Risk factors for the local recurrence of giant cell tumours of the sacrum treated with nerve-sparing surgery

2020 ◽  
Vol 102-B (10) ◽  
pp. 1392-1398
Author(s):  
Yongzhao Zhao ◽  
Xiaodong Tang ◽  
Taiqiang Yan ◽  
Tao Ji ◽  
Rongli Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Local Recurrence ◽  
Cox Regression ◽  
Tumour Size ◽  
Univariate Analysis ◽  
Nerve Sparing ◽  
Large Tumour ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
Large Tumour Size

Aims There is a lack of evidence about the risk factors for local recurrence of a giant cell tumour (GCT) of the sacrum treated with nerve-sparing surgery, probably because of the rarity of the disease. This study aimed to answer two questions: first, what is the rate of local recurrence of sacral GCT treated with nerve-sparing surgery and second, what are the risk factors for its local recurrence? Methods A total of 114 patients with a sacral GCT who underwent nerve-sparing surgery at our hospital between July 2005 and August 2017 were reviewed. The rate of local recurrence was determined, and Kaplan-Meier survival analysis carried out to evaluate the mean recurrence-free survival. Possible risks factors including demographics, tumour characteristics, adjuvant therapy, operation, and laboratory indices were analyzed using univariate analysis. Variables with p < 0.100 in the univariate analysis were further considered in a multivariate Cox regression analysis to identify the risk factors. Results The rate of local recurrence of sacral GCT treated with nerve-sparing surgery was 28.95% (33/114). Multivariate Cox regression analysis showed that large tumour size (> 8.80 cm) (hazard ratio (HR) 3.16; 95% confidence interval (CI) 1.27 to 7.87; p = 0.014), high neutrophil-to-lymphocyte ratio (NLR) (> 2.09) (HR 3.13; 95% CI 1.28 to 7.62; p = 0.012), involvement of a sacroiliac joint (HR 3.09; 95% CI 1.06 to 9.04; p = 0.039), and massive intraoperative blood loss (> 1,550 ml) (HR 2.47; 95% CI 1.14 to 5.36; p = 0.022) were independent risk factors for local recurrence. Conclusion Patients with a sacral GCT who undergo nerve-sparing surgery have a local recurrence rate of 29%. Large tumour size, high NLR, involvement of a sacroiliac joint, and massive intraoperative blood loss are independent risk factors. Cite this article: Bone Joint J 2020;102-B(10):1392–1398.

scholarly journals A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110279
Author(s):  
Qinping Guo ◽  
Yinquan Wang ◽  
Jie An ◽  
Siben Wang ◽  
Xiushan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell ◽  
Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

scholarly journals Impact of Metabolic Syndrome on the Development of Cardiovascular Disease among Kazakhs in Remote Rural Areas of Xinjiang, China: A Cohort Study

2020 ◽  
Author(s):  
Wenwen Yang ◽  
Shuxia Guo ◽  
Haixia Wang ◽  
Yu Li ◽  
Xianghui Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Rural Areas ◽  
Cox Regression ◽  
Baseline Survey ◽  
Minority Populations ◽  
Cox Regression Analysis ◽  
Independent Risk Factors

Abstract Background: Metabolic syndrome (MS) could promote the development of cardiovascular disease(CVD). The aim of this study was to examine the association of MS and its components with CVD among Kazakhs in Xinjiang. Methods: According to the geographical distribution of the minority populations in Xinjiang, we selected the representative prefecture (Yili). A total of 2,644 participants completed the baseline survey between April 2010 and December 2012. The follow-up survey was conducted from April 2016 to December 2016. Only 2,286 out of 2,644 participants were followed-up on, with a follow-up rate of 86.46%. Cox regression was used to evaluate the association of each component and the number of combinations of MS components on the development of CVD. Results: Multivariate Cox regression analysis showed that blood pressure (BP), waist circumference (WC), and triglycerides (TG) were independently associated with CVD. Participants with 1–5 MS components had an increased hazard ratio for developing CVD, from 1.82 to 8.59 (trend P<0.001), compared with those without any MS components. This trend persisted after adjusting for other general risk factors. The risk of developing CVD increased when TG and WC coexisted, or when TG/WC and BP coexisted. However, no significant interactions were found between BP , WC , and TG. Conclusions: BP , WC, and TG were independent risk factors for CVD in Kazakhs. In clinical practice, a more informative assessment may be obtained by taking into account the number of MS components.

scholarly journals Early and Midterm Outcome of TEVAR for Thoracic Aortic Pseudoaneurysm

2021 ◽  
Author(s):  
Hui Wang ◽  
Tun Wang ◽  
Hao He ◽  
Xin Li ◽  
Yuan Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Cardiac Disease ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Aortic Pseudoaneurysm ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
The Mean

Abstract Backgrounds: The prognosis of thoracic aortic pseudoaneurysm (TAP) after thoracic endovascular aortic repair (TEVAR) remains unclear. This study investigates the early and midterm clinical outcome as well as relevant risk factors of TAP patients following TEVAR therapy.Methods: From July 2010 to July 2020, 37 eligible TAP patients who underwent TEVAR were selected into our research. We retrospectively explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan-Meier method were applied for comparing difference between groups. Risk factors of late survival were discerned using Cox regression analysis.Results: There were 29 men and 12 women, with the mean age as 59.5±13.0 years (range, 30-82). The mean follow-up time was 30.7±28.3 months (range, 1-89). For early result, early mortality (≦30days) happened in 3(8.1%) zone 3 TAP patients versus 0 in zone 4 (p= 0.028); acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm result, survival at 3 months, 1 year and 5 years was 88.8±5.3%, 75.9±7.5% and 68.3±9.9%, which showed significant difference between zone 2/3 versus zone 4 group (56.3±14.8% versus 72.9±13.2%, p= 0.013) and emergent versus elective TEVAR groups (0.0±0.0% versus 80.1±8.0%, p= 0.049). On multivariate Cox regression, lesions at zone 2/3 (HR 4.605, 95%CI 1.095-19.359), concomitant cardiac disease (HR 4.932, 95%CI 1.086-22.403) and emergent TEVAR (HR 4.196, 95%CI 1.042-16.891) were significant independent risk factors for worse late clinical outcome. Conclusions: TEVAR therapy is effective and safe with satisfactory early and midterm clinical outcome for TAP patients. Lesions at zone 2/3, concomitant cardiac disease and emergent TEVAR were independent risk factors for midterm survival outcome.

scholarly journals Cox Regression Analysis of 1739 Emergency Trauma Patients

2020 ◽  
Author(s):  
Jun Shen ◽  
Feng Xu ◽  
Du Chen
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Oxygen Saturation ◽  
Cox Regression ◽  
Trauma Patients ◽  
Term Survival ◽  
Cox Regression Analysis ◽  
Revised Trauma Score ◽  
Independent Risk Factors ◽  
Trauma Score

Abstract BACKGROUND: Trauma is a damage caused by physical harm from external source. It has been one of the major causes of mortality. The purpose of this study was to explore the risk factors related to mortality among emergency trauma patients. METHODS: This was a retrospective study in trauma center of the First Affiliated Hospital of Soochow University. The data were obtained from trauma database with patients registered from November 1, 2016 to November 30, 2019.Shapiro–Wilk test, Mann-Whitney test and Likelihood-ratio Chi squared test were used to assess the survival pattern. Cox regressions were performed to calculate the hazard ratios (HRs) of variables for death. RESULTS: The total 1739 emergency trauma patients, 44 (2.53%) died during the study period and 1695 (97.47%) were survival. Through univariable and multivariable Cox regression analysis, three independent risk factors for emergency death were screened out: pulse (Crude HR: 0.97, 95% Confidence Interval [CI]: 0.96-0.98; Adjuste HR: 1.04, 95% CI: 1.02-1.06), pulse oxygen saturation (Crude HR: 0.96, 95% CI: 0.95-0.97; Adjuste HR: 0.94, 95% CI: 0.91-0.97) and Revised Trauma Score (Crude HR: 0.69, 95% CI: 0.65-0.74; Adjuste HR: 0.79, 95% CI: 0.64-0.97).CONCLUSION: The survival outcome of emergency trauma patients was influenced by many factors. Pulse, pulse oxygen saturation (SpO2 ) and Revised Trauma Score (RTS) were the independent risk factors for mortality. Accurate analysis and judgment of the risk factors can improve cure efficiency and long-term survival rate.

scholarly journals PD-L1+NEUT, Foxp3+Treg, and NLR as New Prognostic Marker with Low Survival Benefits Value in Hepatocellular Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110458
Author(s):  
Lin Zhou ◽  
Jing Wang ◽  
Shao-cheng Lyu ◽  
Li-chao Pan ◽  
Xian-jie Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Peripheral Blood ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Rank Test ◽  
Cancer Tissue ◽  
Cox Regression Analysis ◽  
Poorly Differentiated ◽  
Independent Risk Factors

Background: This presented study was aimed to evaluate the diagnostic and prognostic value of PD-L1+Neutrophils (PD-L1+NEUT) and neutrophil to lymphocyte ratio (NLR) based on our previous experience of Foxp3+Treg in transplantation. Methods: the NLR cutoff value of 1.79 was used to include 136 cases from the 204 patients with hepatocellular carcinoma (HCC) confirmed by clinical pathology, which were divided into highly-moderately and poorly differentiated HCC groups. The expressions of PD-L1+NEUT and Foxp3+Treg in peripheral blood and cancer tissue were detected with flow cytometry, meanwhile, PD-L1 and Foxp3 expressed in carcinoma and para-carcinoma tissues were marked by immunohistochemistry. Survival rates, including overall survival and disease-free survival, were calculated by the Kaplan–Meier curve and evaluated with the log-rank test. Finally, Cox risk regression model was used to analyze the independent risk factors for prognostic survival. Results: The level of PD-L1+NEUT, Foxp3+Treg, and NLR in peripheral blood of patients with poorly differentiated HCC were significantly increased (all P < .001). Both PD-L1+NEUT and NLR were positively correlated with Foxp3+Treg ( r = 0.479, P = .0017; r = 0.58, P < .0001). The level of PD-L1+NEUT and Foxp3+Treg as well as PD-L1 and Foxp3 in cancer tissue and patients with poorly differentiated HCC were obviously increased (all P < .01), respectively. Cox regression analysis indicated that PD-L1+NEUT, NLR, and Foxp3+Treg were independent risk factors for the prognosis ( P = .000, .000, .006) with a RR and 95%CI of 2.704-(2.155-3.393), 3.139-(2.361-4.173), 1.409-(1.105-1.798), respectively. Conclusion: PD-L1+NEUT, NLR, and Foxp3+Treg are independent risk factors for prognosis which maybe new marker of lower survival benefits.

Effect of bronchial artery embolisation on the management of tuberculosis-related haemoptysis

2019 ◽  
Vol 23 (12) ◽  
pp. 1269-1276
Author(s):  
Y. Peng ◽  
Y. Zhu ◽  
G. Ao ◽  
Z. Chen ◽  
X. Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cox Regression ◽  
Bronchial Artery ◽  
Cox Regression Analysis ◽  
Pleural Thickening ◽  
Factors Influencing ◽  
Arterial Embolisation ◽  
Independent Risk Factors ◽  
Bronchial Artery Embolisation

OBJECTIVE: To identify risk factors influencing outcomes of bronchial arterial embolisation (BAE) in tuberculosis (TB) related haemoptysis.METHODS: A cohort of 207 patients underwent BAE for TB-related haemoptysis between March 2014 and March 2018. The clinical data were reviewed. Follow-up ranged from 24 to 1749 days.RESULTS: Immediate haemostasis rate was 94.2%; aggressive pleural thickening (PT) was found to be a risk factor for haemoptysis (P = 0.000, OR 22.52). Cumulative recurrence-free rates were respectively 98.5%, 94.8%, 88.7%, 79.9%, 68.5%, 65.7% and 62.7% for 1, 3, 6, 12, 24, 36 and 48 months. Respectively 8 and 15 patients recovered from pneumonectomy and re-BAE. However, five patients required a third BAE. The Cox regression analysis indicated that aggressive PT (P = 0.000), diabetes mellitus (DM) (P = 0.018) and pulmonary fungal infection (PFI) (P = 0.001) were independent risk factors for recurrence. The death rate following BAE was 9.2%; aggressive PT was a risk factor (P = 0.000, OR 8.14).CONCLUSION: BAE is effective for TB-related haemoptysis in most cases. Aggressive PT, DM and PFI are independent risk factors influencing the prognosis following BAE. PFI and DM should be well managed, while proper surgery should be considered for aggressive PT.

Coagulopathy on the first postoperative day predicting the long-term survival of traumatic brain injury patients

2020 ◽  
Author(s):  
Wenxing Cui ◽  
Shunnan Ge ◽  
Yingwu Shi ◽  
Xun Wu ◽  
Jianing Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Relationship ◽  
Underlying Risk

Abstract Objective: The purpose of this study was to identify the relationship between coagulopathy during the perioperative period (before the operation and on the first day after the operation) and the long-term survival of TBI patients undergoing surgery, as well as to explore the predisposing risk factors that may cause perioperative coagulopathy.Methods: This retrospective study included 447 TBI patients who underwent surgery from January 1, 2015 to April 25, 2019. Clinical parameters, including patient demographic characteristics, biochemical tests, perioperative coagulation function tests (before the operation and on the first day after the operation) and intraoperative factors were collected. Log-rank univariate analysis and Cox regression models were conducted to assess the relationship between perioperative coagulopathy and the long-term survival of TBI patients. Furthermore, univariate and multivariate analyses were performed to identify the underlying risk factors for perioperative coagulopathy.Results: Multivariate Cox regression analysis identified age, AIS(head) = 5, GCS ≤ 8, systolic pressure at admission < 90 mmHg and postoperative coagulopathy (all P < 0.05) as independent risk factors for survival following TBI; we were the first to identify postoperative coagulopathy as an independent risk factor. According to multivariate logistic regression analysis, for the first time, abnormal ALT and RBC at admission, preoperative coagulopathy, infusion of colloidal solution > 1100 mL and intraoperative bleeding > 950 mL (all P < 0.005) were identified as independent risk factors for postoperative coagulation following surgery after TBI.Conclusions: Those who suffered from postoperative coagulopathy due to TBI had a higher hazard for poor prognosis than those who did not. Closer attention should be paid to postoperative coagulopathy and more emphasis should be placed on managing the underlying risk factors.

scholarly journals ML-09 The REAL-WORLD of Elderly PCNSL Therapy in Tohoku and Niigata Area According to Retrospective Analysis: A Collaborative Investigation of the Tohoku Brain Tumor Study Group

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii17-ii17
Author(s):  
Kenichiro Asano ◽  
Yoji Yamashita ◽  
Takahiro Ono ◽  
Manabu Natsumeda ◽  
Takaaki Beppu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Real World ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Central Nervous System Lymphoma ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
The Real

Abstract Introduction: Recently, the number of cases of primary central nervous system lymphoma in elderly patients(EL-PCNSL) has been increasing. However, the treatment may be insufficient because of poor performance status and pre- and posttreatment complications. Therefore, we analyzed the risk factors for EL-PCNSL in the Tohoku and Niigata areas of Japan and clarified the REAL-WORLD of EL-PCNSL therapy. Materials & Methods: We investigated surgical and nonsurgical cases of patients aged 71 years or older from eight facilities during the last 8 years. We analyzed patient information, radiotherapy/chemotherapy or not, PFS, OS, RRs, second-line therapy, pre- and posttreatment complications, outcomes, and risk factors for poor prognosis. The log-rank test was used for univariate analysis, and Cox regression analysis was used for a multivariate analysis of risk factors. Results: Of the 142 cases registered, five differed from PCNSL pathologically, three receiving BSC were excluded, 31 were treated without biopsy, three were treated based on CSF-findings, and 100 were treated with biopsy. Total 134 cases were followed. The median age was 76 years, pretreatment KPS was 50%, and 118 cases(88%) had 217 pretreatment complications. The treatment contents consisted of various combinations depending on the attending physician. The retrospective overall PFS was 16 months and OS was 24 months. In the early treatment phase, out of 16 cases with dropout, four tumor and four complication deaths occurred. There were 77 deaths(58%), 39 internal tumor deaths(51%), and 33 complication deaths(43%). Poor prognostic risk factors were &lt;60% posttreatment KPS, complications involving pretreatment cardiovascular and central nervous system disease, posttreatment pneumonia or severe infection, and absence of radiation or chemotherapy. Conclusions: Pretreatment KPS did not affect poor outcomes, but posttreatment KPS &lt;60% and pre- and posttreatment complications did. Radiotherapy and chemotherapy are reportedly effective, but additional research to clarify the details of these modalities is needed.

scholarly journals Preoperative prealbumin-to-fibrinogen ratio predict Survival Outcomes in hepatocellular carcinoma patients after hepatic resection

2021 ◽  
Author(s):  
Yan Haixi ◽  
Chen Shuaishuai ◽  
Yang Qiong ◽  
Cai Linling
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Laboratory Data ◽  
Disease Free Survival ◽  
Factors Affecting ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Clinicopathologic Factors ◽  
Independent Risk Factors

Objective: This study aims to evaluate the clinical application of preoperative prealbumin-to-fibrinogen ratio (PFR) in the clinical diagnosis and prognostic value of hepatocellular carcinoma (HCC) patients. Methods: The clinical and laboratory data of 269 HCC patients undergoing surgical treatment from January 2012 to January 2017 in Taizhou Hospital were retrospectively analyzed. The Cox regression model was used to analyze the correlation between PFR and other clinicopathologic factors in overall survival (OS) and disease-free survival (DFS). Results: Cox regression analysis showed that PFR (hazard ratios [HR] = 2.123; 95% confidence interval [95% CI], 1.271–3.547; P = 0.004)was independent risk factors affecting the OS of HCC patients. Furthermore, a nomogram was built based on these risk factors. The C indices statistics for the OS nomogram was 0.715. Conclusion: Nomograms based on PFR can be recommended as the correct and actual model to evaluate prognosis for patients with HCC.

scholarly journals Characteristic and Early Discontinuation of Obsessive-Compulsive Disorder Trials Registered on ClinicalTrials.gov

2021 ◽  
Vol 12 ◽  
Author(s):  
Shanxia Luo ◽  
Qiong Guo ◽  
Liu Yang ◽  
Yifan Cheng ◽  
Youlin Long ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Obsessive Compulsive Disorder ◽  
Cox Regression ◽  
Drug Trials ◽  
Obsessive Compulsive ◽  
Early Discontinuation ◽  
Cox Regression Analysis ◽  
Compulsive Disorder ◽  
Independent Risk Factors

Objective: This study aimed to analyze the characteristics and reasons of early discontinuation of obsessive-compulsive disorder (OCD) trials registered on ClinicalTrials.gov.Methods: OCD trials and relevant publications were searched on ClinicalTrials.gov and PubMed, respectively. The characteristics and details regarding the timely publication of trials were recorded. Cox regression analysis was used to explore factors associated with the early discontinuation of OCD trials.Results: The analysis included 298 OCD therapy trials. Most investigations recruited &lt;100 patients and were more likely to involve adults. Of all OCD studies identified, 67.8% were randomized and 61.4% were blind (single- or double-blind). Universities and hospitals were recorded as the two primary locations in the majority of trials. A total of 155 trials (52%) were completed; however, only 29% of those were published. Of the published trials, &gt;70% were published at least 1 year after completion. Behavioral therapy trials were the most common type of major treatment-aimed OCD trials (39%), followed by drug trials (35.1%) and device/procedure trials (24.7%). The univariate Cox regression analysis indicated that drug trials [hazard ratio (HR) = 2.56, 95% confidence interval (CI): 1.21–5.43], absence of collaborators (HR = 3.87, 95% CI: 1.62–9.26), and sponsorship by industry (HR = 3.97, 95% CI: 1.49–10.53) were risk factors for early discontinuation of OCD trials. Further multivariate Cox regression showed that drug trials (HR = 3.93, 95% CI: 1.71–9.08) and absence of collaborators (HR = 5.17, 95% CI: 1.97–13.54) were independent risk factors for early trial discontinuation of OCD trials. The sensitivity analysis confirmed these results. Non-drug trials (OR = 3.32, 95% CI: 1.21–9.11), absence of collaborators (OR = 3.25, 95% CI: 1.10–9.60), and non-blinded trials (OR = 5.23, 95% CI: 1.05–26.2) were independent risk factors for unreported results in registry.Conclusion: The diagnosis and prevention of OCD are rarely investigated in trials. Underreporting and delayed reporting remain major problems. The type of intervention and participation of collaborators are associated with early discontinuation of OCD trials.

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