scholarly journals Vliyanie na prognoz estrogenovykh retseptorov a v opukholevykh kletkakh u patsientov, radikal'no operirovannykh po povodu nemelkokletochnogo raka legkogo

2018 ◽  
Vol 20 (3) ◽  
pp. 43-50
Author(s):  
D V Novikov ◽  
B E Polotskiy ◽  
T A Bogush ◽  
M M Davidov ◽  
B B Ahmedov ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Expression Level ◽  
Long Term Results ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Disease Prognosis ◽  
Male Patients ◽  
The Impact

Aim. Evaluation of prognostic role of estrogen receptors a (ERa) expression level at patients with non-small cell lung cancer (NSLC) after surgical treatment. Methods and materials. 115 clinical cases of patients who underwent treatment in N.N.Blokhin Russian Cancer Research Center fr om 2009 to 2016 were studied. There were 95 males and 20 females. All patients had NSLC confirmed by histological analysis and followed-up for long term results. Results. There was no statistical evidence that the level of estrogen a expression in tumor cells has an impact on relapse free survival among men with both adenocarcinoma and squamous cell carcinoma of the lung. Similar results were obtained for women group. Also, no correlations between overall survival and the level of estrogen a expression were noticed among men and women. Thus ERa can’t be used as a predictor marker for patients with NSLC. Conclusion. The level of ERa expression in tumor cells among male patients does not influence on disease prognosis regardless stage of the disease and tumor morphology and can’t be used as a prognostic factor. The impact of the ERa expression level in tumor cells among female patients on disease prognosis is questionable.

Whole lung irradiation for completely responding pulmonary metastases in pediatric Ewing sarcoma

2020 ◽  
Vol 16 (15) ◽  
pp. 1043-1051
Author(s):  
Hagar Elghazawy ◽  
Azza Nasr ◽  
Iman Zaky ◽  
Manal Zamzam ◽  
Ahmed Elgammal ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Pediatric Population ◽  
Event Free Survival ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Real Value ◽  
Lung Irradiation ◽  
Whole Lung Irradiation ◽  
The Impact

Aim: Scarce data assessing the real value of whole lung irradiation (WLI) in Ewing’s sarcoma (ES) with lung-only metastasis, with published conflicting results. We studied the impact of WLI in a homogenous pediatric population. Materials & methods: Retrospective study evaluating the survival outcomes of WLI in these patients. Results: Out of 163 metastatic ES; 41 patients were eligible for WLI. 30 patients (73.1%) received WLI (+ve) while 11 patients (26.8%) did not receive WLI (-ve). Five-year event-free survival was statistically significant in WLI (+ve). Five-year pulmonary relapse-free survival showed trend for improvement with WLI (+ve), while 5-year overall survival was not statistically significant between the two arms. Conclusion: WLI added significantly to the long term clinical outcome of metastatic ES patients, with no irreversible toxicity.

Evolution of public-private partnership: the UK perspective through a case study approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marios Adamou ◽  
Niki Kyriakidou ◽  
Jon Connolly
Keyword(s):  
Public Private Partnership ◽  
Long Term Results ◽  
Private Partnership ◽  
Content Type ◽  
System Resilience ◽  
The Uk ◽  
The Impact

Purpose Since the 1990s, the National Health Service (NHS)advisory officers have developed considerable expertise in managing the process of specifying, procuring, contracting and running public–private partnership (PPP) projects. However, there has been a relatively consistent trajectory in the findings of studies and evaluation of PPP from its initial introduction in the health sector in 1992 to the present time. Therefore, the purpose of this study is to critically evaluate the PPP experience in the UK context using a case study in the NHS. Design/methodology/approach The partnership literature is primarily focussed on process issues, and the impact of partnerships on improving outcomes cannot be assumed. By conducting a critical review on most updated research studies and innovative approaches in this area, the literature as to the place of PPPs in health in the context of the UK is critically explored and whether they have a role in system resilience is examined. A case study has be used as well to describing the processes of a PPP arrangement. Findings Health-care PPP is one of the options relating to health system resilience. However, their contribution in the NHS has been mixed, with success noted in short-term clinical and services contracts while in the long-term the value for money argument has not been proven. In theory, the role of PPPs in bringing together ingredients supporting system resilience such as finance, management and innovation in the UK has not always been successful, and NHS providers have taken the approach to exit such arrangements. Research limitations/implications More research work is needed to capture the 21st-century challenges and critical success factors during its implementation. Practical implications The creation of strong partnerships is moving service delivery away from a project-by-project approach to one that includes strategic and policy developments for long-term results. Originality/value This is a fresh discussion in the role of PPP in system resilience in the UK perspective through a case study describing an exit from a PPP arrangement.

scholarly journals Emergency surgeries for rectal cancer complicated by intestinal obstruction: long-term outcomes and prognostic factors

2020 ◽  
Vol 10 (1) ◽  
pp. 11-19
Author(s):  
S. N. Shchaeva ◽  
E. A. Kazantseva ◽  
E. V. Gordeeva
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factors ◽  
Lymph Nodes ◽  
Median Survival ◽  
Emergency Surgery ◽  
Long Term Results ◽  
Main Stage ◽  
Relapse Free Survival ◽  
Free Survival

The aim of the study: to examine the indicators of relapse-free survival and evaluate prognostic factors that had the greatest impact on relapse- free survival in patients with rectal cancer complicated by obstructive obstruction and undergoing emergency surgery.Materials and methods. The analysis of the immediate and long-term results of treatment – relapse-free survival of patients undergoing emergency surgery for rectal cancer complicated by obstructive obstruction in general surgical and specialized hospitals in Smolensk from 2001 to 2017 is presented. Relapse-free survival was analyzed by the Kaplan–Meier method. To determine the influence of potential risk factors on the rate of occurrence of the studied event, Cox regression was used.Results. Postoperative complications of the III–IV degree according to Clavien–Dindo were more common in patients undergoing emergency surgery for complicated rectal cancer in general surgical hospitals (p = 0.0056). In specialized hospitals, anastomosis leakage in 5.3 % (1 of 19 cases), in general surgical hospitals – 16.3 % (9 of 55 cases). Five-year relapse-free survival in general surgical hospitals at the IIB stage was 18.3 %, median survival – 32 months; in specialized hospitals at stage IIB 5‑year relapse-free was 45.8 %, median survival – 52 months (p = 0.028 and 0.011, respectively). A multivariate analysis confirmed the influence of the following factors on the performance of a 5‑year relapse-free survival: hospital specialization (risk ratio (RR) 1.35; 95 % confidence interval (CI) 1.18–1.55; p <0.001), type of surgery – one-stage operations (RR 1.13; 95 % CI 1.05–1.22; p = 0.001), the presence of metastases in the lymph nodes (RR 0.77; 95 % CI 0.71–0.84; p <0.0001), the number of examined lymph nodes (RR 0.79; 95 % CI 0.72–0.87; p <0.001).Conclusions. It is advisable to carry out two-stage surgical treatment with the formation of a colostomy at the first stage; the main stage of radical intervention should be performed in a specialized hospital.

Long-Term Outcomes of Patients with Acute Myeloid Leukemia Treated with Salvage High-Dose Etoposide and Cyclophosphamide

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2814-2814
Author(s):  
Amir Siddiqui ◽  
Donna E. Hogge ◽  
Thomas J. Nevill ◽  
Stephen H. Nantel ◽  
Michael J Barnett ◽  
...  
Keyword(s):  
Research Funding ◽  
Response Rate ◽  
High Dose ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival ◽  
Baseline Characteristics ◽  
The Impact

Abstract Background Salvage chemotherapy using high-dose etoposide and cyclophosphamide (VP-Cy) was developed for acute leukemia and myeloid malignancies resistant to cytarabine-based induction regimens. The Leukemia/Bone Marrow Transplant (L/BMT) program of British Columbia has a 25-year experience using VP-Cy for patients with relapsed and refractory (R/R) acute myeloid leukemia (AML). We report on a retrospective analysis to evaluate the efficacy and early toxicity of this regimen. Methods The L/BMT database was searched to identify R/R AML patients treated with VP-Cy. Patients were treated with etoposide 2.4 g/m2 given as continuous infusion over 34 hours on days 1-2 followed by cyclophosphamide 2 g/m2/day on days 3-5. The primary aims of this analysis were to determine response rate, long-term survival outcomes, and early toxicity. Secondary aims were to determine the impact of initial induction chemotherapy, using either standard-dose cytarabine and daunorubicin (7+3) or high-dose cytarabine and daunorubicin (HiDAC-D), on response rate to salvage as well as to assess the impact of cytogenetics and FLT3-ITD mutations on outcome. Survival curves were calculated using the Kaplan-Meier method, and comparisons between curves were made using the log-rank test. Chi-squared test was used to compare differences in categorical variables. Results 169 patients diagnosed with R/R AML treated with VP-Cy from 1991-2015 were identified. Baseline characteristics are shown in Table 1. CR rate was 45% and 5-year OS was 20% (95% CI 14-26%) for the entire cohort. Rate of CR (p=0.98) and median OS (p=0.8) were not different between cohorts receiving standard-dose cytarabine vs. high-dose cytarabine during initial induction. 74% (56/76) of responding patients received allogeneic hematopoietic stem cell transplant. 42% (32/76) of patients relapsed after initially responding to VP-Cy and the median CR duration was 221 days (range: 36 to 2561 days). In responding patients (n=76), 5-year relapse-free survival (RFS) and OS were 33% (95% CI 24-46%) and 35% (95% CI 25-47%) respectively. Initial disease status did not significantly influence response rate [52% (refractory day 14) vs. 42% (refractory day 28) vs. 47% (relapsed), p=0.46] although median OS was longer in patients with refractory disease [422 days (refractory day 14) vs. 281 days (refractory day 28) vs. 122 days (relapsed), p=0.03)]. Patients with FLT3-ITD mutation (30/78) had lower CR rate (23% vs. 53%; p=0.01) and worse OS (median OS 135 days vs. 357 days; p<0.0001) compared to those without. Patients with adverse risk cytogenetics (34/169) had a trend towards lower CR rate (38% vs. 50%; p=0.2) and a significantly worse OS (median OS 155 days vs. 304 days; p<0.0001) compared to patients with favourable/intermediate cytogenetics. Rate of early death (<60 days) was 12% (20/171) and causes included: bacterial infection (n=4), fungal infection (n=3), intracranial hemorrhage (n=1), and progressive AML (n=9). Conclusion VP-Cy is an effective salvage regimen with response rates, long-term survival and rates of early death comparable to reported outcomes using cytarabine-based salvage regimens. Initial dose of cytarabine given during induction did not influence response rate or survival. The probability of long-term survival for the entire cohort was low (20%) and outcomes were significantly worse in patients with FLT3-ITD mutation and adverse risk cytogenetics, emphasizing the need for investigation of novel treatments in these groups. Figure (a) Overall Survival. (b) Relapse-Free Survival in Patients Achieving CR Status After VP-Cy. Figure. (a) Overall Survival. (b) Relapse-Free Survival in Patients Achieving CR Status After VP-Cy. Figure Baseline Characteristics of Cohort. Figure. Baseline Characteristics of Cohort. Table 1 Table 1. Disclosures Song: Celgene: Honoraria, Research Funding; Janssen: Honoraria; Otsuka: Honoraria. Toze:Roche Canada: Research Funding. Gerrie:Roche Canada: Research Funding.

Long-term results of combined chemotherapy-radiotherapy approach in Hodgkin's disease: superiority of ABVD plus radiotherapy versus MOPP plus radiotherapy.

1987 ◽  
Vol 5 (1) ◽  
pp. 27-37 ◽  
Author(s):  
A Santoro ◽  
G Bonadonna ◽  
P Valagussa ◽  
R Zucali ◽  
S Viviani ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Remission Rate ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Long Term Results ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Treatment Groups ◽  
Gonadal Dysfunction

In an attempt to reduce some of the delayed sequelae associated with combined modality therapy in Hodgkin's disease, we randomly tested stages IIB, IIIA, and IIIB MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) v ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine). In 232 previously untreated patients, three cycles of either combination preceded and followed extensive irradiation. The complete remission rate was 80.7% following MOPP and 92.4% following ABVD (P less than .02). The 7-year results indicated that ABVD was superior to MOPP in terms of freedom from progression (80.8% v 62.8%; P less than .002), relapse-free survival (87.7% v 77.2%; P = .06), and overall survival (77.4% v 67.9%; P = .03). Moreover, the comparative iatrogenic morbidity showed that irreversible gonadal dysfunction as well as acute leukemia occurred only in patients subjected to MOPP, while cardiopulmonary studies failed to document significant laboratory differences between the two treatment groups. Present findings indicate that ABVD followed by extensive irradiation represents a valid therapeutic alternative to the widely used alkylating agent-containing regimens plus radiotherapy.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

MicroRNA-520c-3p Modulates Doxorubicin-Chemosensitivity in HepG2 Cells

2020 ◽  
Vol 21 (2) ◽  
pp. 237-245 ◽  
Author(s):  
Mohamed A. Ragheb ◽  
Marwa H. Soliman ◽  
Emad M. Elzayat ◽  
Mervat S. Mohamed ◽  
Nada El-Ekiaby ◽  
...  
Keyword(s):  
Hepg2 Cells ◽  
Therapeutic Strategy ◽  
Suppressive Effect ◽  
Expression Level ◽  
Tumor Suppressor Function ◽  
Protein Expression Level ◽  
Blot Technique ◽  
Induction Of Apoptosis ◽  
The Impact

Background: Doxorubicin (DOX) is the most common drugs used in cancer therapy, including Hepatocellular Carcinoma (HCC). Drug resistance, is one of chemotherapy’s significant problems. Emerging studies have shown that microRNAs (miRNAs) could participate in regulating this mechanism. Nevertheless, the impact of miRNAs on HCC chemoresistance is still enigmatic. Objective: Investigating the role of miR-520c-3p in enhancement of anti-tumor effect of DOX against HepG2 cells. Methods: Expression profile for liver related miRNAs (384 miRNAs) has been analyzed on HepG2 cells treated with DOX using qRT-PCR. miR-520c-3p, the most deregulated miRNA, was selected for combination treatment with DOX. Expression level for LEF1, CDK2, CDH1, VIM, Mcl-1 and TP53 was evaluated in miR-520c-3p transfected cells. Cell viability, colony formation, wound healing as well as apoptosis assays have been demonstrated. Furthermore, Mcl-1 protein level was measured using western blot technique. Results: The present data indicated that miR-520c-3p overexpression could render HepG2 cells chemo-sensitive to DOX through enhancing its suppressive effects on proliferation, migration, and induction of apoptosis. The suppressive effect of miR-520c-3p involved altering the expression levels of some key regulators of cell cycle, proliferation, migration and apoptosis including LEF1, CDK2, CDH1, VIM, Mcl-1 and TP53. Interestingly, Mcl-1 was found to be one of the potential targets of miR-520c-3p, and its protein expression level was down-regulated upon miR-520c-3p overexpression. Conclusion: Our data referred to the tumor suppressor function of miR-520c-3p that could modulate chemosensitivity of HepG2 cells toward DOX treatment, providing a promising therapeutic strategy in HCC.

Covid-19 In Man: A Very Dangerous Affair.

2021 ◽  
Vol 21 ◽  
Author(s):  
Giuseppe Lisco ◽  
Vito A. Giagulli ◽  
Giovanni De Pergola ◽  
Anna De Tullio ◽  
Edoardo Guastamacchia ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Metabolic Diseases ◽  
Systemic Disease ◽  
Public Health Issue ◽  
Immune System Dysfunction ◽  
Data Support ◽  
Systemic Spread ◽  
The Impact

Background: The novel pandemic of Coronavirus disease 2019 (COVID-19) has becoming a public health issue since March 2020 considering that more than 30 million people were found to be infected worldwide. Particularly, recent evidences suggested that men may be considered as at higher risk of poor prognosis or death once the infection occurred and concerns surfaced in regard of the risk of a possible testicular injury due to SARS-CoV-2 infection. Results: Several data support the existence of a bivalent role of testosterone (T) in driving poor prognosis in patients with COVID-19. On one hand, this is attributable to the fact that T may facilitate SARS-CoV-2 entry in human cells by means of an enhanced expression of transmembrane serine-protease 2 (TMPRSS2) and angiotensin-converting enzyme 2 (ACE2). At the same time, younger man with normal testicular function compared to women of similar age are prone to develop a blunted immune response against SARS-CoV-2, being exposed to less viral clearance and more viral shedding and systemic spread of the disease. Conversely, low levels of serum T observed in hypogonadal men predispose them to a greater background systemic inflammation, cardiovascular and metabolic diseases, and immune system dysfunction, hence driving harmful consequences once SARS-CoV-2 infection occurred. Finally, SARS-CoV-2, as a systemic disease, may also affect testicles with possible concerns for current and future testicular efficiency. Preliminary data suggested that SARS-CoV-2 genome is not normally found in gonads and gametes, therefore sex transmission could be excluded as a possible way to spread the COVID-19. Conclusion: Most data support a role of T as a bivalent risk factor for poor prognosis (high/normal in younger; lower in elderly) in COVID-19. However, the impact of medical treatment aimed to modify T homeostasis for improving the prognosis of affected patients is unknown in this clinical setting. In addition, testicular damage may be a harmful consequence of the infection even in case it occurred asymptomatically but no long-term evidences are currently available to confirm and quantify this phenomenon. Different authors excluded the presence of SARS-CoV-2 in sperm and oocytes, thus limiting worries about both a potential sexual and gamete-to-embryos transmission of COVID-19. Despite these evidence, long-term and well-designed studies are needed to clarify these issues.

scholarly journals NLRP7 Promotes Choriocarcinoma Growth and Progression through the Establishment of an Immunosuppressive Microenvironment

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2999
Author(s):  
Deborah Reynaud ◽  
Roland Abi Nahed ◽  
Nicolas Lemaitre ◽  
Pierre-Adrien Bolze ◽  
Wael Traboulsi ◽  
...  
Keyword(s):  
Immune Response ◽  
Tumor Cells ◽  
Major Gene ◽  
Critical Role ◽  
Orthotopic Model ◽  
Independent Manner ◽  
Maternal Immune Response ◽  
The Impact

The inflammatory gene NLRP7 is the major gene responsible for recurrent complete hydatidiform moles (CHM), an abnormal pregnancy that can develop into gestational choriocarcinoma (CC). However, the role of NLRP7 in the development and immune tolerance of CC has not been investigated. Three approaches were employed to define the role of NLRP7 in CC development: (i) a clinical study that analyzed human placenta and sera collected from women with normal pregnancies, CHM or CC; (ii) an in vitro study that investigated the impact of NLRP7 knockdown on tumor growth and organization; and (iii) an in vivo study that used two CC mouse models, including an orthotopic model. NLRP7 and circulating inflammatory cytokines were upregulated in tumor cells and in CHM and CC. In tumor cells, NLRP7 functions in an inflammasome-independent manner and promoted their proliferation and 3D organization. Gravid mice placentas injected with CC cells invalidated for NLRP7, exhibited higher maternal immune response, developed smaller tumors, and displayed less metastases. Our data characterized the critical role of NLRP7 in CC and provided evidence of its contribution to the development of an immunosuppressive maternal microenvironment that not only downregulates the maternal immune response but also fosters the growth and progression of CC.

Sign in / Sign up

Export Citation Format

Share Document