Results of Surgical Ttreatment of Patients With Cerebral Aneurysms in the Acute Period of Hemorrhage Transported Over a Considerable Distance

Relevance. To provide emergency specialized neurosurgical care to patients living in rural areas, medical evacuation to a neurosurgical hospital is required. Despite the fact that medical evacuation is a necessary stage of medical care, there are not enough studies on the impact of transportation of patients with a ruptured cerebral aneurysm over long distances. There is little information about the time intervals for transportation, the timing of the start of treatment and the outcomes of the disease in patients who are at a considerable distance from the neurosurgical hospital.Aim of the study. To analyze the impact on the extensive results of surgical treatment of patients with cerebral aneurysm rupture.Material and methods. A retrospective analysis of the results of surgical treatment of 145 patients with cerebral aneurysm rupture in the acute period of hemorrhage, hospitalized in the regional vascular center of the State Budgetary Institution of the Sakha Republic (Yakutia) “Republican Hospital No. 2 — Center for Emergency Medical Aid” in the period from 01.01.2017 to 31.12.2018. Patients were divided into two groups: Group I — patients from remote areas of the Republic of Sakha (Yakutia) who underwent medical evacuation by the Disaster Medicine Service of the Sakha Republic (Yakutia); Group II — hospitalized from the territory of the city of Yakutsk and its nearest suburbs.Results. 145 patients were hospitalized at the regional vascular center in Yakutsk. Sanaviation (Sanitary Aviation) delivered 91 patients from the districts of the republic to the regional vascular center (62.8% of the total number of patients) (Group I), 54 patients (37.2%) were hospitalized from the territory of the urban district of Yakutsk (Group II). The distance of transportation by ambulance aircraft in Group I ranged from 45 to 1330 kilometers. Deterioration from admission to the local medical organization to admission to the regional vascular center was noted in 8 patients (8.8%), improvement in the condition in 25 (27.5%) patients, there were no dynamics of changes in the state of 58 (63.7%) patients. The total number of deaths in two groups of patients was 11 (12.1%) patients. Postoperative mortality had no statistically significant differences between the two study groups: in Group I — 7.7% (7 patients), in Group II — 7.4% (4 observations) (p=1,000).Conclusions. With an established system of medical evacuation, transportation over a considerable distance does not worsen the course of the disease and the results of surgical treatment of patients with cerebral aneurysm ruptures in the acute period of hemorrhage.

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Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

Middle East Current Psychiatry ◽

10.1186/s43045-020-00060-x ◽

2020 ◽

Vol 27 (1) ◽

Author(s):

Um-e-Kalsoom ◽

Sabiha Khan ◽

Israr Ahmad

Keyword(s):

Quality Of Life ◽

Social Support ◽

Perceived Social Support ◽

Kidney Diseases ◽

Chronic Kidney Diseases ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

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The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2018.1.15 ◽

2018 ◽

Vol 90 (1) ◽

pp. 15

Author(s):

Ercan Ogreden ◽

Ural Oguz ◽

Erhan Demirelli ◽

Erdal Benli ◽

Özkan Özen

Keyword(s):

Ureteral Stone ◽

Ureteral Stones ◽

Stent Insertion ◽

Female Ratio ◽

Group I ◽

Dj Stent ◽

Group Ii ◽

Fat Stranding ◽

The Impact ◽

Perirenal Fat

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

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Psychosocial profile of encopretic children and their caregivers in relation to parenting style

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1297 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S362-S362 ◽

Cited By ~ 1

Author(s):

E. Zaky ◽

M. Rashad ◽

H. Elsafoury ◽

E. Ismail

Keyword(s):

Parenting Style ◽

Parenting Styles ◽

Healthy Controls ◽

Psychosocial Profile ◽

Group I ◽

Egyptian Children ◽

Paternal Anxiety ◽

Group Ii ◽

Anxiety Depression ◽

The Impact

BackgroundThe role of psychological factors in the development and maintenance of encopresis is controversial.ObjectivesAssessment of the psychosocial profile of encopretic children and their caregivers in relation to parenting style compared to controls.MethodologyThe current cross sectional study comprised 90 Egyptian children classified into three groups: group I (encopresis without constipation and overflow incontinence), group II (encopresis with constipation and overflow incontinence), and group III (clinically healthy controls); each group included 30 children. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children while caregivers were evaluated for their parenting styles, anxiety, depression, and introversion scores.ResultsHardness, undue blaming, and indecisive parenting styles were significantly more prevalent among caregivers of group I. Encopretic children of group I & II had poorer self-esteem and higher prevalence of clinically manifest depression compared to healthy controls. Furthermore, there was a higher prevalence of clinically manifest paternal anxiety, depression, and introversion and maternal depression among caregivers of group II and higher prevalence of clinically manifest paternal anxiety and depression among fathers of group I.ConclusionThe approach of toilet training, not the time of its initiation, seems to be the factor that really matters in predisposing to and perpetuating encopresis. Further exploration is needed to determine if the documented association of psychological disorders of enrolled encopretic children and their caregivers was causal or being just the impact of the child's encopresis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Results of modern tuboperitoneal infertility treatment

Vojnosanitetski pregled ◽

10.2298/vsp0901057t ◽

2009 ◽

Vol 66 (1) ◽

pp. 57-62 ◽

Cited By ~ 1

Author(s):

Drenka Turjacanin-Pantelic ◽

Dragana Bojovic-Jovic ◽

Biljana Arsic ◽

Eliana Garalejic

Keyword(s):

Statistical Analysis ◽

Surgical Treatment ◽

Infertility Treatment ◽

P Value ◽

Modern Approach ◽

Vitro Fertilization ◽

Group I ◽

Significant Difference ◽

Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

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Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

Vojnosanitetski pregled ◽

10.2298/vsp0808627k ◽

2008 ◽

Vol 65 (8) ◽

pp. 627-631

Author(s):

Tamara Kljakovic-Avramovic ◽

Miroslav Vukosavljevic ◽

Sinisa Avramovic

Keyword(s):

Surgical Treatment ◽

Prospective Study ◽

Children And Adolescents ◽

Deviation Angle ◽

Group Iii ◽

Military Medical Academy ◽

Group I ◽

Medical Academy ◽

Group Ii ◽

Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

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Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto202027316-26 ◽

2020 ◽

Vol 27 (3) ◽

pp. 16-26

Author(s):

Evgenii S. Baykov ◽

Alexey V. Peleganchuk ◽

Abdugafur J. Sanginov ◽

Olga N. Leonova ◽

Aleksandr V. Krutko

Keyword(s):

Surgical Treatment ◽

Blood Loss ◽

Perioperative Complications ◽

Sagittal Imbalance ◽

Radiological Parameters ◽

Results Of Treatment ◽

Group I ◽

Surgical Methods ◽

Group Ii ◽

Clinical And Radiological Results

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.

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Fracture resistance and 3D finite element analysis of machined ceramic crowns bonded to endodontically treated molars with two planes versus flat occlusal preparation designs: an in vitro study

F1000Research ◽

10.12688/f1000research.19455.2 ◽

2021 ◽

Vol 8 ◽

pp. 1020

Author(s):

Omnia Nabil ◽

Carl Hany Halim ◽

Ashraf Hassan Mokhtar

Keyword(s):

Stress Distribution ◽

Fracture Resistance ◽

Element Analysis ◽

3D Finite Element ◽

Mean Values ◽

Group I ◽

Group Ii ◽

The Impact ◽

Preparation Design ◽

Distribution Of Stresses

Background: The flat occlusal preparation design (FOD) of posterior teeth offers promising results of fracture resistance and stress distribution, but its application in vital teeth is limited as there may be a danger of pulp injury. Although this danger is omitted in endodontically treated teeth, there is no research work assessing the impact of FOD on the fracture resistance and distribution of stresses among these teeth. The aim of this study was to assess the impact of FOD of endodontically treated molars on the fracture resistance and distribution of stresses among a ceramic crown-molar structure when compared to the two planes occlusal preparation design (TOD). Methods: 20 human mandibular molars were endodontically treated and distributed equally to two groups: Group I (TOD) and Group II (FOD). Ceramic CAD/CAM milled lithium disilicate (IPS e.max CAD) crowns were produced for all preparations and adhered using self-adhesive resin cement. Using a universal testing machine, the fracture resistance test was performed. The fractured samples were examined using a stereomicroscope and scanning electron microscope to determine modes of failure. Stress distribution was evaluated by 3D finite element analysis, which was performed on digital models of endodontically treated mandibular molars (one model for each design). Results: Group II recorded statistically non-significant higher fracture resistance mean values (3107.2± 604.9 N) than Group I mean values (2962.6 ±524.27 N) as indicated by Student’s t-test (t=0.55, p= 0.57). Also, Group II resulted in more favorable failure mode as compared to Group I. Both preparation designs yielded low von-Mises stresses within the factor of safety. However, the stress distribution among different layers of the model differed. Conclusions: FOD having comparable fracture strength to TOD and a more favorable fracture behavior can be used for the preparation of endodontically treated molars.

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Hormonal status of patients after surgical treatment of fibrocystic mastopathy and possibilityes of its corrections

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.128 ◽

2017 ◽

pp. 128-131

Author(s):

Yu.Ya. Pryshash ◽

Keyword(s):

Surgical Treatment ◽

Standard Dose ◽

Treatment Phase ◽

Nodule Formation ◽

Double Dose ◽

Postoperative Rehabilitation ◽

Group Iii ◽

Group I ◽

Group Ii ◽

High Doses

The purpose of the study was to investigate the efficacy of Mastodynon in terms of indications in elevated doses versus the standard dose. Materials and methods. Data were analyzed for 60 patients after surgical treatment of fibro-cystic mastopathy. Depending on the postoperative therapy received by the patients, they were divided into three groups. Group I (n = 20): patients were observed in accordance with the standards established in mammal practice and did not receive special agents that affect hormonal homeostasis. Group II (n = 20): In addition to observation, patients received Mastodynon® (1 tablet or 30 drops 2 times a day) for 6 months. Group III (n = 20): Patients were given for a post-operative rehabilitation Mastodynon® in a double dose (2 tablets or 60 drops 2 times a day) for 6 months. Results Surgical treatment without conservative therapy eliminates organic changes in the thoracic glands (GH), but hormonal disorders that have led to pathologic and histological changes in the tissues of GZ continue to exist for a long time and can lead to repeated nodal formations. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. The use of Mastodynon® in standard doses (group II) for postoperative rehabilitation contributes to a significant improvement in hormonal homeostasis (normalization of prolactin, estradiol and progesterone levels), a 24.7 mm decrease in the degree of cyclic mastodynia according to the visual analog scale (VAS), and the improvement of ultrasound scan Pictures of GZ in 75% of patients. The most pronounced effect of this rehabilitation approach after the surgical treatment phase was noted for the use of Mastodynone in doble doses (2 tablets or 60 drops 2 times a day) in Group III. In these patients, the degree of reduction of cyclic mastodynia was 30 mm for VAS and positive changes in the tissues of GH were noted in 85% of patients. However, the highest incidence of adverse events was also noted in Group III, although they were temporary in nature and did not require withdrawal or dose reduction. Conclusion. Despite the presence of short-term side effects and rapid rebounding in the double-dose Mastodynon® group, our study showed better results than standard doses, faster and more stable therapeutic effect. Taking into account the results obtained, it can be argued that the use of high doses of Mastodynon® may be recommended to patients for the treatment of mastopathy. For a more complete study of such an important aspect as the tolerability of high doses of Mastodynon®, it is advisable to conduct more extensive studies, taking into account the dosage form and the use of other drugs. Key words: mastopathy, postoperative rehabilitation, Mastodynon®, mastodynia.

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Evolving Solutions in the Surgical Treatment of Isolated Pulmonary Valve Stenosis

10.37191/mapsci-jccr-2(3)-044 ◽

2021 ◽

Author(s):

Sonia B. Albanese Albanese

Keyword(s):

Surgical Treatment ◽

Pressure Gradient ◽

Pulmonary Valve ◽

Balloon Valvuloplasty ◽

Pulmonary Valve Stenosis ◽

Group I ◽

Mean Pressure ◽

Valve Function ◽

Group Ii

Background: Surgical treatment of isolated pulmonary valve stenosis in infants and children has evolved over the years, shifting from the original exclusive aim at lowering right ventricle pressure to the current concomitant focus on preserving pulmonary valve function. In our study, we sought to analyze the effect of such evolving philosophy on long-term results. Methods: All consecutive patients treated in our center between July 1983 and March 2019 were included. Patients were categorized into 2 groups based on the introduction into treatment practice of sparing valve techniques (1995). Actuarial survival, freedom from reintervention on the right outflow tract, transvalvular mean pressure gradient decrease, and pulmonary valve function at follow-up were analyzed. Results: One hundred twenty-three patients operated before (Group I, n=81) or since (Group II, n=42) 1995 were enrolled in the study. Mean age and weight were 3.0 ± 0.36 years and 16.6 ± 1.7kg, respectively. Early mortality occurred exclusively in 3 patients of Group 1. Transvalvular mean pressure gradient decreased in the entire patient population (from 63.28 ± 12.9mmHg to 16.46 ± 7.9mmHg). At a mean follow-up interval of 4.9 ± 33 years, freedom from death was comparable, but freedom from right ventricular outflow tract reintervention was significantly greater in Group II. Although the transvalvular gradient remained stable over time in non-reoperated survivors (mean value of 16.46 ± 7.9mmHg), pulmonary valve function on 2D-Echo showed severe incompetence in 2 patients of Group I and just mild to moderate incompetence in 20 patients of Group II, with a significantly negative effect of unsuccessful preoperative pulmonary balloon valvuloplasty (14/20 vs 6/20, p=0.025) in the latter. Conclusion: Current pulmonary valve sparing techniques are associated with better results, particularly in terms of freedom from re-interventions and pulmonary valve function at follow-up. Balloon valvuloplasty prior to surgery may worsen operative results, promoting pulmonary insufficiency and therefore should probably be avoided in all patients in whom anatomical characteristics predict failure of percutaneous therapy.

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Impact of Age on Short- and Long-Term Outcomes after Pancreatoduodenectomy for Periampullary Neoplasms

Gastroenterology Research and Practice ◽

10.1155/2020/1793051 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mario Gruppo ◽

Francesca Tolin ◽

Boris Franzato ◽

Pierluigi Pilati ◽

Ylenia Camilla Spolverato ◽

...

Keyword(s):

Overall Survival ◽

Elderly Patients ◽

Adjuvant Treatment ◽

Long Term Outcomes ◽

Group I ◽

Periampullary Neoplasms ◽

Short And Long Term ◽

Group Ii ◽

The Impact

Background. Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods. 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I (<75 years) and group II (≥75 years). Demographic features and intraoperative and clinical-pathological data were collected. Primary endpoints were perioperative morbidity and mortality; complications were classified according to the Clavien-Dindo Score. Secondary endpoints included feasibility of adjuvant treatment and overall survival rates. Results. A total of 106 patients were included in this study. There were 73 (68.9%) patients in group I and 33 (31.1%) in group II. Perioperative deceases were 4 (3.6%), and postoperative pancreatic fistulas were 34 (32.1%). Significant difference between two groups was demonstrated for the ASA Score (p=0.004), Karnofsky Score (p=0.025), preoperative jaundice (p=0.004), and pulmonary complications (p=0.034). No significance was shown for diabetes, radicality of resection, stage of disease, operative time, length of stay, postoperative complications according to the Clavien-Dindo Score, postoperative mortality, pancreatic fistula, and reoperation rates. 69.9% of the patients in group I underwent adjuvant treatment vs. 39.4% of the older ones (p=0.012). Mean overall survival was 28.5 months in group I vs. 22 months in group II (p=0.909). Conclusion. PD can be performed safely in elderly patients. Advanced age should not be an absolute contraindication for PD, even if greater frailty should be considered. The outcome of elderly patients who have undergone PD is similar to that of younger patients, even though adjuvant treatment administration is significantly lower, demonstrating that surgery remains the main therapeutic option.

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