographic characteristics, pathology, treatment and survival.Survival rates were estimated by Kaplan Meier method and compared with Log-rank test. A Cox proportional hazard model was fitted to estimate the adjusted effect of AMP versus DA on overall survival (OS). Results: A total of 162 patients with AMP (94) and DA (68) were identified. Median age at diagnosis for AMP was 62 and for DA was 63 years. Equal distribution of males and females was found in both locations. No difference was found comparing grade of the tumors. There was a difference in race. DA presented with larger primary tumor compared to AMP. DA presented with advanced stage. Treatment was driven by stage and included surgery, surgery followed by adjuvant chemotherapy (5-FU based) +/- radiation or chemotherapy alone. Median OS of 27.5 for AMP and 19.3 months for DA, not statistically significant difference. Adjusting for stage, no significant survival difference was observed (HR=0.88 95%CI=0.54 – 1.46, p=0.63). Conclusions: Race, size, stage and treatment were different comparing AMP to DA. Majority of AMP had early stage and were treated with surgery; DA tends to present at a late stage. When accounting for stage and location, the OS was not significantly different. [Table: see text]

scholarly journals Metformin and Diabetes Prevention in Patients with Prediabetes: Results from Isfahan Diabetes Prevention Study (IDPS)

2021 ◽  
pp. 65-74
Author(s):  
Parisa Khodabandeh Shahraki ◽  
Awat Feizi ◽  
Ashraf Aminorroaya ◽  
Mahboubeh Farmani ◽  
Massoud Amini
Keyword(s):  
Diabetes Prevention ◽  
Rank Test ◽  
Proportional Hazard ◽  
Medical Sciences ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Adjusted Model

Aim: Although, the effectiveness of metformin in diabetes treatment is well established, its preventive effect in the development of diabetes is still unclear in real world. We aimed to determine the effectiveness of metformin therapy as a single preventive agent in patients with prediabetes in a cohort study (IDPS). Study Design: In this prospective observational study. Place and Duration of Study: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Methodology: We included 410 patients with prediabetes (168 metformin user, 242 non-users), who participated in IDPS. To determine the association between metformin use and incidence of type 2 diabetes, Cox proportional hazard method, Kaplan-Meier and log Rank test were used. Results: In fully adjusted model for all confounders, significant hazard ratio (HR) for staying prediabetes rather than returning to normal was detected in male group of metformin non-user (HR: 2·41 [95% CI 1.01-5.79]; P<0·05) and those metformin non-user who had both Impaired Fasting Glucose and Impaired Glucose Tolerance (IFG & IGT) (HR: 2.13 [95% CI 1.05-4.34]; P=0·04).  There was no significant difference in terms of developing diabetes risk between metformin users and non-users. Conclusion: This study evidenced that males and patients with IFG & IGT who had not used metformin are at higher risk to staying prediabetes than returning to normal.

scholarly journals SMOKING STATUS AFFECTING SURVIVAL OF ADENOCARCINOMA LUNG CANCER PATIENTS IN KUALA LUMPUR, MALAYSIA

2017 ◽  
Vol 10 (9) ◽  
pp. 312
Author(s):  
Nida Sajid Ali Bangash ◽  
Natasha Hashim ◽  
Nahlah Elkudssiah Ismail
Keyword(s):  
Lung Cancer ◽  
Prognostic Significance ◽  
Hazard Model ◽  
Rank Test ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Kuala Lumpur ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
Survival Difference

  Objective: Adenocarcinoma (AC) of the lung is now the most common histologic type of non-small cell lung cancer (NSCLC) worldwide since the past 20 years. This study was conducted to investigate survival difference among smoker and non-smoker lung AC patients.Methods: A retrospective observational study was conducted for 81 advanced NSCLC adult Malaysian patients in Radiotherapy and Oncology Clinic at Hospital Kuala Lumpur, Malaysia. A total of adult 30 Malaysian smokers and 51 non-smokers with lung AC were included. Ex-smokers were not included in the study. Demographic and clinical data were collected and described. For survival analysis, Kaplan–Meier test and log-rank test were used to calculate overall survival (OS) and analyse the difference in the survival curve. Cox proportional hazard model was used to identify prognostic significance of smoking status.Results: Non-smokers showed a significant association with female gender and Stage IV NSCLC. The median OS was higher for non-smokers (493 days) as compared to smokers (230 days). The Cox proportional hazard model showed higher hazard ratio for smokers.Conclusion: Non-smoking is an independent positive prognostic factor in lung AC.

scholarly journals The productive lifetime of sows on two farms from the aspect of reasons for culling

2015 ◽  
Vol 15 (3) ◽  
pp. 747-758 ◽  
Author(s):  
Peter Balogh ◽  
Wojciech Kapelański ◽  
Hanna Jankowiak ◽  
Lajos Nagy ◽  
Sandor Kovacs ◽  
...  
Keyword(s):  
Old Age ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Large White ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Breeding Farms ◽  
On Farm

Abstract The aim of this study was to compare the characteristics of the productive lifetime (PLT) of sows kept on two farms, from the aspect of reasons for culling. The study was based on data from animals from two breeding farms in Hungary, using the data of 3493 crossbred Dutch Large White and Dutch Landrace sows (DLW × DL) between their first farrowing until the time of culling (2006 and 2012). For six years, the annual culling rate for both farms averaged 45%. The most frequent reasons for removal on both farms were reproductive problems (40%, 51%), leg problems (29%, 23%) and mortality (19%, 15%). There was a significant difference between the distributions of reasons for culling on the two farms (χ2=41.7, P≤0.001). The distributions of reasons for culling differed in three periods of sow breeding (Farm A: χ2=264.7, P≤0.001; Farm B: χ2=511.1, P≤0.001). The percentage of main removal reasons decreased, whereas the frequency of culling due to age increased. Using survival analysis (Kaplan-Meier method and Cox proportional hazard model), significant differences were identified between the PLT of sows culled due to reproductive problems (P≤0.001), leg problems (P≤0.001) and old age (P≤0.001). Reproductive problems (HR: 1.34, P≤0.001) and leg problems (HR: 1.39, P≤0.001) were higher and culling due to old age (HR: 0.44, P≤0.001) was lower on Farm A compared to Farm B. There were no significant differences between the two farms in terms of mortality (HR: 0.99, P=0.923). Overall, the results can be useful for breeders of crossbred (DLW × DL) sow populations in more accurately defining their culling systems.

Outcomes for stage IVA squamous cell carcinoma of the oral cavity according to staging subtypes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6076-6076
Author(s):  
Kristen Marrone ◽  
Michael Otremba ◽  
Roman Groisberg ◽  
Hari Anant Deshpande ◽  
Forrest Crawford ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Rank Test ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Cox Proportional Hazard Regression

6076 Background: Patients with locoregionally advanced squamous cell carcinoma of the oral cavity (SCCOC), defined as stages III to IVB without T4b, are treated similarly and combined for enrollment into most clinical trials. There are several combinations of tumor (T) and lymph node (N) categories for stage IVA. We evaluated the differences in outcomes according to subtypes of patients with stage IVA SCCOC. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients with stage IVA SCCOC diagnosed between 1988 and 2007. Patients were subdivided according to tumor (T) and lymph node (N) status. Overall survival (OS) was estimated by the Kaplan-Meier method and compared by using log-rank test. Cox proportional hazard regression models were used for multivariate analyses. Results: Among the 3,904 patients meeting inclusion criteria, most patients underwent surgery, either alone (24%) or with radiation (59%). There was a significant difference in outcomes according to AJCC subsets (T4aN0, T4aN1, T1N2, T2N2, T3N2 and T4N2), with 5-year OS ranging from 15.8% in T4aN2 to 41.3% in T4aN0 (HR 2.3; 95% CI 2.03-2.62, p < 0.001). Since the 5-year OS was similar for patients with T1N2-T2N2 and T3N2-T4aN2, these groups were further subdivided according to the T (T1-2 or T3-4a) and N2 subsets. The 5-year OS was significantly different according to the subgroups, ranging from 11.8% in T3-4aN2c to 37.5% in T1-2N2a (Table). The stage subgroups remained independent predictors for survival after adjusting for age, gender, race and treatment. Conclusions: Stage IVA SCCOC is a heterogeneous disease with significant differences in outcomes according to its subsets. If these findings are confirmed in additional studies, further subdivision of stage IVA may be warranted. [Table: see text]

MACC1 expression is an indicator of recurrence in early-stage glottic cancer

2019 ◽  
Vol 50 (4) ◽  
pp. 392-398
Author(s):  
Takuma Makino ◽  
Yorihisa Orita ◽  
Yuka Gion ◽  
Tomoyasu Tachibana ◽  
Soshi Takao ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Early Stage ◽  
Glottic Cancer ◽  
Rank Test ◽  
Proportional Hazard ◽  
Free Survival ◽  
Kaplan Meier ◽  
Neck Recurrence ◽  
Clinical Records ◽  
Independent Indicator

Abstract Background Metastasis-associated in colon cancer 1 (MACC1) has been reported to be an independent indicator of poor prognoses in some kinds of cancer due to disease metastasis or recurrence. We investigated the correlation between MACC1 expression and the prognosis of glottic cancer. Methods Paraffin-embedded, early-stage (I or II) glottic cancer specimens (n = 52) were immunohistochemically analyzed to explore MACC1 expression. The clinical records associated with each case were also examined. Recurrence-free survival (RFS) was estimated using the Kaplan–Meier method, and between-group RFS differences were assessed using the log-rank test. The multivariate analyses were evaluated using the Cox’s proportional-hazard model. Results Patients were treated with only radiotherapy (RT) (n = 37, including 18 with T1 disease and 19 with T2 disease), or with chemoradiotherapy (CRT) (n = 15, including 1 with T1 disease and 14 with T2 disease). Eleven patients demonstrated local recurrence and two patients experienced cervical lymph node recurrence. Tumor specimens were MACC1-positive in 9 of the 13 (69.2%) patients with local or neck recurrence, and 7 of the 11 (63.6%) patients with local recurrence. The RFS rate of patients who were treated with only RT was significantly lower than that of patients who were treated with CRT (P = 0.0243). The RFS rate was significantly lower in cases with MACC1 expression than in those without MACC1 expression (P = 0.0003). Multivariate analysis revealed that MACC1 expression was an independent risk factor of local recurrence (P = 0.0016). Conclusion MACC1 is an independent indicator of recurrence related to RFS in early-stage glottic cancer.

scholarly journals Peran Tindakan Revaskularisasi terhadap Kesintasan Pasien Non ST Elevation Myocardial Infarction (NSTEMI)

2017 ◽  
Vol 1 (1) ◽  
pp. 24
Author(s):  
Gerie Amarendra ◽  
Lukman H Makmun ◽  
Dono Antono ◽  
Esthika Dewiasty
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Rank Test ◽  
Proportional Hazard ◽  
Hazard Regression ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
St Elevation ◽  
Cox Proportional Hazard Regression

Pendahuluan. Pengaruh revaskularisasi terhadap kesintasan pasien non ST elevation myocardial infarction (NSTEMI) masih belum jelas. Waktu revaskularisasi yang optimal pada pasien NSTEMI belum ditemukan. Penelitian ini bertujuan mengetahui pengaruh revaskularisasi terhadap kesintasan pasien NSTEMI, juga mengetahui pengaruh waktu revaskularisasi terhadap kesintasan pasien NSTEMI.Metode. Penelitian dengan disain kohort retrospektif dilakukan terhadap 300 pasien non ST elevation myocardial infarction yang dirawat di RSUPNCM pada kurun waktu Desember 2006-Maret 2011. Data klinis, laboratorium, elektrokardiografi (EKG), ekokardiografi, dan angiografi koroner dikumpulkan. Pasien yang telah terhitung enam bulan setelah onset kemudian dihubungi melalui telepon untuk melihat status mortalitasnya. Perbedaan kesintasan revaskularisasi ditampilkan dalam kurva Kaplan Meier dan perbedaan kesintasan diantara dua kelompok diuji dengan Log-rank test dengan batas kemaknaan <0,05, serta analisis multivariat dengan Cox proportional hazard regression untuk menghitung adjusted hazard ratio (dan interval kepercayaan 95%) antara pasien NSTEMI yang menjalani terapi medikamentosa dan revaskularisasi terhadap kelompok medikamentosa dengan memasukkan variabel perancu.Hasil. Terdapat perbedaan kesintasan yang bermakna pada uji log rank (p<0,001) antara pasien NSTEMI yang menjalani revaskularisasi dan terapi medikamentosa saja dengan crude HR 0,19 (IK95% 0,11-0,34) dan fully adjusted HR 0,33 (IK95% 0,17-0,64). Faktor perancu yang bermakna adalah penurunan fungsi ginjal dan syok kardiogenik. Pada analisis kesintasan berdasarkan waktu revaskularisasi tidak didapatkan perbedaan kesintasan antara pasien yang menjalani revaskularisasi < 1 minggu, 1-2 minggu, 2-3 minggu, 3-4 minggu, 4-5 minggu dengan p=0,853.Simpulan. Kesintasan enam bulan pasien NSTEMI yang menjalani terapi medikamentosa dan revaskularisasi lebih baik dibandingkan dengan terapi medikamentosa saja. Tidak terdapat perbedaan kesintasan enam bulan pasien NSTEMI berdasarkan waktu revaskularisasi.

scholarly journals Radiotherapy after mastectomy has significant survival benefits for inflammatory breast cancer: a SEER population-based retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8512
Author(s):  
Zhi-wen Li ◽  
Miao Zhang ◽  
Yong-jing Yang ◽  
Zi-jun Zhou ◽  
Yan-ling Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Stage Iv ◽  
Population Based ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Survival ◽  
Study Population

Objectives The survival benefit of postmastectomy radiotherapy (PMRT) has not been fully proven in inflammatory breast cancer (IBC). Thus, in the present research, we aimed at elucidating the effects of PMRT on the survival of IBC patients. Methods Eligible patients were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset between 2010 and 2013. The Kaplan-Meier method along with the log-rank test was utilized for the comparison of both the overall survival (OS) andthe cancer-specific survival (CSS) in patients undergoing PMRT or not. Additionally, multivariate survival analysis of CSS and OS were performed using the Cox proportional hazard model. Results In total, 293 eligible cases were identified, with the median follow-up time of 27 months (range: 5–59 months). After propensity score matching (PSM), 188 patients (94 for each) were classified intothe No-PMRT and the PMRT group. Consequently, significantly higher OS rates were detected in the PMRT group compared with the No-PMRT group prior to PSM (P = 0.034), and significantly higher CSS (P = 0.013) and OS (P = 0.0063) rates were observed following PSM. Furthermore, multivariate analysis revealed thatPMRT [CSS (HR: 0.519, 95% CI [0.287–0.939], P = 0.030); OS (HR: 0.480, 95% CI [0.269–0.859], P = 0.013)], as well as Her2+/HR+ subtype, was independent favorable prognostic factors.Besides, black ethnicity, AJCC stage IV and triple-negative subtype were independent unfavorable prognostic factors. Further subgroup analysis revealed that most of the study population could benefit from PMRT, no matter OS or CSS. Conclusions Our findings support that PMRT could improve the survival of IBC patients.

scholarly journals Effectiveness of Selective Laser Trabeculoplasty Applied to 360° vs. 180° of the Angle

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Abraham Nirappel ◽  
Emma Klug ◽  
Rebecca Ye ◽  
Nathan Hall ◽  
Marika Chachanidze ◽  
...  
Keyword(s):  
Proportional Hazard ◽  
Selective Laser Trabeculoplasty ◽  
Proportional Hazard Model ◽  
Laser Trabeculoplasty ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Mean ◽  
Cumulative Probabilities

Purpose. To compare the effectiveness and safety of 360° and 180° of Selective Laser Trabeculoplasty (SLT) for the treatment of elevated intraocular pressure (IOP). Methods. Retrospective cohort study. The main outcome measure was the Kaplan–Meier analysis comparing the cumulative probabilities of survival between the 360° and 180° SLT groups in terms of IOP reduction. Success was defined as ≥20% IOP reduction from baseline with an IOP between 5–18 mmHg and ≤1 glaucoma medication added postoperatively. Additional outcome measures included changes in average IOP, number of glaucoma medications, and the incidence of postoperative IOP spikes. Measurements were obtained at 6 weeks, 1 year, and 2 years postoperatively. Results. Two hundred and fifty-eight eyes of 258 patients were included in the 360° group, and 196 eyes of 196 patients were included in the 180° group. The mean IOP reductions at 2 years were 2.21 ± 2.02 mmHg and 2.43 ± 1.81 mmHg ( p = 0.33 ) in the 180° and 360° groups, respectively. There were no significant differences in the incidence of postoperative IOP spikes between the two groups. There was a significant difference in the survival curves of the two groups ( p = 0.035 ). The Cox proportional-hazard model indicated that 360° of SLT application was a significant predictor of long-term success ( p = 0.030 ). Conclusions. 360° of SLT application seems to provide for greater long-term IOP control than 180° of application without putting patients at an elevated risk for postoperative IOP spikes.

scholarly journals Effect of floor type and bedding system on sows lifespan

2013 ◽  
pp. 155-160
Author(s):  
Angéla Soltész
Keyword(s):  
Survival Analysis ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Large White ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Difference ◽  
Comparative Examination

The paper studies two nucleus pig farms in the Great Plain region of Hungary which have same management, same feeding system but different breeding technology (Farm A had solid floor with straw and Farm B had slatted floor without straw). The genetics of sows were crossbred Dutch Large White and Dutch Landrace. The comparative examination was based on the causes of culling according to the different floor type. To the analysis of culling reasons was applied the methods of survival analysis. In the analysis there were used the Kaplan-Meier method and the Cox Proportional Hazard model to the estimate the difference between the farms. The results of survival analysis showed significant difference (p<0.05) between the lifespan of sows that caused the difference between the survival probabilities of sows culled due to lameness. Furthermore there was showed that the sows kept on solid floor with straw have stayed in production longer than on slatted floor without straw. The hazard ratio was 1.434 that means that the culling due to lameness is 1.434 times higher by the slatted floor without straw facing by solid floor with straw.

Combined adjuvant cisplatin and ifosfamide chemotherapy and radiotherapy for malignant mixed müllerian tumors of the uterus

2006 ◽  
Vol 16 (3) ◽  
pp. 1364-1369 ◽  
Author(s):  
L. Wong ◽  
H. T. See ◽  
H. S. Khoo-Tan ◽  
J. S. Low ◽  
W. T. Ng ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Rank Test ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Effect Of Treatment ◽  
Cox Proportional Hazard Regression

The role of adjuvant therapy for malignant mixed müllerian tumors of the uterus has not been established. Our aim was to review our experience with sequential adjuvant therapy using cisplatin and ifosfamide chemotherapy and radiotherapy after surgical staging. A retrospective study of 43 patients from 1995 to 2004 was undertaken. Survival was calculated using the Kaplan–Meier method and compared by the log-rank test. The Cox proportional hazard regression model was used to assess the effect of treatment on survival after adjustment for age and stage. Twenty-eight patients received adjuvant chemotherapy and 28 patients had adjuvant radiotherapy. Twenty-one patients underwent sequential adjuvant chemotherapy and radiotherapy. Tumor recurrence occurred in 14 patients at a median duration of 10 months. The overall 2- and 5-year survival was 64% and 60%, respectively. The 2- and 5-year survival for stage I and II diseases was both 95%, while the 2-year survival for stage III and IV diseases was 25%. Patients who underwent sequential adjuvant therapy had an improved survival compared with patients who did not follow the protocol (P = 0.024). Our results with sequential adjuvant therapy are encouraging and justify future randomized trials.

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