Lymphadenectomy in the Treatment of Colon Cancer: A Survival Nalysis

Colon cancer is a curable disease when restricted to the bowel and colectomy, the primary treatment. However, the presence and number of resected lymph nodes influence the therapeutic approach and prognosis of the patient. To evaluate the impact of the number of resected lymph nodes on the overall survival of patients treated for colon cancer at the League of Cancer Hospital - Natal - State of Rio Grande do Norte (RN) - Northeast Brazil. A retrospective observational study of 80 patients with colon cancer from Dr. Luiz Antônio Hospital (Natal-RN / Brazil), considering the period 2007-2014. Data were collected through medical records review. Survival rates were calculated and compared using the non-parametric Kaplan-Meier and Wilcoxon tests, respectively. All patients underwent radical surgical treatment associated or not with chemotherapy and/or radiotherapy treatment. The median survival time for the group of patients who had 12 or more resected lymph nodes was 9.4 years, in contrast to the 3.3 years of those who had less than 12 lymph nodes. Conclusion: It was concluded that a total of 12 or more resected lymph nodes confirmed by histopathology is associated with increased long-term survival in patients with colon cancer undergoing radical colectomy with or without chemotherapy and radiotherapy.

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Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

The Heart Surgery Forum ◽

10.1532/hsf98.20111084 ◽

2012 ◽

Vol 15 (1) ◽

pp. 4 ◽

Cited By ~ 23

Author(s):

David M. Holzhey ◽

William Shi ◽

A. Rastan ◽

Michael A. Borger ◽

Martin H�nsig ◽

...

Keyword(s):

Aortic Valve ◽

Survival Rates ◽

Long Term Results ◽

Term Survival ◽

Kaplan Meier ◽

Risk Patients ◽

Short And Long Term ◽

Good Treatment Option ◽

Matched Comparison

Introduction: The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).Patients and Methods: All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.Results: The 30-day mortality rate was 10.8% and 8.4% (P = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, P = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, P = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).Conclusion: Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.

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Inter-relationships between Gender, Frailty and 10-Year Survival in Older Italian Adults: an observational longitudinal study

Scientific Reports ◽

10.1038/s41598-019-54897-2 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Graziamaria Corbi ◽

Francesco Cacciatore ◽

Klara Komici ◽

Giuseppe Rengo ◽

Dino Franco Vitale ◽

...

Keyword(s):

Longitudinal Study ◽

Cox Model ◽

Survival Rates ◽

Staging System ◽

Female Gender ◽

Term Survival ◽

Fractional Polynomial ◽

The Impact

AbstractAim of the present study was to assess the impact of gender on the relationship between long-term mortality and clinical frailty. In an observational, longitudinal study on 10-year mortality, we examined 1284 subjects. The Frailty Staging System was used to assess frailty. The Cox model was employed to assess variables independently associated with survival using a backward stepwise algorithm. To investigate the possible interactions between gender and the selected variables, an extension of the multivariable fractional polynomial algorithm was adopted. Women were more likely to be older, have a higher disability, present with more comorbidities, consume more drugs, be frail and have a higher rate of survival at the follow-up than were men. At the Cox multivariate analysis only age (HR 2.26), female gender (HR 0.43), and number of drugs (HR 1.57) were significant and independent factors associated with all-cause mortality. In the survival analyses, only frailty (vs no frailty) showed significant interaction with gender (p < 0.001, HR = 1.92). While the presence of frailty reduced the survival rate in women, no effect was observed in men. Importantly, frail women showed higher survival rates than did both frail and no frail men. The main finding of the present study is that gender shapes up the association between frailty and long-term survival rates.

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Extended ray resection for sarcoma of the hand: long-term survival and functional results

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193419885039 ◽

2019 ◽

Vol 45 (2) ◽

pp. 160-166 ◽

Cited By ~ 1

Author(s):

Farhad Farzaliyev ◽

Hans-Ulrich Steinau ◽

Halil-Ibrahim Karadag ◽

Alexander Touma ◽

Lars Erik Podleska

Keyword(s):

Soft Tissue ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

Functional Results ◽

Contralateral Side ◽

Level Of Evidence ◽

Term Survival ◽

Kaplan Meier

In this retrospective study, we analysed the long-term oncological and functional results after extended ray resection for sarcoma of the hand. Recurrence-free and overall survivals were calculated using the Kaplan–Meier method. The function of the operated hand was assessed with the Michigan Hand Questionnaire and compared with the contralateral side. Extended ray resection was performed in 25 out of 168 consecutive patients with soft-tissue and bony sarcomas of the hand. The overall 5- and 10-year, disease-specific survival rates were 86% and 81%, respectively. Local recurrences were observed in two patients. The Michigan Hand Questionnaire score for the affected hand at follow-up in nine patients was 82 points versus 95 for the healthy contralateral hands. We conclude that extended ray resection of osseous sarcomas breaking through the bone into the soft tissue or for soft tissue sarcomas invading bone is a preferable alternative to hand ablation when excision can be achieved with tumour-free margins. Level of evidence: III

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Sentinel lymph node in colorectal cancer — 5 years follow up

Open Medicine ◽

10.2478/s11536-011-0020-6 ◽

2011 ◽

Vol 6 (3) ◽

pp. 271-278

Author(s):

Jacek Zielinski ◽

Radoslaw Jaworski ◽

Pawel Kabata ◽

Robert Rzepko ◽

Wiesław Kruszewski ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Nodes ◽

Histopathological Examination ◽

Survival Rates ◽

Surgical Oncology ◽

Blue Dye ◽

Chi Square ◽

Regional Lymph Nodes ◽

Term Survival ◽

The Impact

AbstractTo assess the impact of micrometastases in sentinel and non-sentinel lymph nodes on long-term survival rates of patients treated for colorectal cancer (CRC). Data of 57 patients diagnosed with CRC and treated in the Department of Surgical Oncology in Gdansk in the years 2002–2006 were retrospectively analyzed. Clinico-histopathological data were analyzed using chi-square tests. The effect on long-time survival rates was analyzed using Kaplan-Meier survival probability estimates. Identification of the SLN was performed using the blue dye staining method. All regional lymph nodes were subject to standard histopathological examination. Additionally in 32(56.14%) patients whose nodes were found negative for metastases on standard staining further immunohistochemical analyses were performed. In the analyzed group SLNB was performed in 42(73.7%) patients with colon cancer and in 15(26.3%) with rectal cancer. Identification of the SLN was possible in 45(78.9%) patients. The sensitivity of SLNB was 33%. False negatives were found in 66%. SLNB is a feasible method in CRC patients. We presume that lack of micrometastases in the SLN and non-SLN cannot be regarded as a prognostic factor.

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Institutional volume affects long-term survival following lung transplantation in the USA

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz014 ◽

2019 ◽

Vol 56 (2) ◽

pp. 271-276 ◽

Cited By ~ 6

Author(s):

Arman Kilic ◽

Thomas G Gleason ◽

Hiroshi Kagawa ◽

Ahmet Kilic ◽

Ibrahim Sultan

Keyword(s):

Lung Transplantation ◽

High Volume ◽

Term Survival ◽

Long Term Survival ◽

Kaplan Meier ◽

The Usa ◽

Institutional Volume ◽

Low Volume ◽

The Impact

Abstract OBJECTIVES The aim of this study was to evaluate the impact of institutional volume on long-term outcomes following lung transplantation (LTx) in the USA. METHODS Adults undergoing LTx were identified in the United Network for Organ Sharing registry. Patients were divided into equal size tertiles according to the institutional volume. All-cause mortality following LTx was evaluated using the risk-adjusted multivariable Cox regression and the Kaplan–Meier analyses, and compared between these volume cohorts at 3 points: 90 days, 1 year (excluding 90-day deaths) and 10 years (excluding 1-year deaths). Lowess smoothing plots and receiver-operating characteristic analyses were performed to identify optimal volume thresholds associated with long-term survival. RESULTS A total of 13 370 adult LTx recipients were identified. The mean annual centre volume was 33.6 ± 20.1. After risk adjustment, low-volume centres were found to be at increased risk for 90-day mortality, [hazard ratio (HR) 1.56, P < 0.001], 1-year mortality excluding 90-day deaths (HR 1.46, P < 0.001) and 10-year mortality excluding 1-year deaths (HR 1.22, P < 0.001). These findings persisted when the centre volume was modelled as a continuous variable. The Kaplan–Meier analysis also demonstrated significant reductions in survival at each of these time points for low-volume centres (each P < 0.001). The 10-year survival conditional on 1-year survival was 37.4% in high-volume centres vs 28.0% in low-volume centres (P < 0.001). The optimal annual volume threshold for long-term survival was 26 LTx/year. CONCLUSIONS The institutional volume impacts long-term survival following LTx, even after excluding deaths within the first post-transplant year. Identifying the processes of care that lead to longer survival in high-volume centres is prudent.

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Factors affecting survival in laparoscopic vs. open surgery among stage III colon cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15095 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15095-e15095

Author(s):

Yang Zhang ◽

Ryan W Walters ◽

Peter T. Silberstein

Keyword(s):

Colon Cancer ◽

Open Surgery ◽

Private Insurance ◽

Stage Iii ◽

Term Survival ◽

Risk Of Death ◽

Stage Iii Colon Cancer ◽

Kaplan Meier ◽

Facility Level

e15095 Background: The role of laparoscopic surgery (LS) in the cure of advanced non-metastatic colon cancer is controversial. The study aims to define long-term survival of LS and open surgery (OS) of stage III colon cancer as well as to examine factors that influence the choice in surgical approaches. Methods: We abstracted 22,821 patients from the National Cancer Database who were diagnosed with stage III colon cancer from 2010 to 2012 who had undergone surgery of their primary site by either LS or OS; we only included patients who had also received adjuvant chemotherapy. The probability of undergoing a LS or OS was estimated using multivariable marginal logistic regression model, whereas the between-procedure survival difference was estimated with the Kaplan-Meier method with associated log-rank test and a multivariable marginal Cox regression model. Results: Holding the patient- and facility-level characteristics constant, significantly greater odds of receiving LS was associated with private insurance, patients living in areas with higher socio-economic status, patients receiving care at academic facilities, and patients living in the northeast United States. Kaplan-Meier results indicated that patients undergoing LS had significantly longer survival compared to patients undergoing OS (χ21 = 111.6, p < .001). Table 1 shows three-year survival estimates. After adjusting for the patient- and facility-level covariates, patients who underwent LS had 26.7% lower risk of death compared to those undergoing OS (95% CI: 21.7% to 31.4%, p < .001). In general, lower adjusted risk of death was observed in patients who were younger, female, as well as patients with fewer comorbid conditions and those with private insurance (all p< .05). Conclusions: In this largest, most recent analysis of surgical treatment of stage III colon cancer, our data suggest that long-term survival after LS is superior to conventional OS. Identification of associated demographic factors may prove useful for future allocation of treatment resources. [Table: see text]

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Abstract 14472: Indications for ICD Implantation Differ Between Women and Men

Circulation ◽

10.1161/circ.142.suppl_3.14472 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sebastian Ingelaere ◽

Ruben Hoffmann ◽

Georges Mairesse ◽

Yves R Vandekerckhove ◽

Jean-Benoît le Polain de Waroux ◽

...

Keyword(s):

Logistic Regression ◽

Nyha Class ◽

Total Mortality ◽

Categorical Variables ◽

Multivariate Logistic Regression ◽

Icd Implantation ◽

Term Survival ◽

Kaplan Meier ◽

The Impact

Introduction: The impact of gender on ICD implantation practice and survival remain a topic of controversy. We analysed differences between men and women in patients implanted with an ICD in Belgium. Methods: The Belgian governmental health care institution (RIZIV/INAMI) keeps track of every ICD implantation by a digital registry. Participation is mandatory for reimbursement. From this registry, we analysed all new ICD implantations between 01/02/2010 and 31/01/2019 in Belgian patients. We compared men with women for baseline patient characteristics. We used a Chi 2 test for categorical variables (NYHA class, primary vs secondary prevention, underlying heart disease, type of device, QRS duration, presence of atrial fibrillation, diabetes and other comorbidity, center volume, population density and average income of the area of residency) and a Mann-Whitney U test for continuous variables [age and ejection fraction(EF)]. We used the Bonferroni method to correct for multiple testing. Secondly, we performed a Kaplan-Meier analysis. At last, we performed a multivariate logistic regression for 3-year and total mortality. Results: Only 3146 (20.8%) on 14747 implantations were in women. Women were significantly younger and had a better EF compared to men. Except for oncological history, women had less comorbidities (table 1). More women functioned in NYHA class > II and had a QRS > 150ms, which was consistent with a higher CRT-D vs VVI/DDD ratio. Kaplan-Meier showed a survival benefit in women (log-rank, p=<0.001). Further exploration with multivariate logistic regression showed that female gender was significant protective for long-term total mortality, but not for short-term 3-year mortality. Conclusions: Only a minority of patients implanted with a new ICD in Belgium are women. Their clinical profile differs from men. Their long-term survival is better, which can in part be explained by differences in indications and comorbidities.

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Long-term Results after Carpentier-Edwards Pericardial Aortic Valve Implantation, with Attention to the Impact of Age

The Heart Surgery Forum ◽

10.1532/hsf98.20101140 ◽

2011 ◽

Vol 14 (3) ◽

pp. 160 ◽

Cited By ~ 9

Author(s):

Karl F. Welke ◽

YingXing Wu ◽

Gary L. Grunkemeier ◽

Aftab Ahmad ◽

Albert Starr

Keyword(s):

Aortic Valve ◽

Older Patients ◽

Long Term Results ◽

Rank Test ◽

Term Survival ◽

Younger Patients ◽

Kaplan Meier ◽

Valve Implantation ◽

The Impact

Background: The purpose of this study was to determine long-term patient survival and valve durability for Carpentier-Edwards pericardial valves (Edwards Lifesciences) implanted in the aortic position, with specific attention to the impact of patient age.Methods: We performed a retrospective cohort study of 2168 patients who underwent implantation of a Carpentier-Edwards pericardial aortic valve between 1991 and 2008. The mean follow-up time was 4.5 years. Primary outcomes of interest were mortality and valve explantation. Survival curves and event-free curves were obtained with the Kaplan-Meier method and compared with the log-rank test.Results: Survival was 92% at 1 year, 73% at 5 years, 38% at 10 years, and 18% at 15 years. Although the mortality rate of younger patients was worse than in the general population, older patients had significantly better survival than their contemporaries. Age was the independent variable most significantly associated with explantation. There was an early hazard phase for patients between 21 and 49 years of age, such that the freedom from explantation was 89% at 3 years. By 10 years, the freedom from explantation was 58% for patients 21 to 49 years of age, compared with 68% for patients 50 to 64 years, 93% for patients 65 to 74 years, and 99% for patients 75 years of age and older.Conclusion: We found good long-term survival and durability. Older patients had excellent freedom from explantation, whereas younger patients fared worse. As our population ages, this information becomes increasingly important. Assessing the durability of this pericardial aortic valve may aid in predicting the durability of the transcatheter aortic valves that share the same leaflets.

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