Retrospective analysis of outcomes in patients with non metastatic cholangiocarcinoma: A single network experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15643-e15643
Author(s):  
Jyothika Mamadgi ◽  
Kristina Lundeen ◽  
Shaakir Hasan ◽  
Sunita Patruni ◽  
Ahmed Khattab ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Therapy Group ◽  
Progression Free Survival ◽  
Distant Recurrence ◽  
Treatment Modalities ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

e15643 Background: Biliary tract cancers are rare cancers with an annual incidence of about 8,000. In resected non-metastatic BTCs (NM-BTCs), cure rates decrease significantly due to local and distant recurrence. However, guidelines to use adjuvant therapies are not well established due to the lack of well-structured phase three randomized trials, given the rarity of the disease. We present a retrospective study analyzing outcomes of NM-BTCs managed within Allegheny Health Network (AHN) with specific focus on patients who underwent resection and received different adjuvant treatment modalities. Methods: Data of all patients with NM-BTCs treated at AHN from January 2012 to December 2017 was collected and outcomes analyzed for patients treated with surgery vs no surgery We then sub-stratified the patients who received surgery into three groups based on the modality of adjuvant therapy. Group 1 included patients with no additional therapy , Group 2 with adjuvant chemotherapy and Group 3 with adjuvant chemotherapy+radiation. We compared Mean Progression-Free Survival (PFS) and Overall Survival (OS) in these three groups. Results: Of the 59 NM-BTCs treated at AHN, 32(52.4%) underwent surgery. The OS for surgical vs non-surgically treated patients was 23 vs 17 months (p = 0.008) and PFS 26 vs 19 months (P = 0.06) respectively. Of the resected –patients, PFS for patients in Group1 vs Group2 vs Group3 was 16 vs 21 vs 34 months (pooled P = 0.05) and OS was 19 vs 22 vs 19 months respectively (pooled P = 0.5). PFS for patients in Group1 vs Group (2+3),i.e, patients treated surgery only vs surgery+ any adjuvant treatment was 16 vs 28 months (P = 0.1), OS was 19 vs 22 months (P = 0.7)respectively. PFS in patients in Group 3 vs Group (1+2),i.e, patients treated with adjuvant chemotherapy+radiation vs others was 34 vs 19 months. (p = 0.0183) respectively. Conclusions: This analysis revealed a statistically significant improvement in OS in patients with NM-BTCs who received surgery. There was a trend towards improvement in PFS/OS in patients who received adjuvant therapy, though not statistically-significant. Use of adjuvant chemotherapy+radiation resulted in statistically significant improvements in PFS as compared to other treatment modalities.

scholarly journals Comparison of Rare Types of Breast Cancer

2021 ◽  
pp. 9-17
Author(s):  
Osman Erdogan ◽  
Alper Parlakgumus ◽  
Ugur Topal ◽  
Kemal Yener ◽  
Umit Turan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Radical Mastectomy ◽  
Treatment Modalities ◽  
Breast Carcinomas ◽  
Term Survival ◽  
Prognostic Features ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aims: Mucinous, medullary, and papillary carcinomas are rarely encountered types of breast cancer. This study aims to contribute to the literature by comparing the clinical and prognostic features and treatment alternatives of rare breast carcinomas. Study Design: Thirty-four patients with rare breast cancer out of a total of 1368 patients who underwent surgery for breast cancer in our clinic between January 2011 and December 2020 were included in the study. Methodology: The patients were assigned into three groups, i.e., medullary carcinoma group (Group 1), mucinous carcinoma group (Group 2) and papillary carcinoma group (Group 3). Demographic and clinical features, treatment modalities used, surgical approaches, pathological features of tumors and survival were compared between the groups. Results: Thirty-four patients were included in the study. The mean age of the patients in Group 3 was higher, though it was not statistically significant. Modified radical mastectomy was more frequently performed in all the groups. The number of the lymph nodes removed through axillary dissections and the number of the positive lymph nodes were similar in all the groups. The tumors in all the groups were also of comparable sizes (30 mm in Group 1, 42.5 mm in Group 2 and 30 mm in Group 3; p:0.464). Estrogen receptors were negative in a significantly higher rate of Group 1(66.7% of Group 1, p<0,001). A significantly higher rate of Group 1 received postoperative chemotherapy (93,3% of Group 1,p:0.001), but the rate of the patients receiving hormonotherapy in this group was significantly lower (26.7% of Group, p<0,001). The patients with medullary cancer had significantly longer survival than those with mucinous cancer and those with papillary cancer (76.2 in Group 1, 54.5 in Group 2 and 58.4 in Group 3; p:0.005). Conclusion: While rare subtypes of breast carcinoma did not affect opting for surgical treatment, selection of oncological therapy was affected depending on the hormone receptor status of these tumors. The long-term survival differed between rare breast tumors. In view of the unique clinical pictures of the tumors, the patients should be evaluated individually, and the evaluation should be associated with theevidence-based principles available for more common breast carcinomas.

Anticancer treatment and cognitive functions in elderly cancer patients: A prospective study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8543-8543
Author(s):  
A. M. Minisini ◽  
P. Ermacora ◽  
S. Russo ◽  
G. Cardellino ◽  
C. Andreetta ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Endocrine Therapy ◽  
Cognitive Functions ◽  
Therapy Group ◽  
Anxiety And Depression ◽  
Elderly Cancer Patients ◽  
Anticancer Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

8543 Background: It has been reported that anticancer treatment may alterate cognitive functions in cancer patients but very few prospective studied addressed this issue. Moreover, little is known about the cognitive impact of anticancer treatment in elderly cancer patients. We aimed at investigating the effect on cognitive functions of antiblastic chemotherapy and endocrine therapy in a consecutive series of elderly cancer outpatients. Methods: We evaluated cognitive functions by means of the Cambridge Cognitive Examination (CAMCOG) test and the Mini-Mental Scale Examination (MMSE) at baseline (before anticancer systemic treatment), after 3 months and after 6 months in cancer patients aged more than 65 years. Mood disturbances such as anxiety and depression were also evaluated (Hospital Anxiety and Depression Scale); comprehensive geriatric assessment and blood tests were performed at each evaluation. Results: Sixty patients were enrolled, 15 patients received chemotherapy (group 1), 13 patients received endocrine therapy (group 2) and 32 patients had neither chemotherapy nor endocrine therapy (group 3, control). Fifty-eight (97%) patients had no evidence of disease at the time of assessment. Median age was 71.5, 73 and 71 years in group 1, 2 and 3, respectively. At baseline, median Activities of Daily Living (ADL) score, Instrumental Activity of Daily Living (IADL) score, number of comorbidities and concomitant medications were 6, 8, 5, 1 in group 1, and 6, 8, 3, 2 in group 2, and 6, 8, 4, 2 in group 3, respectively. Median hemoglobin value was 12.9, 12.8, 13.3 g/dl in group 1, 2 and 3 respectively. At baseline, no significant unbalance was evident among groups. There was a statistically significant correlation between ADL or IADL score and CAMCOG total score (Spearman test, rho=0.4, p<0.05). Higher scolarity level was associated with higher CAMCOG total score. No deterioration of CAMCOG score was evident in group 1, 2 and 3 after 3 and 6 months (paired t-test p>.05); the separate analyses for the different items in CAMCOG test did not evidence any deterioration in time in the 3 groups. No worsening was seen in MMSE. Conclusions: Our study showed that anticancer treatment is not associated with rapid cognitive deterioration in elderly cancer patients. No significant financial relationships to disclose.

scholarly journals EVALUATION OF PATIENT'S PERCEPTION AND HEALING, FOLLOWING CONVENTIONAL AND PARALLELING TECHNIQUE OF FRENECTOMY USING SCALPEL AND OTHER MODALITY

2020 ◽  
Vol 6 (1) ◽  
pp. 21-27
Author(s):  
Dr. Ira Gupta ◽  
Saranik Sarkar ◽  
Rohit Gupta ◽  
Nidhi Gupta ◽  
Janardhana Amaranath B. J. ◽  
...  
Keyword(s):  
Wound Healing ◽  
Gingival Recession ◽  
Conventional Technique ◽  
Treatment Modalities ◽  
Group 3 ◽  
Group 2 ◽  
Patient’S Perception ◽  
Better Than ◽  
Group 1 ◽  
Operative Wound

Background: Frenum that encroaches on the margin of the gingiva may interfere with plaque removal and can lead to gingival recession and midline diastema. Thus, to maintain proper oral hygiene and prevent gingival recession, frenectomy is done. Frenectomy can be accomplished by conventional frenectomy technique, which has certain disadvantages. To overcome those drawbacks, paralleling technique of frenectomy has been introduced. Both the techniques can be performed by using various treatment modalities. Aim: The purpose of this clinical study was to compare the bleeding during surgery, post-operative wound healing and patient's perception towards the conventional frenectomy technique with scalpel, paralleling frenectomy technique with scalpel and paralleling technique with electrocautery. Materials and method: A total of 30 subjects with gingival or papillary frenal attachment were selected and equally divided into three groups. Group 1 was treated by conventional technique with scalpel, Group 2 by paralleling technique with scalpel and Group 3 by paralleling technique with electrocautery. Various parameters such as bleeding during surgery, patient's perception towards the various techniques and post-operative wound healing were evaluated. Results: The results showed that bleeding during surgery was minimum in group 3 as compared to other two groups. Patient's perception towards paralleling technique with scalpel, was found better than the other groups. At 7th day, though there was a difference in the healing but at 21st day wound healing was almost similar in all the three groups. Conclusion: Based on our findings and clinical outcome, paralleling technique with scalpel provided better patient's perception and an efficient and satisfactory option for frenectomy.  

scholarly journals Improvement in Survival of Multiple Myeloma Patients: A Long-Term Institutional Experience

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4573-4573
Author(s):  
Jordan Nunnelee ◽  
Qiuhong Zhao ◽  
Don M. Benson ◽  
Ashley E. Rosko ◽  
Maria Chaudhry ◽  
...  
Keyword(s):  
High Risk ◽  
Maintenance Therapy ◽  
Therapy Group ◽  
Standard Of Care ◽  
Group 4 ◽  
Dexamethasone Group ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Introduction-Multiple myeloma (MM) represents 1.8% of all new cancer cases in the U.S., with an estimated 32,110 new cases in 2019. While not curable, advances in treatment, including autologous stem cell transplant (ASCT) and maintenance therapy, have dramatically improved progression free survival (PFS) and overall survival (OS). The Ohio State University bone marrow transplant program began utilizing ASCT for newly diagnosed MM (NDMM) patients in 1992. With the introduction of new and more effective drugs used before and after ASCT, we performed survival analysis in NDMM patients from 1992-2016 receiving ASCT to examine our institutional progress. Method-We performed a retrospective analysis of 1002 consecutive transplant eligible NDMM patients. Patients were split into five groups based on historic changes in novel agents for treatment of MM: 1992-1998 (vincristine/doxorubicin/dexamethasone-group 1), 1999-2002 (thalidomide/dexamethasone-group 2), 2003-2008 (bortezomib/lenalidomide/dexamethasone-group 3), 2009-2013 (carfilzomib/pomalidomide/dexamethasone, and maintenance therapy-group 4), and 2014-2016 (agents used for relapsed MM, including daratumumab/elotuzumab/ixazomib/dexamethasone, and maintenance therapy-group 5). Pre-ASCT conditioning regimen was melphalan 140-200 mg/m2 in 94.4% of patients. Data were consistently obtained since 2003 for both standard and high-risk patients at diagnosis. High-risk patients had del17, t(4:14), t(14:16), hypodiploidy and/or 1q abnormality. Primary endpoints were PFS and OS. PFS was defined as time to progressive disease or death from any cause from the date of transplantation. OS was defined as time from transplantation to death from any cause, censoring those who were still alive at the last follow up. Kaplan Meier curves were used to calculate PFS and OS. Results-The median age of all patients at transplant was 58 years (range: 18-81 years) and 58.5% were male. The median patient age increased significantly, from 54 to 60 years, over 1992-2016 (p<0.001). The majority of patients (53.6%) had IgG myeloma and 19.3% had light chain disease. 30% of patients with known cytogenetic data were high-risk. Melphalan 200 mg/m2 was used in 80.5% of patients. It was noted that across the years (1992-2016), there was a statistically significant improvement in both PFS (p<0.01) and OS (p<0.01). Median PFS and OS of all patients was 1.3 and 2.0 years in group 1 (1992-1998); 1.0 and 3.2 years in group 2 (1999-2002); and 2.0 and 5.8 years in group 3 (2003-2008), respectively. This response was further improved to PFS and OS of 4.1 years and not reached (NR) in group 4 (2009-2013), and 3.8 years and NR in group 5 (2014-2016), respectively (Figure 1). The 3 year PFS of groups 1 through 5 was 26%, 25%, 35%, 57% and 58%, respectively. The 3 year OS of groups 1 through 5 was 45%, 54%, 74%, 82% and 80%, respectively. On subset analysis, across years, significant increases in PFS (p<0.01) and OS (p<0.01) were seen in patients ≤65 years of age. For patients >65 years old, there was a statistically significant improvement in PFS (p<0.01) but not in OS (p=0.054). For both standard and high-risk disease, there was significant improvement in PFS (p<0.01 and p<0.01), and OS (p=0.02 and p=0.02), respectively. The rate of response both pre- and post-transplant showed statistically significant improvement across the years (p<0.01). The pre-transplant rate of very good partial response (VGPR), or better, increased from 5.3% in early 1990's (group 1), 15.3% (group 2), 39.8% (group 3) to 51.2% (group 4) and 54% (group 5). The post-transplant rate of response (VGPR or better) also increased from 31.5% (group 1), 28.8% (group 2), 65.6% (group 3), to 79.6% (group 4) and 76.3 % (group 5). Conclusion-Our data show that NDMM patients' survival and response to standard of care treatment have improved dramatically since 1992, primarily due to inclusion of novel therapies and maintenance. For NDMM patients receiving ASCT, the 3 year overall survival rate has significantly improved from 45% in 1992-1998 to 80% in 2014-2016, which is similar to the post-ASCT OS shown in the 2012 study by McCarthy et al. The significantly increasing age of NDMM patients receiving ASCT over time suggests improving supportive care and expansion of standard of care therapies to more of the population, improving survival and quality of life. Disclosures Rosko: Vyxeos: Other: Travel support. Efebera:Takeda: Honoraria; Akcea: Other: Advisory board, Speakers Bureau; Janssen: Speakers Bureau.

NUDT15 genetic variants are related to thiopurine-induced neutropenia in Thai children with acute lymphoblastic leukemia

2020 ◽  
Vol 21 (6) ◽  
pp. 403-410
Author(s):  
Apichaya Puangpetch ◽  
Rawiporn Tiyasirichokchai ◽  
Samart Pakakasama ◽  
Supaporn Wiwattanakul ◽  
Usanarat Anurathapan ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Maintenance Therapy ◽  
Therapy Group ◽  
Lymphoblastic Leukemia ◽  
Wild Type ◽  
Homozygous Variant ◽  
Heterozygous Variant ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: 6-Mercaptopurine (6MP) is key to the treatment of acute lymphoblastic leukemia (ALL) as part of maintenance therapy. NUDT15 was identified as a novel thiopurine regulator conferring 6MP sensitivity. The aim of this study was to evaluate the influence of NUDT15 variants on 6MP-induced neutropenia in Thai children with ALL. Materials & methodology: Genotyping of NUDT15 (c.415C>T; rs116855232) and c.36_37insGGAGTC; rs554405994) was performed by Sanger sequencing in 100 patients with ALL. Patients were classified into wild-type (group 1), heterozygous variant (group 2) and homozygous variant (group 3). Clinical and laboratory features during the first 6 months of maintenance therapy were investigated. Therapy-induced neutropenia was observed in 31 patients during the weeks 1–8 (early myelotoxicity), while therapy-induced neutropenia was observed in 47 patients during the weeks 9–24 (late myelotoxicity). Results: There were 85 wild-type patients, 14 heterozygous variant patients and one homozygous variant patient. NUDT15 variants were associated with neutropenia as compared with wild-type (odds ratio: 17.862; 95% CI: 4.198–75.992, padj = 9.5 × 10-5). Multivariate analysis showed that the low-risk group was associated with neutropenia (p = 0.014) in the first 8 weeks of 6MP therapy. Group 2 and group 3 patients had significantly lower absolute neutrophil counts compared with group 1. The adjusted dose during the first 6 months of maintenance therapy with NUDT15 genotype group 1, 2 and 3 were 50, 36.6 and 12.5 mg/m2/day, respectively. Conclusion: Taken together, our results indicate NUDT15 variants may cause neutropenia, and the 6MP dosage should be considered in patients according to the NUDT15 variants to inform personalized 6MP therapy.

scholarly journals PRescriptiOn PattERns of Oral Anticoagulants in Nonvalvular Atrial Fibrillation (PROPER study)

2015 ◽  
Vol 23 (4) ◽  
pp. 384-391 ◽  
Author(s):  
Ozcan Basaran ◽  
Nesrin Filiz Basaran ◽  
Edip Guvenc Cekic ◽  
Ibrahim Altun ◽  
Volkan Dogan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Therapy Group ◽  
Oral Anticoagulants ◽  
Inappropriate Drug ◽  
Nonvalvular Atrial Fibrillation ◽  
Prescription Patterns ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: Inappropriate use of oral anticoagulants (OACs) have not been well investigatedand, however, may be frequent in real-world practice in patients with nonvalvular atrial fibrillation (NVAF). This study was designed to evaluate the prescription patterns and appropriateness of OACs in patients with NVAF in real-world clinical settings. Methods: We performed a prospective, observational study (NCT02366338). A total of 148 patients with NVAF were screened for OAC prescription. Appropriateness of prescribing was evaluated using 9 criteria of the Medication Appropriateness Index (MAI): indication, choice, dosage, modalities and practicability of administration, drug–drug interactions, drug–disease interactions, duplication, and duration. For each criterion, the evaluator has to rate whether the medication is (A) appropriate, (B) inappropriate but with limited clinical importance, and (C) inappropriate. Results: Of 148 patients, 73 (50%) were on warfarin (group 1), 39 (26%) were on rivaroxaban (group 2), and 36 (24%) were on dabigatran therapy (group 3). The MAI showed that 83% of group 1, 28% of group 2, and 47% of group 3 patients had at least 1 inappropriate criterion. Moreover, according to the choice criterion, 37% of group 1, 8% of group 2 and 5% of group 3 were rated as inappropriate, and dosage was not appropriate in 77% of group 1, 23% of group 2, and 42% of group 3. Conclusion: Inappropriate drug use is frequent among patients with NVAF not only for warfarin but also for NOACs. Although there is an apparent improvement in thromboprophylaxis of NVAF, much more effort is needed for appropriate use of OACs.

scholarly journals Twenty-Four-Hour Contact Lens Sensor Monitoring of Aqueous Humor Dynamics in Surgically or Medically Treated Glaucoma Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Chiara Posarelli ◽  
Pierluigi Ortenzio ◽  
Antonio Ferreras ◽  
Mario Damiano Toro ◽  
Andrea Passani ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Contact Lens ◽  
Open Angle Glaucoma ◽  
Therapy Group ◽  
Open Angle ◽  
Aqueous Humor Dynamics ◽  
Contact Lens Sensor ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. This study assessed the 24 h circadian rhythm of intraocular pressure (IOP) using a contact lens sensor in three groups of patients with open-angle glaucoma. Methods. This study was a monocentric, cross-sectional, nonrandomized, prospective, pilot study. Eighty-nine patients were enrolled: 29 patients previously underwent an Ex-PRESS mini glaucoma device procedure (Group 1), 28 patients previously underwent Hydrus microstent implantation (Group 2), and 32 patients were currently being treated medically for primary open-angle glaucoma (Group 3). Circadian rhythm patterns were considered with five circadian indicators: fluctuation ranges, maximum, minimum, acrophase (time of peak value), and bathyphase (time of trough value). A two-tailed Mann–Whitney U-test was used to evaluate differences between groups. Results. All subjects exhibited a circadian rhythm and a nocturnal pattern. The signal fluctuation range was significantly smaller in the surgical groups than in the medically treated group (Group 1 vs. Group 3, p=0.003; Group 2 vs. Group 3, p=0.010). Subjects who underwent the Ex-PRESS procedure (Group 1) exhibited significant differences compared with the drug therapy group (Group 3) with regard to the minimum value (p=0.015), acrophase (p=0.009), and bathyphase (p=0.002). The other circadian indicators were not significantly different among groups. Conclusions. Patients who underwent IOP-lowering surgery had an intrinsic nyctohemeral rhythm. Both surgical procedures, Ex-PRESS and Hydrus, were associated with smaller signal fluctuations compared with medical treatment.

scholarly journals Outcome of Infants with Hypoxic-Ischemic Encephalopathy Treated by Whole Body Cooling and Magnesium Sulfate

2021 ◽  
Vol 11 (01) ◽  
pp. e280-e286
Author(s):  
Safwat M. Abdel-Aziz ◽  
Mohamed Sabry M. Abdel Rahman ◽  
Asmaa H. Shoreit ◽  
Moustafa Ez El Din ◽  
Enas A. Hamed ◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Therapy Group ◽  
Whole Body ◽  
P Value ◽  
Short Term ◽  
Group 3 ◽  
Group 2 ◽  
Body Cooling ◽  
Whole Body Cooling ◽  
Group 1

AbstractTherapeutic hypothermia (TH) either by selective head cooling or whole-body cooling decreases brain damage and provide neuroprotection and reduced mortality rate in cases of moderate-to-severe hypoxia-ischemia encephalopathy (HIE) of newborns, especially if started at first 6 hours after birth. Also, management with adjuvant therapies like magnesium sulfate (MS) provides more neuroprotection. The interventional randomized controlled research aimed to assess short-term actions of TH as sole therapy and in combination with MS as a neuroprotective agent for the treatment of HIE newborn infants. A total of 36 full-terms and near-term infants delivered at Assiut University Children's Hospital and fulfilled HIE criteria were enrolled. They were divided equally into three groups; Group 1 (n = 12) received whole body cooling during first 6 hours of life as a sole therapy; Group 2 (n = 12) received whole body cooling in addition to MS as adjuvant therapy; Group 3 (n = 12) received supportive intensive care measures as a control. TH plus MS group (group 2) had a significantly good short-term outcomes as short period of respiratory support and mechanical ventilation (p-value =0.001), less in incidence of convulsion (p-value = 0.001) and early in feeding initiation (p-value = 0.009), compared with other groups managed by TH (group 1) or by supportive treatment (group 3). In conclusion, whole body cooling in addition to MS as adjunctive therapy for the treatment of HIE neonates is safe therapy that improves short-term outcome both clinically and radiologically.

scholarly journals Prognostic value of intraductal carcinoma for adjuvant radiotherapy candidates after radical prostatectomy

2020 ◽  
Author(s):  
Sedat Karakoc ◽  
Serdar Çelik ◽  
Nilhan Akbulut ◽  
Ozan Bozkurt ◽  
Hulya Ellidokuz ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Radical Prostatectomy ◽  
Adjuvant Therapy ◽  
Biochemical Recurrence ◽  
Progression Free Survival ◽  
Surgical Margins ◽  
Intraductal Carcinoma ◽  
Free Survival ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective: We aimed to investigate the prognostic significance of intraductal carcinoma in radical prostatectomy (RP) specimens and predictive value of IDC-P for biochemical recurrence and adjuvant therapy decision. Method: Patients who underwent RP between 2000-2014 with final pathological stage pT3a and negative surgical margins (Group 1, n=35) and pT2 with positive surgical margins (Group 2, n=32) were included. RP specimens were re-evaluated for the presence of IDC-P component and other prognostic factors. In both groups, prognostic factors were compared according to the presence of IDC-P and biochemical recurrence status. Results: In group 1, IDC-P was detected in 5 cases and biochemical recurrence was detected in 3 cases. Patients with IDC-P showed significantly higher biochemical recurrence than those without IDC-P (p=0.002). In univariate analysis, IDC-P was found to be significantly associated with worse progression free survival (p<0.001). In group 2, IDC-P was detected in 4 cases and biochemical recurrence was detected in 10 cases. Also, tumor volume was significantly higher in patients with IDC-P than those without IDC-P (p=0.02). IDC-P was also significantly associated with worse progression free survival in group 2 (p=0.033). Conclusions: In both groups, IDC-P is a prognostic factor for progression free survival and / or biochemical recurrence. Especially in these patients, presence of IDC-P might be helpful for postoperative adjuvant therapy management decision. Keywords: radical prostatectomy, intraductal carcinoma of prostate (IDC-P), prostate cancer, biochemical recurrence, progression free survival.

«PROTEIN OF YOUTH» GDF11, HEMOSTASIS AND BLOOD FLOW PECULIARITIES IN WOMEN WITH ESSENTIAL HYPERTENSION

2018 ◽  
Author(s):  
Б.И. Кузник ◽  
С.О. Давыдов ◽  
А.В. Степанов ◽  
Е.С. Гусева ◽  
Ю.Н. Смоляков ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Antihypertensive Therapy ◽  
Therapy Group ◽  
Fibrin Clot ◽  
Fibrinogen Concentration ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

Цель исследования: изучить взаимосвязь между концентрацией «белка молодости» GDF11 в крови и состоянием системы гемостаза у здоровых людей и больных гипертонической болезнью (ГБ). Материалы и методы. Обследовано 102 женщины: 30 относительно здоровых женщин (1 группа); 37 женщин, больных ГБ, находившихся на медикаментозном лечении (2 группа); 35 женщин, больных ГБ, находившихся на медикаментозном лечении и регулярно принимавших курсы кинезитерапии (3 группа). Результаты. При ГБ не обнаружено существенных отклонений в числе тромбоцитов, значениях активированного частичного тромбопластинового времени, протромбиновом и тромбиновом времени, содержании фибриногена, но значительно увеличена скорость образования и размер фибринового сгустка, что свидетельствовало о выраженной гиперкоагуляции. Одновременно у страдающих ГБ отмечены выраженные сдвиги в гемодинамических и осцилляторных индексах, говорящих о расстройствах осевого и пристеночного кровотока. У больных ГБ, которые помимо медикаментозной антигипертензивной терапии систематически принимали курсы кинезитерапии на протяжении 2-3 лет, не только нормализовалось кровяное давление, но и приблизились к норме показатели тромбо- и гемодинамики. Заключение. У женщин, страдающих ГБ и находящихся на медикаментозной терапии, содержание «белка молодости» GDF11 резко снижено. У больных ГБ выявлены многочисленные положительные и отрицательные корреляционные взаимосвязи между уровнем GDF11, системой гемостаза, кровяным давлением и гемодинамическими и осцилляторными индексами, характеризующими состояние осевого и пристеночного кровотока. Aim: to study the relationship between blood level of «youth protein» GDF11 and hemostatic parameters in healthy people and hypertensive patients. Materials and methods. We examined 102 women: 30 relatively healthy women (group 1); 37 women with hypertensive disease (HD) who received antihypertensive therapy (group 2); 35 women with HD who received antihypertensive therapy and regular courses of kinesitherapy (group 3). Results. In hypertensive women there were no significant deviations in platelets number, values of activated partial thromboplastin time, prothrombin and thrombin times, fibrinogen concentration, but the rate of formation and size of fibrin clot were significantly increased that was the evidence of significant hypercoagulation. At the same time in patients with HD significant changes in hemodynamic and oscillatory indices were revealed that illustrated the disorders of axial and parietal blood flow. In patients with GB who received antihypertensive therapy and regular courses of kinesitherapy (over the time of 2-3 years) we found normalization of blood pressure, also thrombodynamic and hemodynamic parameters approached to normal. Conclusion. In women with HD who received antihypertensive therapy blood content of «youth protein» GDF11 was significantly reduced. Numerous positive and negative correlations between the level of GDF11, hemostatic parameters, blood pressure and hemodynamic and oscillatory indices that characterized axial and parietal blood flow were revealed in patients with GB.

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