scholarly journals Impact of examined lymph node count on long-term survival of T1-2N0M0 double primary NSCLC patients after surgery: a SEER study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8692 ◽  
Author(s):  
Kan Jiang ◽  
Xiaohui Zhi ◽  
Yue Shen ◽  
Yuanyuan Ma ◽  
Xinyu Su ◽  
...  
Keyword(s):  
Cox Regression ◽  
Early Stage ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Cutoff Value ◽  
Long Term Survival ◽  
Lymph Node Count ◽  
Primary Nsclc ◽  
Nsclc Patients

Purpose The relationship between examined lymph nodes (ELN) and survival has been confirmed in several single early-stage malignancies. We studied the association between the ELN count and the long-term survival of T1-2N0M0 double primary non-small cell lung cancer (DP-NSCLC) patients after surgery, based on the Surveillance, Epidemiology and End Results (SEER) database. Methods A total of 948 patients were identified and their independent prognostic factors were analyzed. These factors included the ELN count, which related to overall survival (OS) and the cancer-specific survival (CSS) of synchronous (n = 426) and metachronous (n = 522) T1-2N0M0 DP-NSCLC patients after surgery. Results X-tile analysis indicated that the cutoff value for the sum of ELNs was 22 for both OS and CSS in the synchronous DP-NSCLC group. Patients with a sum of ELNs >22 were statistically more likely to survive than those with ≤22 ELNs. X-tile analysis revealed that the ELN count of the second lesion was related to both OS and CSS in the metachronous DP-NSCLC group. The optimal cutoff value was nine. These results were confirmed using univariate and multivariate Cox regression analyses. Conclusion Our findings indicate that ELN count was highly correlated with the long-term survival of T1-2N0M0 double primary NSCLC patients after surgery.

Anatomic resection has superior long-term survival compared with wedge resection for second primary lung cancer after prior lobectomy

2020 ◽  
Author(s):  
Mirza Zain Baig ◽  
Syed S Razi ◽  
Stephanie Stroever ◽  
Joanna F Weber ◽  
Cliff P Connery ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cox Regression ◽  
Early Stage ◽  
Wedge Resection ◽  
Primary Lung Cancer ◽  
Second Primary ◽  
Anatomic Resection ◽  
Term Survival ◽  
Long Term Survival

Abstract OBJECTIVES The extent of surgical resection for early-stage second primary lung cancer (SPLC) in patients with a previous lobectomy is unclear. We sought to compare anatomic lung resections (lobectomy and segmentectomy) and wedge resections for small peripheral SPLC using a population-based database. METHODS The Surveillance, Epidemiology and End Results database was queried for all patients with ≤2 cm peripheral SPLC diagnosed between 2004 and 2015 who underwent prior lobectomy for the first primary and surgical resection only for the SPLC. American College of Chest Physicians guidelines were used to classify SPLC. Kaplan–Meier analysis and multivariable Cox regression were used to compare overall survival. RESULTS A total of 356 patients met the inclusion criteria with 203 (57%) treated with wedge resection and 153 (43%) treated with anatomic resection. Significantly better median survival was observed with anatomic resection than with wedge resection using a Kaplan–Meier analysis (124 vs 63 months; P < 0.001). With multivariable Cox regression, improved long-term survival was observed for anatomic resection (hazard ratio: 0.44, confidence interval: 0.27–0.70; P = 0.001). Improvement in survival was demonstrated with wedge resection when lymph node sampling was done. Lastly, we calculated the average treatment effect on the treated with inverse probability weighting for a subgroup of patients and found that those with wedge resection and lymph node sampling had shorter long-term survival times. CONCLUSIONS Anatomic resections may provide better long-term survival than wedge resections for patients with early-stage peripheral SPLC after prior lobectomy. Significant improvement in survival was observed with wedge resection for SPLC when adequate lymph node dissection was performed.

scholarly journals Undifferentiated Embryonal Sarcoma of the Liver in Children Versus Adults: A National Cancer Database Analysis

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2918
Author(s):  
Ioannis A. Ziogas ◽  
Irving J. Zamora ◽  
Harold N. Lovvorn III ◽  
Christina E. Bailey ◽  
Sophoclis P. Alexopoulos
Keyword(s):  
Surgical Treatment ◽  
Cox Regression ◽  
Clinicopathological Characteristics ◽  
National Cancer Database ◽  
Term Survival ◽  
Long Term Survival ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Embryonal Sarcoma

This study evaluates the clinicopathological characteristics and outcomes of children vs. adults with undifferentiated embryonal sarcoma of the liver (UESL). A retrospective analysis of 82 children (<18 years) and 41 adults (≥18 years) with UESL registered in the National Cancer Database between 2004–2015 was conducted. No between-group differences were observed regarding tumor size, metastasis, surgical treatment, margin status, and radiation. Children received chemotherapy more often than adults (92.7% vs. 65.9%; p < 0.001). Children demonstrated superior overall survival vs. adults (log-rank, p < 0.001) with 5-year rates of 84.4% vs. 48.2%, respectively. In multivariable Cox regression for all patients, adults demonstrated an increased risk of mortality compared to children (p < 0.001), while metastasis was associated with an increased (p = 0.02) and surgical treatment with a decreased (p = 0.001) risk of mortality. In multivariable Cox regression for surgically-treated patients, adulthood (p = 0.004) and margin-positive resection (p = 0.03) were independently associated with an increased risk of mortality. Multimodal treatment including complete surgical resection and chemotherapy results in long-term survival in most children with UESL. However, adults with UESL have poorer long-term survival that may reflect differences in disease biology and an opportunity to further refine currently available treatment schemas.

Abstract 19408: Impact of Perioperative Liver Dysfunction on In-hospital Mortality and Long-term Survival in Infective Endocarditis Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mahmoud Diab ◽  
Christoph Sponholz ◽  
Michael Bauer ◽  
Andreas Kortgen ◽  
Philipp Scheffel ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Liver Dysfunction ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Aureus Infection

Background: Infective endocarditis (IE) is a dangerous disease with high mortality (20-40%). A leading cause of death is multi-organ failure (MODS) with liver dysfunction (LD) as major contributor. Data on LD in IE patients are scarce. We assessed the impact of preoperative - and newly occurring LD on in-hospital mortality and long-term survival in IE patients. Methods: We retrospectively reviewed our database for surgery of left-sided endocarditis between 1/07 and 4/13. We used the hepatic Sepsis-related Organ Failure Assessment (hSOFA) score to assess the degree of LD. We performed Chi-Square, Cox regression and multivariate analyses. Results: The 308 patients had a mean age of 62 ±13.9. Preoperative LD (hSOFA > 0, Bilirubin > 32 μmol/L) was present in 1/4 (n=81) of patients and was associated with severely elevated in-hospital mortality (51.9% vs.14.6% without preoperative LD, p<0.001). Newly-occurring postoperative LD developed in another quarter (n=57 of 227 patients without LD) of patients and was associated with elevated in-hospital mortality (24.6% vs. 11.2%, p<0.001). Kaplan-Meyer 5-year survival was significantly better in patients without LD (51% vs. 19.9%, p<0.01). Survival curves were practically identical after the perioperative phase was over (Fig.). Quality of life in survivors was also the same. Cox regression analysis revealed preoperative LD as independent predictor of long-term survival (adjusted hazard ratio 1.695, 95% confidence interval 1.160-2.477, p=0.009) and duration of cardiopulmonary bypass (CPB) and S. aureus infection as independent predictors of newly-occurring postoperative LD. Conclusions: LD in patients with endocarditis is a significant independent risk factor for in-hospital mortality. A considerable fraction of patients develop LD perioperatively, which is associated with cardiopulmonary bypass-duration and S. aureus infection. However, after surviving surgery, prognosis no longer seems to be predicted by LD.

scholarly journals NT-proBNP and postoperative heart failure in surgery for aortic stenosis

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e001063 ◽  
Author(s):  
Huiqi Jiang ◽  
Farkas Vánky ◽  
Henrik Hultkvist ◽  
Jonas Holm ◽  
Yanqi Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Cox Regression ◽  
Preoperative Evaluation ◽  
Area Under The Curve ◽  
Term Survival ◽  
Long Term Survival ◽  
Clinical Endpoints ◽  
Long Term Consequences

ObjectivePostoperative heart failure (PHF) after aortic valve replacement (AVR) for aortic stenosis (AS) may initially appear mild and transient but has serious long-term consequences. Methods to assess PHF are not well documented. We studied the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PHF after AVR for AS.MethodsThis is a prospective, observational, longitudinal study of 203 patients undergoing elective first-time AVR for AS. Plasma NT-proBNP was assessed at preoperative evaluation, the day before surgery, and the first (POD1) and third postoperative morning. A clinical endpoints committee, blinded to NT-proBNP results, used prespecified haemodynamic criteria to diagnose PHF. The mean follow-up was 8.6±1.1 years.ResultsNo patient with PHF (n=18) died within 30 days after surgery, but PHF was associated with poor long-term survival (HR 3.01, 95% CI 1.45 to 6.21, p=0.003). NT-proBNP was significantly higher in patients with PHF only on POD1 (6415 (3145–11 220) vs 2445 (1540–3855) ng/L, p<0.0001). NT-proBNP POD1 provided good discrimination of PHF (area under the curve=0.82, 95% CI 0.72 to 0.91, p<0.0001; best cut-off 5290 ng/L: sensitivity 63%, specificity 85%). NT-proBNP POD1 ≥5290 ng/L identified which patients with PHF carried a risk of poor long-term survival, and PHF with NT-proBNP POD1 ≥ 5290 ng/L emerged as a risk factor for long-term mortality in the multivariable Cox regression (HR 6.20, 95% CI 2.72 to 14.1, p<0.0001).ConclusionsThe serious long-term consequences associated with PHF after AVR for AS were confirmed. NT-proBNP level on POD1 aids in the assessment of PHF and identifies patients at particular risk of poor long-term survival.

scholarly journals Long-term survival without surgery in NSCLC patients with synchronous brain oligometastasis: systemic chemotherapy revisited

2018 ◽  
Vol 10 (3) ◽  
pp. 1696-1702 ◽  
Author(s):  
Jun Sato ◽  
Hidehito Horinouchi ◽  
Yasushi Goto ◽  
Shintaro Kanda ◽  
Yutaka Fujiwara ◽  
...  
Keyword(s):  
Systemic Chemotherapy ◽  
Term Survival ◽  
Long Term Survival ◽  
Nsclc Patients
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