Predictors of immunotherapy (IO) response in hepatocellular carcinoma (HCC).

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 555-555
Author(s):  
Samantha Ann Armstrong ◽  
Bhavana Pendurthi Singh ◽  
Monika Kulasekaran ◽  
Petra Prins ◽  
Aiwu Ruth He
Keyword(s):  
Progression Free Survival ◽  
Viral Etiology ◽  
Chi Square ◽  
Steroid Use ◽  
Kaplan Meier ◽  
Best Response ◽  
Chi Square Test ◽  
Grade 3 ◽  
Student’S T ◽  
Multifocal Disease

555 Background: Despite advances in understanding the molecular pathways of HCC, therapeutic options are limited and patient survival is dismal. IO is a promising HCC treatment. There are currently no indicators to identify which patients (pts) will have a prolonged response. Methods: In this single-institutional retrospective analysis, pts received one of five IO containing regimens with nivolumab, pembrolizumab, atezolizumab plus bevacizumab, durvalumab or cemiplimab until disease progression (PD) or unacceptable toxicity. Relevant factors including: stage, viral etiology, vascular invasion (VI), tumor thrombus (TT), multifocal disease, toxicity grade, steroid use for IO mediated toxicities and derived Neutrophil-to Lymphocyte ratio (dNLR), were correlated to clinical outcome: progression free survival (PFS), overall survival (OS), response rate (RR), using Pearson’s chi-square test or student's t-test . Responses were assessed using RECIST v 1.1 criteria for stable disease (SD), partial response (PR) and PD were correlated with best response and PFS. OS was calculated by the Kaplan-Meier method. Results: Cohort demographics (n = 76) were: 72% male; 38% African American, 30% Caucasian and 16% Asian; 29% of pts had HBV, 41% had HCV, 1% had both HBV/HCV and 13% had no viral etiology (n = 64). The majority of pts were stage III (43%) or IV (38%). At the start of IO, 32% had VI, 32% had TT and 80% had multifocal or metastatic disease. 65% of pts experienced IO toxicity, with 24.3% at grade 3 or higher, and 34% requiring steroids. Best response to IO was SD in 65.7% of pts, PR in 25.7% and PD in 8.6%. Median OS was 13m (95% CI 7.9-18.1) from the start of IO and median PFS (n = 65) was 14m (95% CI 6.8-21.2). Median OS and PFS were significantly improved in pts with PR compared to PD (45 vs 8m, p < 0.0005, PFS 15 vs 3m p = 0.007). Both OS and PFS showed benefits for SD of ≥2 months compared to those with PD (11 vs 8m, p < .0005, PFS 5 vs 3m p = .007). VI, TT, stage, viral etiology, toxicity grade or dNLR did not correlate with OS, PFS and RR, however need of steroid treatment trended toward worse outcome. Conclusions: PR and SD are independent predictors for prolonged PFS and OS in HCC pts receiving IO therapy. Absence of steroid use for toxicity trended toward improved IO response.

Predictors of immunotherapy (IO) response and subsequent tyrosine kinase inhibitor (TKI) response in hepatocellular carcinoma (HCC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16642-e16642
Author(s):  
Samantha Ann Armstrong ◽  
Bhavana Pendurthi Singh ◽  
Monika Kulasekaran ◽  
Petra Prins ◽  
Aiwu Ruth He
Keyword(s):  
Kinase Inhibitor ◽  
Progression Free Survival ◽  
Viral Etiology ◽  
Chi Square ◽  
First Line Therapy ◽  
Best Response ◽  
Chi Square Test ◽  
Student’S T ◽  
Tki Treatment ◽  
Multifocal Disease

e16642 Background: Despite advances in understanding the molecular pathways of HCC, therapeutic options are limited and patient survival is dismal. IO is a promising HCC treatment and predicted to become first line therapy. Little is known about indicators predicting a prolonged response to IO or the effects of IO on subsequent TKI treatment. Methods: In this single-institutional retrospective analysis, pts received one of five IO containing regimens with nivolumab, pembrolizumab, atezolizumab plus bevacizumab, durvalumab or cemiplimab until disease progression (PD) or unacceptable toxicity. Relevant clinical factors including, but not limited to: stage, viral etiology, vascular invasion, tumor thrombus, multifocal disease, toxicity grade and additional therapies, were correlated to clinical outcome: progression free survival (PFS), overall survival (OS), response rate (RR), using Pearson’s chi-square test or student's t-test. Responses were assessed using RECIST v 1.1 criteria for stable disease (SD), partial response (PR) and PD were correlated with best response and PFS. OS was calculated by the Kaplan-Meier method. Results: Cohort demographics (n = 76) were: 72% male; 38% African American, 30% Caucasian and 16% Asian; 29% of pts had HBV, 41% had HCV, 1% had both HBV/HCV and 13% had no viral etiology (n = 64). The majority of pts were stage III (43%) or IV (38%). Best response to IO was SD in 65.7% of pts, PR in 25.7% and PD in 8.6%. Median OS was 13m (95% CI 7.9-18.1) from the start of IO and median PFS (n = 65) was 14m (95% CI 6.8-21.2). Median OS and PFS were significantly improved in pts with PR compared to PD (45 vs 8m, p < 0.0005, PFS 15 vs 3m p = 0.007). Both OS and PFS showed benefits for SD of ≥2 months compared to those with PD (11 vs 8m, p < .0005, PFS 5 vs 3m p = .007). Abnormal TSH anytime during IO treatment tended toward prolonged mOS (20 vs 9m p = 0.126). Thirty-five pts received additional lines of therapy after IO, 57% (N = 20) received a TKI and 14.2% (N = 5) received additional IO agents. Those who received TKI upon completion of IO had a significantly improved OS (p = 0.014) versus those who did not; median OS 22 m (95%CI 12.7-31.3) versus 10m (95%CI 5.4-14.6). Conclusions: PR and SD are independent predictors for prolonged PFS and OS in HCC pts receiving IO therapy. Abnormal TSH during IO treatment tended toward improved mOS. In addition data strongly indicates subsequent TKI therapy improves patient outcomes after IO.

CIP4 Expression is Associated With The Prognosis in Colorectal Cancer

2020 ◽  
Author(s):  
Keqian Zhang ◽  
Tianqi Mao ◽  
Zhicheng He ◽  
Xiaojiao Wu ◽  
Yu Peng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Lymphatic Invasion ◽  
Chi Square ◽  
Interacting Protein ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
Student’S T

Abstract Background: This study was conducted to detect the expression of Cdc42 interacting protein 4 (CIP4) in patients with colorectal cancer (CRC), and explore the role of CIP4 in prognosis of CRC patients.Methods: The expression of CIP4 mRNA was determined by quantitative real-time PCR (qRT-CPR) and compared by student’s t-test between groups. Relationships of clinical characteristics and CIP4 expression were analyzed by Chi-square test. Kaplan-Meier curves were used to estimate the overall survival of CRC patients. And Cox regression analysis was conducted to identify the prognostic biomarkers for CRC patients.Results: The qRT-PCR results showed that CRC tissues were detected with significantly high CIP4 mRNA expression compared with adjacent normal controls (P<0.0001). The overexpression of CIP4 in CRC tissues was influenced by distant metastasis (P=0.021), lymphatic invasion (P=0.012) and TNM stage (P=0.006). But, other clinical factors including age, gender, differentiation and tumor site were proved to have no obvious effects on CIP4 expression (all, P>0.05). The survival curves showed that patients with high CIP4 expression generally lived shorter than those with low CIP4 expression (P<0.001). In addition, the multivariate analysis revealed that differentiation (P=0.044, HR=1.631, 95%CI=1.013-2.626) and CIP4 expression (P=0.000, HR=5.283, 95%CI=3.138-8.893) were of great prognostic significance for CRC patients.Conclusion: Taken together, up-regulation of CIP4 in CRC tissues represented poor prognosis for patients.

Phase II study of the combination of thalidomide and irinotecan in patients with recurrent anaplastic gliomas not on enzyme inducing anticonvulsants

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1564-1564 ◽  
Author(s):  
V. K. Puduvalli ◽  
P. Giglio ◽  
M. D. Groves ◽  
K. R. Hess ◽  
M. Gilbert ◽  
...  
Keyword(s):  
Treatment Options ◽  
Progression Free Survival ◽  
Antiangiogenic Agents ◽  
Synergistic Activity ◽  
Free Survival ◽  
Mr Perfusion Imaging ◽  
Kaplan Meier ◽  
Anaplastic Gliomas ◽  
Best Response ◽  
Grade 3

1564 Background: Patients with recurrent anaplastic glioma (AG) have few treatment options after initial alkylating agent therapy. In this study, the efficacy of thalidomide and irinotecan against recurrent AG was tested to assess if synergistic activity of cytotoxic and antiangiogenic agents could affect clinical outcome. Methods: Patients with recurrent AG with a KPS≥70 not on enzyme inducing anticonvulsants and with fewer than three relapses after radiation therapy and chemotherapies were eligible; the total planned enrollment is 39 patients. Irinotecan is administered at 125 mg/m2 weekly for 4 weeks followed by 2 weeks rest; thalidomide is initiated at 100 mg daily and escalated weekly up to 400 mg daily. Warfarin (1 mg) is given for prevention of venous thromboembolism (VTE). Patients undergo clinical and radiologic evaluations every 6-weeks. The primary endpoint is progression free survival at 6 months (PFS-6). To determine possible radiologic correlates to treatment effects, DCE- MR perfusion-imaging studies are obtained at baseline and subsequent follow up visits. Results: 17 are evaluable for response; the remainder were inevaluable. All evaluable patients had previously failed temozolomide and 9 had also failed nitrosourea therapy. The median age is 44 yrs and median KPS is 90. Four patients are alive and progression free at 6-months whereas 9 have progressed; the median progression free survival is 23 weeks and the PFS-6 is 34%. The best response was a CR in one patient, PR in 2 and stable disease in 9. Two patients have died of unspecified causes probably related to treatment. Median overall survival has not been reached; the 12-month and 18 month survivals by Kaplan Meier analysis are 73% and 26% respectively. Grade 3 and 4 toxicities included fatigue (29%), leukopenia (29%), nausea/vomitting (24%), and diarrhea (18%) requiring dose reductions. Two patients had VTE. Conclusions: The preliminary results of this ongoing study suggest that the combination of irinotecan and thalidomide has activity in patients with recurrent anaplastic gliomas; the ongoing assessment of this combination in patients with AG will more definitively define whether the combination can be an effective second line therapy for this population. [Table: see text]

Bevacizumab-induced bleeding in colorectal and noncolorectal cancer patients in a community oncology setting: An Abington Memorial Hospital experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18250-e18250 ◽  
Author(s):  
Naveed Ali ◽  
Faizan Malik ◽  
Mary Naglak ◽  
Syed Imran Mustafa Jafri ◽  
Christian Fidler ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Bleeding Risk ◽  
Community Practice ◽  
Chi Square ◽  
Kaplan Meier ◽  
Community Oncology ◽  
Increased Risk ◽  
Clinically Significant ◽  
Grade 3 ◽  
Bleeding History

e18250 Background: Bevacizumab (Bev) can be associated with clinically significant bleeding. Patients (pts) in community practice have increased comorbidities, leading to some reluctance to use Bev with anticoagulation (AC) or antiplatelet therapy (APT). This study was conducted to determine the incidence of Bev induced bleeding in colorectal (CRC) and non-colorectal (non-CRC) cancer pts in a real-world setting. Methods: In this retrospective analysis, pts with Bev treated CRC and non-CRC from Jan 2010 to Jan 2017 at our hospital were identified. Bleeding was graded according to CTCAE v4.0. Chi-Square and ANOVA were used to calculate associations. Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier and log rank methods. Results: 241 pts were evaluated (mean age = 63; 54% females), 112 with CRC and 129 with non-CRC (lung = 27%; gynecologic = 14%; CNS = 7%; other = 5%). Median duration of Bev therapy was 21 weeks. Overall bleeding was 22% (mucocutaneous = 14%; hematochezia = 4.5%; hematemesis = 1%; hematuria 2.5%; cerebral hemorrhage = 1%). Grade 3 bleeding occurred in 8 pts (epistaxis = 1; hematemesis = 2; hematochezia = 1; hematuria = 4), of whom 1 was on AC. There were no grade > 3 events. Concomitant AC (n = 35) increased bleeding risk ( p = 0.01) whereas APT (n = 43) did not ( p = 0.4). There was no association of bleeding and Bev dose ( p = 0.1); however, longer duration of therapy increased bleeding risk ( p = 0.01). In CRC pts, concomitant chemotherapy (oxaliplatin vs irinotecan), bleeding history, intact tumors and tumor side were not associated with increased risk ( p > 0.05). In CRC, pts with bleeding had longer estimated median OS (52 [95%CI, 35-66] vs 35 [95%CI, 22-48] months; p= 0.079) and PFS (80 [95%CI, 59-101] vs 72 [95%CI, 49-95] months; p= 0.048). Conclusions: We demonstrated in a modern community hospital practice that there is a 22% incidence of bleeding with Bev, although mostly mild even with concurrent AC, and only 3% grade 3. Concurrent AC but not APT was associated with increased bleeding risk and warrants careful discussion with pts. The observation of longer OS and PFS in pts with Bev induced bleeding warrants further investigation.

Predictors of poor outcome for transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4100-4100
Author(s):  
Petra Prins ◽  
Bhavana P Singh ◽  
Samantha Ann Armstrong ◽  
Aiwu Ruth He
Keyword(s):  
Prognostic Factors ◽  
Systemic Therapy ◽  
Strong Association ◽  
Median Number ◽  
Chi Square ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
Student’S T ◽  
Poor Outcomes ◽  
Relevant Factors

4100 Background: The use of TACE in select patients with BCLC stage B HCC has been shown to improve survival. Despite this, it remains unclear which patients will benefit from repeated TACE versus switching to systemic therapy upon disease progression. The purpose of this study is to identify prognostic factors that predict poor outcomes in patients who receive TACE. Methods: In this single-institutional retrospective analysis, patients with unresectable HCC were treated with TACE between 2007-2016. Relevant factors such as staging by BCLC stage B, Child-Pugh score, vascular invasion (VI), tumor thrombus (TT), AFP levels, and number of TACE treatments within six months from the initiation of TACE were analyzed using either Pearson’s chi-square test or the student's t-test. The Kaplan-Meier method was used for survival analysis. Results: Patients (n = 176) underwent TACE; 45% had stage I-II disease, 42% were BCLC stage B prior to TACE, 71% were Child-Pugh A, 21% had extrahepatic spread, 34.7% had VI, and 26% had TT. The median number of TACE treatments was 2 (range, 1- 6). The median overall survival (mOS) was 43 months (m) (95% CI 31.3-54.7) and mOS from start of TACE was 34m (95% CI 26.2-41.8). Elevated AFP (>400) correlated with decreased mOS (25m vs. 35m, p=0.041). Similarly, the presence of TT correlated with poor outcomes (25m vs. 37m, p=0.015). The mOS was also negatively impacted by having 3 or more TACE treatments within a 6 m period (25m vs. 38m, p = 0.09). AFP >400, TT, and interval between TACE were all independent factors in this multivariate analysis, resulting in a shorter mOS of approx. 2 years compared to 3 years in patients without these negative prognostic factors. There was a strong association with both elevated AFP and TT (Chi square p=0.009). Conclusions: Elevated AFP (>400), the presence of TT, and a need for 3 or more TACE treatments within 6 months appear to be independent predictors for shorter mOS in patients receiving TACE. Patients with these poor prognostic factors tend to have more aggressive HCC, and earlier initiation of systemic therapy might provide benefit to these patients. A larger study is needed for confirmation of these findings.

scholarly journals Thyroid Complications Negatively Affect Therapeutic Response and Survival in Waldenstrom Macroglobulinaemia/ Lymphoplasmacytoid Lymphoma

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4513-4513
Author(s):  
Xinting Hu ◽  
Hua Wang ◽  
Hongzhi Xu ◽  
Xin Liu ◽  
Ying Li ◽  
...  
Keyword(s):  
Gene Expression ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Chi Square ◽  
Free Survival ◽  
Kaplan Meier ◽  
Chi Square Test

Abstract Introduction: Waldenström macroglobulinaemia/ Lymphoplasmacytoid lymphoma (WM/LPL) is a rare lymphoproliferative neoplasm characterized by small B lymphocytes proliferation. Abnormalities of thyroid hormones are common in clinical courses. Yet, the role of thyroid complications has not been explored in WM/LPL. Hence, the aim of this study was to investigate the clinical significance of thyroid complications in WM/LPL. Methods: 105 clinically diagnostic WM/LPL patients from Shandong Provincial Hospital were enrolled with informed consents. Baseline and clinical data concerning sex, age, International Staging System Waldenstrom Macroglobulinemia (ISSWM) score et al were collected. Chi-square test was used for comparison of clinical characteristics. The Kaplan-Meier method was used for analysis of survival outcomes. Cox regression analyses were utilized to identify prognostic-related key factors associated with overall survival (OS) and progression-free survival (PFS) in WM/LPL patients. Microarray datasets GSE6691 were obtained from Gene Expression Omnibus. Results: Over the 105 WM/LPL patients, the median overall survival (OS) was not reached and median progression-free survival (PFS) was 96 months (Figure 1A, 1B). Patients classified as complete response (CR)/ partial response (PR)/ stable disease (SD), showed better OS and PFS than patients with progression disease (PD) (Figure 1C, D). There were 13.3% of enrolled patients with mixed thyroid complications. The results of Chi-square test showed that thyroid complications were significantly associated with reduced IgM level (p=0.036) and elevated β2-macroglobulin (p=0.032). Moreover, patients without thyroid comorbidities were more likely to get overall response (CR+PR) to the first-line treatment (p=0.004). Kaplan-Meier curves showed patients with thyroid complications had significantly shorter OS (p=0.02) and PFS (p&lt;0.001) versus those without thyroid complications (Figure 1E, F). In the univariate Cox regression model, age (p=0.022), ISSWM score (p=0.014) and thyroid complications (p&lt;0.001) were significantly associated with an increased risk of progression developed. Subsequent multivariate analysis showed the presence of thyroid complications was an independent prognostic indicator for PFS in WM/LPL patients (p=0.03). However, there was no statistical significance of thyroid complications in OS. Microarray dataset analysis was conducted to further investigate the role of thyroid-related genes in WM/LPL patients. A network of interactions among thyroid-related genes and critical factors in WM/LPL, including MYD88 and CXCR4, was shown in Figure 1G. Correlations were statistically significant between SLC5A5 (p&lt;0.05), TG (p&lt;0.01), TPO (p&lt;0.01) and CXCR4 by Spearman correlation analysis (Figure 1H, I). In addition, differential gene expression analysis between the WM and normal lymphocytes was assessed (Figure 1J). Thyroid-related genes with statistical significance were annotated in the volcano plots (Figure 1K). Enrichment analysis indicated that differential genes were involving in PI3K-Akt signaling pathway and response to peptide hormone (Figure 1L). Moreover, five of them reached statistical significance, illuminating the potential importance of thyroid-related genes in WM/LPL (Figure 1M). Conclusion: Taken together, the present study was the first investigation on the role of thyroid complications in WM/LPL. Patients with thyroid complications showed worse clinical characteristics and conferred independent prognostic significance. The primary strength of this study is that it provides robust real-world evidence on the prognostic role of thyroid complications, highlighting the need to monitor and appropriately manage WM/LPL patients with thyroid complications in medical admissions. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Phase II trial combining atezolizumab concurrently with chemoradiation therapy in locally advanced non-small cell lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8512-8512 ◽  
Author(s):  
Steven H. Lin ◽  
Yan Lin ◽  
Isabel Mok ◽  
Jenean A. Young ◽  
See Phan ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Trial ◽  
Locally Advanced ◽  
Cancer Recurrence ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Chi Square ◽  
Tumor Biopsy ◽  
Chi Square Test ◽  
Grade 3

8512 Background: Consolidation durvalumab after chemoradiation (CRT) is the new standard of care in locally advanced NSCLC (LA-NSCLC). We hypothesized that adding immunotherapy concurrently with CRT (cCRT) would increase efficacy without significant additive toxicity. To test this concept, we conducted a phase II trial called DETERRED combining atezolizumab (atezo) with cCRT followed by consolidation full dose carboplatin/paclitaxel (CP) with atezo (CP-atezo) for 2 cycles and then maintenance atezo for 1 year. The primary endpoint was safety/toxicity and feasibility. Methods: This study enrolled patients (pts) between February 2016 - April 2018 and was done in two parts: In part 1 (N=10), conventionally fractionated CRT (60-66 Gy in 30-33 fractions combined with weekly low dose CP) was followed by CP-atezo then maintenance atezo. Part 2 was cCRT (N=30) with atezo followed by CP-atezo then maintenance atezo. Atezo was given at 1200 mg IV Q3 weeks. Severe adverse events (SAEs) ≥ grade 3 were defined by CTCAE v5.0. Evaluable pts received at least one dose of atezo. PD-L1 staining utilizes the DAKO 22C3 platform. Kaplan Meier were analyzed for progression free survival (PFS) and overall survival (OS), and chi-square test for PD-L1 levels on any recurrence, with significance set at <0.05. Results: In Part 1, atezo related SAEs were seen in 4 pts (40%) (2 grade 3 arthralgia, 1 grade 3 dyspnea and 1 grade 5 TE fistula). Grade 2 radiation pneumonitis (RP) was seen in 1 pt. In Part 2, seven (23%) pts had atezo related SAEs (diarrhea, nephritis, dyspnea, fatigue and heart failure). RP was seen in 3 pts, 2 grade 2 and 1 grade 3, which led to atezo discontinuation. In Part 1, with an overall median follow up (f/u) time of 22.5 months and 27.4 months for survivors, the 1-year PFS is 50%, and OS is 79%. In part 2, with a median f/u time of 11.8 months and 13.7 months for survivors, the 1-year PFS was 57%, and OS is 79%. Baseline tumor biopsy PD-L1 status was evaluable for 34 pts. There were no significant differences in cancer recurrence for PD-L1 <1% (7/16=44%) vs ≥1% (6/18=33%), or for the PD-L1 cutoff of <50% (11/26=42%) vs ≥50% (2/8=25%). Conclusions: Concurrent atezo with CRT followed by CP-atezo and maintenance atezo is safe without increased toxicities compared to CRT alone followed by CP-atezo and maintenance atezo. Updated efficacy results from DETERRED will be presented. Ultimately, the clinical benefit of immunotherapy with cCRT followed by consolidation chemo-immunotherapy will need to be compared to the PACIFIC regimen in a larger randomized trial. Clinical trial information: NCT02525757.

scholarly journals 791. Hyponatremia Incidence and Its Association With Mortality in Patients With Tuberculosis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S283-S284
Author(s):  
Andrea Llamas-Lopez ◽  
Tania Vargas ◽  
Luis Morales-Garza ◽  
Rogelio Maya
Keyword(s):  
Strong Association ◽  
Serum Glucose ◽  
Categorical Variables ◽  
Chi Square ◽  
Electronic File ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
Student’S T ◽  
Overall Mortality

Abstract Background In 2014, 26,000 new cases of tuberculosis were reported in Mexico. TB infection can cause hyponatremia which has a strong association with mortality. The objective of this study was to determine the association of mortality with hyponatremia in patients with tuberculosis infection. Methods Patients were collected from a 2-year period in the Hospital Dr. Bernardo Sepœlveda in Nuevo Leon, Mexico. Inclusion criteria were patients &gt;18 years of age, with positive tuberculosis tests, and sodium and serum glucose values upon admission. Clinical data from the electronic file were collected and analyzed by descriptive statistics; Student’s t-test and chi-square test were used to compare categorical variables, and Kaplan–Meier to estimate survival curves. Results There were 314 patients with suspected TB, 77 patients were included (Table 1). Mean follow-up was 6.5 ± 7.1 months. Overall mortality rate was 36.3%. Analysis of mortality is presented in Fig 2, and in severe hyponatremia in Figure 3. Conclusion Overall mortality was higher than previously reported, but there was no statistical association between hyponatremia and mortality compared with patients with normal sodium, or by severity. Within the limitations of this study, we must consider that 92% of patients were hospitalized patients at the time of diagnosis, implying that they were patients with complications and may be the reason why both mortality and the incidence of hyponatremia were higher. Disclosures All authors: No reported disclosures.

scholarly journals Pelvic Exenteration: Experience from a Rural Cancer Center in Developing World

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Sampada B. Dessai ◽  
Satheesan Balasubramanian ◽  
Vijay M. Patil ◽  
Santam Chakraborty ◽  
Atanu Bhattacharjee ◽  
...  
Keyword(s):  
Pelvic Exenteration ◽  
Progression Free Survival ◽  
Surgical Oncology ◽  
Cancer Center ◽  
Chi Square ◽  
Factors Affecting ◽  
Resource Limited ◽  
Kaplan Meier ◽  
Retrospective Audit ◽  
Chi Square Test

Background. Pelvic exenteration (PE) is a morbid procedure. Ours is a rural based cancer center limited trained surgical oncology staff. Hence, this audit was planned to evaluate morbidity and outcomes of all patients undergoing PE at our center.Methods. This is a IRB approved retrospective audit of all patients who underwent PE at our center from January 2010 to August 2013. The toxicity grades were retrospectively assigned according to the CTCAE version 4.02 criteria. Chi-square test was done to identify factors affecting grades 3–5 morbidity. Kaplan Meier survival analysis has been used for estimation of median PFS and OS.Results. 34 patients were identified, with the median age of 52 years (28–73 years). Total, anterior, posterior, and modified posterior exenterations were performed in 4 (11.8%), 5 (14.7%), 14 (41.2%), and 11 (32.4%) patients, respectively. The median time for surgery was 5.5 hours (3–8 hours). The median blood loss was 500 mL (200–4000 mL). CTCAE version 4.02 grades 3-4 toxicity was seen in nine patients (25.7%). The median estimated progression free survival was 31.76 months (25.13–38.40 months). The 2-year overall survival was 97.14%.Conclusion. PE related grades 3–5 morbidity of 25.7% and mortality of 2.9% at our resource limited center are encouraging.

The management of colorectal cancer (CRC) liver metastases with yttrium-90 microspheres (Y90): The south Australian (SA) experience.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 666-666 ◽  
Author(s):  
Christos Stelios Karapetis ◽  
Sunita Jo-Anne Padman ◽  
Carol Beeke ◽  
Robert Padbury ◽  
Michael Kitchener ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Tumour Response ◽  
Progression Free Survival ◽  
Adverse Outcomes ◽  
Chi Square ◽  
Free Survival ◽  
Kaplan Meier ◽  
Select Group ◽  
Baseline Characteristics ◽  
Grade 3

666 Background: Treatment of CRC liver metastases with Y90 may provide a survival benefit but remains under investigation. We report on the accumulated SA clinical experience of using Y90 in the treatment of patients with metastatic CRC. Methods: Data from the SA mCRC Database was used to analyse the baseline characteristics of patients treated with Y90 to determine patterns of care. Safety and adverse outcomes, tumour response, disease progression, and survival were also examined. Survival outcomes were analysed using Kaplan Meier estimates, and chi square testing used for comparisons. Results: 33 patients received Y90, with median age 67 (range 33-83), 25 male, 29 colon/4 rectal primary, 25 hepatic only metastatic disease. Systemic therapy pre Y90 was as follows; nil=4, 1 line=7, 2 lines=9, ≥3=11, unknown=2. There were no immediate Grade III/IV adverse events, though immediate toxicity occurred in 9 patients; liver capsule pain in 8, chest pain and vomiting in 1 patient. Following Y90 treatment, radiologist reported response showed: measurable reduction =3 (ORR 9%), SD=4, PD=20, and 1 patient unknown. Treatment beyond Y90; nil=16 patients, 1 line=7, 2 lines=7 and >3=2 patients. Data on hepatic progression free survival (PFS) and overall PFS is currently being analysed. Median survival from the time of Y90 treatment was 10.3 months. Conclusions: Our data show Y90 use in SA occurs most often after 2 lines of chemotherapy. No immediate grade 3/4 toxicity was encountered. Survival for this select group appears longer than expected. Data on mOS from delivery of Y90, hepatic PFS and overall PFS for subgroups will be reported.

Sign in / Sign up

Export Citation Format

Share Document