scholarly journals Analysis of factors related to recurrence of paediatric hepatoblastoma -A single centre retrospective study

2019 ◽  
Author(s):  
Wei Yang ◽  
Yiwei Chen ◽  
Yijin Huang ◽  
Huanmin Wang
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Recurrence ◽  
Tumour Size ◽  
Alpha Fetoprotein ◽  
Therapeutic Effects ◽  
Significant Difference ◽  
Prognostic Risk Factors

Abstract Purpose: This study was performed to identify risk factors associated with recurrence of hepatoblastoma. Methods: A retrospective study was conducted on 56 patients with hepatoblastoma from 2012 to 2015 in Beijing Children’s Hospital. PRETEXT stage, serum alpha fetoprotein (AFP) value, change trend of tumors after treatment and some other clinical characteristics were collected and analyzed. The comparison of independent variables that were not distributed normally was performed with the log-rank test. Results: 28 patients with tumor recurrence and 28 non-recurrence patients were included in this study, the median age at presentation was 46.5 (26, 71.5) months. There was a significant difference in the 3-year recurrence free survival (RFS) probability between the patients over 54 months and those younger than 54 months (p=0.007). After neoadjuvant chemotherapy, the chance of recurrence in PR patients was shown to be significantly lower than that in SD patients (p=0.004). The 3-year RFS of patients with a decrease in AFP of more than 60% after neoadjuvant chemotherapy was significantly higher than that of patients with a decrease rate of less than 60% (p=0.005). Postoperative follow-up revealed that patients whose postoperative AFP fell to normal levels within six months of the start of treatment had a three-year RFS of 68.6%, which is higher than that of patients whose AFP fell below the normal range after six months (p=0.0005). Finally, multivariate analysis by Cox regression showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors for 3-year RFS. Other clinical features were not significantly associated with tumor recurrence in this study. Conclusion: Through this study, we concluded that the prognosis of childhood HB is related to the age at presentation and the response of chemotherapy. The results of the multivariate analysis showed that AFP that decreased by less than 60% and tumour size that decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors. These findings can be helpful to evaluate therapeutic effects and predict prognosis. Key words: hepatoblastoma; alpha fetoprotein; risk factor

scholarly journals Analysis of factors related to recurrence of paediatric hepatoblastoma - a single Centre retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wei Yang ◽  
Yiwei Chen ◽  
Yijin Huang ◽  
Huanmin Wang
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Retrospective Study ◽  
Neoadjuvant Chemotherapy ◽  
Cox Regression ◽  
Tumour Size ◽  
Tumour Recurrence ◽  
Therapeutic Effects ◽  
Significant Difference ◽  
Prognostic Risk Factors

Abstract Background This study was performed to identify risk factors associated with recurrence of hepatoblastoma. Methods A retrospective study was conducted on 56 patients with hepatoblastoma from 2012 to 2015 in Beijing Children’s Hospital. Pretreatment extension stage (PRETEXT), serum alpha fetoprotein (AFP) value, change trend of tumors after treatment and some other clinical characteristics were collected and analyzed. The comparison of independent variables that were not distributed normally was performed with the log-rank test. Results Twenty-eight patients with tumour recurrence and 28 patients without recurrence were included in this study, and the median age at presentation was 46.5 (26, 71.5) months. There was a significant difference in the 3-year recurrence-free survival (RFS) probability between patients aged over 54 months and those younger than 54 months (p = 0.007). After neoadjuvant chemotherapy, the chance of recurrence in partial response (PR) patients was significantly lower than that in stable disease (SD) patients (p = 0.004). The 3-year RFS rate of patients with a reduction in AFP of more than 60% after neoadjuvant chemotherapy was significantly higher than that of patients with a reduction of less than 60% (p = 0.005). The postoperative follow-up revealed that patients whose postoperative AFP fell to normal levels within 6 months of the start of treatment had a 3-year RFS rate of 68.6%, which is higher than that of patients whose AFP fell below the normal range after 6 months (p = 0.0005). Finally, the multivariate analysis by Cox regression showed that AFP decreased by less than 60% and tumour size decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors for the 3-year RFS rate. The other clinical features were not significantly associated with tumour recurrence in this study. Conclusions Through this study, we concluded that the prognosis of childhood HB is related to the age at presentation and the response of chemotherapy. The results of the multivariate analysis showed that AFP decreased by less than 60% and tumour size decreased by less than 50% after neoadjuvant chemotherapy were significant independent prognostic risk factors. These findings can be helpful to evaluate therapeutic effects and predict prognosis.

scholarly journals Incidence and Risk Factors for Neurological Deterioration in Posterior Corrective Surgeries for Severe Angular Kyphotic Deformities: A 10-Year Institutional Retrospective Study

2020 ◽  
pp. 219256822097912
Author(s):  
Kalyan Kumar Varma Kalidindi ◽  
Sulaiman Sath ◽  
Jeevan Kumar Sharma ◽  
Gayatri Vishwakarma ◽  
Harvinder Singh Chhabra
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Neurological Deficit ◽  
Operative Time ◽  
Deformity Correction ◽  
Neurological Deterioration ◽  
Kyphotic Deformity ◽  
Neurological Deficits ◽  
Retrospective Case ◽  
Significant Difference

Study Design: Retrospective case-control study. Objective: Neurological deficit is one of the dreaded complications of kyphotic deformity correction procedures. There is inconsistency in the reports of neurological outcomes following such procedures and only a few studies have analyzed the risk factors for neurological deficits. We aimed to analyze the factors associated with neurological deterioration in severe kyphotic deformity correction surgeries. Methods: We performed a retrospective study of 121 consecutive surgically treated severe kyphotic deformity cases (49 males, 56 females) at a single institute (May 1st 2008 to May 31st 2018) and analyzed the risk factors for neurological deterioration. The demographic, surgical and clinical details of the patients were obtained by reviewing the medical records. Results: 105 included patients were divided into 2 groups: Group A (without neurological deficit) with 92 patients (42 males, 50 females) and Group B (with neurological deficit) with 13 patients (7 males, 6 females) (12.4%). Statistically significant difference between the 2 groups was observed in the preoperative sagittal Cobbs angle (p < 0.0001), operative time (p = 0.003) and the presence of myelopathic signs on neurological examination (p = 0.048) and location of the apex of deformity (p = 0.010) but not in other factors. Conclusions: Preoperative Sagittal Cobbs angle, presence of signs of myelopathy, operative time and location of apex in the distal thoracic region were significantly higher in patients with neurological deterioration as compared to those without neurological deterioration during kyphotic deformity correction surgery. Distal thoracic curve was found to have 4 times more risk of neurological deterioration compared to others.

scholarly journals Pola makan berhubungan dengan sindrom metabolik pada lanjut usia di Poliklinik Geriatri RSUP Sanglah Denpasar

2010 ◽  
Vol 6 (3) ◽  
pp. 105
Author(s):  
IGA Sagung Kusuma Dewi ◽  
I Dewa Putu Pramantara ◽  
Retno Pangastuti
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Multivariate Analysis ◽  
The Elderly ◽  
Control Group ◽  
Chi Square ◽  
Eating Pattern ◽  
Significant Difference ◽  
And Gender ◽  
Obesity Hypertension

Background: Food intake is a factor determining health status and risk for degenerative diseases including metabolic syndrome. The fundamental function of someone’s nutritional status in the process of the emergence of generative disease and metabolic syndrome can be identified through the effect of food to the prevalence of obesity, hypertension, dyslipidemia or glucose tolerance disorder.Objective: To identify the association between eating pattern and the prevalence of metabolic syndrome among the elderly at Geriatric Polyclinic of Sanglah Hospital Denpasar.Method: The study was analytic observational with matched case control study design using ratio 1:1. There were 80 samples consisting of 40 as control group and 40 as cases matched by age and gender. Eating pattern was identified through food frequency questionnaire and calculated and compared to the need. Statistical analysis used chi square and risk factors were measured using odds ratio (OR). Multivariate analysis used double logistic regression to find out risk factors dominantly affected metabolic syndrome.Result: The result of bivariate statistical test showed significant difference in the prevalence of metabolic syndrome (p < 0.05) for energy intake (OR: 9.1; CI95%: 1.9-43.8), protein (OR: 3.8; CI95%: 1.5-9.7), fat (OR: 3.8; CI95%: 1.1-13.2), carbohydrate (OR:11.4; CI95%: 2.3-54.2). The result of multivariate analysis showed that the variables having dominant risk and significant difference in the prevalence of metabolic syndrome were carbohydrate consumption (OR: 8.1; CI95%: 1.29–50.89), fat consumption (OR: 4.9; CI95%: 1.17-20.61) and protein consumption (OR: 3.9; CI95%: 1.27-12.30).Conclusion: There was difference in eating pattern, i.e. high consumption of carbohydrate, fat and protein which became risk factor for the prevalence of metabolic syndrome among the elderly at Geriatric Polyclinic of Sanglah Hospital Denpasar.

scholarly journals Preoperative Nutritional Status and Risk Factors Associated with Delayed Discharge in Geriatric Patients Undergoing Gastrectomy: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
Xining Zhao ◽  
Jie Liu ◽  
Ying Wang ◽  
Yuying Yang ◽  
Yan Pan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Geriatric Patients ◽  
Cox Regression ◽  
Significant Risk ◽  
Related Factors ◽  
Factors Associated ◽  
Delayed Discharge ◽  
Significant Difference

Abstract Background Preoperative malnutrition is an independent risk factor for postoperative complications and survival for gastric cancer (GC) patients. This study aimed to investigate the prevalence of malnutrition and the risk factors associated with the delayed discharge of geriatric patients undergoing gastrectomy. Material and Methods A retrospective study of GC patients (age ≥ 65) who underwent gastrectomy at Zhongshan Hospital from January 2018 to May 2020 was conducted. Clinical data, including demographic information, medical history, surgery-related factors, and perioperative nutritional management were collected and analyzed. Results A total of 783 patients were reviewed. The overall frequency of malnutrition was 31.3% (249/783). The levels of albumin, prealbumin, and hemoglobin were lower in the malnutrition group compared with the well-nourished group. Moreover, 51 (6.5%) patients received preoperative total parenteral nutritional support. All patients received postoperative parenteral nutrition; 194 (77.9%) patients in the malnutrition group received an infusion of carbohydrates with composite amino acid and 55 (22.1%) received total nutrient admixture. No significant difference was found in the duration of postoperative nutrition between the groups (P>0.05). The malnutrition group was associated with a higher rate of surgical site infections (SSIs) (P<0.001). Multivariate cox regression revealed that age >70 years, length of surgery >180 min, and postoperative complications were significant risk factors associated with delayed discharge. Conclusion Malnutrition is relatively common in elderly patients undergoing gastrectomy. Age, length of surgery, and postoperative complications are important risk factors associated with delayed discharge. Elderly GC patients with risk factors urgently require specific attention to shorten hospital stays.

scholarly journals Effect of Bevacizumab Combined with Neoadjuvant Chemotherapy in Advanced Ovarian Cancer and the Occurrence of Adverse Reactions

2021 ◽  
Vol 5 (6) ◽  
pp. 52-56
Author(s):  
Qin Si
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Reactions ◽  
Treatment Cycle ◽  
Combined Therapy ◽  
Advanced Ovarian Cancer ◽  
Inflammatory Factors ◽  
Therapeutic Effects ◽  
Chemotherapy Group ◽  
Significant Difference

Objective: To explore the effect of bevacizumab combined with neoadjuvant chemotherapy in advanced ovarian cancer and the occurrence of adverse reactions. Methods: A total of 80 patients with advanced ovarian cancer, treated in Affiliated People’s Hospital of Inner Mongolia Medical University from June 2019 to December 2020, were randomly divided into two groups. In the chemotherapy group, 40 patients were treated with neoadjuvant chemotherapy, while in the combined group, another 40 patients were treated with bevacizumab combined with neoadjuvant chemotherapy. The therapeutic effects were compared at the end of the treatment cycle. Results: There was no significant difference in the levels of CA125, CEA, and VEGF between the two groups before treatment. However, after the treatment cycle, the levels of CA125, CEA, and VEGF in the combined group were significantly better than those in the chemotherapy group (P < 0.05). At the same time, the incidence of adverse reactions of the chemotherapy group was 67.50%, which was significantly higher than that of the combined group (35.00%; P < 0.05). Conclusion: Bevacizumab combined with neoadjuvant chemotherapy for patients with advanced ovarian cancer has significant curative effect. The combined therapy reduces the levels of tumor markers and inflammatory factors, improves patients’ quality of life, as well as reduces adverse reactions. It has high clinical promotion value.

scholarly journals Risk factors for unsuccessful removal of central venous access ports implanted in the forearm of adult oncologic patients

2021 ◽  
Author(s):  
Mitsuhiro Kinoshita ◽  
Shoichiro Takao ◽  
Junichiro Hiraoka ◽  
Katsuya Takechi ◽  
Yoko Akagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Central Venous Access ◽  
Univariate Analysis ◽  
Venous Access ◽  
Central Venous ◽  
Significant Difference ◽  
Oncologic Patients

Abstract Purpose To evaluate the risk factors for unsuccessful removal of a central venous access port (CV port) implanted in the forearm of adult oncologic patients. Materials and methods This study included 97 adult oncologic patients (51 males, 46 females; age range, 30–88 years; mean age, 63.7 years) in whom removal of a CV port implanted in the forearm was attempted at our hospital between January 2015 and May 2021. Gender, age at removal, body mass index, and diagnosis were examined as patient characteristics; and indwelling period, indwelling side, and indication for removal were examined as factors associated with removal of a CV port. These variables were compared between successful and unsuccessful cases using univariate analysis. Then, multivariate analysis was performed to identify independent risk factors for unsuccessful removal of a CV port using variables with a significant difference in the univariate analysis. A receiver-operating characteristics (ROC) curve was drawn for significant risk factors in the multivariate analysis and the Youden index was used to determine the optimum cut-off value for predicting unsuccessful removal of a CV port. Results Removal of CV ports was successful in 79 cases (81.4%), but unsuccessful in 18 cases (18.6%) due to fixation of the catheter to the vessel wall. Multivariate logistic regression analysis showed that the indwelling period (odds ratio 1.048; 95% confidence interval 1.026–1.070; P < 0.0001) was a significant independent risk factor for unsuccessful removal of a CV port. ROC analysis showed that the cut-off value for successful removal was 41 months, and 54% of cases with an indwelling period > 60 months had unsuccessful removal. Conclusion The indwelling period is an independent risk factor for unsuccessful removal of a CV port implanted in the forearm of adult oncologic patients, with a cut-off of 41 months.

scholarly journals Vascular Endothelial Growth Factor-C (VEGF-C) Expression Can Not Predict Pelvic Lymph Node Metastases and Response to Neo-adjuvant Chemotherapy in Bulky Cervical Cancer

2016 ◽  
Author(s):  
Johnson Hutapea
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Tumour Size ◽  
Response To Treatment ◽  
Chemotherapy Response ◽  
Response To Chemotherapy ◽  
The Difference ◽  
Neo Adjuvant Chemotherapy ◽  
Factor C

Objective: To assess whether VEGF-C expression can predict the response to neoadjuvant chemotherapy and pelvic lymphnode metastases in bulky cevical cancer. Methods: Seventeen cervical cancer stage IB2 and IIA2 cases during the period of July 2009 until June 2010 were collected consecutively and given neoadjuvant chemotherapy (NAC) PVB prior radical surgery. Response to treatment was evaluated based on the change of tumour size. VEGF-C expression was examined immunohistochemically at tumour biopsy before chemotherapy. The presence of lymphnode metastases histopathologically were obtained from pelvic lymphnode dissection. The difference and correlation of response and metastases on VEGF-C expression were analized statistically. The validity of the cut off percentage of immunopositive cells to VEGF-C to identify non responding and metastatic cases was calculated with the ROC. Multivariate analysis were done to determine the predictor of no response to chemotherapy. Results: Clinical response, using the RECIST version 1.1 criteria, was found in 41.18% cases and lymphnode metastases were found in 27.27% cases. VEGF-C was expressed in all cases. Statistically, there were no significant differences and correlation in response to treatment and pelvic lymphnode metastases on VEGF-C expression. At the cut off ≥ 76% immunopositivity to VEGF-C, the sensitivity to identify no response and the specificity to identify response to NAC are 70.00% and 71.43% respectively (LR+ 2.45 and LR- 0.42); whereas at the cut off ≥ 75% immunopositivity to VEGF-C, the sensitivity to identify lymphnode metastases and the specificity to identify no lymphnode metastases are 100.00% and 75.00% (LR+ 4.0 and LR- 0). With multivariate analysis using logistic regression, the cut off ≥ 76% immunopositive cells to VEGF-C were found to have positive coefficient, largest OR and statistic score, 1.93, 6.88 (96% CI OR 0.45; 104.34) and 41 respectively, to predict non responders in a prediction score model. Conclusion: VEGF-C expression on biopsy specimen bulky cervical cancers can not differentiate cases that respond to NAC and metastases to the pelvic lymphnode from that do not. The cut off ≥ 76% immunopositive cells to VEGF-C in a prediction model can be used as an alternative predictor to identify non responders. [Indones J Obstet Gynecol 2012; 36-3: 144-9] Keywords: bulky cervical cancer, neoadjuvant chemotherapy, response and metastases prediction, VEGF-C immunohistochemistry expression

scholarly journals ENDOSCOPIC PIECEMEAL RESECTION OF LARGE BENIGN COLORECTAL NEOPLASIA: RESULTS OF A RUSSIAN MULTICENTER STUDY

2020 ◽  
Vol 19 (1) ◽  
pp. 73-79
Author(s):  
D. V. Zavyalov ◽  
S. V. Kashin ◽  
E. R. Olevskaya ◽  
S. V. Molchanov ◽  
E. A. Fedorova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Tumor Recurrence ◽  
Colorectal Neoplasia ◽  
Postoperative Bleeding ◽  
Significant Risk ◽  
Inverse Correlation ◽  
Male Gender ◽  
Intraoperative Bleeding ◽  
Piecemeal Resection

AIM: to assess the safety of endoscopic piecemeal mucosal resection (EPMR) of large epithelial colorectal lesions and to identify risk factors for tumor recurrence.PATIENTS AND METHODS: results of EPMR were evaluated in retrospective study, which was carried out in five regional endoscopic centers. The criterion for inclusion in the study was benign colorectal lesion of 20 mm and larger.RESULTS: we found that complications of EPMR occurred in 13% of cases. In 9.2% it was intraoperative bleeding, which was stopped endoscopically. Postoperative bleeding was detected in 1.2% of patients, perforation – in 2.4%. Tumor recurrence developed in 12%. We have revealed a direct correlation between tumor recurrence and intraoperative bleeding (p=0.013) and a size of lesion >4 cm (p=0.012); the inverse correlation between the tumor recurrence and the fullness of the lifting during the removal (p=0.008) and the male gender of the patient (p=0.043).CONCLUSION: significant risk factors of tumor recurrence after endoscopic piecemeal resection of large benign colorectal neoplasia were identified before the procedure (gender and tumor size) and intraoperatively (completeness of lifting and the intraoperative bleeding).

scholarly journals Linezolid-containing Regimen Lowers Mortality of Rifampicin/multidrug-resistant Tuberculous Meningitis in Shenzhen, China

2020 ◽  
Author(s):  
Mu-tong Fang ◽  
You-feng Su ◽  
Guo-fang Deng ◽  
Pei-ze Zhang ◽  
Hou-ming Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tuberculous Meningitis ◽  
Migrant Workers ◽  
Drug Susceptibility ◽  
Multidrug Resistant ◽  
Therapeutic Effects ◽  
Related Risk ◽  
Significant Difference ◽  
High Risk Factor ◽  
Previously Treated

Abstract Background: The morbidity of rifampicin/multidrug-resistant tuberculous meningitis (RR/MDR-TBM) is increasing in many countries and regions in the world. Its mortality is significantly higher than non rifampicin/multidrug-resistant ones (NRR/MDR-TBM ). This article aims to explore the RR/MDR-TBM related risk factors, and compare the different therapeutic effects to the RR/MDR-TBM patients between linezolid-containing anti-tuberculosis regimen and non linezolid regimen in Shenzhen city. Furthermore, we want to find a better therapy for pathogen negative TBM with RR/MDR-TBM related risk factors. Methods: 137 cases with confirmed TBM (pathogen positive), who were hospitalized in the Third People’s Hospital of Shenzhen from June 2014 to March 2020, were enrolled in this study, all patients were divided into RR/MDR-TBM group (12 cases) and NRR/MDR-TBM group (125 cases) according to the GeneXpert MTB/RIF and (or) phenotypic drug susceptibility test of CSF (cerebral spinal fluid). The risk factors related to RR/MDR-TBM were investigated through comparing the clinical and examination features between the two groups.The mortality of RR/MDR-TBM patients treated with different regimens was analyzed to compare their respective therapeutic effects to the RR/MDR-TBM . P<0.05 differences is considered statistically significant. Results: Most of the patients(111/137, 81%) were from southern or southwestern China, and a large proportion(72/137, 52.55%) is migrant workers. 12 cases were RR/MDR-TBM (12/137,8.8%) in all TBM patients while 125 cases were NRR/MDR-TBM(125/137,91.2%). The proportion of previously treated cases in RR/MDR-TBM group was significantly higher than that in NRR/MDR-TBM group (6/12vs12/125, 50%vs10.5%,P<0.01), while there was no significant difference in other clinical and examination features between the two groups. The mortality of RR/MDR-TBM treated with the linezolid-containing regimen was significantly lower than that treated with non linezolid regimen (P=0.045). Conclusions: The main related high-risk factor of RR/MDR-TBM is the history of anti-tuberculosis treatment. Linezolid -containing regimen appears to lower the mortality of RR/MDR-TBM significantly. Therefore, it is recommended that linezolid-containing regimen can be used as a better empirical anti-tuberculosis therapy for pathogen negative TBM previously treated in China.

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