Analysis of remote results of treatment of patients with maxillary sinus cancer

Maxillary sinus cancer is one of the most complex malignancies to treat and has an unfavorable prognosis for long-term outcomes. The purpose of the study: based on the evaluation of long-term treatment outcomes (mortality, survival) to analyze the effectiveness of treatment of patients with maxillary sinus cancer and other factors which influence the outcome, including the level of expression of molecular markers. Object and methods: Long-term results of surgical treatment of 103 patients with maxillary sinus cancer stage II-IV (T2-4N0-3M0) were evaluated, which was performed in the ENT oncology department of І.І. Mechnikov Dnipropetrovsk Regional Clinical Hospital over the period of 2011-2017. Remote follow-up of patients was conducted until 2019. Results: The effectiveness of the treatment is confirmed by the analysis of survival in the studied sample: annual survival of 87.36% (95% CI 80.94-93.78); three-years’ survival – 42.75% (95% CI 33.2-52.3); five-years’ survival – 19.76% (95% CI 12.07-27.45); median survival – 32.13 (95% CI 27.0-53.0) months. Using a regression analysis of the proportional risks by Cox, it was proved that patients with recurrences of thyroid cancer die from cancer 3.13 times more often (p=0.009) than individuals in whom cancer was not accompanied by recurrence, with increasing expression of the marker TIMP-1 per unit the risk of adverse outcomes for patients is reduced by 2.56 times (p=0.034). Conclusions: Evaluation of long-term treatment outcomes (mortality, one-, three-, and five-years’ survival) of patients with maxillary sinus cancer has proven the effectiveness of treatment and approaches to their determination.

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APPLICATION OF NEW TECHNIQUES IN THE TREATMENT OF PATIENTS WITH FRACTURES OF LONG TUBULAR BONES IN SEVERE COMBINED TRAUMA

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-9-59-66 ◽

2021 ◽

pp. 59-66

Author(s):

Khromov A.A. ◽

Gumanenko E.K. ◽

Linnik S.A.

Keyword(s):

Quality Of Life ◽

Surgical Intervention ◽

Term Treatment ◽

Long Term Results ◽

Results Of Treatment ◽

Long Term Treatment ◽

Combined Injuries ◽

Tubular Bones

Severe combined injuries, and especially polytrauma, differ significantly from other types of injuries by high requirements for the organization of medical care at all its stages, miltidisciplinarity, high financial costs, poor short-term outcomes and long-term treatment results. Therefore, the search for new concepts, strategies and tactics for the treatment of victims is an urgent problem not only for surgeons, resuscitators and traumatologists, but also for healthcare in general. Fractures of long tubular bones accompanying severe combined injuries or polytrauma pose a lesser threat to the life of the victim than severe traumatic brain injuries or damage to internal organs, but they are the main cause of long-term treatment and disability. Such victims make up a significant group of patients-66.2%, therefore they represent a separate problem in traumatology and injury surgery. A modern solution to this problem, improving the results of treatment and the quality of life of victims after suffering a severe combined injury or polytrauma is possible on the basis of new approaches, as well as on the new ideology of osteosynthesis. In the present study, 392 minimally invasive osteosyntheses were performed in 274 patients with severe combined trauma and polytrauma. The indication was the need to fix fractures in order to create favorable conditions for rapid and lasting fusion, early functional treatment and rehabilitation of victims, and to achieve the highest possible level of quality of life after treatment. The possibility and duration of osteosynthesis were determined by the severity of the condition of the victims, assessed by objective methods: a simple clinical scale of VPH-SG or, much less often, specialized resuscitation scales of VPH-SS, SAPS or MODS. The surgical intervention was possible when the severity of the victim's condition reached the highest level of compensation: 16-30 points on the VPH-SG scale. The immediate outcomes of treatment of 274 patients with severe combined trauma and polytrauma after performing a full and final volume of surgery were good. There were no fatal outcomes. The frequency of mild local infectious complications in the field of surgical intervention was 4.0%. The average duration of inpatient treatment was 23.8±2.3 days: with closed intramedullary osteosynthesis - 19.8±0.3 days, with bone osteosynthesis - 24.2±1.2 days, with non - focal osteosynthesis-27.3±1.9 days. The long-term and anatomical and functional results of treatment were analyzed in 158 patients. There were no unsatisfactory long-term results of treatment. Good long-term results were achieved in 81.0%, satisfactory – in 19.0% of the victims. Thus, the results of the analysis of the immediate outcomes and long-term results of treatment of fractures of long tubular bones using the technology of minimally invasive osteosynthesis in patients with severe combined trauma and polytrauma demonstrated the high effectiveness of this surgical technology, on the one hand, and the direct dependence of the treatment outcomes on the severity of the injuries, the severity of the condition of the victims and the number of fractures in one victim, on the other hand.

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THE EXPERIENCE OF DENERVATION OF FACET JOINTS IN THE LUMBAR SPINE

Hirurgiâ pozvonočnika ◽

10.14531/ss2019.1.57-62 ◽

2019 ◽

Vol 16 (1) ◽

pp. 57-62 ◽

Cited By ~ 1

Author(s):

M. V. Shpagin ◽

A. V. Yarikov ◽

I. A. Nazmeev ◽

S. A. Gorelov ◽

A. P. Fraerman

Keyword(s):

Lumbar Spine ◽

Term Treatment ◽

Long Term Results ◽

Facet Joints ◽

Treatment Results ◽

Results Of Treatment ◽

Long Term Treatment ◽

Invasive Method ◽

Facet Syndrome

Objective.To analyze the immediate and long-term results of denervation of facet joints for facet syndrome in the lumbar spine.Material and Methods.The immediate and long-term results of the treatment of 59 patients with severe pain in the lumbar spine who underwent facet joints denervation were studied.Results.On a MacNab scale, 39 (66.1 %) patients rated the treatment results as good, and 20 (33.9 %) as mediocre. According to the Nurick scale, the 2nd level results of treatment (improvement) were recorded in 55 (93.2 %) cases, the 3rd level ones (unaltered) – in 4 (6.8 %). The follow-up data were collected on 37 (62.7 %) patients from 1.7 months up to 1.5 years after surgery: 13 (35.2 %) of them rated the long-term treatment results as good, 8 (21.6 %) – as mediocre, and 16 (43.2 %) – as bad.Conclusions.Denervation of facet joints is an effective minimally invasive method for treating facet syndrome caused by spondyloarthrosis. It allows significantly reducing pain and improving the quality of life of patients in the early and long-term postoperative period.

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Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

PsycEXTRA Dataset ◽

10.1037/e612192013-001 ◽

2013 ◽

Author(s):

Christina Marel ◽

Maree Teesson ◽

Shane Darke ◽

Katherine Mills ◽

Joanne Ross ◽

...

Keyword(s):

Treatment Outcomes ◽

Term Treatment ◽

Heroin Dependence ◽

Long Term Treatment

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Invasion of the pterygoid plates: an indicator for regional lymph node failure in maxillary sinus cancer

Radiation Oncology ◽

10.1186/s13014-020-01726-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yasuo Kosugi ◽

Terufumi Kawamoto ◽

Masaki Oshima ◽

Mitsuhisa Fujimaki ◽

Shinichi Ohba ◽

...

Keyword(s):

Lymph Node ◽

Oral Cavity ◽

Maxillary Sinus ◽

Regional Lymph Node ◽

Locally Advanced ◽

Intraarterial Chemotherapy ◽

Node Failure ◽

Long Term Treatment ◽

Maxillary Sinus Cancer ◽

Sinus Cancer

Abstract Background The aim of this study was to evaluate the long-term treatment results of combined superselective intraarterial chemotherapy and radiation therapy for advanced maxillary sinus cancer (MSC) and the incidence of regional lymph node failure, and to reveal the clinical and anatomical predictive factors for metastasis. Methods We retrospectively evaluated 55 consecutive patients with locally advanced squamous cell carcinoma of the maxillary sinus who were treated with external radiotherapy and superselective intraarterial chemotherapy. Elective nodal irradiation (ENI) was performed only in the clinical node-positive (cN+) cases and not in the clinical node-negative (cN0) cases. Results: Thirty-eight patients were cN0, and 17 were cN+ at diagnosis. Regional lymph node metastases occurred in 7 of 38 patients with cN0, and 2 of 17 with cN+ during the median follow-up period of 36 months. There were more cases of high-grade (3 or 4) late adverse events in the ENI group than in the non-ENI group (13% vs. 41%, respectively; p = 0.03). In cN0 cases without ENI, invasion of the pterygoid plates (57% vs. 90%; p < 0.01) and oral cavity (35% vs. 92%, with invasion vs without invasion, respectively; p = 0.02) was significantly correlated with a low 5-year regional recurrence-free rate. Conclusions Patients with MCS and invasion of the pterygoid plates and oral cavity can be considered appropriate candidates for ENI.

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