scholarly journals Combination With Glucocoriticoids and/or Immunosuppressants Brings Few Benefits in Patients With Primary Biliary Cholangitis

2021 ◽  
Author(s):  
Zilong Wang ◽  
Rui Jin ◽  
Mei Hao ◽  
Yandi Xie ◽  
Hao Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Survival Rate ◽  
Triple Therapy ◽  
Primary Biliary Cholangitis ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year ◽  
The One

Abstract Objective To compare the efficacy of ursodeoxycholic acid (UDCA) monotherapy, and UDCA combined with glucocorticoids and/or immunosuppressants for patients with primary biliary cholangitis (PBC), and to search for relevant factors influencing the efficacy. Methods This retrospective study enrolled 266 patients who were initially diagnosed with PBC were grouped according to different treatment regimes. We analyzed and compared demographic characteristics, immune parameters, biochemistry profiles and other indicators collected at baseline, six months and one year of treatment. The prognosis was evaluated by Paris II standard and GLOBE score. T test, chi-square test and logistic regression were used for statistical analysis. Results According to Paris II standard and GLOBE score, there was no significant difference in one-year response rate and GLOBE score among the three treatment schemes (P > 0.05). GLOBE score > 0.3 indicated a decrease of the long-term survival rate, it was found that the long-term survival rate of the triple therapy group was significantly improved compared with the monotherapy group (p=0.005). Multivariate logistic regression analysis showed that PLT, ALP and ALB levels were risk factors for poor response. For the patients whose IgG levels were elevated but below twice upper limit of normal (ULN), the clinical benefit from combination therapy was not significant compared with monotherapy (p>0.05). Conclusion: Compared with monotherapy, the double therapy did not improve the one-year efficacy and long-term survival rate of PBC patients. However, triple therapy may improve the long-term survival rate of patients, although it does not significantly improve the one-year efficacy.

scholarly journals Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Retrospective Studies ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

Short-term efficacy and long-term survival of limited-stage small cell lung cancer treated with large fractionation radiotherapy and conventional fractionation radiotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20586-e20586
Author(s):  
Cheng Chen ◽  
Yingying Jiang ◽  
Ning Jiang ◽  
Kang He ◽  
Cheng Chen ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Dose ◽  
Survival Benefit ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Conventional Fractionation ◽  
Term Efficacy ◽  
Significant Difference

e20586 Background: Hyperfractionation (1.5Gy per dose twice a day, total dose 45Gy) or conventional fractionation (2Gy per dose once a day, total dose 60-70Gy) is the recommended dose fractionation for LS-SCLC. However, the optimal segmentation mode and dose of radiotherapy have not been determined. In this study, we evaluated the short-term efficacy and toxic and side effects of macrofractionation to explore the feasibility of macrofractionation radiotherapy in the treatment of LS-SCLC patients. Methods: From May 2011 to February 2020, 52 patients with LS-SCLC admitted to Jiangsu Cancer Hospital were retrospectively analyzed. The patients were divided into two groups according to the dose separation mode, including 29 cases in the large division group (3-4Gy per dose once a day, total dose 45-60Gy) and 23 cases (2Gy per dose once a day, total dose 50-68Gy) in the conventional division group. The short-term efficacy, 1-year survival rate and some other aspects of the two groups were compared. Results: The short-term overall response rate of large segmentation group was 79.3%, and there was significant difference compared with 52.2% of conventional segmentation group ( χ2 =4.293, P<0. 05) (Table). The 1-year survival rate of the large segmentation group was similar to that of the conventional segmentation group (82.8% vs．82.6%). The median survival time of large segment group was 30 months,which was not significantly different from the 34 months of conventional segment group (χ2=0.417, P>0.05). In terms of the effect of the two fractionated dose modes on long survival, 31.0% of patients in the large fractionation group survived more than 48 months, compared with only 13% in the conventional fractionation group. In addition, in the subgroup analysis of this study, it was found that compared with conventional fractionation radiotherapy, patients aged 45-65 years with ECOG score of 0-1 and lesions less than 5cm before radiotherapy could obtain more significant survival benefit from large fractionation radiotherapy, with statistically significant difference between the two groups (χ2=4.874, P<0.05). Conclusions: Large segmentation radiotherapy in the treatment of patients with LS-SCLC can improve the therapeutic effect and prolong the survival, especially for patients aged 45-65 years with ECOG score of 0-1 and lesions less than 5cm before radiotherapy , the survival benefit is more significant. In addition, large fractionated radiotherapy showed certain advantages in the long-term survival of patients with LS-SCLC, which is worthy of further clinical application.[Table: see text]

Prolonged prophylaxis against venous thromboembolism with enoxaparin in patients undergoing cancer surgery: long-term survival analysis

2006 ◽  
Vol 21 (4) ◽  
pp. 195-198 ◽  
Author(s):  
D Bergqvist ◽  
G Agnelli ◽  
A T Cohen ◽  
P E Nilsson ◽  
A Le Moigne-Amrani ◽  
...  
Keyword(s):  
Survival Rates ◽  
Palliative Surgery ◽  
Curative Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year ◽  
Type Of Surgery

Objective: ENOXACAN II was a randomized, double-blind trial that showed prolonged (four-week) thromboprophylaxis with enoxaparin to be more effective than and as safe as standard (one-week) thromboprophylaxis in patients undergoing surgery with a curative intent for abdominopelvic cancer. This follow-up study compared long-term, all-cause mortality in both groups. Methods: Survival rates were calculated on the randomized, treated population ( n = 501). The primary efficacy endpoint was survival at one year. An exploratory analysis including survival data up to 44 months was performed. Because some patients were deemed to have undergone palliative as opposed to curative surgery, and there was a significant difference between the treatment groups in the percentage of patients undergoing palliative surgery, the survival analyses were adjusted for the type of surgery performed. Results: When adjusted for type of surgery, there was a trend towards reduced mortality among patients undergoing palliative surgery in the prolonged prophylaxis group (hazard ratio [HR] = 0.598, P = 0.3565) that became more pronounced beyond the pre-specified one year follow-up period (HR = 0.469, P = 0.078). This trend may reflect a beneficial effect of prolonged prophylaxis on survival in the palliative surgery group (one-year survival 65.4 versus 50% for standard prophylaxis). In patients undergoing curative surgery, one-year survival rates were equal in the standard and prolonged prophylaxis groups (93.8 and 93.2%, respectively). Conclusion: Prolonged thromboprophylaxis with enoxaparin may affect long-term survival in palliative surgery for cancer, but further investigation is warranted.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

Long-term survival rate of teeth receiving multidisciplinary endodontic, periodontal and prosthodontic treatments

2014 ◽  
Vol 41 (3) ◽  
pp. 236-242 ◽  
Author(s):  
A. S. Moghaddam ◽  
G. Radafshar ◽  
M. Taramsari ◽  
F. Darabi
Keyword(s):  
Survival Rate ◽  
Term Survival ◽  
Long Term Survival

Octogenarian Patients with Colon Cancer – Postoperative Morbidity and Mortality are the Major Challenges

2021 ◽  
Author(s):  
Øystein Høydahl ◽  
Tom-Harald Edna ◽  
Athanasios Xanthoulis ◽  
Stian Lydersen ◽  
Birger Henning Endreseth
Keyword(s):  
Colon Cancer ◽  
Survival Rate ◽  
Emergency Surgery ◽  
Relative Survival ◽  
Curative Intent ◽  
Term Survival ◽  
Younger Patients ◽  
Long Term Survival ◽  
Over Time

Abstract Background Few studies have addressed colon cancer surgery outcomes in an unselected cohort of octogenarian patients. The present study aimed to evaluate the relative survival of octogenarian patients after a major resection of colon cancer with a curative intent. Methods All patients diagnosed with colon cancer at Levanger Hospital between 1980 and 2016 were included. We performed logistic regression to test for associations between 100-day mortality and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.Results Among 239 octogenarian patients treated with major resections with curative intent, the 100-day mortality was 10.1%. Among 215 patients that survived the first 100 days, the five-year relative survival rate was 99.7%. The 100-day mortality of octogenarian patients was significantly shorter than that of younger patients, but the long-term survival converged with that of younger patients. Among octogenarian patients, the incidence of colon cancer more than doubled during our 37-year observation period. The relative increase in patients undergoing surgery exceeded the increase in incidence; hence, more patients were selected for surgery over time. A high 100-day mortality was associated with older age, a high American Society of Anaesthesiologists (ASA) score, and emergency surgery. Moreover, worse long-term survival was associated with a high Charlson Comorbidity Index, a high ASA score, a worse TNM stage, emergency surgery and residual tumours. Both the 100‑day and long-term survival rates improved over time. Conclusion Among octogenarian patients with colon cancer that underwent major resections with curative intent, the 100-day mortality was high, but after surviving 100 days, the relative long-term survival rate was comparable to that of younger patients. Further improvements in survival will primarily require measures to reduce the 100-day mortality risk.

Long Term Survival Rate and Prognostic Factors of Acute Myocardial Infarction

1999 ◽  
Vol 29 (1) ◽  
pp. 14 ◽  
Author(s):  
Seok-Yeon Kim ◽  
Joo-Yong Han ◽  
Yong-Jin Kim ◽  
Ji-Dong Sung ◽  
In-Ho Chae ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Term Survival ◽  
Long Term Survival

Identification of characteristics associated with long-term survival in patients with metastatic urothelial carcinoma (mUC) who received durvalumab (D) with or without tremelimumab (T) in clinical studies.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 441-441
Author(s):  
Marie Alt ◽  
Carlos Stecca ◽  
Shaum Kabadi ◽  
Benga Kazeem ◽  
Srikala S. Sridhar
Keyword(s):  
Logistic Regression ◽  
Phase I ◽  
Regression Model ◽  
Clinical Studies ◽  
Logistic Regression Model ◽  
Multivariate Logistic Regression Model ◽  
Multivariate Logistic Regression ◽  
Term Survival ◽  
Long Term Survival

441 Background: Immune checkpoint inhibitors (ICI) have changed the landscape of mUC, yet outcomes are variable as some patients (pts) do not respond to treatment while others have a durable response. To optimally select pts who may derive benefit from ICIs, predictive factors are required. This retrospective, post-hoc analysis evaluated pt characteristics to determine differences between short and long-term survivors among pts with mUC who received D (anti–PD-L1) with or without T (anti–CTLA-4) in two clinical studies. Methods: Pts with platinum-refractory mUC who received D monotherapy in the phase I/II study 1108 (10 mg/kg Q2W, up to 12 mo) or D+T in the phase I study 10 (D at 20 mg/kg + T at 1 mg/kg Q4W for 4 mo, then D at 10 mg/kg Q2W for 12 mo) were included. Pt characteristics, tumor characteristics, radiological assessments, and biological assessments were collected. The primary outcome measure was long-term overall survival (OS). Pts were categorized as OS ≥2 yrs (from 1st dose of study drug) or OS <2 yrs. A univariate analysis was conducted on each baseline characteristic to assess independent associations with long-term OS; a multivariate logistic regression model was employed including each variable with a p-value ≤0.1 as factors or covariates. Results: A total of 367 pts with mUC were included in the analysis: 88 (24.0%) had OS ≥2 yrs (range: 2.09–4.99) and 279 (76.0%) had OS <2 yrs (range: 0.03–1.98). Pts with OS ≥2 yrs had a significantly higher objective response rates than those with OS <2 yrs (71.6% vs 5.7%; p<0.0001) and a significantly longer duration of response (median 2.3 yrs vs 0.39 yrs; p<0.0001). The characteristics included in the multivariate logistic regression model are listed in the Table. Long-term OS was significantly associated with ECOG PS, PD-L1 status, baseline hemoglobin level, and baseline absolute neutrophils count. Conclusions: Our analyses show that several characteristics, including tumor response to treatment, are associated with long-term OS for pts with mUC treated with D or D+T. Further investigation into these and other characteristics may provide additional insights into long-term survival outcomes with ICIs. [Table: see text]

O193 ROLE OF MALNUTRITION IN 0ESOPHAGEAL SURGERY FOR CANCER

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
R Alfieri ◽  
M Nardi ◽  
V Moretto ◽  
E Pinto ◽  
M Briarava ◽  
...  
Keyword(s):  
Weight Loss ◽  
Postoperative Complications ◽  
Nutritional Status ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Oesophagogastric Junction ◽  
Significant Difference ◽  
The Impact

Abstract Aim To investigate whether preoperative malnutrition is associated with long term outcome and survival in patients undergoing radical oesophagectomy for oesophageal or oesophagogastric junction cancer. Background & Methods Dysphagia, weight loss, chemo-radiationtherapy frequently lead to malnutrition in patients with oesophageal or oesophagogastric junction cancer. Severe malnutrition is associated with higher risk of postoperative complications but little is known on the correlation with long term survival. We conducted a single center retrospective study on a prospectively collected database of patients undergoing oesophagectomy from 2008 and 2012 in order to evaluate the impact of preoperative malnutrition with postoperative outcome and long term survival. Preoperative malnutrition was classified as: prealbumin level less than 220 mg/dL (PL), MUST index (Malnutrition Universal Screeening Tool) >2 and weight loss >10%. Results 177 consecutive patients were considered: due to incomplete data 60 were excluded from the analysis that was performed on 117 patients. PL was reported in 52 (44%) patients, MUST index was recorded in 62 (53%), 58 (49%) patients presented more than 10% weight loss at the preoperative evaluation. PL was associated with more postoperative Clavien-Dindo 1-2 complications (p=0.048, OR 2.35 95%IC 1.001-5.50), no differences were observed in mortality, anastomotic leak, major pulmonary complications. MUST index was not correlated with postoperative complications nor mortality but resulted worse in patients treated with chemo-radiotherapy (p=0.046, OR 1.92 95%CI 1.011-3.64). Weight loss >10% was not associated with postoperative complications or mortality. Overall 7 years survival rate was 69%. and DFS was 68%. Malnourished patients did not differ from non-malnourished regarding age, sex, tumor site, tumor stage and histology. No significant difference in 7 years survival rates was observed in patients with PL <220 mg/dL ( 55 % vs 67%), neither in patients with MUST score>2 (58% vs 72%), nor in patients with weight loss >10% (53% vs 70%). Conclusions Malnutrition is more common in patients treated with chemoradiation therapy and it is associated with postoperative complications. However, both long term and disease free survival are not affected by preoperative nutritional status. Larger patient population and data on long term postoperative nutritional status will be analyzed in further studies.

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