scholarly journals Shorter-Duration Therapy Using Vincristine, Dactinomycin, and Lower-Dose Cyclophosphamide With or Without Radiotherapy for Patients With Newly Diagnosed Low-Risk Rhabdomyosarcoma: A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group

2014 ◽  
Vol 32 (31) ◽  
pp. 3547-3552 ◽  
Author(s):  
David O. Walterhouse ◽  
Alberto S. Pappo ◽  
Jane L. Meza ◽  
John C. Breneman ◽  
Andrea A. Hayes-Jordan ◽  
...  
Keyword(s):  
Residual Disease ◽  
Incidence Rates ◽  
Low Risk ◽  
Newly Diagnosed ◽  
Oncology Group ◽  
Group Iii ◽  
Group I ◽  
Risk Patients ◽  
Stage 1 ◽  
Length Of Therapy

Purpose Intergroup Rhabdomyosarcoma Study Group (IRSG) studies III and IV showed improved failure-free survival (FFS) rates with vincristine, dactinomycin, and cyclophosphamide (VAC; total cumulative cyclophosphamide dose, 26.4 g/m2) compared with vincristine and dactinomycin (VA) for patients with subset-one low-risk embryonal rhabdomyosarcoma (ERMS; stage 1/2 group I/II ERMS or stage 1 group III orbit ERMS). The objective of Children's Oncology Group ARST0331 was to reduce the length of therapy without compromising FFS for this subset of low-risk patients by using VA in combination with lower-dose cyclophosphamide (total cumulative dose, 4.8 g/m2) plus radiotherapy (RT). Patients and Methods This noninferiority prospective clinical trial enrolled newly diagnosed patients with subset-one clinical features. Therapy included four cycles of VAC followed by four cycles of VA over 22 weeks. Patients with microscopic or gross residual disease at study entry received RT. Results With a median follow-up of 4.3 years, we observed 35 failures among 271 eligible patients versus 48.4 expected failures, calculated using a fixed outcome based on the FFS expected for similar patients treated on the IRSG D9602 protocol. The estimated 3-year FFS rate was 89% (95% CI, 85% to 92%), and the overall survival rate was 98% (95% CI, 95% to 99%). Patients with paratesticular tumors had the most favorable outcome. Three-year cumulative incidence rates for any local, regional, or distant failures were 7.6%, 1.5%, and 3.4%, respectively. Conclusion Shorter-duration therapy that included lower-dose cyclophosphamide and RT did not compromise FFS for patients with subset-one low-risk ERMS.

Vincristine (V), dactinomycin (A), and lower doses of cyclophosphamide (C) with or without radiation therapy for patients with newly diagnosed low-risk embryonal rhabdomyosarcoma (ERMS): A report from the Children’s Oncology Group (COG).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9509-9509 ◽  
Author(s):  
David Walterhouse ◽  
Alberto S. Pappo ◽  
Jane L Meza ◽  
John C. Breneman ◽  
Andrea Anita Hayes-Jordan ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Complete Response ◽  
Low Risk ◽  
Phase Iii ◽  
Newly Diagnosed ◽  
Group Iii ◽  
Group I ◽  
Phase Iii Study ◽  
Stage 1

9509 Background: Intergroup Rhabdomyosarcoma Study (IRS) trials showed improved survival with VAC compared with VA for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II ERMS (see table). In COG ARST0331, we hypothesized that VA in combination with lower doses of C (total cumulative dose=4.8 g/m2) would produce the benefit of IRS-IV VAC with less toxicity for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II low-risk ERMS. Methods: This single arm, non-inferiority, phase III study enrolled newly diagnosed patients with Stage 1 Group III (non-orbit) ERMS or Stage 3 Group I/II ERMS onto Subset 2. Therapy was 4 cycles of VAC followed by 12 cycles of VA over 46 weeks (total cumulative doses: V=54 mg/m2, A=21.6 mg/m2, C=4.8 g/m2). The radiation therapy dose was 36 Gy for Group IIA patients, 41.4 Gy for Group IIB/C patients, and 50.4 Gy for Group III patients. From 2004–2008 girls with Group III vaginal RMS did not receive radiotherapy if a complete response was achieved with chemotherapy with or without delayed resection. The primary endpoint was failure-free survival (FFS), and results were compared with a fixed expected outcome. Results: With a median follow-up of 3.0 yrs, we observed 16 failures vs. 7.8 expected failures. Estimated 3-yr FFS was 63% (95% CI: 46%, 75%) (n=60), and overall survival (OS) was 84% (95% CI: 68%, 93%). Estimated 3-yr FFS was 46% (95% CI: 23%, 67%) for girls with non-bladder genitourinary tract ERMS (n=21) and 75% (95% CI: 53%, 88%) for all other Subset 2 patients (n=39). Conclusions: We observed suboptimal FFS of patients with Subset 2 low-risk RMS using reduced total cyclophosphamide (4.8 g/m2). Results were complicated by the choice of no radiation therapy for girls with vaginal tumors. Future studies for low-risk RMS Subset 2 patients could investigate a dose of C between 4.8 and 26.4 g/m2 with VA and local radiotherapy. [Table: see text]

scholarly journals Results of the Intergroup Rhabdomyosarcoma Study Group D9602 Protocol, Using Vincristine and Dactinomycin With or Without Cyclophosphamide and Radiation Therapy, for Newly Diagnosed Patients With Low-Risk Embryonal Rhabdomyosarcoma: A Report From the Soft Tissue Sarcoma Committee of the Children's Oncology Group

2011 ◽  
Vol 29 (10) ◽  
pp. 1312-1318 ◽  
Author(s):  
R. Beverly Raney ◽  
David O. Walterhouse ◽  
Jane L. Meza ◽  
Richard J. Andrassy ◽  
John C. Breneman ◽  
...  
Keyword(s):  
Survival Rates ◽  
Embryonal Rhabdomyosarcoma ◽  
Study Group ◽  
Free Survival ◽  
Group Iii ◽  
Group I ◽  
Risk Patients ◽  
Group Ii ◽  
Stage 1

Purpose Patients with localized, grossly resected, or gross residual (orbital only) embryonal rhabdomyosarcoma (ERMS) had 5-year failure-free survival (FFS) rates of 83% and overall survival rates of 95% on Intergroup Rhabdomyosarcoma Study Group (IRSG) protocols III/IV. IRSG D9602 protocol (1997 to 2004) objectives were to decrease toxicity in similar patients by reducing radiotherapy (RT) doses and eliminating cyclophosphamide for the lowest-risk patients. Patients and Methods Subgroup A patients (lowest risk, with ERMS, stage 1 group I/IIA, stage 1 group III orbit, stage 2 group I) received vincristine plus dactinomycin (VA). Subgroup B patients (ERMS, stage 1 group IIB/C, stage I group III nonorbit, stage 2 group II, stage 3 group I/II) received VA plus cyclophosphamide. Patients in group II/III received RT. Compared with IRS-IV, doses were reduced from 41.4 to 36 Gy for stage 1 group IIA patients and from 50 or 59 to 45 Gy for group III orbit patients. Results Estimated 5-year FFS rates were 89% (95% CI, 84% to 92%) for subgroup A patients (n = 264) and 85% (95% CI, 74%, 91%) for subgroup B patients (n = 78); median follow-up: 5.1 years. Estimated 5-year FFS rates were 81% (95% CI, 68% to 90%) for patients with stage 1 group IIA tumors (n = 62) and 86% (95% CI, 76% to 92%) for patients with group III orbit tumors (n = 77). Conclusion Five-year FFS and OS rates were similar to those observed in comparable IRS-III patients, including patients receiving reduced RT doses, but were lower than in comparable IRS-IV patients receiving VA plus cyclophosphamide. Five-year FFS rates were similar among subgroups A and B patients.

Analysis of Prognostic Factors in Patients With Nonmetastatic Rhabdomyosarcoma Treated on Intergroup Rhabdomyosarcoma Studies III and IV: The Children's Oncology Group

2006 ◽  
Vol 24 (24) ◽  
pp. 3844-3851 ◽  
Author(s):  
Jane L. Meza ◽  
James Anderson ◽  
Alberto S. Pappo ◽  
William H. Meyer
Keyword(s):  
Regional Lymph Node ◽  
Oncology Group ◽  
Anatomic Site ◽  
Primary Tumors ◽  
Undifferentiated Sarcoma ◽  
Group Iii ◽  
Disease Characteristics ◽  
Group I ◽  
Node Disease ◽  
Stage 1

Purpose The outcome for localized rhabdomyosarcoma (RMS) or undifferentiated sarcoma (UDS) is affected by age, histology, primary anatomic site, extent of disease, and therapy. Patients and Methods We evaluated patient and disease characteristics for their ability to predict outcome for patients with nonmetastatic RMS or UDS treated on Intergroup Rhabdomyosarcoma Study (IRS) -III (1984 to 1991) or IRS-IV (1991 to 1997). Results The estimated 5-year failure-free survival (FFS) rate was 90% for patients with embryonal RMS (ERMS) stage 1, group I or IIa; stage 2, group I; or group III orbit. The estimated 5-year FFS rate was 87% for patients with ERMS stage 1, group IIb or IIc; stage 1, group III nonorbit; stage 2, group II; and stage 3, group I or II; and 73% for patients with ERMS stage 2 or 3, group III. The estimated 5-year FFS rate was poor for patients with stage 2 or 3, group III ERMS with invasive (T2) tumors who were age younger than 1 year or 10 years or older (56%) and patients with stage 2 or 3, group III extremity primary tumors (43%). Overall, outcomes for patients with alveolar RMS (ARMS) or UDS were worse than for patients with ERMS. However, the 5-year FFS rate was good for patients with ARMS/UDS at favorable sites with group I or II (80%) or group III (76%) disease. The FFS rate was poorer for patients with ARMS/UDS at unfavorable sites with group I or II (66%) or group III (45%) disease. The estimated 5-year FFS rate was 31% for patients with group III ARMS/UDS at unfavorable sites with regional lymph node disease, which is similar to metastatic RMS. Conclusion Patient and disease characteristics identify distinct subsets with different outcomes, allowing the Soft Tissue Sarcoma Committee of the Children's Oncology Group to refine risk-adapted therapy assignment.

Benefit of Intensified Therapy for Patients With Local or Regional Embryonal Rhabdomyosarcoma: Results From the Intergroup Rhabdomyosarcoma Study IV

2000 ◽  
Vol 18 (12) ◽  
pp. 2427-2434 ◽  
Author(s):  
K. Scott Baker ◽  
James R. Anderson ◽  
Michael P. Link ◽  
Holcombe E. Grier ◽  
Stephen J. Qualman ◽  
...  
Keyword(s):  
Head And Neck ◽  
Residual Disease ◽  
Embryonal Rhabdomyosarcoma ◽  
Intermediate Risk ◽  
Primary Tumors ◽  
Free Survival ◽  
Group Iii ◽  
Group I ◽  
Resected Tumor ◽  
Risk Patients

PURPOSE: To compare failure-free survival (FFS) and survival for patients with local or regional embryonal rhabdomyosarcoma treated on the Intergroup Rhabdomyosarcoma Study (IRS)–IV with that of comparable patients treated on IRS-III. PATIENTS AND METHODS: Patients were retrospectively classified as low- or intermediate-risk. Low-risk patients were defined as those with primary tumors at favorable sites, completely resected or microscopic residual, or orbit/eyelid primaries with gross residual disease and tumors less than 5 cm at unfavorable sites but completely resected. Intermediate-risk patients were all other patients with local or regional tumors. RESULTS: Three-year FFS improved from 72% on IRS-III to 78% on IRS-IV for patients with intermediate-risk embryonal rhabdomyosarcoma (P = .02). Subset analysis revealed two groups that benefited most from IRS-IV therapy. FFS at 3 years for patients with resectable node-positive or unresectable (group III) embryonal rhabdomyosarcoma arising at certain favorable sites (head and neck [not orbit/eyelid or parameningeal] and genitourinary [not bladder or prostate]) improved from 72% on IRS-III to 92% on IRS-IV (P = .01). Similarly, 3-year FFS for patients with completely resected tumor or with only microscopic disease remaining (group I or II) at unfavorable sites improved from 71% on IRS-III to 86% on IRS-IV (P = .04). Only patients with unresectable embryonal rhabdomyosarcoma (group III) at unfavorable sites had no improvement in outcome on IRS-IV (3-year FFS for IRS-III and IRS-IV, 72% and 75%, respectively; P = .31). CONCLUSION: IRS-IV therapy benefited certain subgroups of patients with intermediate-risk embryonal rhabdomyosarcoma. A doubling of the intensity of cyclophosphamide (or ifosfamide equivalent) dosing per cycle between IRS-III and IRS-IV is thought to be a key contributing factor for this improvement.

Abstract P482: Long-term Health and Cost Impact of the 2017 American College of Cardiology/American Heart Association (2017 Acc/aha) Hypertension Guidelines for Low-risk Adults

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Pengxiao C Wei ◽  
Joanne Penko ◽  
Pamela Coxson ◽  
Brandon Bellows ◽  
Leah Machen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Clinical Setting ◽  
Healthcare Costs ◽  
Low Risk ◽  
Dynamic State ◽  
High Uptake ◽  
Newly Diagnosed ◽  
Complete Control ◽  
Stage 1

Introduction: The 2017 ACC/AHA guidelines redefined stage 1 hypertension to include blood pressure 130-139 mmHg/80-89 mmHg and recommended non-pharmacologic interventions (e.g., DASH diet, physical activity) for those with stage 1 hypertension and a low 10-year risk of cardiovascular disease (CVD). The cost-effectiveness of achieving target blood pressure in this low risk population in the clinical setting (via identification, diagnosis, and counseling on diet and exercise) has not been assessed. Methods: We used the Cardiovascular Disease Policy Model (CVDPM), a dynamic state-transition model of CVD in US adults to simulate achieving blood pressure control in low-risk adults aged 35-64 years with untreated stage 1 hypertension based on the 2017 ACC/AHA guidelines. Outcomes included incident CVD (coronary heart disease and stroke), CVD healthcare costs (2018 dollars), and quality-adjusted life years (QALYs) over 10 years. We projected outcomes assuming all low-risk young adults achieve control. We then varied the degree to which patients would change behaviors following diagnosis, using low uptake (20%) and high uptake (70%) estimates sourced from literature. We tested the sensitivity of health gains to decrements in QALYs associated with receiving a diagnosis using estimates from the Global Burden of Disease. Results: An estimated 7.0 million men and 6.6 million women age 35-64 years would be newly diagnosed with stage 1 hypertension and indicated for non-pharmacologic interventions according to 2017 ACC/AHA. Achieving targets of <130/80 mmHg is projected to prevent 63,200 incident CVD events and 4,800 CVD deaths and lower CVD related healthcare costs by $3.6 billion (2018 USD) over 10 years compared to no BP change. Assuming less than complete control (because of variable uptake of non-pharmacologic interventions) resulted in lower rates of CVD prevention (low uptake - 13,900 events prevented and $0.8 billion lower costs; high uptake 41,000 events prevented and $2.3 billion lower costs). In all scenarios, the magnitude of QALYs gained from preventing CVD was highly sensitive to decrements associated with anxiety from receiving a diagnosis. Conclusions: Achieving 2017 ACC/AHA stage 1 hypertension goals in newly diagnosed low-risk adults would result in substantial CVD benefit and reductions in CVD-related healthcare costs. . If these goals are to be achieved in the clinical setting, gains are likely to be offset by degree of uptake of counseling regarding non-pharmacologic interventions and anxiety related to a new diagnosis of hypertension.

Wound Healing: An Endpoint for Complex Peripheral Angioplasty

1994 ◽  
Vol 1 (1) ◽  
pp. 88-91 ◽  
Author(s):  
John R. Crew ◽  
Marilyn Thuener
Keyword(s):  
Wound Healing ◽  
High Risk ◽  
San Francisco ◽  
Wound Management ◽  
Group Iii ◽  
High Risk Patients ◽  
Group I ◽  
Risk Patients ◽  
Group Ii ◽  
End Stage

Purpose: The standard endpoint for lower limb revascularization is long-term patency; however, in high-risk patients with end-stage ischemia, healing of chronic ulcerations has been proposed as an acceptable endpoint. To evaluate if today's minimally invasive interventions, in combination with comprehensive wound healing procedures, can resolve nonhealing wounds, we performed a retrospective review of chronic ulceration patients treated at the San Francisco Wound Care Center. Methods: Eight-five patients with 96 limbs at risk due to nonhealing ulcers were treated with a variety of endovacular procedures: 7 patients (group 1) received PalmazR stents for unilateral iliac occlusions; 42 limbs (group II) in 39 patients were treated with balloon angioplasty for superficial femoral and popliteal lesions; and 47 extremities in 39 patients (group III) underwent rotational atherectomy for tibioperoneal lesions. Comprehensive wound management techniques, including the application of growth factors, were used. Results: All group I wounds healed, although 6 of 7 patients required additional procedures to address outflow lesions. In groups II and III, primary patencies were similar (64% and 70%, respectively), and nine treated sites reoccluded in each group. Restenotic lesions were retreated in both groups (three in group II and four in group III); secondary patencies were 71% and 78%, respectively. There were more amputations in group III patients (five) compared to group II (one). In both groups after 5 months, 90% of wounds had healed in group II and 72% in group III. Conclusion: The use of endovascular procedures appears to play an important role in the healing of chronic lower extremity ulcerations in high-risk patients with end-stage ischemia.

scholarly journals Integrated Mutational and Cytogenetic Analysis Identifies New Prognostic Subgroups in Chronic Lymphocytic Leukemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 712-712
Author(s):  
Davide Rossi ◽  
Silvia Rasi ◽  
Valeria Spina ◽  
Alessio Bruscaggin ◽  
Sara Monti ◽  
...  
Keyword(s):  
High Risk ◽  
General Population ◽  
Life Expectancy ◽  
Clonal Evolution ◽  
Lymphocytic Leukemia ◽  
Low Risk ◽  
Risk Category ◽  
Intermediate Risk ◽  
Newly Diagnosed ◽  
Risk Patients

Abstract Abstract 712 The identification of NOTCH1, SF3B1, MYD88 and BIRC3 genetic lesions in chronic lymphocytic leukemia (CLL) prompts a comprehensive and dynamic prognostic algorithm including gene mutations, chromosomal abnormalities, and their changes during clonal evolution. The study utilized both time-fixed (637 newly diagnosed CLL) and time-dependent (257 CLL provided with 524 sequential samples) approaches. Each sample was investigated for TP53, NOTCH1, SF3B1, MYD88, and BIRC3 mutations by Sanger sequencing and for 17p13, 11q22-q23, 13q14 and BIRC3 deletions and +12 by FISH. Del13q14 and +12 distributed in a mutually exclusive fashion (p<0.0001), and identified three main genetic subgroups: cases harboring del13q14, cases harboring +12 and cases lacking both del13q14 and +12. With the sole exception of the expected association between NOTCH1 mutations and +12 CLL (p=0.0014), the prevalence of the other genetic lesions did not differ among molecular subgroups. FISH abnormalities segregated patients in distinct prognostic groups according to Döhner (Fig 1A). Among new genetic lesions, survival analysis confirmed the independent prognostic value of NOTCH1, SF3B1 and BIRC3 lesions in this study cohort. MYD88 mutations had no prognostic effect (p=0.1728). Recursive partitioning analysis followed by random survival forest validation established the hierarchical order of relevance of the genetic lesions, and created an integrated mutational and cytogenetic (MUCY) model that classified newly diagnosed CLL into four prognostic subgroups (Fig 1B). High risk patients harbored TP53 disruption and/or BIRC3 disruption independent of co-occurring lesions (10-year survival: 29.1%). When the demographic effects of age, sex and year of diagnosis were compensated, the 10-year life expectancy of high risk patients was only 37.7% of that expected in the matched general population (p<0.0001). Intermediate risk patients harbored NOTCH1 and/or SF3B1 mutations and/or del11q22-q23 in the absence of TP53 and BIRC3 abnormalities (10-year OS: 37.1%). The 10-year life expectancy of intermediate risk patients was reduced to 48.5% compared to the matched general population (p<0.0001). The low risk category comprised both patients harboring +12 and patients wild type for all genetic lesions (i.e. normal) (10-year OS: 57.3%), with a 10-year life expectancy of 70.7% compared to the matched general population (p<0.0001). Very low risk patients harbored del13q14 as the sole genetic lesion (10-year OS: 69.3%), with a 10-year life expectancy only slightly (84.2%) and not significantly (p=0.1455) lower than that expected in the matched general population. Multivariate analysis selected the MUCY model as one of the most important independent risk factor of CLL OS (HR: 1.38; 95% CI: 1.18–1.60; p<0.0001; 99% bootstrap selection), along with age (HR: 1.06; 95% CI: 1.04–1.07; p<0.0001; 100% bootstrap selection), Rai stage (HR: 1.36; 95% CI: 1.23-1-51; p<0.0001; 100% bootstrap selection) and unmutated IGHV genes (HR: 1.63; 95% CI: 1.17–2.26; p=0.0039; 92% bootstrap selection). Overall, 21.5% (105/488) low risk patients according to the FISH model (del13q14, normal and +12) were reclassified into high risk genetic subgroups by the MUCY model because of the co-occurrence of NOTCH1 (64/488, 13.1%), SF3B1 (35/488, 7.1%), and TP53 (17/488, 3.4%) mutations or BIRC3 disruption (14/488, 2.8%). Consistently, the inclusion of NOTCH1, SF3B1 and BIRC3 lesions in addition to FISH abnormalities significantly improved the model accuracy of OS prediction (c-index: 0.617 vs c-index: 0.642 p<0.0001). At 10 years from diagnosis, 24.5% CLL of the very low and low risk genetic subgroups developed new TP53, NOTCH1, SF3B1, BIRC3 or del11q22-q23 lesions due to clonal evolution, and therefore switched to a higher risk category of the MUCY model. By time-dependent and landmark analysis, the MUCY model retained a statistically significant impact on CLL OS (HR: 1.52; 95% CI: 1.21–1.90; p=0.0003) at any time from diagnosis and independent of its dynamic changes due to clonal evolution. The MUCY model classifies CLL patients into more precise subgroups, advances our understanding of CLL biology, and improves current prognostic algorithms. These findings have relevant implications for the design of clinical trials aimed at assessing the use of mutational profiling to inform therapeutic decisions based on risk stratification. Disclosures: No relevant conflicts of interest to declare.

Extended vs. limited laparoscopic pelvic lymph node dissection for prostate cancer: The value of Partin tables in selection of the need for and the extent of dissection

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4654-4654 ◽  
Author(s):  
K. Touijer ◽  
F. Rabbani ◽  
J. Romero Otero ◽  
F. Secin ◽  
B. Guillonneau
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Low Risk ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Group I ◽  
Risk Patients ◽  
Group Ii

4654 Background: To determine if pelvic lymph node dissection (LND) can be omitted in prostate cancer patients at low risk of nodal metastases according to the Partin tables and to determine the yield on extended vs limited LND in patients at high risk to better define the appropriate template of dissection. Methods: A total of 577 patients with clinically localized prostate cancer underwent a laparoscopic radical prostatectomy (LRP). In the first 363 patients, a cutoff of 1% on the Partin tables’ predicted probability of lymph node invasion (PPLNI) was used to select patients for a limited LND (external iliac nodes only). In the subsequent 214 patients, all patients underwent an extended LND (external iliac, obturator and hypogastric nodes). Patients were classified into 4 groups: Group I, 186 patients with a PPLNI ≤1%, did not undergo a LND; Group II, 110 patients with PPLNI ≤ 1%, underwent an extended LND; Group III, 177 patients with PPLNI >1% underwent a limited LND and Group IV, 104 patients with PPLNI >1%, underwent an extended LND. We compared Group I and II to assess the value of the Partin tables in selecting low risk patients for nodal metastasis. Multivariate logistic regression analysis was performed to compare the node positivity rate between groups III and IV, controlling for preoperative and pathological parameters. Results: None of the patients in group II had a positive lymph node after an extended LND. On multivariate analysis, controlling for PSA, biopsy Gleason, clinical stage, pathological Gleason and stage, and seminal vesicle invasion, the extended LND independently impacted the rate of node positivity with a relative risk (RR) of 15.6 (95% CI 3.7 -66.4, p < 0.001). The median (mean) number of nodes retrieved was 9 (10) and 14 (15) after limited and extended LND respectively (p < 0.001). Conclusions: A lymph node dissection including the external iliac, obturator and hypogastric lymph node groups yields positive nodes more frequently and retrieves a higher total nodal count than the often-performed LND limited to the external iliac nodes. Decision to forgo LND in low risk patients needs to be validated by long-term biochemical recurrence data No significant financial relationships to disclose.

COMPONENTS OF MILK OF SIMMENTAL BREED BELONGING TO VARIOUS GENOTYPES

2020 ◽  
pp. 14-18
Author(s):  
Г.Н. ЛЕВИНА ◽  
А.И. НАЗАРЕНКО
Keyword(s):  
Milk Yield ◽  
Mass Fraction ◽  
Freezing Temperature ◽  
Energy Value ◽  
Group Iii ◽  
Holstein Breed ◽  
Group I ◽  
Milk Components ◽  
Beta Hydroxybutyrate ◽  
Stage 1

Изучены удой, калорийность и компоненты молока по трем лактациям у коров, имеющих разную кровность по породам: I группа — ¾ голштинской породы красно-пестрой масти (КГШ); ¼ симментальской породы (СИМ), II группа — ¾ СИМ; ¼ КГШ и III группа — ½ монбельярдской породы (МБ); ¼ СИМ; ¼ КГШ. Исследования проводили с 2014 по 2020 год на базе племенного завода ООО «Сапфир-Агро» Курской области. Удой коров был более 7000 кг молока за лактацию. Цель исследований заключалась в сравнительной оценке по удою и компонентам молока дочерей от маточного поголовья симментальской породы, имеющего кровность ½ по голштинской и быков монбельярдской, симментальской и голштинской пород для определения рационального приема дальнейшего совершенствования симментальской породы. В каждую группу отбирали животных по принципу пар-аналогов, с учетом возраста и даты отела, по 70 коров, полученных не менее чем от 3 быков-производителей. Животные находились в одинаковых условиях кормления и содержания. Установлено, что по суммарному удою за три лактации коровы разных генотипов равноценны (21,3—21,8 тыс. кг молока). Однако по калорийности молоко дочерей быков монбельярдской (72,7—74,7 ккал в 100 г) и симментальской (73,2—75,0 ккал) пород достоверно выше, чем в группе коров, имеющей кровность ¾ по КГШ породе (70,9—71,6 ккал), достоверное превосходство над коровами с ¾ КГШ было и по МДБ и казеину. МДЖ у всех животных была значительно выше 4,0% (4,12—5,01%). Достоверное превосходство коров II и III групп над сверстницами I группы наблюдалось на 1 и 3 стадиях, а по лактозе — на всех стадиях 1-й лактации. Температура замерзания молока была минимальной на 1 стадии всех лактаций. Максимальные величины бета-гидроксибутирата (БГБ) и ацетона в молоке были в 1 стадию всех лактаций. Изменчивость этих показателей была высокой у коров всех групп (57,0—217,0%). С учетом величины удоя и компонентов молока за три лактации снижение кровности по голштинам для потомства симментальской породы рационально, кроме того использование быков монбельярдской и симментальской породы на маточном голштинизированном поголовье симментальской породы способствует сохранению и развитию ее оригинальных качеств. Milk yield, energy value and milk components according to three lactations in cows with various pedigree by breeds were studied: Group I — ¾ of Holstein breed of red-and-white color (KGSh); ¼ of Simmental breed (SIM); Group II — ¾ SIM; ¼ KGSh; and group III — ½ of Montbéliarde breed (MB); ¼ SIM; ¼ KGSh. Research was carried out from 2014 until 2020 at OOO Sapfir-Agro stud farm located in the Kursk Region. Milk yield amounted to more than 7000 kg of milk per lactation. The purpose of study was to carry out comparative evaluation of pedigree stock calves belonging to Simmental breed with ½ pedigree of Holstein breed and bulls of Montbéliarde, Simmental, and Holstein breeds by milk yield and milk components to determine the rational method of further improvement of Simmental breed. Animals were chosen for each group according to the pair-analogue principle taking into account their age and date of calving. 70 cows from not less than 3 seed bulls were included. All of the animals were provided with the same feeding conditions and husbandry. It was determined that the cows with various genotypes are equivalent by total milk yield per three lactations (21.3—21.8 thousand kilograms of milk). However, energy value of milk obtained from the daughters of Montbéliarde (72.7—74.7 kcal per 100 g) and Simmental (73.2—75.0 kcal) bulls was reliably higher than that of the group of cows with ¾ pedigree of KGSh breed (70.9—71.6 kcal), and the reliable superiority over cows with ¾ KGSh was seen both in mass fraction of protein and casein. Mass fraction of fat was significantly higher than 4.0% (4.12—5.01%) in all animals. Reliable superiority of cows belonging to groups II and III over their counterparts belonging to group I was observed during stages 1 and 3, and superiority according to lactose was seen in all stages of the 1st lactation. Freezing temperature of milk was minimal on stage 1 of all lactations. Maximum values of beta-hydroxybutyrate (BHB) and acetone in milk were observed during stage 1 of all lactation. Variability of these parameters was high in cows belonging to all groups (57.0—217.0%). Taking milk yield and milk components values for three lactations into account, the decrease of pedigree by Holstein breed for Simmental offspring is rational. Also, the use of Montbéliarde and Simmental bulls on Holsteinised breeding stock of Simmental breed facilitates the preservation and development of its original qualities.

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