Analysis of Pelvic Lymph Nodal Metastasis in Operable Cases of Cancer Cervix-A One Year Cohort Study at a Regional Cancer Centre

Medical assistance in dying (maid) is a new medical service in Canada. Access to maid for patients with advanced cancer can be daunting during periods of declining health near the end of life. In this report, we describe a collaborative approach between the centralized coordination service and a regional cancer centre as an effective strategy for enabling interdisciplinary care delivery and enhancing patient-centred care at the end of the patient’s cancer journey.

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Failure of radical hysterectomy in early invasive cancer cervix: an A. H. regional cancer centre experience

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174478 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4277

Author(s):

Jita Parija

Keyword(s):

Treatment Failure ◽

Radical Hysterectomy ◽

Early Stage ◽

Pelvic Lymphadenectomy ◽

First Year ◽

Cancer Cervix ◽

Cancer Centre ◽

Node Involvement ◽

Poorly Differentiated ◽

Regional Cancer Centre

Background: Early invasive invasive carcinoma of cervix is adequately treated by surgery,radiotherapy or by combination of both.The disease-free and overall survival varies from centre to centre. Recurrence of the disease is a reflection of failure in treatment.Methods: A total of 541 cases of Radical hysterectomy with pelvic lymphadenectomy, for early stage cancer cervix performed during the period 2006 April - 2017 March at A. H. Regional Cancer Centre Cuttack, were retrospectively analysed, with an objective to identify the risk factors responsible for treatment failure. All cases were followed-up for 5 years or more.Results: Radiotherapy was supplemented in 27% of cases. Recurrence occurred in 17.18% cases. The incidence of recurrence increased from 13.9% in Stage IB to 26.3% in Stage IIB. Younger patients showed a higher recurrence of 19.16% compared to older group. Poorly differentiated squamous cell carcinoma showed 15.9% recurrence and adenocarcinoma showed 15.38% recurrence. Only 3.7% of recurrence occurred in growths <2cms which increased to 20.6% in tumors >5cms diameter. Infiltrating growths were responsible for treatment failure, recurring in 52.4%. Nodal involvement in >2 groups showed increased recurrence (30%) in contrast to 15.65% in node negative patients. Maximum recurrence occurred in the first year of treatment and beyond three years it looked safe. Adjuvant radiotherapy given in 27%, encountered 18.3% recurrence in comparison to the overall treatment failure.Conclusions: Age, stage, nature of growth, node-involvement, tumor-bulk and histo-pathological grading, combinedly altered the prognosis in early invasive cervical carcinoma treated with radical hysterectomy and selectively supplemented by radiotherapy.

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Faculty Opinions recommendation of Preadmission statin use and one-year mortality among patients in intensive care - a cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4324971.4144071 ◽

2010 ◽

Author(s):

Younsuck Koh ◽

Jin Won Huh

Keyword(s):

Cohort Study ◽

Intensive Care ◽

One Year ◽

Statin Use

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Retrospective analysis of mortality within 30 days of systemic anticancer therapy and comparison with a previous audit at an Australian Regional Cancer Centre

Journal of Oncology Pharmacy Practice ◽

10.1177/10781552211016086 ◽

2021 ◽

pp. 107815522110160

Author(s):

Bernadatte Zimbwa ◽

Peter J Gilbar ◽

Mark R Davis ◽

Srinivas Kondalsamy-Chennakesavan

Keyword(s):

Checkpoint Inhibitors ◽

Anticancer Therapy ◽

Mortality Rates ◽

Feedback Process ◽

Time To Death ◽

Cancer Centre ◽

Haematology Patients ◽

The Mean ◽

Regional Cancer Centre ◽

Mean Time

Purpose To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates. Method All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included. Results Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%). Conclusion The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.

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Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03960-z ◽

2021 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Jacques P. Brown ◽

Jonathan D. Adachi ◽

Emil Schemitsch ◽

Jean-Eric Tarride ◽

Vivien Brown ◽

...

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Fragility Fracture ◽

Mortality Risk ◽

Real World ◽

First Year ◽

Matched Cohort ◽

Matched Cohort Study ◽

Fracture Cohort ◽

One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

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