Early and long-term excess mortality in 227 patients with intracranial dural arteriovenous fistulas

2013 ◽  
Vol 119 (1) ◽  
pp. 164-171 ◽  
Author(s):  
Anna Piippo ◽  
Aki Laakso ◽  
Karri Seppä ◽  
Jaakko Rinne ◽  
Juha E. Jääskeläinen ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Relative Survival ◽  
Venous Drainage ◽  
Population Based ◽  
Survival Ratio ◽  
University Hospitals ◽  
Finnish Population ◽  
Term Survival ◽  
Treatment Complications

Object The aim of this study was to assess the early and long-term excess mortality in patients with intracranial dural arteriovenous fistula (DAVF) compared with a matched general Finnish population in an unselected, population-based series. Methods The authors identified 227 patients with DAVFs admitted to 2 of the 5 Departments of Neurosurgery in Finland—Helsinki and Kuopio University Hospitals—between 1944 and 2006. All patients were followed until death or the end of 2009. Long-term excess mortality was estimated using the relative survival ratio compared with the general Finnish population matched by age, sex, and calendar year. Results The median follow-up period was 10 years (range 0–44 years). Two-thirds (67%) of the DAVFs were located in the region of transverse and sigmoid sinuses. Cortical venous drainage (CVD) was present in 28% of the DAVFs (18% transverse and sigmoid sinus, 42% others). Of the 61 deaths counted, 11 (18%) were during the first 12 months and were mainly caused by treatment complications (5 of 11, 45%). The 1-year survivors presenting with hemorrhage experienced excess mortality until 7 years from admission. However, DAVFs with CVD were associated with significant, continuous excess mortality. There were more cerebrovascular and cardiovascular deaths in this group of patients than expected in the general Finnish population. Location other than transverse and sigmoid sinuses was also associated with excess mortality. Conclusions In the patients with DAVF there was excess mortality during the first 12 months, mainly due to treatment complications. Thereafter, their overall long-term survival became similar to that of the matched general population. However, DAVFs with CVD and those located in regions other than transverse and sigmoid sinuses were associated with marked long-term excess mortality after the first 12 months.

Long-term Excess Mortality of 244 Familial and 1502 Sporadic One-Year Survivors of Aneurysmal Subarachnoid Hemorrhage Compared With a Matched Eastern Finnish Catchment Population

Neurosurgery ◽  
2011 ◽  
Vol 68 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Terhi. Huttunen ◽  
Mikael. von und zu Fraunberg ◽  
Timo. Koivisto ◽  
Antti. Ronkainen ◽  
Jaakko. Rinne ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Glasgow Outcome Scale ◽  
Excess Mortality ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Relative Survival ◽  
Survival Ratio ◽  
Catchment Population ◽  
One Year ◽  
The Impact

Abstract BACKGROUND: Saccular intracranial aneurysms (sIAs) develop in 2% of the population. Rupture of the sIA wall causes almost all cases of aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: We analyzed the long-term excess mortality of 244 familial and 1502 sporadic 1-year survivors of aSAH from sIA compared with a matched Eastern Finnish catchment population. METHODS: The Kuopio Neurosurgery Database contains 1746 one-year survivors of aSAH (1980–2007) from a defined population. The median follow-up time, until death (n = 494) or the end of 2008, was 12 years. Relative survival ratios were calculated compared with the matched (sex, age, calendar time) catchment population. Relative excess risk of death (RER) was estimated for variables known on admission for aSAH as well as Glasgow Outcome Scale score at 12 months. RESULTS: There was 12% excess mortality at 15 years (cumulative relative survival ratio: 0.88; 95% confidence interval: 0.85-0.91). Independent risk factors were male sex (RER: 1.6), age older than 64 years (RER: 2.9), ruptured basilar tip sIA (RER: 4.5), severe hydrocephalus on admission (RER: 3.6), no occlusive therapy (RER: 6.0), and Glasgow Outcome Scale scores of 2, 3, or 4 at 12 months (RER: 23, 4.1, 2.1, respectively), but not familial sIA disease. There were lethal rebleeds from 13 of the 1440 clipped sIAs, 2 of the 265 coiled sIAs, and 2 from the 17 nonoccluded sIAs, and 14 new lethal bleeds from other sIAs. CONCLUSION: The impact of both sporadic and familial aSAH and their sequelae in the central nervous and cardiovascular systems may cause long-term morbidity and mortality. The complex sIA disease may predispose to other vascular events later in life. The causes of the long-term excess mortality are heterogeneous, and more detailed analyses are required.

scholarly journals Uveal melanoma: Long-term survival

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250939
Author(s):  
Tomas Radivoyevitch ◽  
Emily C. Zabor ◽  
Arun D. Singh
Keyword(s):  
Uveal Melanoma ◽  
Absolute Risk ◽  
Relative Survival ◽  
Population Based ◽  
Parametric Modeling ◽  
Primary Therapy ◽  
Term Survival ◽  
Long Term Survival ◽  
Melanoma Patients

Purpose The long-term survival of uveal melanoma patients in the US is not known. We compared long-term survival estimates using relative survival, excess absolute risk (EAR), Kaplan-Meier (KM), and competing risk analyses. Setting Population based cohort study. Study population Pooled databases from Surveillance, Epidemiology, and End Results data (SEER, SEER-9+SEER-13+SEER-18). Main outcome measure Overall Survival (OS), Metastasis Free Survival (MFS) and relative survival, computed directly or estimated via a model fitted to excess mortality. Results There were 10678 cases of uveal melanoma spanning a period of 42 years (1975–2016). The median age at diagnosis was 63 years (range 3–99). Over half the patients were still alive at the end of 2016 (53%, 5625). The KM estimates of MFS were 0.729 (0.719, 0.74), 0.648 (0.633, 0.663), and 0.616 (0.596, 0.636) at 10, 20, and 30 years, respectively. The cumulative probabilities of melanoma metastatic death at 10, 20 and 30 years were 0.241 (0.236, 0.245), 0.289 (0.283, 0.294), and 0.301 (0.295, 0.307). In the first 5 years since diagnosis of uveal melanoma, the proportion of deaths attributable to uveal melanoma were 1.3 with rapid fall after 10 years. Death due to melanoma were rare beyond 20 years. Relative survival (RS) plateaued to ~60% across 20 to 30 years. EAR parametric modeling yielded a survival probability of 57%. Conclusions Relative survival methods can be used to estimate long term survival of uveal melanoma patients without knowing the exact cause of death. RS and EAR provide more realistic estimates as they compare the survival to that of a normal matched population. Death due to melanoma were rare beyond 20 years with normal life expectancy reached at 25 years after primary therapy.

scholarly journals Using Population-Based Cancer Registration Data and Period Analysis to Accurately Assess and Predict 5-Year Relative Survival for Lung Cancer Patients in Eastern China

2021 ◽  
Vol 11 ◽  
Author(s):  
Runhua Li ◽  
Min Zhang ◽  
Yongran Cheng ◽  
Xiyi Jiang ◽  
Huijuan Tang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Eastern China ◽  
Relative Survival ◽  
Population Based ◽  
Term Survival ◽  
Period Analysis ◽  
Long Term Survival ◽  
Lung Cancer Patients

BackgroundThe assessment of long-term survival of lung cancer patients based on data from population-based caner registries, using period analysis, was scarce in China. We aimed to accurately assess the long-term survival of lung cancer patients, and to predict the long-term survival in the future, using cancer registry data from Taizhou City, eastern China.MethodsFour cancer registries with high-quality data were selected. Patients diagnosed with lung cancer during 2004–2018 were included. The long-term survival was evaluated using period analysis, with further stratification by sex, age at diagnosis and region. Additionally, projected 5-year relative survival (RS) of lung cancer patients for 2019-2023 was evaluated, using model-based period analysis.ResultsThe 5-year RS of lung cancer patients diagnosed during 2014–2018 was 40.2% (31.5% for men and 56.2% for women). A moderate age gradient was observed for the period estimate, with the estimate decreasing from 50.5 to 26.5% in the age group of 15–44 years and ≥75 years, respectively. The 5-year RS of urban area was higher than that of rural area (52.3% vs. 38.9%). The overall projected 5-year RS of lung cancer patients was 52.7% for 2019–2023, with estimate of 43.0 and 73.2% for men and women, respectively. A moderate age gradient was also observed for the projected estimate. Moreover, estimate reached nearly 50% for rural and urban areas.ConclusionPeriod analysis tended to provide the up-to-date and precise survival estimates for lung cancer patients, which is worth further application, and provides important evidence for prevention and intervention of lung cancer.

Long-Term Survival Rates of Patients With Prostate Cancer in the Prostate-Specific Antigen Screening Era: Population-Based Estimates for the Year 2000 by Period Analysis

2005 ◽  
Vol 23 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Hermann Brenner ◽  
Volker Arndt
Keyword(s):  
Prostate Cancer ◽  
General Population ◽  
Excess Mortality ◽  
Survival Rates ◽  
Specific Antigen ◽  
Relative Survival ◽  
Term Survival ◽  
Psa Screening ◽  
Year 2000

Purpose In the era of widespread prostate specific antigen (PSA) screening, a large proportion of older men have to live with a diagnosis of prostate cancer. In this study, we applied a new method for up-to-date analysis of long-term survival to evaluate if and to what extent these patients still have any excess mortality compared to the general population. Methods Five- and 10-year absolute and relative survival rates for the year 2000 were derived from the 1973 to 2000 database of the Surveillance, Epidemiology and End Results Program using the recently introduced period analysis methodology. Results Overall, 5- and 10-year relative survival rates were approximately 99% and 95%; that is, excess mortality compared with the general population was as low as 1% and 5% within 5 and 10 years following diagnosis, respectively. Two-thirds of patients were diagnosed with well or moderately differentiated localized/regional prostate cancer, and among these patients, 5- and 10-year relative survival rates were above 100% (indicating the lack of any excess mortality) at all ages. Conclusion While the value of PSA screening for lowering mortality due to prostate cancer remains to be shown by randomized clinical trials, the majority of patients diagnosed with prostate cancer in the PSA screening era do not have excess mortality compared to the general population under current patterns of medical care. This information may be important for both clinical management of, and for patients' coping with, the disease.

scholarly journals P50.11 Long-Term Survival after Surgical Resection of Carcinoid Tumors in a Population-Based Cohort

2021 ◽  
Vol 16 (3) ◽  
pp. S516-S517
Author(s):  
M. Taylor ◽  
M. Smeltzer ◽  
R. Ramirez ◽  
C. Fehnel ◽  
O. Akinbobola ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Population Based ◽  
Carcinoid Tumors ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Patterns of Survival Among Patients With Myeloproliferative Neoplasms Diagnosed in Sweden From 1973 to 2008: A Population-Based Study

2012 ◽  
Vol 30 (24) ◽  
pp. 2995-3001 ◽  
Author(s):  
Malin Hultcrantz ◽  
Sigurdur Yngvi Kristinsson ◽  
Therese M.-L. Andersson ◽  
Ola Landgren ◽  
Sandra Eloranta ◽  
...  
Keyword(s):  
General Population ◽  
Life Expectancy ◽  
Excess Mortality ◽  
Myeloproliferative Neoplasms ◽  
Treatment Options ◽  
Large Population ◽  
Relative Survival ◽  
Population Based ◽  
Population Based Study ◽  
Over Time

PurposeReported survival in patients with myeloproliferative neoplasms (MPNs) shows great variation. Patients with primary myelofibrosis (PMF) have substantially reduced life expectancy, whereas patients with polycythemia vera (PV) and essential thrombocythemia (ET) have moderately reduced survival in most, but not all, studies. We conducted a large population-based study to establish patterns of survival in more than 9,000 patients with MPNs.Patients and MethodsWe identified 9,384 patients with MPNs (from the Swedish Cancer Register) diagnosed from 1973 to 2008 (divided into four calendar periods) with follow-up to 2009. Relative survival ratios (RSRs) and excess mortality rate ratios were computed as measures of survival.ResultsPatient survival was considerably lower in all MPN subtypes compared with expected survival in the general population, reflected in 10-year RSRs of 0.64 (95% CI, 0.62 to 0.67) in patients with PV, 0.68 (95% CI, 0.64 to 0.71) in those with ET, and 0.21 (95% CI, 0.18 to 0.25) in those with PMF. Excess mortality was observed in patients with any MPN subtype during all four calendar periods (P < .001). Survival improved significantly over time (P < .001); however, the improvement was less pronounced after the year 2000 and was confined to patients with PV and ET.ConclusionWe found patients with any MPN subtype to have significantly reduced life expectancy compared with the general population. The improvement over time is most likely explained by better overall clinical management of patients with MPN. The decreased life expectancy even in the most recent calendar period emphasizes the need for new treatment options for these patients.

Socioeconomic Inequalities in Treatment and Relative Survival Among Patients with Diffuse Large B-Cell Lymphoma: A Hong Kong Population-Based Study

2021 ◽  
Author(s):  
Shing Fung Lee ◽  
Andrew Evens ◽  
Andrea Ng ◽  
Miguel-Angel Luque-Fernandez
Keyword(s):  
Hong Kong ◽  
Excess Mortality ◽  
Cell Lymphoma ◽  
Relative Survival ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Secular Trends ◽  
Low Ses ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4,017 patients with DLBCL, 2,363 (58.8%) patients received both chemotherapy and rituximab and 740 (18.4%) patients received chemotherapy alone, while 1,612 (40.1%) and 914 (22.8%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio [OR], 0.44; 95% CI 0.34–0.57) and rituximab (OR, 0.41; 95% CI, 0.32–0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95% CI, 1.67–3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients’ SES.

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