scholarly journals Clinicopathologic Characteristics, Therapeutic Modalities and Survival Outcomes of Plasmablastic Lymphoma: A Real-World Study

2021 ◽  
Author(s):  
Yan-Hua Zheng ◽  
Hai-Tao Wang ◽  
Zhuo Wan ◽  
Biao Tian ◽  
Hong-Yuan Shen ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cox Model ◽  
Plasmablastic Lymphoma ◽  
Therapeutic Modality ◽  
Survival Outcomes ◽  
Rapid Progression ◽  
Clinicopathologic Characteristics ◽  
Therapeutic Modalities ◽  
Risk Of Death ◽  
Ann Arbor

Abstract Introduction: Plasmablastic lymphoma(PBL)，an extremely rare subtype of B-cell non-Hodgkin lymphoma(NHL), is characterized by aggressiveness, rapid progression and bleak prognosis. Neither standardized regimen nor consensus for PBL treatment has been established.Methods: We retrospectively analyzed the clinicopathologic characteristics, therapeutic modalities and survival outcomes of 418 patients registered in the Surveillance, Epidemiology, and End Results (SEER) database from 2008 to 2016 and 21 (19 treated) patients in our institution. Kaplan-Meier survival curves and log-rank test for overall survival (OS) and cancer-specific survival (CSS) were performed to compare each variable. Variables with statistical significance in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors.Results: In patient cohort from the SEER, PBL has a striking male predilection. The median OS for all PBL patients was 17 months. The 1-year,3-year and 5-year OS rate were 54.4%, 40.4% and 37.2% respectively. Patients who suffered from previous malignancy had a significant survival disadvantage compared to those without previous cancer. Patients with higher Ann Arbor stage at diagnosis were at higher risk of death than those with lower stage. Chemotherapy alone or chemotherapy combined with radiotherapy could significantly reduce the risk of death and extend the patients’ survival, yielding HR of 0.209(95%CI 0.152-0.288) and 0.187(95%CI 0.089-0.394), respectively. Radiation alone seemed useless. All patients from our institution were HIV-negative. The main therapeutic regimens were CHOP or CHOPE, DA-EPOCH, DHAP and ESHAP. Complete response (CR) was achieved in only 3 patients, while partial response (PR) in 10 patients. The median OS was 7 months. Fourteen patients later died of the disease progression.Conclusions: Previous malignancy history, Ann Arbor stage and therapeutic modality were independent prognostic factors. Bortezomib combined with DA-EPOCH may serve as an effective regimen for PBL. The optimal therapeutic modality necessitates further exploration.

scholarly journals Clinicopathologic characteristics, therapeutic modalities and survival outcomes of plasmablastic lymphoma: A real-world study

2021 ◽  
Author(s):  
Yan-Hua Zheng ◽  
Kun Xie ◽  
Hong-Yuan Shen ◽  
Zhuo Wan ◽  
Shan Gao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cox Regression ◽  
Statistical Significance ◽  
Plasmablastic Lymphoma ◽  
Therapeutic Modality ◽  
Survival Outcomes ◽  
Rapid Progression ◽  
Clinicopathologic Characteristics ◽  
Therapeutic Modalities ◽  
Risk Of Death

IntroductionPlasmablastic lymphoma(PBL)，an extremely rare subtype of B-cell non-Hodgkin lymphoma, is characterized by aggressiveness, rapid progression and bleak prognosis. Neither standardized regimen nor consensus for PBL treatment has been established.Material and methodsWe retrospectively analyzed the clinicopathologic characteristics, therapeutic modalities and survival outcomes of 418 patients registered in the Surveillance, Epidemiology, and End Results (SEER) database from 2008 to 2016 and 21 (19 treated) patients in our institution. Kaplan-Meier survival curves and log-rank test for overall survival and disease-specific survival were performed to compare each variable. Variables with statistical significance in the univariate Cox regression were incorporated into the multivariate model to determine the independent prognostic factors.ResultsIn patient cohort from SEER, PBL has a striking male predilection. The median OS for all PBL patients was 17 months. The 1-year,3-year and 5-year OS rate were 54.4%, 40.4% and 37.2% respectively.Chemotherapy alone or chemotherapy combined with radiotherapy could significantly reduce the risk of death and extend the patients’ survival, yielding HR of 0.209(95%CI 0.152-0.288) and 0.187(95%CI 0.089-0.394), respectively. Radiation alone seemed useless. All patients from our institution were HIV-negative. The main therapeutic regimens were CHOP or CHOPE, DA-EPOCH, DHAP and ESHAP. Complete response was achieved in only 3 patients, while partial response in 10 patients. The median OS was 7 months. Fourteen patients later died of the disease progression.ConclusionsPrevious malignancy history, Ann Arbor stage and therapeutic modality were independent prognostic factors. Bortezomib combined with DA-EPOCH may serve as an effective regimen for PBL. The optimal therapeutic modality necessitates further exploration.

Secondary surgery with intraoperative chemohyperthermia in recurrent ovarian adenocarcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5075-5075
Author(s):  
Jean Marc Bereder ◽  
Mariangella Desantis ◽  
Emmanuel Benizri ◽  
Abakar Abakar-mahamat ◽  
jean-Louis Bernard ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Survival Data ◽  
Peritoneal Cancer Index ◽  
Cox Model ◽  
Disease Free Survival ◽  
Ovarian Adenocarcinoma ◽  
Secondary Surgery ◽  
Risk Of Death

5075 Background: Optimal treatment of peritoneal recurrences in ovarian cancer is debating with second line chemotherapies. We proposed association of secondary surgery with heated intraperitoneal per operative chemotherapy (HIPEC). The aim of study is to determine prognostic factors in a single center cohort. Methods: Retrospective study of consecutive 169 patients with peritoneal recurrence from ovarian cancer were performed to evaluate HIPEC and to identify prognostic factors. Peritoneal Cancer Index (PCI) assess tumor load and completeness cytoreductive score (CCS) were used to give quality of resection CCS0 (no visible tumor), CCS1 (persistent diffuse lesions < 2.5mm), CCS2 (2.5mm <CC2< 25mm) and over CCS3 status. HIPEC is performed with platinum based regimen. Endpoint was survival. Cox's regression model was used for multivariate survival analysis and extending Cox model for modelling survival data. Results: We have operated on 197 procedures (HIPEC) in 169 patients from 2000 to 2011. Mean age was 58 years old range [28-75]. Median PCI was 10. After completion of resection, allocation of CCS was CCS0=120, CCS1=70, CCS2 & CCS3 =7. Procedure related mortality was 1% and morbidity 21%, mean length of hospital stay was 17 days range [7-51]. 3 and 5 years overall survival were respectively 64.7% and 37.4 %. Median survival was 47.6 months and the median disease free survival was 20 months. PCI >10 (even if complete resection performed) and CCS2&3 were worse prognostic factors (HR respectively = 2.64 IC 95% [1.29-5.36] and = 3.31 IC 95 % [1.55-7.08]). Modelling of these factors, is very strong to predict risk of death over the 2 first years after HIPEC. Conclusions: The chemo-hyperthermia is a standardized and reproducible feasible method. Less extensive disease and the quality of cytoreduction remain an independent factor of better outcome. To date HIPEC allows to reach the longest median time survival in peritoneal recurrent ovarian cancer. Modelling survival data is useful to know the risk of dying.

Prognostic factors for overall survival in non-Hodgkin lymphomas: Nonlinear effect of continuous covariates.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19538-e19538
Author(s):  
Claudio J. Flores ◽  
Luis Augusto Casanova
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Nonlinear Effect ◽  
Cox Model ◽  
Clinical Stage ◽  
Performance Status ◽  
P Value ◽  
Continuous Covariates ◽  
Ann Arbor

e19538 Background: To evaluate prognostic factors in patients with primary non-Hodgkin lymphomas (NHL). Methods: We retrospectively analyzed prognostic factors (PFs) for overall survival (OS) in 2160 patients (pts) with NHL treated at INEN between 1990-2002. PFs were determinate according to Cox model with P-splines. Results: The median age was 54 years (range 14 - 96) and 51% were male. The majority of the pts had good performance status (73%, WHO 0-1). The Ann Arbor stage was I-II in 51%, III-IV in 49% and B symptoms were present in 38% of the pts. The hemoglobin (Hb) was low in 48%. Leukocytes (WBC), lymphocytes and LDH were elevated in 17.7%, 7.7% and 60% of pts, respectively. Of all patients, 709 (32.8 %) pts had died. The median follow-up was 12.6 months, with a median survival of 61.8 months and the survival rate at 5 and 10 years of 51.2 % and 41.7 % respectively. PFs identified were: age, sex, zubrod, clinical stage, Hb, leukocytes, lymphocytes and LDH. The following table shows the p-value and hazard ratio (HR). The effect of continuous covariates in the log(HR) is non-linear. The cutoff points of highest (HR >1) match the clinically defined ones, which are: age >60yrs, Hb<12g/dl and LDH >240UI/L. Both leukocytes and lymphocytes have two higher risk breakpoints: leukocytes >3x103 and >10x103, lymphocytes <20% and >60%. Conclusions: PFs for OS in our group of pts were similar to other reports in NHL. Age, Hb, leukocytes, and lymphocytes are relevant to OS, which showed a nonlinear effect in the log (HR). [Table: see text]

Survival Outcomes and Prognostic Factors of Open Partial Laryngeal Surgery: A Thirty Years’ Experience

2020 ◽  
Vol 129 (7) ◽  
pp. 669-676
Author(s):  
Oreste Gallo ◽  
Angelo Cannavicci ◽  
Chiara Bruno ◽  
Giandomenico Maggiore ◽  
Luca Giovanni Locatello
Keyword(s):  
Prognostic Factors ◽  
Correct Selection ◽  
Survival Outcomes ◽  
Surgical Strategies ◽  
Risk Of Death ◽  
Laryngeal Surgery ◽  
Kaplan Meier ◽  
Surgical Expertise ◽  
Institutional Experience

Background: Open partial laryngeal surgery (OPLS) represents a wide array of procedures that can be fitted to treat different types of laryngeal cancer (LC). We would like to present our 30-years’ institutional experience, to analyze survival outcomes and to critically discuss prognostic factors. Methods: We reviewed all cases of OPLS performed at our Institution from 1982 to 2016 for LC. Survival analysis by Kaplan–Meier estimate was performed and prognostic variables by multivariate analysis were identified. Results: Mean follow-up time was 68.3 months, 30-day mortality 0.2%, subsequent functional total laryngectomy (TL) was 1.01%. Over 80% of cases were stage I to II. We had 25 local, 62 regional and eight distant recurrences. Local control was 94.9%, overall survival (OS) was 83.4% and disease-specific survival (DSS) was 87.7%. The two major risk factors significantly associated with the risk of death were cT and cN stage. CONCLUSIONS: We have confirmed that OPLS represents an oncologically sound option in the treatment of LC despite the emergence of non-surgical strategies and new transoral mininvasive techniques. Our results highlight that accurate staging, correct selection of the patient and a strong surgical expertise are of paramount importance in this type of surgery.

scholarly journals Clinical Characteristics and Prognostic Analysis of Multiple Myeloma with Extramedullary Disease: A SEER-Based Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Guang Li ◽  
Yan-Ping Song ◽  
Yao Lv ◽  
Zhen-Zhen Li ◽  
Yan-Hua Zheng
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Factors ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Cox Model ◽  
Rank Test ◽  
Time Interval ◽  
Risk Of Death ◽  
Extramedullary Disease ◽  
Prognostic Analysis

Background. Extramedullary disease (EMD), an infrequent manifestation of multiple myeloma (MM), can present at diagnosis or develop during the disease course. EMD can be clinically divided into bone-related EMD (EMD-B) and soft tissue-related EMD (EMD-S). The purpose of our study is to investigate the clinical characteristics, survival outcomes, and prognostic factors of MM patients with EMD. Methods. A total of 155 MM patients with EMD were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier survival curves and log-rank test for overall survival (OS) and myeloma-specific survival (MSS) were conducted to compare each potential variable. Variables with a p value <0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) >1 representing adverse prognostic factors. Results. The median age at diagnosis was 63 years old. EMD-B occurred in 99 patients (63.90%), while EMD-S occurred in 56 cases (36.10%). Patients with EMD-S had a significant survival disadvantage in MSS (HR = 1.844, 95% CI 1.117–3.042, p  = 0.017) and OS (HR = 1.853, 95% CI 1.166–2.942, p  = 0.009) compared to those with EMD-B. Patients with EMD interval ≤24 months were at higher risk of death than those with EMD at diagnosis in MSS (HR = 1.885, 95% CI 1.175–3.346, p  = 0.042) and in OS (HR = 1.33, 95% CI 1.119–2.529, p  = 0.036). Patients with EMD interval >24 months were at a lower risk of death as opposed to those with EMD at diagnosis. Conclusion. Age at MM diagnosis, site of EMD, and time interval from diagnosis to EMD occurrence were independent prognostic factors in MM patients with EMD. EMD-B bore a better prognosis than EMD-S.

scholarly journals Primary lymphoma of bone: a population-based study of 2558 patients

2020 ◽  
Vol 11 ◽  
pp. 204062072095853
Author(s):  
Chen-Xin Liu ◽  
Tian-Qi Xu ◽  
Li Xu ◽  
Pan-Pan Wang ◽  
Chun Cao ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Primary Tumor ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Primary Lymphoma ◽  
Anatomic Site ◽  
Risk Of Death ◽  
Ann Arbor

Background: Primary lymphoma of bone (PLB) is an extremely rare malignancy arising in the skeletal system. There is no consensus over the best definition of PLB. Most of the published articles are single-institutional retrospective studies with a limited sample size. The rarity of PLB and discrepancies on diagnostic criteria has resulted in a vague understanding of PLB. Methods We retrospectively analyzed the clinical characteristics and prognostic factors of 2558 PLB patients who were registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2016. Survival rates were calculated using the Kaplan–Meier method. The effects of various factors on survival outcomes were analyzed by using the log-rank test. Univariate and multivariate analyses were conducted by using the Cox proportional hazards model to determine independent prognostic factors. Results: The median follow-up time of all eligible patients was 58 months. There seemed no sex preponderance in PLB incidence. The most involved sites are axial skeletons. The most common histological subtype was diffuse large B-cell lymphoma. The 3-, 5-, 10-, and 20-year overall survival (OS) rates were 70.70%, 65.70%, 54.40% and 39.50%, respectively. PLB patients whose primary tumor sites were appendicular and craniofacial skeletons had a significant survival advantage [hazard ratio (HR) = 0.694, 95% confidence interval (CI) 0.552–0.872; HR = 0.729, 95% CI 0.597–0.889, respectively] over those with axial skeletons as primary tumor sites. Patients with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL)–mature B-cell lymphoma, and NHL-precursor-cell lymphoblastic lymphoma also had a significant OS advantage (HR = 0.392, 95% CI 0.200–0.771; HR = 0.826, 95% CI 0.700–0.973; and HR = 0.453, 95% CI 0.223–0.923, respectively). Patients with Ann Arbor stage III–IV at diagnosis were at higher risk of death than those with stage I–II (HR = 1.348, 95% CI 1.107–1.641). Chemotherapy was an independent favorable prognostic factor (HR = 0.734, 95% CI 0.605–0.890). Conclusions: Primary anatomic site, histology type, higher Ann Arbor stage and chemotherapy were independent prognostic factors. Chemotherapy played a pivotal role in PLB treatment.

Nasal and paranasal sinus mucosal melanoma: Long-term survival outcomes and prognostic factors

2021 ◽  
Vol 42 (6) ◽  
pp. 103070
Author(s):  
Nicholas B. Abt ◽  
Lauren E. Miller ◽  
Tara E. Mokhtari ◽  
Derrick T. Lin ◽  
Jeremy D. Richmon ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Paranasal Sinus ◽  
Mucosal Melanoma ◽  
Survival Outcomes ◽  
Term Survival ◽  
Long Term Survival

Prognostic factors and survival outcomes of women with uterine leiomyosarcoma: A Turkish Uterine Sarcoma Group Study-003

2021 ◽  
pp. 100712
Author(s):  
Ali Ayhan ◽  
Kemal Gungorduk ◽  
Ghanim Khatib ◽  
Zeliha Fırat Cüylan ◽  
Nurettin Boran ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Uterine Sarcoma ◽  
Survival Outcomes ◽  
Uterine Leiomyosarcoma

scholarly journals Comparative effectiveness of bisoprolol and carvedilol among patients receiving maintenance hemodialysis

2021 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Jia-Sin Liu ◽  
Yi-Chun Tsai ◽  
Mei-Chuan Kuo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ischemic Stroke ◽  
Lower Risk ◽  
Cox Model ◽  
Major Adverse Cardiovascular Events ◽  
Maintenance Hemodialysis ◽  
Risk Of Death ◽  
Relative Safety ◽  
Dialysis Vintage ◽  
All Cause Mortality

Abstract Background Despite widespread use, there is no trial evidence to inform β-blocker’s (BB) relative safety and efficacy among patients undergoing hemodialysis (HD). We herein compare health outcomes associated with carvedilol or bisoprolol use, the most commonly prescribed BBs in these patients. Methods We created a cohort study of 9305 HD patients who initiated bisoprolol and 11 171 HD patients who initiated carvedilol treatment between 2004 and 2011. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs) between carvedilol and bisoprolol users during a 2-year follow-up. Results Bisoprolol initiators were younger, had shorter dialysis vintage, were women, had common comorbidities of hypertension and hyperlipidemia and were receiving statins and antiplatelets, but they had less heart failure and digoxin prescriptions than carvedilol initiators. During our observations, 1555 deaths and 5167 MACEs were recorded. In the multivariable-adjusted Cox model, bisoprolol initiation was associated with a lower all-cause mortality {hazard ratio [HR] 0.66 [95% confidence interval (CI) 0.60–0.73]} compared with carvedilol initiation. After accounting for the competing risk of death, bisoprolol use (versus carvedilol) was associated with a lower risk of MACEs [HR 0.85 (95% CI 0.80–0.91)] and attributed to a lower risk of heart failure [HR 0.83 (95% CI 0.77–0.91)] and ischemic stroke [HR 0.84 (95% CI 0.72–0.97)], but not to differences in the risk of acute myocardial infarction [HR 1.03 (95% CI 0.93–1.15)]. Results were confirmed in propensity score matching analyses, stratified analyses and analyses that considered prescribed dosages or censored patients discontinuing or switching BBs. Conclusions Relative to carvedilol, bisoprolol initiation by HD patients was associated with a lower 2-year risk of death and MACEs, mainly attributed to lower heart failure and ischemic stroke risk.

Anaemia: A risk factor for death and adverse outcomes following surgery for acute lower limb ischaemia

Vascular ◽  
2021 ◽  
pp. 170853812110261
Author(s):  
Daniel Perren ◽  
Lauren Shelmerdine ◽  
Luke Boylan ◽  
Craig Nesbitt ◽  
James Prentis ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cox Model ◽  
Univariate Analysis ◽  
Adverse Outcomes ◽  
Limb Ischaemia ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Acute Limb Ischaemia ◽  
Impact On Survival ◽  
Poor Outcomes

Introduction Acute limb ischaemia (ALI) forms a significant part of the vascular surgery workload and carries with it high rates of morbidity and mortality. Anaemia is also common amongst vascular surgical patients and has been linked with poor outcomes in some subgroups. We aimed to assess the frequency of anaemia in patients with ALI and its impact on survival and complications following revascularisation to help direct future efforts to optimise outcomes in this patient group. Methods A retrospective analysis of prospectively collected departmental data on patients undergoing surgical intervention for ALI between 2014 and 2018 was performed. Anaemia was defined as a pre-operative haemoglobin (Hb) of <120 g/L for women and <130 g/L for men. The primary outcome was overall survival, assessed with the Kaplan–Meier estimator, with application of Cox proportional hazard modelling to adjust for confounding covariates. Results There were 158 patients who underwent treatment for ALI: 89 (56.3%) of these were non-anaemic with a mean Hb of 146 (SD = 18.4), and 69 (43.7%) were anaemic with a mean Hb of 106 (SD = 13.4). Anaemic patients had a significantly higher risk of death than their non-anaemic counterparts on univariate analysis (HR = 2.11, 95% CIs, 1.28–3.5, p = 0.0036). There was ongoing divergence in survival up to around 6 months between anaemic and non-anaemic groups. Under the Cox model, anaemia was similarly significant as a predictor of death (HR = 2.15, 95% CIs, 1.17–3.95, p = 0.013), accounting for recorded comorbidities, medication use and blood transfusion. Conclusions Anaemia is a significant and independent risk factor for death following revascularisation for ALI and can be potentially be modified. Vascular surgical centres should ensure they have robust pathways in place to identify and consider treating anaemia. There is scope for further work to assess how to best optimise a patient’s levels of circulating haemoglobin.

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