Features of clinical course, morphological diagnosis and prognosis factors for neuroendocrine neoplasms of rare localizations

Currently, neuroendocrine neoplasms (NENs) of the gastroenteropancreat-ic and bronchopulmonary systems are well studied and the most common, the share of which is 73 and 25 % of cases, respectively. The remaining 2 % of cases are attributed to NEN of more rare localizations, the static registration of which is difficult due to their rarity, and clinical cases are presented by episodic descriptions of single observations. Such tumors include NEN of the prostate gland from 0.5 to 1.0 %, NEN of ovaries 0.5 %, NEN of the mammary gland from 0.3 to 0.5 %, NEN of the kidney (practically devoid of static data), bladder 0.48-1.00 %. The retrospective study included 92 patients with NEN of rare localizations who were examined and treated of the N. N. Blochin National Medical Research Center of Oncology from 1990 to 2019. Currently, there are no generally accepted methods of treatment for this group of patients due to the rarity of the pathology, and it is carried out according to the NEN of other localizations. NEN of rare localizations have high survival rates (the observation period was from a month to 14 years), both general and without progression and require long-term monitoring and observation. At the time of assessment of long-term results, 20 (21.8 %) patients died of progression, 12 (13.1 %) patients dropped out of observation. The rest were alive at the date of the last control.

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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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Pulmonary Homografts for Aortic Valve Replacement: Long-term Comparison with Aortic Grafts

The Heart Surgery Forum ◽

10.1532/hsf98.20101162 ◽

2011 ◽

Vol 14 (4) ◽

pp. 237 ◽

Cited By ~ 3

Author(s):

Ferdinand Vogt ◽

Anke Kowert ◽

Andres Beiras-Fernandez ◽

Martin Oberhoffer ◽

Ingo Kaczmarek ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Survival Rates ◽

Long Term Results ◽

Rank Test ◽

Aortic Graft ◽

Valve Prostheses ◽

Retrospective Comparative Study

Objective: The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.Methods: Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.Results: Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (P = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (P < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).Conclusion: Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.

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Surgical treatment of pulmonary artery sarcoma: a report of 17 cases

Pulmonary Circulation ◽

10.1177/2045894020986394 ◽

2021 ◽

Vol 11 (1) ◽

pp. 204589402098639

Author(s):

Wu Song ◽

Long Deng ◽

Jiade Zhu ◽

Shanshan Zheng ◽

Haiping Wang ◽

...

Keyword(s):

Pulmonary Artery ◽

Survival Rates ◽

Tumor Resection ◽

Long Term Results ◽

Pulmonary Endarterectomy ◽

Pulmonary Artery Sarcoma ◽

The Mean ◽

Operative Findings

Pulmonary artery sarcoma (PAS) is a rare and devastating disease. The diagnosis is often delayed, and optimal treatment remains unclear. The aim of this study is to report our experience in the surgical management of this disease. Between 2000 and 2018, 17 patients underwent operations for PAS at our center. The medical records were retrospectively reviewed to evaluate the clinical characteristics, operative findings, the postoperative outcomes, and the long-term results. The mean age at operation was 46.0 ± 12.4 years (range, 26–79 years), and eight (47.1%) patients were male. Six patients underwent tumor resection alone, whereas the other 11 patients received pulmonary endarterectomy (PEA). There were two perioperative deaths. Follow-up was completed for all patients with a mean duration of 23.5 ± 17.6 months (1–52 months). For all 17 patients, the median postoperative survival was 36 months, and estimated cumulative survival rates at 1, 2, 3, and 4 years were 60.0%, 51.4%, 42.9%, and 21.4%, respectively. The mean survival was 37.0 months after PEA and 14.6 months after tumor resection only ( p = 0.046). Patients who had no pulmonary hypertension (PH) postoperatively were associated with improved median survival (48 vs. 5 months, p = 0.023). In conclusion, PAS is often mistaken for chronic pulmonary thromboembolism. The prognosis of this very infrequent disease remains poor. Early detection is essential for prompt and best surgical approach, superior to tumor resection alone, and PEA surgery with PH relieved can provide better chance of survival.

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LONG-TERM RESULTS AND LATE COMPLICATIONS AFTER INTRACAVITARY YTTRIUM-90 COLLOID IRRADIATION OF RECURRENT CYSTIC CRANIOPHARYNGIOMAS

Neurosurgery ◽

10.1227/01.neu.0000255528.68963.ef ◽

2007 ◽

Vol 61 (2) ◽

pp. 288-296 ◽

Cited By ~ 50

Author(s):

Jenö Julow ◽

Erik-Olof Backlund ◽

Ferenc Lányi ◽

Márta Hajda ◽

Katalin Bálint ◽

...

Keyword(s):

Survival Rates ◽

Late Complications ◽

Long Term Results ◽

Actuarial Survival ◽

Valuable Treatment ◽

Internal Carotid Artery Injury ◽

Beta Dose ◽

Anatomic Localization ◽

Yttrium 90

Abstract OBJECTIVE Data were analyzed to assess the value of stereotactically applied intracystic colloidal yttrium-90 (YTx) for the treatment of recurrent cystic craniopharyngiomas during a 30-year period. METHODS This article compares data from 73 YTx procedures in 60 patients between 1975 and 2006. The cumulative beta dose aimed at the inner surface of the cyst wall was 300 Gy. RESULTS After YTx, the initial cyst volumes decreased an average of 79%. In 47, the reduction was more than 80%; in 27 of them, the cyst disappeared completely within 1 year. The mean survival after YTx was 9.4 years (range, 0.7–30 yr). Actuarial survival rates at 5, 10, 15, 20, 25, and 30 years were 81, 61, 45, 18, 2, and 0%, respectively. Late complications of YTx were related to the anatomic localization of the cyst, either presellar and retrosellar, e.g., a presellar (prechiasmatic/suprasellar) localization caused neuro-ophthalmological complications in 5.8% and internal carotid artery injury in 1.6%. The treatment of retrosellar (retrochiasmatic, suprasellar) tumors occasionally induced hypothalamic and/or pontomesencephalothalamic damage obviously by untoward radiation to the so-called perforating arteries. This occurred in 3.2% of these latter patients. CONCLUSION Despite sporadic complications, intracavitary YTx irradiation is a valuable treatment alternative for craniopharyngioma cysts, sometimes as part of a multimodality management in these tumors, especially in precarious surgical cases.

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A New Aortic Arch Dissection Classification: The Fuwai Classification

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.710281 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juntao Qiu ◽

Xinjin Luo ◽

Jinlin Wu ◽

Wei Pan ◽

Qian Chang ◽

...

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Survival Rates ◽

Innominate Artery ◽

Long Term Results ◽

Surgical Mortality ◽

Left Carotid Artery ◽

Term Survival ◽

Long Term Survival

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are defined as type Ct. The Chi-square test was adopted for the pairwise comparison among the three types. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation.Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p < 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19).Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.

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D2 Lymphadenectomy for Gastric Adenocarcinoma: Long-term Results and the Impact of Surgeon Experience on the Survival Rates

Chirurgia ◽

10.21614/chirurgia.113.6.772 ◽

2018 ◽

Vol 113 (6) ◽

pp. 772

Author(s):

Stefan Tudor ◽

Traian Dumitrascu ◽

Mircea Manuc ◽

Bogdan Trandafir ◽

Mihnea Ionescu ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Survival Rates ◽

Long Term Results ◽

D2 Lymphadenectomy ◽

Surgeon Experience ◽

The Impact

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Long-Term Results of Kidney Transplantation in the Elderly: Comparison between Different Donor Settings

Journal of Clinical Medicine ◽

10.3390/jcm10225308 ◽

2021 ◽

Vol 10 (22) ◽

pp. 5308

Author(s):

Renana Yemini ◽

Ruth Rahamimov ◽

Ronen Ghinea ◽

Eytan Mor

Keyword(s):

Graft Survival ◽

Cox Regression ◽

Survival Rates ◽

The Elderly ◽

Long Term Results ◽

Live Donor ◽

Allocation Policy ◽

Cox Regression Analysis ◽

Factors Associated

With scarce organ supply, a selection of suitable elderly candidates for transplant is needed, as well as auditing the long-term outcomes after transplant. We conducted an observational cohort study among our patient cohort >60 years old with a long follow up. (1). Patients and Methods: We used our database to study the results after transplant for 593 patients >60 years old who underwent a transplant between 2000–2017. The outcome was compared between live donor (LD; n = 257) recipients, an old-to-old (OTO, n = 215) group using an extended criteria donor (ECD) kidney, and a young-to-old (YTO, n = 123) group using a standard-criteria donor. The Kaplan−Meir method was used to calculate the patient and graft survival and Cox regression analysis in order to find risk factors associated with death. (2). Results: The 5- and 10-year patient survival was significantly better in the LD group (92.7% and 66.9%) compared with the OTO group (73.3% and 42.8%) and YTO group (70.9% and 40.6%) (p < 0.0001). The 5- and 10-year graft survival rates were 90.3% and 68.5% (LD), 61.7% and 30.9% (OTO), and 64.1% and 39.9%, respectively (YTO group; p < 0.0001 between the LD and the two DD groups). There was no difference in outcome between patients in their 60’s and their 70’s. Factors associated with mortality included: age (HR-1.060), DM (HR-1.773), IHD (HR-1.510), and LD/DD (HR-2.865). (3). Conclusions: Our 17-years of experience seems to justify the rational of an old-to-old allocation policy in the elderly population. Live-donor transplant should be encouraged whenever possible. Each individual decision of elderly candidates for transplant should be based on the patient’s comorbidity and predicted life expectancy.

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Dual-Mobility Cups in Primary Total Hip Arthroplasty

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1527-7758 ◽

2021 ◽

Author(s):

Petri Bellova ◽

Jens Goronzy ◽

Roman Riedel ◽

Tim Grothe ◽

Albrecht Hartmann ◽

...

Keyword(s):

Hip Arthroplasty ◽

Neuromuscular Disorders ◽

Survival Rates ◽

High Survival ◽

Dual Mobility ◽

Advantages And Disadvantages ◽

Large Head ◽

Dual Mobility Cups ◽

Primary Hip Arthroplasty

AbstractDual-mobility cups (DMCs) were introduced in France more than 40 years ago and are increasingly used not only in hip revision but also primary hip arthroplasty. Due to a simulated large-head articulation and increased jumping distance, DMCs can contribute to a high range of motion in the hip joint and reduce the risk of instability. Numerous studies have reported low dislocation rates and high survival rates in the mid-term follow-up. Nevertheless, long-term data, especially on primary hip replacement, remain limited, and the effect of recent designs and material innovations is still unclear. Therefore, primary DMCs are mainly proposed in patients at high risk for dislocation (i.e. pelvitrochanteric insufficiency, compromised spinopelvic mobility, neuromuscular disorders, obesity and femoral neck fractures). Based on a review of recently published studies referring to these indications, the current study discusses the advantages and disadvantages of DMCs.

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Errors in Implant Positioning Due to Lack of Planning: A Clinical Case Report of New Prosthetic Materials and Solutions

Materials ◽

10.3390/ma13081883 ◽

2020 ◽

Vol 13 (8) ◽

pp. 1883 ◽

Cited By ~ 7

Author(s):

Marco Tallarico ◽

Roberto Scrascia ◽

Marco Annucci ◽

Silvio Mario Meloni ◽

Aurea Immacolata Lumbau ◽

...

Keyword(s):

Case Report ◽

Treatment Plan ◽

Survival Rates ◽

Primary Treatment ◽

High Survival ◽

Adequate Treatment ◽

Implant Position ◽

Implant Positioning ◽

Implant Placement

The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment plan, is a prerequisite for long-term successful implant-based therapy. The aim of the present case report is to describe a step-by-step prosthetic retreatment of a patient with primary treatment failure due to incorrect dental implant placement. Although dental implants achieve high survival rates, the success of implant prosthetic therapy significantly relies on an appropriate implant position. Malpositioned implants can cause damage to vital structures, like nerves or vessels. Moreover, improper implant positioning can result in esthetic, biological, and technical complications and can, in extreme situations, render the desired prosthetic rehabilitation impossible to achieve.

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Surgical Treatment of Bilateral Lung Cancers: Long-Term Outcomes and Prognostic Factors

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-1685472 ◽

2019 ◽

Vol 68 (07) ◽

pp. 646-651

Author(s):

Francesco Petrella ◽

Samuele Frassoni ◽

Vincenzo Bagnardi ◽

Monica Casiraghi ◽

Daniela Brambilla ◽

...

Keyword(s):

Pulmonary Resection ◽

Survival Rates ◽

Staging System ◽

Patient Characteristics ◽

Tumor Stage ◽

Long Term Results ◽

Long Term Outcomes ◽

Lung Cancers ◽

Bilateral Lung

Abstract Background Bilateral lung neoplasms are becoming more common, but distinguishing two primary lung cancers from metastatic disease can be difficult and only long-term follow-up after treatment can disclose the real behavior of the disease.The present study aimed to identify the appropriate candidates for bilateral surgical resections from the perspective of short-term postoperative complications and long-term outcomes. Methods Two hundred and fifteen consecutive patients undergoing bilateral pulmonary resection for lung cancers over a 20-year period were analyzed. Preoperative patient characteristics were noted, including demographic information, operative details, pathologic information including histology and tumor stage according to the eighth edition of the tumor nodes metastases staging system, and the use of neoadjuvant or adjuvant treatments. Results Patients receiving the second pulmonary resection more than 24 months from the first procedure as well as patients receiving bilateral lobectomies had higher overall 3-, 5-, and 10-year survival rates compared with the others. Conclusion Patients receiving the second resection more than 24 months from the first procedure have the best long-term results irrespective of the type of resection.

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