scholarly journals Clinical, Pathological, Laboratory Characteristics, and Treatment Regimens of Kimura Disease and Their Relationships With Tumor Size and Recurrence

2021 ◽  
Vol 8 ◽  
Author(s):  
Lina Fan ◽  
Shiyan Mo ◽  
Yanyan Wang ◽  
Jian Zhu
Keyword(s):  
Surgical Treatment ◽  
Combination Therapy ◽  
Tumor Size ◽  
Clinical Symptoms ◽  
Disease Recurrence ◽  
Tumor Diameter ◽  
Kimura Disease ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Maximum Tumor Diameter

Objective: As of date, Kimura disease (KD) has an unclear etiology, no accepted diagnostic standard, and no definite treatment regimen. In this study, clinical and pathological laboratory characteristics and treatment regimens of patients with KD with different tumor sizes and status of tumor recurrence were analyzed. This was performed to identify the factors, which determine tumor size and recurrence, and to identify effective treatment methods for patients with KD.Methods: A total of 33 hospitalized patients with a definite diagnosis of KD were enrolled in this study.Results: There were 15 patients (45.5%) with a maximum tumor diameter of <3 cm. There were no statistically significant differences in age, gender, clinical symptoms, lesion sites, laboratory indicators, and treatment regimens among patients with a maximum tumor diameter <3 cm or ≥3 cm (P > 0.05). Among the 25 patients who completed the follow-up, there were 18 patients (72%) who had a recurrence of KD. There were no statistically significant differences in age, gender, clinical symptoms, the maximum tumor diameter, lesion sites, laboratory indicators, and initial treatment regimens between patients with or without the recurrence of KD (P > 0.05). There was a statistically significant difference in systolic blood pressure (SBP) between patients with or without the recurrence of KD (P < 0.05). All patients who received only surgical treatment had disease recurrence, 33.3% of patients who received prednisone therapy had no disease recurrence, and 37.5% of patients who received combination therapy showed recurrence.Conclusion: The current study summarized clinical manifestations, pathological features, laboratory indicators, and treatment regimens of patients with KD. There were no significant differences in these aspects among patients with different tumor sizes, and there was no significant difference in these aspects except in the SBP between patients with or without the recurrence of KD, indicating that SBP is a significant clinical factor affecting disease recurrence in patients. Combination therapy with prednisone was found to be superior to surgical treatment.

scholarly journals Higher Rate of Hyperbilirubinemia and Arrythmia in COVID-19 Cases Receiving Combination Therapy Atazanavir /ritonavir vs. Lopinavir /ritonavir

2021 ◽  
Author(s):  
Hossein Mazaherpour ◽  
Masoomeh Sofian ◽  
Elham Farahani ◽  
Alireza Abdi ◽  
Sakine Mazaherpour ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Combination Therapy ◽  
Clinical Symptoms ◽  
Length Of Hospital Stay ◽  
Severe Form ◽  
The Other ◽  
Combination Therapies ◽  
Treatment Regimens ◽  
Significant Difference

Background: Many treatments for COVID-19 are currently under studying, such as combination therapies with hydroxychloroquine plus antiviral drugs. In this study, we compared the efficacy and side effects of two types of combination therapy including atazanavir /ritonavir (ATV/r) or lopinavir /ritonavir (LPV/r) plus hydroxychloroquine among COVID-19 patients. Methods: In a non-randomized clinical trial, 108 eligible patients with moderate and severe form of COVID-19 were divided into two groups. Each group consisted of 54 patients. One group received ATV/r plus hydroxychloroquine and the other group received hydroxychloroquine plus LPV/r. Then, the two groups were evaluated and compared for clinical symptoms, recovery rates and complications of treatment regimens. Results: The findings of this research showed a significant increase in bilirubin in ATV/r receiving group compared to LPV/r receivers (p<0.001). there was also a significant increase in arrhythmias in the LPV/r group compared to ATV/r group during the treatment period (p=0.019). Other findings including length of hospital stay, outcome, and treatment complications were not statistically significant. Conclusions: There is not statistically significant difference between protease inhibitor drugs including ATV/r and LPV/r in the treatment of COVID-19 regarding to progress and clinical outcomes. However, some side effects such as hyperbilirubinemia and arrhythmia was significantly different by application of atazanavir or lopinavir.

Significance of Platelet and AFP Levels and Liver Function Parameters for HCC Size and Survival

2014 ◽  
Vol 29 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Brian I. Carr ◽  
Vito Guerra ◽  
Edoardo G. Giannini ◽  
Fabio Farinati ◽  
Francesca Ciccarese ◽  
...  
Keyword(s):  
Tumor Size ◽  
Blood Platelet ◽  
Tumor Diameter ◽  
Proportional Hazard ◽  
Gamma Glutamyl Transpeptidase ◽  
Vein Thrombosis ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Maximum Tumor Diameter ◽  
Glutamyl Transpeptidase

Background Hepatocellular carcinoma (HCC) is a heterogeneous disease with both tumor and liver factors being involved. Aims To investigate HCC clinical phenotypes and factors related to HCC size. Methods Prospectively-collected HCC patients' data from a large Italian database were arranged according to the maximum tumor diameter (MTD) and divided into tumor size terciles, which were then compared in terms of several common clinical parameters and patients' survival. Results An higer MTD tercile was significantly associated with increased blood alpha-fetoprotein (AFP), gamma-glutamyl transpeptidase (GGTP), and platelet levels. Patients with higher platelet levels had larger tumors and higher GGTP levels, with lower bilirubin levels. However, patients with the highest AFP levels had larger tumors and higher bilirubin levels, reflecting an aggressive biology. AFP correlation analysis revealed the existence of 2 different groups of patients: those with higher and with lower AFP levels, each with different patient and tumor characteristics. The Cox proportional-hazard model showed that a higher risk of death was correlated with GGTP and bilirubin levels, tumor size and number, and portal vein thrombosis (PVT), but not with AFP or platelet levels. Conclusions An increased tumor size was associated with increased blood platelet counts, AFP and GGTP levels. Platelet and AFP levels were important indicators of tumor size, but not of survival.

CRANIOPHARYNGIOMA IN THE ELDERLY: A MULTICENTER AND NATION-WIDE STUDY IN SPAIN

2020 ◽  
Author(s):  
Pedro Iglesias ◽  
Ignacio Nocete ◽  
María Dolores Moure Rodríguez ◽  
Eva Venegas-Moreno ◽  
Jessica Ares ◽  
...  
Keyword(s):  
Visual Field ◽  
Clinical Symptoms ◽  
The Elderly ◽  
National Study ◽  
Visual Field Defects ◽  
Subtotal Resection ◽  
Similar Distribution ◽  
Tumor Diameter ◽  
Maximum Tumor Diameter ◽  
Field Defects

Background. Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim. To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods. A retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated was performed. Results. From a total of 384 adult CP patients, we selected 53 (13.8%) patients [27 women (50.9%), mean age 72.3 ± 5.1 years (range 65-83 yr)] diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). Maximum tumor diameter was 2.9 ± 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%) and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP (ACP) and papillary CP (PCP) were present in 51% and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9% to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs 53.6%, p=0.008). Patients were followed for 46.7±40.8 months. Mortality rate was 39.6% with a median survival time of 88 (95% CI, 57-118) months. DI at last visit was associated with a lower survival. Conclusion. CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population.

The possibilities of treatment of gastrointestinal stromal tumors.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 222-222
Author(s):  
Stanislaw Gluszek ◽  
Dorota Koziel ◽  
Jarosław Matykiewicz ◽  
Rafal Rylski
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Gastric Wall ◽  
Safety Margin ◽  
Gastrointestinal Stromal Tumour ◽  
Tumour Resection ◽  
Imatinib Treatment ◽  
Tumor Diameter

222 Background: Gastrointestinal stromal tumour (GIST) is the most common mesenchymal tumour of digestive tract, presesting less than 1% of all digestive tumours. This study is analyse a group of patients treated surgically due to GIST. Methods: The group of 71 patients consisted of 34 males and 37 females between the age of 32 and 89 (M 44-83, average 64.6; F 43-89, average 66.5) treated surgically due to GIST. Analysis included clinical symptoms, diagnosis, surgical treatment, location of tumour, outcome of histopathological and immunohistochemical examinations, recurrence of disease, metastases and mortality rate. Results: Among 71 GIST patients 35 were with low aggressivity level, 14 with average and 22 with high. Most of patients were subjected to surgical treatment (laparoscopic or open) on a planned basis and in 3 cases on an emergency basis due to the intensified symptoms of intestinal occlusion, 50 patients were found to have gastric tumours, 3 duodenal tumours, 13 small intestine tumours, 3 colonic tumours, 2 rectal tumours. Histopathological examination outcome showed radical tumour resection in all cases Tumours of size exceeding 5 cm in diameter were found in 30 cases. Most patients had definited type of mutation. Predominated mutations localized in exon 11. There was no perioperative mortality rate. During follow up (from 1 month to 130 months), 16 patients died, including 4 due to GIST dissemination, 4 were diagnosed with recurrence of GIST and two of them were qualified for imatinib treatment others died of cardio-vasculary diseases. Most of patient underwent resection of tumor with safety margin of gastric wall (21), 5 patients were treated by laparoscopic surgery. All patients, who subsequently had postoperative recurrence or died due to GIST metastases, were diagnosed with highly aggressive tumor. Conclusions: GIST - still unknown treatment possibilities [surgery, imatinib, other specific tyrosine kinase inhibitors, what next?]. Analysis of cases from our study confirms that large size of tumor (diameter > 5cm) and high mitotic index (MI >5/50 HPF) are factors associated with bad prognosis (metastases, recurrence).

scholarly journals How much tumor volume is responsible for development of clinical symptoms in patients with convexity, parasagittal, and falx meningiomas?

2021 ◽  
Author(s):  
Shuhei Yamada ◽  
Noriyuki Kijima ◽  
Tomoyoshi Nakagawa ◽  
Ryuichi Hirayama ◽  
Manabu Kinoshita ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Clinical Symptoms ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Area Under The Curve ◽  
Volumetric Analysis ◽  
Tumor Diameter ◽  
Peritumoral Edema ◽  
Asymptomatic Group ◽  
Maximum Tumor Diameter

Abstract Purpose Meningiomas are the most common primary intracranial neoplasms. Their volume and location are important factors related to the appearance of clinical symptoms. This study aimed to identify factors that influence clinical symptoms and to determine a specific threshold tumor volume for the prediction of symptomatic progression in patients with convexity, parasagittal, and falx meningiomas. Methods We retrospectively studied patients with radiologically suspected convexity, parasagittal, or falx meningiomas at our institution. Results The data of three hundred thirty-three patients were analyzed. We further divided patients into two groups based on clinical symptoms: as asymptomatic group (250 cases) and a symptomatic group (83 cases). Univariate analysis revealed significant differences between the groups in terms of sex (p = 0.002), age at the time of volumetric analysis (p < 0.001), hyperintense lesions on T2-weighted images (p = 0.029), peritumoral edema (p < 0.001), maximum tumor diameter (p < 0.001), and tumor volume (p < 0.001). Further multivariate analysis revealed significant differences between the groups in terms of age at the time of volumetric analysis (p = 0.002), peritumoral edema (p < 0.001), and tumor volume (p < 0.001). Receiver operating characteristic curve revealed a threshold tumor volume of 21.1 ml for predicting whether a patient would develop symptoms (sensitivity 0.843, specificity 0.880, an area under the curve 0.919 [95% confidence interval: 0.887–0.951]). Conclusion We identified factors predictive of clinical symptoms in patients with convexity, parasagittal, and falx meningiomas and determined the first-ever threshold tumor volume for predicting symptomatic progression in such patients.

scholarly journals Differential Dermatologic Adverse Events Associated With Checkpoint Inhibitor Monotherapy and Combination Therapy: A Meta-Analysis of Randomized Control Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Yang Ge ◽  
Huiyun Zhang ◽  
Nathaniel Weygant ◽  
Jiannan Yao
Keyword(s):  
Relative Risk ◽  
Combination Therapy ◽  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
High Grade ◽  
Treatment Regimens ◽  
Increased Risk ◽  
Significant Difference ◽  
Dermatologic Adverse Events

Background: As immune checkpoint inhibitors (ICIs) transition to the forefront of cancer treatment, a better understanding of immune related adverse events (IRAEs) is essential to promote safe clinical practice. Dermatologic adverse events are the most common IRAEs and can lead to drug withdrawal and decreased quality of life. This meta-analysis aimed to investigate the risk of the most prevalent dermatologic adverse events (pruritus and rash) among various ICI treatment regimens.Methods: A systematic search of electronic databases was performed to identify qualified randomized controlled trials (RCTs). Data for any grade and high grade pruritus and rash were extracted for meta-analysis. Two reviewers independently assessed methodological quality. The relative risk summary and 95% confidence interval were calculated.Results: 50 RCTs involving 29941 patients were analyzed. The risk of pruritus (2.15 and 4.21 relative risk respectively) and rash (1.61 and 3.89 relative risk respectively) developing from CTLA-4 or PD-1/-L1 inhibitor were increased compared to placebo, but this effect was not dose-dependent. PD-1/-L1 plus CTLA-4 inhibitor was associated with increased risk of pruritus (1.76 and 0.98 relative risk respectively) and rash (1.72 and 1.37 relative risk respectively) compared to either monotherapy. Compared with CTLA-4 inhibitor, PD-1/-L1 inhibitor had a significantly decreased risk of pruritus and rash in both monotherapy and combination therapy (0.65 and 0.29 relative risk respectively). No significant difference was found between PD-1/-L1 inhibitor combined with chemotherapy and PD-1/-L1 monotherapy in any grade and high grade rash (0.84 and 1.43 relative risk respectively). In subgroup analyses, PD-1 inhibitor was associated with reduced risk of pruritus and rash compared to PD-L1 inhibitor.Conclusion: Our meta-analysis demonstrates a better safety profile for PD-1/-L1 inhibitor compared to CTLA-4 inhibitor in terms of pruritus and rash among both monotherapy and multiple combination therapies. PD-L1 inhibitor may contribute to an increased risk of pruritus and rash compared to PD-1 inhibitor.

Comparative study of chemoradiation and neoadjuvant chemotherapy effects before radical hysterectomy in stage IB–IIB bulky cervical cancer and with tumor diameter greater than 4 cm

2005 ◽  
Vol 15 (3) ◽  
pp. 483-488
Author(s):  
M. Modarress ◽  
F. Q. Maghami ◽  
M. Golnavaz ◽  
N. Behtash ◽  
A. Mousavi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Hysterectomy ◽  
Tumor Size ◽  
Pathologic Complete Response ◽  
Residual Tumor ◽  
Preoperative Treatment ◽  
Tumor Diameter ◽  
Stage Ib ◽  
Significant Difference

Tumor size seems to be a determinant in the prognosis of early cervical cancer. Patients with tumor greater than 4 cm (bulky) in diameter have worse outcome. The purpose of this study was to compare the efficacy of preoperative combined chemoradiation and neoadjuvant chemotherapy (NAIC) programs followed by radical hysterectomy in stage IB–IIB bulky cervical cancer. From September 1999 to April 2002, 60 patients with stage IB–IIB bulky cervical cancer were treated with preoperative external-beam radiotherapy to 45 Gy plus weekly cisplatin 50 mg/m2 or preoperative NAIC by cisplatin 50 mg/m2 and vincristin 1 mg/m2 every 7–10 days, for three courses. Surgery was performed 4–6 weeks after the completion of the preoperative treatment. There were no significant difference between age, stage, tumor size, and histopathologic type in two groups (P > 0.05). Toxicity associated with two treatment methods was usually mild. In chemoradiation group, two patients developed vesicovaginal fistula, and four patients developed long-term hydronephrosis that needed urethral stenting. Before surgery, complete and partial clinical response had no significant difference between two groups (P > 0.05). After surgery, lymph node and parametrial involvement had no significant difference between two groups (P > 0.05). In NAIC group, more patients had significantly residual tumor (P = 0.012), but residual tumor size had no significant difference between two groups (P > 0.05). Pathologic complete response was significantly higher in chemoradiation group (P = 0.004). According to the result of this study, it seems that NAIC and chemoradiation had similar effects in survival prognostic factors.

Indications and Long-Term Outcome after Elective Surgery for Hepatocellular Adenoma

2012 ◽  
Vol 78 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Aristotelis Perrakis ◽  
Volker Müller ◽  
Karin Oeckl ◽  
Boris Adamietz ◽  
Resit Demir ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Elective Surgery ◽  
Demographic Data ◽  
Hepatocellular Adenoma ◽  
Tumor Diameter ◽  
Safe Procedure ◽  
Term Outcome ◽  
Long Term Outcome

The management of hepatocellular adenoma (HA) is dependent on several parameters, which are influencing the decision for further management. The aim of this study was to evaluate the clinical presentation, indications, and long-term outcome of surgical treatment in a single-institution analysis. Forty-nine patients underwent elective hepatectomy for HA between 1990 and 2007. Analysis parameters included demographic data, lesion number and size, diagnostic method, mode of surgery, and postoperative outcome. Mean follow-up was 108 months. Thirty-six patients underwent hormone therapy and four patients had a history of cancer before surgical treatment. The mean tumor diameter was 9.8 cm. Mild or moderate postoperative complications were recorded in 16 patients. There was no perioperative mortality. Symptoms were relieved in 95 per cent of the patients. Intratumoral hemorrhage was detected in 21 specimens (43%); malignant transformation was detected in zero specimens. Among patients with HA with clinical symptoms, tumor diameter greater than 5 cm and in male patients the indication for surgery should be given because of the high risk of tumor-related complications. Elective liver resection for HA is a safe procedure and results in a good long-term outcome.

scholarly journals Maximum tumor diameter is associated with event-free survival in PET-negative patients with stage I/IIA Hodgkin lymphoma

2020 ◽  
Vol 4 (1) ◽  
pp. 203-206 ◽  
Author(s):  
Tim M. Illidge ◽  
Elizabeth H. Phillips ◽  
Nicholas Counsell ◽  
Ruth Pettengell ◽  
Peter W. M. Johnson ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Tumor Size ◽  
Stage I ◽  
Important Predictor ◽  
Tumor Diameter ◽  
Event Free Survival ◽  
Free Survival ◽  
Key Points ◽  
Maximum Tumor Diameter ◽  
Consolidation Radiotherapy

Key Points Baseline maximum tumor diameter is an important predictor of relapse for patients with ES-HL achieving complete metabolic remission. Patients with baseline tumor size ≥5 cm have worse outcomes with ABVD alone and are likely to benefit from consolidation radiotherapy.

Comparing clinicopathologic feature and treatment outcome of patients who underwent surgical resection or liver transplant for nonalcoholic fatty liver disease (NAFLD)-related and non-NAFLD related hepatocellular carcinoma (HCC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16675-e16675
Author(s):  
Surendra Pal Chaudhary ◽  
Lipika Goyal ◽  
Matthew L Chase ◽  
Andrew X. Zhu ◽  
Nikroo Hashemi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Liver Transplant ◽  
Tumor Size ◽  
Massachusetts General Hospital ◽  
Disease Recurrence ◽  
Large Tumor ◽  
Nonalcoholic Fatty Liver ◽  
Risk Of Death ◽  
Clinicopathologic Feature ◽  
Significant Difference

e16675 Background: NAFLD associated HCC is rapidly increasing in frequency worldwide. In this study, we evaluated potential differences in clinical characteristics and outcomes of patients who underwent surgery or liver transplant for NAFLD-associated HCC compared to HCC from other etiologies. Methods: Demographic, clinicopathological features and outcomes of patients with HCC who underwent liver resection or liver transplant at Massachusetts General Hospital and Brigham and Women’s Hospital were collected (January 2004 - April 2018). Of 713 patients screened, 481were eligible: 260 underwent resection [NAFLD (n = 61), viral (n = 150), cryptogenic (CC) (n = 49)]. 221 underwent transplant [(NAFLD (n = 14), viral (n = 201), CC (n = 6)]. Results: In the Resected cohort, NAFLD patients presented with median age of (71.5 years) compared with Viral (63.4) and Cryptogenic (68.4). NAFLD patients had significantly higher Body Mass Index (BMI) > 28.8 39(66%) p = < 0.001, while patients with cryptogenic HCC presented with large tumor size (>5cm) 37(75%) p = 0.001. In multivariate analysis, tumor size 5cm (HR1.78,p = 0.002), R1 or R2 resection (HR 2.48, p = < 0.001and 2.8,p = 0.007), low platelet count (HR 2.8,p = 0.002) and diabetes (HR 1.5,p = 0.025) were poor prognostic factors in resection cohort. Median overall survival (OS) was not significantly different between NAFLD, Cryptogenic and Viral (47.2, 69.7 and 69.0 months, p = 0.18) etiologies, respectively. In the Transplant cohort, NAFLD patients had a median age of 65.5 and cryptogenic, viral (61.3 and 58.5 years) respectively. NAFLD and Cryptogenic HCC patients compared with viral HCC patients had low AFP median 3.7, 3.9 and 7.5 ng/mL(p = 0.012) respectively. In multivariate analysis patients with perineural invasion (HR 20.7,p = 0.009), disease recurrence (HR 2.5,p = 0.001) and high AFP (HR 2.1,p = 0.001) were at higher risk of death among transplant patients. No significant difference in median OS was seen between NAFLD, cryptogenic and viral (69.1,92.3 and 88.0 months, p = 0.38). Conclusions: NAFLD patients had higher BMI and had a lower AFP than viral and CC. NAFLD had similar median OS following resection and transplant when compared to those with Viral and CC.

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