scholarly journals New factors of pterygium occurrence and recurrence after surgical treatment

2021 ◽  
Vol 9 (2) ◽  
pp. 49-57
Author(s):  
K.O. Usenko
Keyword(s):  
Regression Analysis ◽  
Surgical Treatment ◽  
Mitomycin C ◽  
Mixed Infection ◽  
Stage Iv ◽  
Stage I ◽  
Braf Gene ◽  
Surgical Interventions ◽  
Barr Virus ◽  
Significant Difference

Background. Occurrence and recurrence of pterygium after surgical treatment are still urgent problems of modern ophthalmology. The purpose was to determine the main factors leading to the occurrence and recurrence of pterygium after surgical treatment. Materials and methods. We observed 203 patients (232 eyes) with pterygium. There were 108 men and 95 women. The age of patients ranged from 35 to 65 years. The duration of the disease is 2.5–2.7 years. Patients underwent surgical treatment for pterygium by the McReynolds’ method forming a cul-de-sac, by the Artl method with its incision, and the McReynolds and Artl methods using 0.02% solution of mitomycin C. The patients were examined in 3, 6 months, and one year after surgery. The statistical analysis of the results of clinical trials was performed using the software package SPSS 11.0, MedStat (Lyakh Y.E., Guryanov V.G., 2004–2012), MedCalc (MedCalc Software bvba, 1993–2013). Results. The results of clinical studies have found that the frequency of pterygium recurrence after traditional surgical interventions by the McReynolds method, the McReynolds method using 0.02% solution of mitomycin C, by the traditional Arlt method, the Arlt me­thod using 0.02% solution of mitomycin C in 3 months was 20, 17, 15, and 8.7 %, respectively; in 6 months — 29.5, 27, 27, and 26 %, respectively; after 1 year — 26.5, 26.5, 30.6, and 37 %, respectively. Long-term recurrence of pterygium did not differ significantly (p < 0.05). Viral infection was found in pterygium tissue in 50.9 % of cases, including herpesviruses (33.6 %) and human papillomavirus (HPV, 34.0 %). Among herpesviruses, herpes simplex virus (HSV) was found in 15.1 % of cases, cytomegalovirus (CMV) in 7.3 %, and Epstein-Barr virus (EBV) in 11.2 % of cases. The regression analysis showed an association of HSV with stage II and stage III pterygium (p < 0.05). No such dependencies were found for CMV and EBV. There was a relationship of HPV with the I–III stages of pterygium (p < 0.01). There were types 6 (34.2 %), 11 (24.1 %), 16 (21.5 %), and 18 (20.2 %) among HPV. Types 6 and 11 were mainly detected at the first stages and were not detected in stage IV; types 16 and 18 were not detected in stage I (p = 7.9e-04). Among other types, only HPV6 was associated with the I and III stages of pterygium (p < 0.05). Double mixed infection was detec­ted in 32.1 % of patients. The most common was the combination of HSV and HPV (30.6 % of all cases of mixed infection), three viruses — in 2.5 % of cases in the combination of HSV + CMV + HPV and HSV + EBV + HPV. It was first established that the V600E mutation of the BRAF gene was detected in 35.3 % of cases of pterygium. No significant difference in mutation frequency depending on the sex and age of patients was found. The frequency of mutation by stages increased from 21.3 % at stage I to 57.7 % at stage IV (p = 0.0003). The regression analysis showed a strong progressive association with the presence of the BRAF gene V600E mutation with the pterygium stage and, therefore, its progression. Conclusions. Thus, it was proved that the presence of HSV, HPV, and mutation V600E of the BRAF gene significantly influenced the occurrence and progression of pterygium after surgical treatment.

Anti-Epstein Barr Virus Antibody in Nasopharyngeal Carcinoma

1974 ◽  
Vol 83 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Mow-Ming Hsu ◽  
Jwo-Farn Chiou ◽  
Brian F. McCabe
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Geometric Mean ◽  
Stage Iv ◽  
Stage I ◽  
Clinical Staging ◽  
Control Groups ◽  
Barr Virus ◽  
Significant Difference ◽  
Epstein Barr

A retrospective study of anti-Epstein Barr virus (anti-EBV titers) in the sera of 400 patients with nasopharyngeal carcinoma (NPC) in Taiwan according to the clinical staging system of American Joint Committee is reported. Of NPC patients, 60% were seropositive (> 1:1640), while such values occurred only in 17.7, 10.9 and 20.6% respectively of normal adults, inflammatory diseases of the nose and throat, and head and neck tumor patients other than NPC (control groups). The geometric mean titer was 1:404 in NPC patients, and 1:116, 1:80 and 1:125 respectively in the three control groups. When 321 patients were staged, the seropositive rate increased successively from 12.5% in Stage I to 77.2% in Stage IV. Statistically, Stage I NPC patients had the same titer as the three control groups and a highly significant difference in chi-square tests from those in other stages. Radiotherapy did not influence the anti-EBV titers much; however, there was a definite decrease of titers in patients 7–18 months postradiotherapy. Thirty patients with recurrent disease and 28 patients with distant metastases demonstrated high positive titers and high geometric mean titers falling between those in Stage III and Stage IV. The correlation between EBV and NPC is discussed.

scholarly journals The Spectrum, Tendency and Predictive Value of PIK3CA Mutation in Chinese Colorectal Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Xinhui Fu ◽  
Hanjie Lin ◽  
Xinjuan Fan ◽  
Yaxi Zhu ◽  
Chao Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Regression Analysis ◽  
Stage Iv ◽  
Stage Iii ◽  
Wild Type ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Exon 9 ◽  
Exon 20

BackgroundPIK3CA is a high-frequency mutation gene in colorectal cancer, while its prognostic value remains unclear. This study evaluated the mutation tendency, spectrum, prognosis power and predictive power in cetuximab treatment of PIK3CA in Chinese CRC cohort.MethodsThe PIK3CA exon 9 and 20 status of 5763 CRC patients was detected with Sanger sequencing and a high-resolution melting test. Clinicopathological characteristics of 5733 patients were analyzed. Kaplan-Meier method and nomogram were used to evaluate the overall survival curve and disease recurrence, respectively.ResultsFifty-eight types of mutations in 13.4% (771/5733) of the patients were detected. From 2014 to 2018, the mutation rate of PIK3CA increased from 11.0% to 13.5%. At stage IV, exon 20 mutated patients suffered shorter overall survival time than wild-type patients (multivariate COX regression analysis, HR = 2.72, 95% CIs = 1.47-5.09; p-value = 0.012). At stage III, PIK3CA mutated patients were more likely to relapse (multivariate Logistic regression analysis, exon 9: OR = 2.54, 95% CI = 1.34-4.73, p = 0.003; exon 20: OR = 3.89, 95% CI = 1.66-9.10, p = 0.002). The concordance index of the nomogram for predicting the recurrence risk of stage III patients was 0.685. After cetuximab treatment, the median PFS of PIK3CA exon 9 wild-type patients (n = 9) and mutant patients (n = 5) did not reach a significant difference (3.6 months vs. 2.3 months, Log-rank test, p-value = 0.513).ConclusionsWe found that PIK3CA mutation was an adverse predictive marker for the overall survival of stage IV patients and recurrence of stage III patients, respectively. Further more, we suggested that PIK3CA exon 9 mutations are not negative predictors of cetuximab treatment in KRAS, NRAS, and BRAF wild-type mCRC patients.

A multicenter analysis of treatment and outcomes in neuroendocrine carcinoma of the uterine cervix (NCUC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17518-e17518
Author(s):  
Ashley Deanelle Hickman ◽  
Patrick Walsh McGarrah ◽  
Gretchen Glaser ◽  
Boris Naraev ◽  
Andrea Elisabeth Wahner Hendrickson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Survival ◽  
Multimodal Therapy ◽  
Stage Iv ◽  
Stage I ◽  
Stage Iii ◽  
First Line ◽  
Chemotherapy Agent ◽  
Significant Difference ◽  
Line Chemotherapy

e17518 Background: Morbidity and mortality for patients with cervical cancer has improved significantly over the past few decades with modern multimodal therapy. However, neuroendocrine carcinoma of the uterine cervix (NCUC), which accounts for 1-2% of cervical cancers, remains a deadly subtype. In this study, we combine data from Mayo Clinic (MC) and the University of Iowa Hospitals and Clinics (UIHC) to provide information on tumor characteristics, treatment, and outcomes. Methods: The electronic medical record was reviewed for patients with NCUC from MC and UIHC. Data on diagnosis, treatment, and outcomes were collected through chart review. Primary endpoints included progression-free survival (PFS) and overall survival (OS). Secondary endpoints included median survival, survival at 1 year after surgery, and survival at 1 year by first line chemotherapy agent. Kaplan-Meier survival analysis was used to estimate median PFS, median survival, and OS. Fisher’s test analysis was used to calculate survival at 1 year after surgery and by first line chemotherapy agent. Results: There were 62 patients (MC: 26, UIHCC: 36) with NCUC stage I-IV (stage I: 29, stage II: 9, stage III: 7, stage IV: 14, unknown: 3). Median age of diagnosis was 47 years (range 21-77 years). By subtype, 47 were small cell (76%), 9 were large cell (15%), and 6 were unknown/undetermined (9%). The initial treatment modalities for each patient are outlined in the table. 28 patients had complete/partial response or stable disease from first line treatment, while 10 patients had disease progression. Of the patients who initially responded or had stable disease, 16 later progressed (57%) with a median time to progression of 15 months. Median follow up was 65.1 months with a median OS of 28.5 months. Median survival for those with stage I was 40.9 months, stage II: 54.6 months, stage III: 8.75 months, and stage IV: 11.7 months. There was a significant difference in overall survival at 1 year between those who received surgery and those who did not in stage I/II ( p = 0.01). There was no significant difference in overall survival at 1 year for those who received surgery in stage III/IV. There was no statistical difference in survival at 1 year for carboplatin or cisplatin in combination with etoposide as first line chemotherapy agent. Conclusions: NCUC is an aggressive malignancy that is usually progressive despite multimodal therapy. Our study demonstrated a median overall survival of 28.5 months and 5-year survival rate of 21%. Our study showed a survival benefit at 1 year for those who receive surgery with stage I/II NCUC. There was no significant survival benefit at 1 year between carboplatin or cisplatin in combination with etoposide as first line agent.[Table: see text]

scholarly journals A Mitomycin C-Sparing Novel Technique for Subscleral Trabeculectomy in Primary Congenital Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ashraf Bor’i ◽  
Salah M. Al-Mosallamy ◽  
Tamer G. Elsayed ◽  
Wael M. El-Haig
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Congenital Glaucoma ◽  
Surgical Interventions ◽  
Primary Congenital Glaucoma ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Contralateral Eye

Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary congenital glaucoma. Methods. This study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I), while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). The mean preoperative intraocular pressure was 31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. The mean postoperative intraocular pressure was 9.0 ± 1.0, 11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and 17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. There was no statistically significant difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit. Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II (P>0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards associated with mitomycin C application.

scholarly journals Conservative Surgical Management of Stage I Bisphosphonate-Related Osteonecrosis of the Jaw

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Vescovi ◽  
Elisabetta Merigo ◽  
Marco Meleti ◽  
Maddalena Manfredi ◽  
Carlo Fornaini ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Staging System ◽  
Oral Pathology ◽  
Osteonecrosis Of The Jaw ◽  
Complete Healing ◽  
Stage I ◽  
Low Level Laser Therapy ◽  
Surgical Interventions ◽  
Level Laser ◽  
High Control

Purpose. To report the efficacy of conservative surgical treatment for stage I bisphosphonate-related osteonecrosis of the jaw (BRONJ).Materials and Methods. This study reports the clinical outcomes of 63 patients treated for BRONJ stage I (according to Ruggiero's staging system) at the Oral Pathology and Laser-Assisted Surgery Unit of the University of Parma between January 2004 and January 2011. Surgical interventions were performed, under local analgesia, in patients unresponsive for a period of six months to noninvasive treatments such as cycles of local or systemic antibacterial therapy combined or not to low level laser therapy, ozone therapy, or Hyperbaric Oxygen Therapy. All interventions were performed after the consultation of oncologist or physician.Results. In our experience, conservative surgical treatment is associated with the highest number of BRONJ healed sites in stage I disease. Complete healing was observed in 92.6% of sites surgically treated.Conclusions. This study confirms that treatment of patients affected by minimal bone exposition, (stage I of BRONJ), through conservative surgical strategies, possibly with laser, may result in a high control of the disease in the long term.

scholarly journals Comparison of the Clinical Efficacy of Draining Autovalve Limbosclerectomy and Trabeculectomy in the Treatment of Primary Open-Angle Glaucoma with Long-Term Follow-Up

2020 ◽  
Vol 17 (1) ◽  
pp. 49-55
Author(s):  
D. V. Lapochkin ◽  
V. I. Lapochkin ◽  
A. V. Lapochkin
Keyword(s):  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Stage Iv ◽  
Stage I ◽  
Control Group ◽  
Open Angle ◽  
Disposable Instruments

Purpose: to evaluate the immediate and long-term hypotensive efficacy, the number of complications, and the clinical benefits of a draining autovalve limbosclerectomy (DALS) performed using a kit of disposable instruments in patients with POAG of various stages in comparison with trabeculectomy (TE).Patients and Methods. The study is based on the analysis of the clinical and functional condition of 127 eyes of 127 patients with primary open-angle glaucoma (stage I POAG was detected in 2 eyes, stage II in 30 eyes, stage III in 88 eyes and stage IV in 7 eyes). Patients were divided into groups: the main group—76 people who underwent DALS using a set of disposable instruments, and the control group—51 people who underwent TE. The average age of patients is 68.9 ± 10.3 years. Before and within 24 months after surgery, all patients underwent standard diagnostic examinations. The initial level of IOP against the background of the maximum antihypertensive mode varied from 24 to 50 mm. Hg. According to gonioscopy, the angle of the anterior chamber was open in all cases (III–IV degree). Patient exclusion criteria: history of laser or surgical treatment of glaucoma, cataract treatment.Results. After 24 months of follow-up after DALS, the level of IOP in patients with stage I–II of POAG was 14.19 ± 1.83 mm Hg and with III–IV stage of POAG 14.95 ± 2.15 mm Hg, compensation was achieved in 88.2 % of patients without the use of antihypertensive drops. After TE, compensation was received in 72.6 % of patients, the IOP level was 16.9 ± 2.21 and 17.78 ± 2.31 mm Hg. respectively (p < 0.01). After DALS surgery, a decrease in the number of complications was revealed in comparison with TE: a decrease in сiliochoroidal detachment by 9.1 %, hyphema by 2.5 %, ophthalmic hypertension in the early p/o period by 3.2 %, cystic changes in the filtering bleb by 7.1 %.Conclusion. The standardized DALS operation using a disposable tool kit is a new highly effective and safe method for the surgical treatment of glaucoma. DALS may be the operation of choice in the treatment of POAG of all stages.

Surgical treatment of primary lung cancer in patients less than 40 years of age.

1994 ◽  
Vol 12 (5) ◽  
pp. 981-985 ◽  
Author(s):  
T Shimono ◽  
T Hayashi ◽  
M Kimura ◽  
I Yada ◽  
S Namikawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Older Patients ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iiia ◽  
Term Survival ◽  
Younger Patients

PURPOSE AND METHODS The major purpose of this study was to determine whether the survival rate in young lung cancer patients after surgical treatment differs from that in older patients. An analysis was performed for all patients with bronchogenic carcinoma who underwent surgery at Mie University Hospital from 1965 to 1990. RESULTS Of 803 patients, 24 (2.99%) were 33 to 39 years old. At the time of surgery, the disease was diagnosed as stage I in seven patients (29%), stage II in four (17%), stage IIIa in seven (29%), stage IIIb in two (8%), and stage IV in four (17%), while 46.3% of the patients older than 40 years of age had either stage IIIa, IIIb, or IV disease. All of the 24 patients less than 40 years of age underwent thoracotomy: curative resection in 14 cases, palliative resection in sex, and probe-thoracotomy in four. The 5-year survival rate for all stages of disease was 31.4% in these 24 patients, and 41.9% in 603 patients greater than 40 years of age. The 5-year survival rate for stage I disease was 35.7% in the seven younger patients and 78.0% in the 207 older patients; for stage II, it was 25.5% in the four younger patients and 40.6% in the 98 older patients; for stage III, it was 33.3% in the nine younger patients and 15.6% in the 250 older patients; and for stage IV, it was 25% in the four younger patients and 6.6% in the 48 older patients. There were no significant differences in survival rate between the two age groups for all patients or for those with each stage of disease. CONCLUSION Although younger patients tended to have more advanced disease, long-term survival in these patients did not differ from that of older patients.

scholarly journals The features of KRAS gene transcriptional activity and significance in colorectal cancer

2019 ◽  
Vol 23 (1) ◽  
pp. 153-158
Author(s):  
М. А. Shyshkin ◽  
V. A. Tumanskiy
Keyword(s):  
Mrna Expression ◽  
Transcriptional Activity ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Kras Gene ◽  
Ki 67 ◽  
Significant Difference ◽  
Medium Correlation

Colorectal adenocarcinoma (CRA) is the result of numerous mutations accumulation. The aim of the work was to study KRAS gene transcriptional activity at I, II, III, and IV stages of CRA development and to analyze the correlations between KRAS and Ki-67, TP53, CDH1, CTNNB1 genes transcriptional activity. Pathohistological and molecular-genetic study of surgical material from 40 patients with CRA, as well as sectional material of 10 fragments of the distal colonic wall was conducted. The following statistical methods were used: descriptive statistics, χ2 test, Kruskal-Wallis test, Spearman’s rank correlation coefficient. It was established that CRA is characterized by increased KRAS transcriptional activity: Me of mRNA expression is 0.42 (0.36; 0.43) at stage I, 1.31 (1.09; 2.91) at stage II, 1.75 (1.31; 2.93) at stage III, and 2.91 (1.85; 3.50) at stage IV. Decreasing of Ki-67 gene transcriptional activity was revealed: Me of mRNA expression is 3.20 (2.31; 3.59) at stage I, 2.92 (1.80; 3.50) at stage II, 1,27 (1.19; 2.08) at stage III, and 0.52 (0.28; 1.04) at stage IV. As about TP53 gene, increasing of transcriptional activity was detected: Me is 2.15 (0.82; 2.30) at stage I, 2.80 (1.32; 4.50) at stage II, 3.80 (2.32; 6.50) at stage III, 7.80 (5.99; 8.92) at stage IV. Also, a direct medium correlation between the KRAS and TP53 transcriptional activity levels was revealed. There is a decreasing of CDH1 transcriptional activity: Me is 0.88 (0.42; 1.14) at stage I, 0.48 (0.23; 1.13) at stage II, 0.15 (0.09; 0.36) at stage III and 0.08 (0.04; 0.41) at stage IV. A reverse medium correlation between KRAS and CDH1 was revealed. The study of CTNNB1 gene mRNA at different stages of CRA indicated the absence of statistically significant difference: Me is 2.88 (2.38; 5.38) at stage I, 3.83 (2.59; 5.99) at stage II, 2.02 (1.38; 6.95) at stage III, and 2.27 (1.23; 2.93) at stage IV. So, KRAS gene transcriptional activity increases from I to IV stages in CRA, affecting apoptosis and adhesive properties of cancer cells.

The Role of Bone Marrow Examination in the Initial Evaluation of Pediatric Hodgkin’ Disease: The Canadian Perspective.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2326-2326
Author(s):  
David C. Simpson ◽  
Jun Gao ◽  
Conrad V. Fernandez ◽  
Margaret Yhap ◽  
Victoria E. Price ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Bone Marrow Examination ◽  
Pet Scan ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Significant Difference ◽  
The Impact

Abstract Hodgkin’s Disease (HD) is the most common lymphoma affecting young adults and teenagers. Bone marrow involvement is rare but if present, infers Stage IV disease and an inferior outcome. Adult studies have suggested that bone marrow examination (BME) may not be necessary unless certain risk factors are present. However, some pediatric centers continue to perform BME routinely on all children with HD. BME is invasive and generally performed under conscious sedation in children. We validated and administered an internet-based survey to examine the practice of all Canadian pediatric oncologists regarding BME in children with HD. We also retrospectively evaluated the impact of routine BME on the HD patients treated at our institution over the past 27 years. Forty-three percent of eligible physicians (n=93) completed the survey and 16 of a total of 17 Canadian pediatric oncology centers were represented. BME universally consisted of bilateral bone marrow aspirates and trephine biopsies. Routine BME for Stage III and IV disease was consistently practised nationally (by 92% and 97% of respondents, respectively). By contrast, 54% and 70% of respondents reported performing routine BME in low stage (Stage I and II) disease, respectively. Respondents were more likely to report performing routine BME in low stage patients, if their pediatric hematology/oncology training was entirely outside Canada (p=0.04 for Stage I and p=0.07 for Stage II) and if they practiced at smaller centers (p=0.05 for Stage I and p=0.03 for Stage II). There were no differences in practice regarding BME associated with the number of years in practice or the number of patients seen annually by the respondent. If not part of routine staging for all patients, BME was more likely performed if there were “B” symptoms, cytopenias, and/or bulky disease. Most respondents (95%) would proceed with BME following a positive PET scan. In the review of local institutional practice, 62 patients with HD and BME were eligible for analysis. Only 4 patients (6.5%) had a positive BME. No patient with otherwise low stage disease was found to have bone marrow involvement. Two patients, who would have been assigned as Stage III disease, were upstaged to Stage IV due to their BME. Comparison of staging with and without BME demonstrated no significant difference. Hemoglobin level was found to be the to be the only significant risk factor for marrow involvement based on univariate analysis(put in statisticp=0.006). Age, gender, histologic subtype, presence of “B” symptoms, and other blood parameters (white count, platelets, ESR and transaminases) were not significant factors. Practice regarding BME in children with low stage HD is highly variable across Canada. Bone marrow examination in pediatric patients with low stage HD should be abandoned, unless there is a specific indication to do so (for example positive PET scan or unexplained anemia). Moreover, BME does not appear to add any additional therapeutic direction for higher stage patients.

A National Cancer Data Base report on mesothelioma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18501-e18501
Author(s):  
Lauren Brin ◽  
Mary Warlaumont ◽  
Timothy Fuller ◽  
Peter T. Silberstein
Keyword(s):  
Surgical Treatment ◽  
Private Insurance ◽  
Stage Iv ◽  
Standard Of Care ◽  
National Cancer Data Base ◽  
Stage I ◽  
National Cancer Database ◽  
Cancer Data ◽  
Stage Iv Disease ◽  
Receive Treatment

e18501 Background: This is the first report on mesothelioma using Commission on Cancer National Cancer Database information and this is the largest study on mesothelioma to date. Methods: Using the National Cancer Database (NCDB) 26,605 patients diagnosed with mesothelioma between 2000 and 2010 were identified and analyzed. The NCDB contains data from more than 70% of all new cancers diagnosed in the U.S. each year. Results: The majority of mesothelioma patients are Caucasian (89%), males (78%), over the age of 70 (60%), and are diagnosed with stage IV disease (41%). The majority of patients (41%) received no first course treatment. The patients that were most likely to have surgery include patients <70 years old, at academic centers, with stage I-III disease, and of these only 37% received surgery and 15% received no first course treatment. The youngest patients <50 years received the most surgical therapy (36%) and the oldest patients >80 received the least (12%). Patients with private insurance received more surgical treatment (28%) than patients with Medicaid (22%), Medicare (18%), and VHA (12%)(p<0.009). Private insurance holders also received no first course treatment less often (29.6%) than Medicaid (37%), Medicare (46%), VHA (52%), and uninsured patients (37%)(p<0.002). Conclusions: The majority of patients with mesothelioma are elderly, Caucasian males and many of which do not receive treatment. The standard of care for resectable stage I-III mesothelioma includes surgery and chemotherapy. The results from this study indicate that 41% of all patients received no first course treatment and only 21% of patients received surgical treatment. Of patients most likely to receive surgery, only 37% of patients received surgical treatment and 15% of these patients did not receive any first course treatment. Age and insurance status also affect treatment as the youngest patients and private insurance holders received the most surgical treatment. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document