scholarly journals CORRELATION ANALYSIS BETWEEN LABORATORY IMMUNE AND METABOLIC PARAMETERS IN CHRONIC BRAIN ISCHEMIA STAGES I AND II ALONG WITH HYPERTENSION AFTER TREATMENT

2021 ◽  
Vol 23 (4) ◽  
pp. 737-742
Author(s):  
N. A. Bystrova ◽  
A. A. Shulginova ◽  
A. I. Konoplya
Keyword(s):  
Sorption Capacity ◽  
Metabolic Disorders ◽  
Objective Assessment ◽  
Laboratory Data ◽  
Stage I ◽  
Stage Ii ◽  
Metabolic Status ◽  
Blood Leukocytes ◽  
Laboratory Parameters ◽  
Chronic Brain Ischemia

Determination of interrelationships between impairments of laboratory parameters of immune and metabolic status in patients with chronic cerebral ischemia of I-II stages was carried out. The study included 104 patients, of which 76 were female and 28 males, with CCI on the background of II degree hypertension, of which 52 patients were with stage I and 52 with stage II at the age of 50 ± 5 years. Also, clinical and laboratory parameters were studied in 22 healthy donors of the same age. Evaluation of clinical and laboratory data was carried out at the beginning of treatment and 2 weeks after its end. The sorption capacity of erythrocytes and the sorption capacity of the glycocalyx (SEG), the activity of lipid peroxidation processes, the state of the antioxidant system were determined in blood plasma and erythrocytes, the level of stable metabolites of nitric oxide (SMNO), neopterin, C-reactive protein, cytokines (TNFα, IL- 1β, IL-8, IFNγ, IL-18, G-CSF, IL-4, IL-10), immunoglobulins (IgM, IgG, IgA), complement system components (C3, C4, C5, C5А), the phagocytic and oxygen-dependent activity of polymorphonuclear blood leukocytes. Comparative assessment of the results of correlation, factorial and cluster analyzes for assessing the parameters of the immune and metabolic status in patients with stage I CCI revealed the most significant laboratory parameters necessary for determination in the clinic for objective assessment of the severity of immune and metabolic disorders: TNFα, IL-8, IL-10, SMNO and NEG. In patients with CCI stage II, to objectively assess the severity of immune and metabolic disorders, TNFα, IL-8, IL-17, IL-10, the phagocytic number of neutrophils and SEG are recommended. 

scholarly journals PERSONALIZED PHARMACOLOGICAL CORRECTION OF IMMUNE SYSTEMS, METABOLIC AND NEUROPSYCHIC PARAMETERS IN CHRONIC BRAIN ISCHEMIA OF STAGE I AND II ON THE BACKGROUND OF HYPERTENSION DISEASE

2021 ◽  
Vol 23 (4) ◽  
pp. 957-962
Author(s):  
A. I. Konoplya ◽  
A. A. Shulginova ◽  
N. A. Bystrova ◽  
V. P. Gavrilyuk ◽  
G. N. Ryzhikova
Keyword(s):  
Sorption Capacity ◽  
Laboratory Data ◽  
Treatment Method ◽  
Stage I ◽  
Control Group ◽  
Blood Leukocytes ◽  
Chronic Brain Ischemia ◽  
Pharmacological Correction ◽  
High Concentrations ◽  
Peroxidation Processes

The study aimed to develop a personalized pharmacological correction of immune, metabolic and neuropsychiatric disorders in chronic cerebral ischemia (CCI) stages I and II. The study included 104 patients, of which 76 were female and 28 were male, with CCI on the background of grade II hypertension, of which 52 patients were with stage I and 52 with stage II at the age of 50±5 years. Clinical and laboratory parameters were studied in 22 healthy donors of the same age who formed a control group. Patients with CCI were randomized according to gender, age, treatment method, concomitant pathology, and duration of the disease. Evaluation of clinical and laboratory data was carried out at the beginning of treatment and 2 weeks after its end. The sorption capacity of erythrocytes and the sorption capacity of the glycocalyx (SEG), the activity of lipid peroxidation processes, the state of the antioxidant system were determined in blood plasma and erythrocytes, the level of stable metabolites of nitric oxide (SMNO), neopterin, C-reactive protein, cytokines (TNFα, IL-1β, IL-8, IFNγ, IL-18, G-CSF, IL-4, IL-10), immunoglobulins (IgM, IgG, IgA), complement system components (C3, C4, C5, C5A), phagocytic and oxygen-dependent activity of polymorphonuclear blood leukocytes. It has been established that for patients with CCI I with high concentrations of IL-8, IL-10, SMNO and a low SEG index, the intake of Cereton and Actovegin or Ceraxon and Mexicor will be insufficient for effective correction of immunometabolic disorders, which requires additional administration of an immunomodulator. Patients with CCI II, who have a higher plasma level of TNFα, IL-10 and low SEG values, need to prescribe Ceraxon, Mexicor and Glutoxim or Ceraxon, Mexicor and Polyoxidonium in order to obtain the maximum clinical and laboratory positive effect. 

Blood and tumor inflammation markers in non-small cell lung cancer (NSCLC): Blood leukocytosis as an independent risk factor in early stage.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21110-e21110
Author(s):  
Andreas Carus ◽  
Morten Ladekarl ◽  
Henrik Hager ◽  
Hans Pilegaard ◽  
Patricia Switten Nielsen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Stage I ◽  
Stage Ii ◽  
Recurrence Free Survival ◽  
Elevated Blood ◽  
Blood Leukocytes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Cancer Inflammation

e21110 Background: Cancer inflammation is associated with impaired survival in a range of cancers. We reviewed blood and intratumoral inflammatory markers in NSCLC. Methods: At the Departmentof Thoracic Surgery, Skejby Hospital, Aarhus, Denmark, consecutive patients with resected NSCLC from 2000 to 2008 were reviewed, and 906 patients with complete clinical data were identified. A subset of 341 consecutive patients, resected between 2003 and 2006, also had intratumoral CD66b+ neutrophils and CD163+ macrophages measured by immunohistochemistry and evaluated by stereological assessment. Results: A total of 526, 197, and 183 patients had stage I, II, and III, respectively. Multivariate analysis stratified for tumor stage revealed elevated blood leukocytes above upper limit of normal as a significant prognostic factor for recurrence-free survival (RFS)(hazard ratio [HR] 1.9; 95% CI 1.4-2.6; p<0.0001), cancer specific survival (CSS)(HR 1.9; 95% CI 1.4-2.7; p<0.0001), and overall survival (OS)(HR 1.5; 95% CI 1.1-1.9; p<0.006) in stage I NSCLC, but not in stage II and III. No prognostic impact of intratumoral neutrophils or macrophages was seen on CSS, RFS, or OS, neither in the entire cohort, nor limited to stage I patients with elevated blood leukocytes or with normal counts. Controlling intratumoral neutrophils and macrophages for localization restricted to tumor tissue, stromal tissue, or blood vessels, respectively, were also with no statistically significant difference. Conclusions: Blood leukocytosis is an independent prognostic factor for short recurrence free survival, cancer specific survival, and overall survival in stage I NSCLC, but not in stage II and III. However, intratumoral neutrophils or macrophages did not impact prognosis. Further studies are needed to elucidate the role of cancer inflammation in NSCLC.

scholarly journals Predicting the risk of tumor progression in patients with early stages of adenocarcinoma and squamous cell lung carcinoma based on laboratory parameters

2021 ◽  
Vol 67 (6) ◽  
pp. 507-517
Author(s):  
A.D. Tahanovich ◽  
N.N. Kauhanka ◽  
V.I. Prohorova ◽  
D.I. Murashka ◽  
O.V. Gotko
Keyword(s):  
Tumor Progression ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Recurrence ◽  
Relative Content ◽  
Stage I ◽  
Stage Ii ◽  
Laboratory Parameters ◽  
Early Stages ◽  
One Year

Non-small cell carcinoma (NSCLC) prevails in the structure of the incidence of lung cancer. In patients with I stage NSCLC, only 60-70% overcome the 5-year survival barrier, and at II stage it decreases to 35-40%. The reason for such a high mortality rate is almost always a relapse of the disease. The main histological forms of NSCLC — adenocarcinoma (AC) and squamous cell carcinoma (SCLC) — differ in the course, protocols and effectiveness of the treatment. Comparative survival data for AK and PCLC are controversial, and reliable biomarkers for determining the risk of tumor progression are lacking. In thus study we have investigated the possibility of using laboratory parameters characterizing the level of some blood proteins involved in carcinogenesis in patients with early stages of AC and SCLC to determine the risk of disease progression. We retrospectively analyzed the duration of the relapse-free period after surgical treatment for one year in 1250 patients (816 with stages I and II of adenocarcinoma, G1-3 and 434 with early stages of SCLC, G1-3). In 81 patients with AC and 36 — with SCLC (stages I-II, G1-3) the level of CYFRA 21-1 and SCC by electrochemiluminescent method, chemokines CXCL5, CXCL8, TPA, pyruvate kinase M2, HIF-1α and hyaluronic acid by enzyme immunoassay, receptors CXCR1, CXCR2, CD44v6 by flow cytometry were determined. Using the Kaplan-Meier graphical analysis, groups of low (stage I G1-2 + stage II G1) and high (stage I G3 + stage II G2-3) risk of tumor progression were identified. In the case of the one-year survival rate of patients with AC was higher than with SCLC. In patients with AC and a high risk of tumor recurrence, compared with a low one, the level of CYFRA 21-1, the mean intensity of fluorescence (MFI) of the CXCR1 receptor in granulocytes, and the relative content of the CXCR2 receptor in lymphocytes were higher. In the case of rapid progression of SCLC in patients, the relative content of the CXCR2 receptor in lymphocytes, the proportion of monocytes equipped with the CD44v6 receptor, and the SCC level were higher than with slow progression. Regression equations, including combinations of the above parameters (threshold value for AC — 0,512, for SCLC — 0,409, sensitivity — 91,9% and 90,0%, specificity — 90,0% and 87,5%, respectively), allow to predict the probability of tumor recurrence.

Treatment Strategy and Prognosis of Myeloma Patients According to ISS Stage at Diagnosis.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5133-5133
Author(s):  
Yoshihiro Hatta ◽  
Susumu Nishinarita ◽  
Takeyoshi Itoh ◽  
Jin Takeuchi ◽  
Umihiko Sawada
Keyword(s):  
Survival Time ◽  
Treatment Strategy ◽  
Laboratory Data ◽  
Staging System ◽  
Initial Diagnosis ◽  
Stage I ◽  
Stage Ii ◽  
Survival Duration ◽  
Newly Diagnosed ◽  
Survival Times

Abstract Background: Recently, a new ISS staging system for myeloma has been developed. By analyzing over 10,000 patients, ISS is a simple and useful system to estimate prognosis. However, by ISS, survival time was evaluated only for the time after chemotherapy. The prognosis of untreated patients and survival time after initial diagnosis were not well understood by ISS. Our aim was to evaluate the prognosis and define treatment strategy for newly diagnosed, untreated myeloma patients using ISS at diagnosis. Especially, treatment strategy for ISS stage I was received attention. Methods: 127 newly diagnosed, untreated myeloma patients referred to Nihon University Itabashi Hospital between 1994 and 2004 were retrospectively analyzed. ISS stage was determined with the laboratory data at diagnosis. Median age of the patients was 62 y (range 30–88). Median follow-up duration was 32.5 months (range 0–171). Transplanted patients were censored at the time of transplantation. Results: 50% survival duration after initial diagnosis for stage I (n=54), II (n=26), and III (n=47) were 106, 36, and 14.5 months, respectively. For stage I patients given chemotherapy, both 50% survival times after initial diagnosis and after chemotherapy were the same, 85 months, suggesting that stage I patients required chemotherapy were treated early after diagnosis. Fifteen stage I patients have not been treated and all of them are alive. Of these 15 patients, 14 were in Durie-Salmon stage I and one was in Durie-Salmon stage II at diagnosis. 50% progression time from ISS stage I to II in untreated patients was 2 months. For the patients treated at ISS stage I, 50% progression time from stage I to II and I to III were 61 and 155 months, respectively. These data suggest that the progression from stage I to II could be postponed by early chemotherapy. However, overall survival duration of the patients treated at stage I and of those treated after progression to stage II was not different. Conclusion: We defined treatment strategy for myeloma using ISS at diagnosis. Certain amounts of myeloma patients with Durie-Salmon stage I and ISS stage I concomitantly at diagnosis were not required chemotherapy. Administration of chemotherapy for ISS stage I patients at diagnosis are recommended after they progress to stage II.

Identification of biomarkers and functional modules from genomic data in stage-wise breast cancer

2020 ◽  
Vol 15 ◽  
Author(s):  
Athira K ◽  
Vrinda C ◽  
Sunil Kumar P V ◽  
Gopakumar G
Keyword(s):  
Breast Cancer ◽  
Expression Patterns ◽  
Differential Expression Analysis ◽  
Predictive Biomarkers ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Functional Modules ◽  
Incidence And Mortality ◽  
Multiple Stages

Background: Breast cancer is the most common cancer in women across the world, with high incidence and mortality rates. Being a heterogeneous disease, gene expression profiling based analysis plays a significant role in understanding breast cancer. Since expression patterns of patients belonging to the same stage of breast cancer vary considerably, an integrated stage-wise analysis involving multiple samples is expected to give more comprehensive results and understanding of breast cancer. Objective: The objective of this study is to detect functionally significant modules from gene co-expression network of cancerous tissues and to extract prognostic genes related to multiple stages of breast cancer. Methods: To achieve this, a multiplex framework is modelled to map the multiple stages of breast cancer, which is followed by a modularity optimization method to identify functional modules from it. These functional modules are found to enrich many Gene Ontology terms significantly that are associated with cancer. Result and Discussion: predictive biomarkers are identified based on differential expression analysis of multiple stages of breast cancer. Conclusion: Our analysis identified 13 stage-I specific genes, 12 stage-II specific genes, and 42 stage-III specific genes that are significantly regulated and could be promising targets of breast cancer therapy. That apart, we could identify 29, 18 and 26 lncRNAs specific to stage I, stage II and stage III respectively.

Cardiac transthyretin wild-type amyloidosis (ATTRwt): a prospective study of 400 patients followed at the Italian referral center

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Milani ◽  
L Obici ◽  
R Mussinelli ◽  
M Basset ◽  
G Manfrinato ◽  
...  
Keyword(s):  
Natural History ◽  
Median Survival ◽  
Troponin I ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Wild Type ◽  
Staging Systems ◽  
Significant Difference ◽  
History Of

Abstract Background Cardiac wild type transthyretin (ATTRwt) amyloidosis, formerly known as senile systemic amyloidosis, is an increasingly recognized, progressive, and fatal cardiomyopathy. Two biomarkers staging systems were proposed based on NT-proBNP (in both cases) and troponin or estimated glomerular filtration rate, that are able to predict survival in this population. The availability of novel effective treatments requires large studies to describe the natural history of the disease in different populations. Objective To describe the natural history of the disease in a large, prospective, national series. Methods Starting in 2007, we protocolized data collection in all the patients diagnosed at our center (n=400 up to 7/2019). Results The referrals to our center increased over time: 5 cases (1%) between 2007–2009, 33 (9%) in 2010–2012, 90 (22%) in 2013–2015 and 272 (68%) in 2016–2019. Median age was 76 years [interquartile range (IQR): 71–80 years] and 372 patients (93%) were males. One hundred and seventy-three (43%) had atrial fibrillation, 63 (15%) had a history of ischemic cardiomyopathy and 64 (15%) underwent pacemaker or ICD implantation. NYHA class was I in 58 subjects (16%), II in 225 (63%) and III in 74 (21%). Median NT-proBNP was 3064 ng/L (IQR: 1817–5579 ng/L), troponin I 0.096 ng/mL (IQR: 0.063–0.158 ng/mL), eGFR 62 mL/min (IQR: 50–78 mL/min). Median IVS was 17 mm (IQR: 15–19 mm), PW 16 mm (IQR: 14–18 mm) and EF 53% (IQR: 45–57%). One-hundred and forty-eight subjects (37%) had a concomitant monoclonal component in serum and/or urine and/or an abnormal free light chain ratio. In these patients, the diagnosis was confirmed by immunoelectron microscopy or mass spectrometry. In 252 (63%) the diagnosis was based on bone scintigraphy. DNA analysis for amyloidogenic mutations in transthyretin and apolipoprotein A-I genes was negative in all subjects. The median survival of the whole cohort was 59 months. The Mayo Clinic staging based on NT-proBNP (cutoff: 3000 ng/L) and troponin I (cutoff: 0.1 ng/mL) discriminated 3 different groups [stage I: 131 (35%), stage II: 123 (32%) and stage III: 127 (33%)] with different survival between stage I and II (median 86 vs. 81 months, P=0.04) and between stage II and III (median 81 vs. 62 months, P&lt;0.001). The UK staging system (NT-proBNP 3000 ng/L and eGFR 45 mL/min), discriminated three groups [stage I: 170 (45%), stage II: 165 (43%) and stage III: 45 (12%)] with a significant difference in survival: between stage I and stage II (86 vs. 52 months, P&lt;0.001) and between stage II and stage III (median survival 52 vs. 33 months, P=0.045). Conclusions This is one of the largest series of patients with cardiac ATTRwt reported so far. Referrals and diagnoses increased exponentially in recent years, One-third of patients has a concomitant monoclonal gammopathy and needed tissue typing. Both the current staging systems offered good discrimination of staging and were validated in our independent cohort. Funding Acknowledgement Type of funding source: None

scholarly journals Incidence and Severity of Nasal Injuries in Preterm Infants Associated to Non-Invasive Ventilation Using Short Binasal Prong

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110104
Author(s):  
Débora de Fátima Camillo Ribeiro ◽  
Frieda Saicla Barros ◽  
Beatriz Luci Fernandes ◽  
Adriane Muller Nakato ◽  
Percy Nohama
Keyword(s):  
Preterm Infants ◽  
Professional Competence ◽  
Stage I ◽  
Stage Ii ◽  
Invasive Ventilation ◽  
Cause And Effect ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Nasal Injury ◽  
Cause And Effect Diagram

Short binasal prongs can cause skin and mucosal damage in the nostrils of preterm infants. The objective of this study was to investigate the incidence and severity of nasal injuries in preterm infants during the use of short binasal prongs as non-invasive ventilation (NIV) interfaces. A prospective observational study was carried out in the public hospital in a Southern Brazil. The incidence and severity of internal and external nasal injuries were evaluated in 28 preterm infants who required NIV using short binasal prongs for more than 24 hours. In order to identify possible causes of those nasal injuries, the expertise researcher physiotherapist has been carried empirical observations, analyzed the collected data, and correlated them to the literature data. A cause and effect diagram was prepared to present the main causes of the nasal injury occurred in the preterm infants assessed. The incidence of external nasal injuries was 67.86%, and internal ones 71.43%. The external nasal injuries were classified as Stage I (68.42%) and Stage II (31.58%). All the internal injuries had Stage II. The cause and effect diagram was organized into 5 categories containing 17 secondary causes of nasal injuries. There was a high incidence of Stage II-internal nasal injury and Stage I-external nasal injury in preterm infants submitted to NIV using prongs. The injuries genesis can be related to intrinsic characteristics of materials, health care, neonatal conditions, professional competence, and equipment issues.

scholarly journals A Preliminary Study on the Use of Xylit as Filter Material for Domestic Wastewater Treatment

2021 ◽  
Vol 11 (11) ◽  
pp. 5281
Author(s):  
Marcin Spychała ◽  
Tadeusz Nawrot ◽  
Radosław Matz
Keyword(s):  
Quality Indicators ◽  
Initial Period ◽  
Oxygen Demand ◽  
Domestic Wastewater ◽  
Filter Material ◽  
Stage I ◽  
Stage Ii ◽  
Septic Tank ◽  
Preliminary Stage ◽  
Wastewater Quality

The aim of the study was to verify two morphological forms (“angel hair” and “scraps”) of xylit as a trickling filter material. The study was carried out on two types of polluted media: septic tank effluent (STE) and seminatural greywater (GW). The basic wastewater quality indicators, namely, chemical oxygen demand (COD), biochemical oxygen demand (BOD5), total suspended solids (TSS), ammonium nitrogen (NNH4), and total phosphorus (Ptot) were used as the indicators of treatment efficiency. Filtering columns filled with the investigated material acted as conventional trickling filters at a hydraulic load of 376–472 cm3/d during the preliminary stage, 198–245 cm3/d during stage I, and 184–223 cm3/d during stage II. The removal efficiency of the two morphological forms of xylit did not differ significantly. The average efficiencies of treatment were as follows: for COD, over 70, 80, and 85% for preliminary stage, stage I and stage II, respectively; for BOD5, 77–79% (preliminary stage); for TSS, 42% and 70% during the preliminary stage, and 88, 91, and 65% during stage I; for NNH4, 97–99% for stage I and 36–49% for stage II; for Ptot, 51–54% for stage I and 52–56% for stage II. The study demonstrated that xylit was a material highly effective in wastewater quality indicators removal, even during the initial period of its use.

scholarly journals Gastric Cancer Treatments and Survival Trends in the United States

2020 ◽  
Vol 28 (1) ◽  
pp. 138-151
Author(s):  
Kelly A. Stahl ◽  
Elizabeth J. Olecki ◽  
Matthew E. Dixon ◽  
June S. Peng ◽  
Madeline B. Torres ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
The United States ◽  
Current Treatment ◽  
Stage I ◽  
Stage Ii ◽  
Chi Square ◽  
Specific Guideline ◽  
Kaplan Meier

Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease.

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

2019 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Valdano Manuel ◽  
Humberto Morais ◽  
Aida L. R. Turquetto ◽  
Gade Miguel ◽  
Leonardo A. Miana ◽  
...  
Keyword(s):  
Confidence Interval ◽  
African Country ◽  
Single Ventricle ◽  
Hazard Ratio ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Lost To Follow Up ◽  
Single Ventricle Palliation

Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock–Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

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