scholarly journals Survival and prognostic factors in HIV-infected adults treated with Antiretroviral Therapy in a Malaysian referral hospital: A retrospective cohort study

2019 ◽  
Author(s):  
Lee Sing Chet ◽  
Siti Azrin Ab Hamid ◽  
Norsa'adah Bachok ◽  
Suresh Kumar Chidambaram
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Antiretroviral Therapy ◽  
Haemoglobin Level ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Baseline Haemoglobin ◽  
History Of ◽  
Overall Survival Rates

Abstract Background: It is well established that antiretroviral therapy (ART) is beneficial in reducing the mortality among patients with human immunodeficiency virus (HIV). In Malaysia, there is lack of study and information regarding the overall survival rates and prognostic factors for survival in HIV-infected adults treated with ART. Therefore, this study aimed to assess and compare the survival rates as well as to identify the prognostic factors for survival among HIV adults in Malaysia.Methods: A retrospective cohort study was conducted by reviewing the medical records of HIV patients who started ART between year 2007 and 2016 at a tertiary referral hospital in Malaysia. ART-naive adults aged 15 years and above were included and those who were transferred out were excluded. After applying inclusion and exclusion criteria, there were 339 cases eligible in this study. Systematic sampling method was applied. Kaplan Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.Results: The estimated overall survival rates were 95.9%, 93.8%, 90.4%, 84.9%, and 72.8% at 6 months, 1 year, 3 years, 5 years and 10 years, respectively. The overall survival rates were significantly different according to age group (p<0.001), employment status (p<0.001), transmission mode (p=0.003), and history of illicit drug use (p=0.017), baseline CD4 cell count (p<0.001), baseline haemoglobin level (p<0.001), tuberculosis co-infection (p<0.001), hepatitis co-infection (p=0.008), first NRTI (p<0.001) and history of defaults (p=0.021). Based on multiple Cox regression, patients who were anaemic had 3.76 times (95% CI: 1.97, 7.18; p<0.001) higher hazard of death than their non-anaemic counterparts. The hazard risk was 2.09 times (95% CI: 1.10, 3.96; p=0.024) higher among HIV patients co-infected with tuberculosis compared to those who were not. Conclusion: Overall survival rates were higher than low-income countries but lower than in high-income countries, and comparable with middle-income countries. Low baseline haemoglobin level and tuberculosis co-infection were strong prognostic factors for HIV survival

The outcome of definitive or salvage radiotherapy for locally advanced hepatocellular carcinoma: A retrospective cohort study of 822 patients from a single institution.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 248-248
Author(s):  
J. Seong
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Locally Advanced ◽  
Survival Rates ◽  
Advanced Hcc ◽  
Overall Survival Rates ◽  
Better Than ◽  
3D Crt

248 Background: With technological development and awareness of efficacy, radiotherapy (RT) is more frequently adopted in management of hepatocellular carcinoma (HCC). To assess the efficacy of RT, we conducted this retrospective cohort study from a single institute. Methods: The analysis involved 822 patients who underwent definitive or salvage RT for locally advanced HCC from January 1997 to August 2009. Two-dimensional RT, 3-dimensional conformal RT (3D-CRT), and intensity-modulated RT including tomotherapy (IMRT) were carried out for 186 (22.6%), 579 (70.4%), and 57 (6.9%) patients, respectively. In a majority of patients, RT was done either concurrently with intra-arterial 5-FU (500 mg/m2) chemotherapy (CCRT group; 326 patients, 39.7%), or following transarterial chemoembolization (TACE+RT group; 244 patients, 29.7%). Total radiation dose was 30 to 64.8 Gy (median dose 45 Gy) in 1.8-2 Gy fraction. Results: The median age of total 822 patients was 55 and 84.3% was male. The 2, 3, and 4-year overall survival rates of total patients were 21.2, 13.1, and 10.1%, respectively. In 2-year survival, the patients with Child-Pugh class A did better than B or C (23% vs 10.9%, p<0.001), without portal vein thrombosis (PVT) did better than with PVT (26.8% vs 14.3%, p<0.001), and without lymph node metastasis (LNM) did better than with LNM (22.9% vs 11.7%, p<0.001). Patients with total dose higher than 45 Gy did better than those with less than 45 Gy (30.1% vs. 15.6%, p<0.001). The best outcome was shown in patients received higher than 45 Gy using 3D-CRT or IMRT, with 2-year overall survival rates of 25.9% (CCRT) and 41.3% (TACE+RT). Conclusions: This study showed a substantial effect of RT in locally advanced HCC. Further analysis will be continued to provide the best option of radiotherapy for locally advanced HCC. No significant financial relationships to disclose.

scholarly journals Transcatheter arterial infusion combined with radioactive particles in the treatment of advanced body/tail pancreatic cancer: a retrospective cohort study

2020 ◽  
Author(s):  
Shilong Han ◽  
Chuanwu Cao ◽  
Yifeng Yuan ◽  
Jun Chen ◽  
Linan Yin ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Control Group ◽  
Arterial Infusion ◽  
Intravenous Chemotherapy ◽  
Overall Survival Rates

Abstract Background Patients with advanced body/tail pancreatic cancer have poor quality of life and low overall survival rate. In recent years, interventional diagnosis and treatment of advanced pancreatic cancer have become increasingly widespread. This retrospective cohort study investigated the efficacy of routine intravenous chemotherapy (the control group), transcatheter arterial infusion (TAI) chemotherapy, and TAI combined with radioactive particles as therapeutic methods for advanced body/tail cancer pancreatic by assessing the short-term and overall survival rates. Methods We screened our prospective database for patients with advanced body/tail pancreatic cancer, which tumor deemed unresectable and no other confirmed malignant tumors, patients were assigned into three groups according to their treatment. Analyses with regard to the clinical responses, the 6, 12, and 18-month survival rates and overall survival rates were performed. Results The median survival time was 6 months in the control group, 10 months in the TAI group and 13 months in the TAI combined group. The Kaplan–Meier estimates of the OS among the three groups, indicating that there is significant difference among three groups (P༜0.000). The clinical remission rates were 17.5% in the control group, 41.5% in the TAI group, and 48.0% in the TAI combined group. Covariates analyzed showed that different treatment methods and times affected the results significantly (P༜0.002). Conclusions In the treatment of advanced body/tail pancreatic cancer, TAI and TAI combined with radioactive particles significantly improved the clinical outcomes in patients compared with routine intravenous chemotherapy.

Follicular large-cell lymphoma: intermediate or low grade?

1994 ◽  
Vol 12 (7) ◽  
pp. 1349-1357 ◽  
Author(s):  
N L Bartlett ◽  
M Rizeq ◽  
R F Dorfman ◽  
J Halpern ◽  
S J Horning
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Medical Center ◽  
Performance Status ◽  
Survival Rates ◽  
Large Cell ◽  
Poor Performance Status ◽  
Low Grade ◽  
Curative Intent ◽  
Overall Survival Rates

PURPOSE To evaluate the benefit of anthracycline-based chemotherapy, identify prognostic factors, and determine the value of the International Prognostic Factors Index for patients with follicular large-cell (FLC) lymphoma. PATIENTS AND METHODS This retrospective study includes 96 patients with FLC lymphoma treated at Stanford University Medical Center between 1969 and 1991. Fifty-five patients received doxorubicin plus cyclophosphamide-containing chemotherapy regimens, 21 patients received other chemotherapy regimens, 15 patients received radiotherapy only, and five patients received no initial therapy. Thirty-four patients had stage I or II disease and 62 patients had stage III or IV disease. RESULTS With a median follow-up duration of 5.2 years (range, 1 to 18), the actuarial 5- and 10-year overall survival rates were 75% and 54%, with actuarial 5- and 10-year freedom from progression (FFP) rates of 53% and 42%, respectively. Patients treated with chemotherapy regimens that contained both doxorubicin and cyclophosphamide had a superior actuarial 10-year FFP rate (55% v 25%, P = .06) and overall survival rate (65% v 42%, P = .04) compared with patients treated with other chemotherapy regimens. Only one patient treated with doxorubicin plus cyclophosphamide relapsed after 3 years. In the multivariate analysis, discordant lymphoma and treatment with chemotherapy regimens not containing both cyclophosphamide and doxorubicin predicted for worse FFP and overall survival rates. In addition, poor performance status and increasing areas of diffuse histology predicted for a worse survival, while anemia and male sex predicted for a worse FFP. The age-specific International Index was useful in predicting outcome; however, few patients with FLC lymphoma had high-risk features. CONCLUSION The plateau in FFP implies that patients with FLC lymphoma enjoy sustained remissions after standard anthracycline-based chemotherapy. FLC lymphoma should continue to be approached as an intermediate-grade lymphoma with curative intent.

PS02.032: PRETREATMENT INFLAMMATORY STATUS INFLUENCES THE PROGNOSIS OF CT4B ESOPHAGEAL CARCINOMA PATIENTS UNDERGOING DEFINITIVE CHEMORADIOTHERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 129-129
Author(s):  
Kotaro Sugawara ◽  
Koichi Yagi ◽  
Masato Nishida ◽  
Hiroharu Yamashita ◽  
Yasuyuki Seto
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Esophageal Carcinoma ◽  
Poor Prognosis ◽  
Conflicts Of Interest ◽  
Survival Rates ◽  
Clinical Staging ◽  
Definitive Chemoradiotherapy ◽  
Inflammatory Status ◽  
Overall Survival Rates

Abstract Background The outcome of definitive chemoradiotherapy (dCRT) for patients with cT4b esophageal carcinoma (EC) remains poor. Also, few studies focused on the prognostic factors in cT4b EC patients undergoing dCRT. Methods 80 patients undergoing dCRT for cT4b EC between 2006 and 2016 were retrospectively reviewed. All were in ECOG-PS 0–1. For evaluation of the pretreatment status, we employed demographic data, BMI, inflammatory marker (CRP), nutritional marker (Alb, prognostic nutritional index (PNI)) and tumor factors (clinical staging, pretreatment stenosis, tumor marker). Results There were 62 men with a mean age of 65 years (range, 41–83 years). 77 patients were squamous cell carcinoma, while 3 were adenocarcinoma. There were 12 (15%) patients with cM1 (lym) status. 36 (45.0%) patients had esophageal stenosis. 70 patients had cN + before dCRT, while 22 had cN + after dCRT. 30 patients (37.5%) had a CRP > 10 mg/l before dCRT, while 15 patients (18.8%) were in poor-nutritional status (PNI < 40). Of 80 patients, 1 patient gave up the treatment developing cerebral infarction. We analyzed survival in the 79 patients completing dCRT. Esophageal perforations were occurred in 5 (6.3%) patients. The 1- and 3-year overall survival rates were 59.8% and 38.3%, respectively. Salvage surgery was performed in 29 (36.3%) patients. R0 resection was achieved in 20 (69.0%) patients. Surgery-related death was developed in 3 patients. Pathological complete response was found in 10 (34.5%) patients. The 1- and 3-year overall survival rates of these 29 patients were 64.3% and 40.5%, respectively. Lastly, we evaluated prognostic factors in 79 patients. In univariable analysis, PNI < 40 (HR 2.43, 95% CI 1.19–4.63, P = 0.02), CRP ≥ 10 mg/l (HR 2.21, 95% CI 1.23–3.95, P = 0.01), pretreatment stenosis (HR 1.68, 95% CI 0.94–3.00, P = 0.08), cN + status after dCRT (HR 1.84, 95% CI 0.98–3.33, P = 0.06) were associated with poor prognosis. Subsequent multivariable Cox proportional hazards model revealed that CRP ≥ 10 mg/l (HR 2.00, 95% CI 1.03–3.81, P = 0.04) and cN + status after dCRT (HR 2.02, 95% CI 1.05–3.73, P = 0.03) were both independent risk factors for poor prognosis. Conclusion The outcome of dCRT for cT4b EC is acceptable. Pretreatment inflammatory status significantly influences the prognosis of patients undergoing dCRT. Disclosure All authors have declared no conflicts of interest.

scholarly journals Survival of colorectal cancer patients in Brunei Darussalam: comparison between 2002–09 and 2010–17

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shirley H. F. Lee ◽  
Hanif Abdul Rahman ◽  
Nadiah Abidin ◽  
Sok King Ong ◽  
Elvynna Leong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Survival Rates ◽  
Brunei Darussalam ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Overall Survival Rates

Abstract Background Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. Methods This retrospective cohort study (n = 1035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002–2017), to compare survival rates between two study periods (2002–2009 and 2010–2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. Results The 1-, 3- and 5-year survival rates of CRC patients are 78.6, 62.5, and 56.0% respectively from 2002 to 2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002–2009 are 82.2, 69.6, and 64.7%; 77.0, 59.1, and 51.3% for 2010–2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p < 0.05). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010–17 period (Adj. HR = 1.78, p < 0.001), older age group ( ≥ 60 years) (Adj. HR = 1.93, p = 0.005), distant cancer (Adj. HR = 4.69, p < 0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR = 2.44, p = 0.009), and lower in the Chinese(Adj. HR = 0.63, p = 0.003). Conclusion This study highlights the lower survival rates of CRC patients in 2010–2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.

Poor Prognostic Factors after Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma in the Modern Era

2012 ◽  
Vol 78 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Eiji Tsujita ◽  
Yo-Ichi Yamashita ◽  
Kazuki Takeishi ◽  
Ayumi Matsuyama ◽  
Shin-Ichi Tsutsui ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Repeat Hepatectomy ◽  
Recurrent Hepatocellular Carcinoma ◽  
The Poor ◽  
Estimated Blood Loss ◽  
Poor Outcomes ◽  
Overall Survival Rates

The purpose of this study was to determine the poor prognostic factors after repeat hepatectomy (Hx) in patients with recurrent hepatocellular carcinoma (HCC). Overall survival rates and clinicopathological variables in 112 patients with repeat Hx from 1992 to 2010 were compared with those in 531 patients who underwent a primary Hx. To clarify the poor prognosis factors after repeat Hx, survival data among 112 patients were univariately and multivariately analyzed. Overall survival after repeat Hx was similar for that of the patients who underwent a primary Hx. The mean age of repeat Hx group was significantly higher, and a well-preserved liver function was recognized than the primary Hx group. Multivariate analysis revealed that: 1) indocyanine green retention rate at 15 minutes; 2) disease-free interval; 3) tumor size; 4) portal vein invasion at primary Hx; 5) gender; and 6) estimated blood loss to be an independent and significant poor prognostic factors. The overall 3-year postrecurrence overall survival rates were 100, 91.3, 59.6, and 0 per cent at risk number (R) R0, R1/2, R3, R4, respectively ( P < 0.05). Repeat Hx provided a good compatible prognosis with primary Hx. In our findings, five risk factors to predict poor outcomes after repeat Hx were useful. Patients with recurrent HCC do not have universally poor outcomes, and our simple scoring system using five poor prognostic factors could serve to advise the prognosis and the potential benefit for patient selection about repeat Hx.

Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer

2005 ◽  
Vol 23 (21) ◽  
pp. 4602-4608 ◽  
Author(s):  
Hans von der Maase ◽  
Lisa Sengelov ◽  
James T. Roberts ◽  
Sergio Ricci ◽  
Luigi Dogliotti ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Locally Advanced ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Visceral Metastases ◽  
Overall Survival Rates

Purpose To compare long-term survival in patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium treated with gemcitabine/cisplatin (GC) or methotrexate/vinblastine/doxorubicin/cisplatin (MVAC). Patients and Methods Efficacy data from a large randomized phase III study of GC versus MVAC were updated. Time-to-event analyses were performed on the observed distributions of overall and progression-free survival. Results A total of 405 patients were randomly assigned: 203 to the GC arm and 202 to the MVAC arm. At the time of analysis, 347 patients had died (GC arm, 176 patients; MVAC arm, 171 patients). Overall survival was similar in both arms (hazard ratio [HR], 1.09; 95% CI, 0.88 to 1.34; P = .66) with a median survival of 14.0 months for GC and 15.2 months for MVAC. The 5-year overall survival rates were 13.0% and 15.3%, respectively (P = .53). The median progression-free survival was 7.7 months for GC and 8.3 months for MVAC, with an HR of 1.09. The 5-year progression-free survival rates were 9.8% and 11.3%, respectively (P = .63). Significant prognostic factors favoring overall survival included performance score (> 70), TNM staging (M0 v M1), low/normal alkaline phosphatase level, number of disease sites (≤ three), and the absence of visceral metastases. By adjusting for these prognostic factors, the HR was 0.99 for overall survival and 1.01 for progression-free survival. The 5-year overall survival rates for patients with and without visceral metastases were 6.8% and 20.9%, respectively. Conclusion Long-term overall and progression-free survival after treatment with GC or MVAC are similar. These results strengthen the role of GC as a standard of care in patients with locally advanced or metastatic TCC.

scholarly journals Factors Affecting Virological Outcome When First-Line Antiretroviral Therapy Is Reintroduced After Unplanned Interruption

2020 ◽  
Vol 19 ◽  
pp. 232595821989953
Author(s):  
Suzy Maria ◽  
Evy Yunihastuti ◽  
Siti Rizny F. Saldi ◽  
Zubairi Djoerban
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adjusted Odds Ratio ◽  
First Line ◽  
Factors Affecting ◽  
Virological Success ◽  
Virological Outcome ◽  
History Of

There is no guideline concerning choice of antiretroviral therapy (ART) for HIV-infected patients after unplanned interruption. We conducted a retrospective cohort study of HIV-infected patients reintroduced to first-line ART after having unplanned interruption for at least 1 month. Viral load was evaluated at 6 to 18 months after the reintroduction. There were 100 patients included in our study, and 55 of them achieved virological success. History of single interruption (adjusted odds ratio [aOR] 5.51%, 95% confidence interval [CI] 1.82-16.68, P = .003) and CD4 count ≥200 cell/mm3 at the time of reintroduction (aOR 4.33, 95% CI 1.14-16.39, P = .031) increased likelihood to achieve virological success.

Survival of Colorectal Cancer Patients in Brunei Darussalam: Comparison between 2002-09 and 2010-17

2020 ◽  
Author(s):  
Shirley Lee ◽  
Hanif Abdul Rahman ◽  
Nadiah 'Aqilah Abidin ◽  
Sok King Ong ◽  
Elvynna Leong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Survival Rates ◽  
Brunei Darussalam ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Overall Survival Rates

Abstract BACKGROUND Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Brunei Darussalam in 2017, posing a major burden on society. METHODS This retrospective cohort study (n = 1,035 patients diagnosed with CRC in Brunei Darussalam from 1st January 2002 until 31st December 2017) aims to compare the overall survival rates of CRC patients (2002-2017), to compare survival rates between two study periods (2002-2009 and 2010-2017) and to identify prognostic factors of CRC. Kaplan-Meier estimator and log-rank tests were performed to analyse the overall survival rates of CRC patients. Multiple Cox regression was performed to determine the prognostic factors of CRC with adjusted hazard ratios (Adj. HRs) reported. RESULTS The 1-, 3- and 5-year survival rates of CRC patients are 78.6%, 62.5%, and 56.0% respectively from 2002-2017. The 1-, 3-, and 5-year survival rates of CRC patients for 2002-2009 are 82.2%, 69.6%, and 64.7%; 77.0%, 59.1%, and 51.3% for 2010-2017 respectively. A significant difference in CRC patients’ survival rate was observed between the two study periods, age groups, ethnic groups, cancer stages, and sites of cancer (p<0.001). The Adjusted Hazard Ratios (Adj. HRs) were significantly higher in the 2010-17 period (Adj. HR=1.78, p<0.001), older age group (>=60 years) (Adj. HR=1.93, p=0.005), distant cancer (Adj. HR=4.69, p<0.010), tumor at transverse colon and splenic flexure of colon (Adj. HR=2.44, p=0.009), and lower in the Chinese group (Adj. HR=0.63, p=0.003). CONCLUSION This study highlights the lower survival rates of CRC patients in 2010-2017, Malays, older patients, distant cancer, and tumors located at the latter half of the proximal colon (transverse colon), and predominantly LCRC (splenic flexure, descending colon, sigmoid colon, overlapping lesion colon and colon (NOS), as well as the rectosigmoid junction and rectum (NOS)). Age, ethnicity, cancer stage, and tumor location are significant prognostic factors for CRC. These findings underscore the importance of public health policies and programmes to enhance awareness on CRC from screening to developing strategies for early detection and management, to reduce CRC-associated mortality.

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