Background: The clinical characteristics of patients who had lymph node-negative early breast cancer were assessed.
Patients and Methods: We assessed a total of 576 patients in the study, including ...74 patients (12.8%) with T1a, 119 patients (20.7%) T1b, and 367 patients (63.7%) with T1c. Patients with T1 tumors were further classified into three groups according to hormone receptor (HR) and human epidermal growth factor-receptor 2 (HER2) status.
Results: In patients with T1a, the disease-free survival (DFS) rate was 98.4% at 2 years (P = 0.001). In subgroup analysis of early breast cancers, 10-year-DFS rates of the patients in HR+/HER2-, HR-/HER2+, and HR-/HER2- subgroups were not significantly different (P = 0.917).
Conclusion: The T1a group had a worse prognosis than T1b and T1c groups in second years (P = 0.001); however, there was not statistically important difference between HR+, HER2+ and triple negative subgroups (P = 0.917). Although there are differences in patients and tumor features, the prognosis of patients with T1a, b, c N0M0 breast cancer is excellent.
We aimed to establish a laboratory prognostic index (LPI) in advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze the predictive value ...of LPI on NSCLC survival.
The study retrospectively reviewed 462 patients with advanced NSCLC diagnosed between 2000 and 2010 in a single institution. We developed an LPI that included serum levels of white blood cells (WBC), lactate dehydrogenase (LDH), albumin, calcium, and alkaline phosphatase (ALP), based on the results of a Cox regression analysis. The patients were classified into 3 LPI groups as follows: LPI 0: normal; LPI 1: one abnormal laboratory finding; and LPI 2: at least 2 abnormal laboratory findings.
The median follow up period was 44 months; the median overall survival (OS) and median progression-free survival (PFS) were 11 and 6 months, respectively. A multivariate analysis revealed that the following could be used as independent prognostic factors: an Eastern Cooperative Oncology Group performance status score (ECOG PS) ≥2, a high LDH level, serum albumin <3 g/dL, serum calcium>10.5 g/dL, number of metastases>2, presence of liver metastases, malignant pleural effusion, or receiving chemotherapy ≥4 cycles. The 1-year OS rates according to LPI 0, LPI 1, and LPI 2 were 54%, 34%, and 17% (p<0.001), respectively and 6-month PFS rates were 44%, 27%, and 15% (p<0.001), respectively. The LPI was a significant predictor for OS (Hazard Ratio (HR): 1.41; 1.05-1.88, p<0.001) and PFS (HR: 1.48; 1.14-1.93, p<0.001).
An LPI is an inexpensive, easily accessible and independent prognostic index for advanced NSCLC and may be helpful in making individualized treatment plans and predicting survival rates when combined with clinical parameters.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases.
Of 4,617 gastric cancer patients ...who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed.
The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio HR: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.
Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases.
We compared the efficacy and safety of low-molecular-weight heparins (LMWHs) in patients with cancer who are at low risk of venous thromboembolism (VTE). Patients were treated by medical oncologists ...in Turkey at 15 sites, where they were enrolled and followed up for a period of 12 months. Due to the study design, there was no specific treatment protocol for LMWH. Primary end points were efficacy and the time to change in VTE status. Of the included 250 patients, 239 (95.6%), 176 (70.4%), 130 (52.0%), and 91 (36.4%) completed their day 15, month 3, month 6, and month 12 visits, respectively. Number of patients treated with enoxaparin, bemiparin, and tinzaparin were 133, 112, and 5, respectively. Anticoagulant therapy provoked thrombus resolution in 1.2% and 12.7% of patients using enoxaparin and bemiparin, respectively (P = .004). Thrombus resolution was observed in 81 more patients at month 3 visit. This ratio was 35 (40.2%) of 87 and 46 (54.1%) of 85 patients administered enoxaparin and bemiparin at the third visit, respectively (P = .038). Thrombus resolution was observed in 21 more patients during month 6 visit. This ratio was 5 (7.7%) of 65 and 15 (23.4%) of 64 patients administered enoxaparin and bemiparin at the fourth visit, respectively (P = .022). The LMWH was discontinued in only 2 patients due to gastrointestinal bleeding. This pioneering study shows bemiparin is more effective than enoxaparin in thrombosis resolution and has a similar tolerability profile.
...in a recently published randomized Phase III SIRFLOX trial, Van Hazel and colleagues reported that adding selective internal radiation therapy (SIRT) with yttrium-90 resin microspheres to standard ...fluorouracil, leucovorin and oxaliplatin ± bevacizumab regimen did not improve primary end point PFS at any site but did significantly improve PFS in the liver of patients with liver-dominant or liver-only metastatic colorectal cancer (3). According to the multivariate analysis of 3825 patients in patients treated with 5-fluorouracil-based treatment, metastatic colorectal cancer patients can be classified into three risk groups depending on their four baseline clinical risk factors: performance status, white blood cell count, alkaline phosphatase and number of metastatic sites. ...the predictive and prognostic roles of tumor location, RAS and BRAF mutations in metastatic colorectal cancer are well known and established. On these grounds, in addition to clinical risk factors it would be interesting to know the distribution of the tumor location, RAS and BRAF mutational status, before commenting that adding SIRT has no additional PFS benefit in patients with liver-dominant or liver-only metastatic colorectal cancer.
How Safe is Dabigatran in Elderly? Ulaş,Arife; Akinci,Sema; Yalçın,Ahmet ...
Gazi tıp dergisi,
01/2016, Letnik:
27, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The aim is to report a case of dabigatran induced gastrointestinal bleeding without any obvious source and emphasize the risk of drug interaction in an elderly patient. An 87 year-old female who was ...treated with dabigatran and nifedipine for nonvalvular atrial fibrillation developed gastrointestinal bleeding. Endoscopy and colonoscopy was performed and no pathology was identified. Bleeding stopped spontaneously. Our case suggests that drug interactions may increase the risk of bleeding additional to old age in patients who are treated with dabigatran. Clinicians should use these medications with caution in geriatric population particularly over 85 years old.
Aim: Thiols are the organic compounds of the antioxidant system. There is limited data in the literature concerning chemotherapy (CT) in cancer and thiol balance. In this study, we aimed to evaluate ...the possible changes of thiol/disulfide levels with the recurrent CT cycles and type of cancer.
Materials and Methods: The 40 healthy individuals and 40 patients who had been newly diagnosed with early-stage breast, ovary and endometrium cancer receiving adjuvant CT. Blood samples were taken from all patients three times as basal and after the first and second CT sessions.
Results: We compared preadjuvant treatment levels of thiol and disulfide parameters in the patients group with the control group. The median of native thiol and total thiol was found to be higher in the control group than in the study group (P < 0.001). In addition, disulfide/native thiol and disulfide/total thiol rates were found to be higher in the patient group (P = 0.001). When we look at the comparison before and after CT in the patient group, disulfide/native thiol and disulfide/total thiol rates, which represent increased oxidative stress (OS) levels were found to be higher after CT than before CT measurement (P < 0.016).
Discussion: This is the first study, which has researched the relationship between cancer type and thiol compounds and changes of thiol compounds during CT therapy, by using the method designed by Erel and Neşelioğlu. In this study, we found that pre-CT thiol disulfide balance in cancer patients shifted toward disulfide direction and OS levels may increase after repetitive CT sessions.
Background
Soft tissue sarcomas (STSs) are rare malignant tumors of embryogenic mesoderm origin. Primary thoracic STSs account for a small percentage of all STSs and limited published information is ...available. This study aimed to identify the prognostic factors for thoracic STSs and evaluate the disease's clinical outcomes.
Methods
The medical records of 109 patients with thoracic STSs who were treated between 2003 and 2013 were retrospectively reviewed. Patients' survival rates were analyzed and potential prognostic factors evaluated.
Results
The median follow‐up period was 29 months (range: 1–121 months). STSs were most frequently localized on the chest wall (n = 42; 38.5%) and lungs (n = 42; 38.5%). The most common histological types were malignant fibrous histiocytoma (n = 23; 21.1%), liposarcoma (n = 17; 15.6%), and leiomyosarcoma (n = 16; 14.7%). The median survival time of all patients was 40.3 months (95% confidence interval, 14.22–66.37 months), with one and five‐year survival rates of 93.4% and 63.5%, respectively. Univariate analysis of all groups revealed that metastatic stage, unresectability, tumor diameter of >10 cm, tumor location other than the chest wall, and grade 3 diseases were predictable of poor survival. However, only grade 3 diseases and tumor location other than the chest wall were confirmed by multivariate analysis as poor prognostic factors.
Conclusions
Primary thoracic STSs are rarely seen malignant tumors. Our results indicated that patients with low‐grade tumors and those localized on the chest wall often experienced better survival outcomes.
LANGUAGE= "English" Objectives: Small-cell lung cancer (SCLC) is the most aggressive type of lung cancer. Despite advances in technology and treatments there is no desirable improvement in survival. ...The present study evaluated the factors affecting survival in patients with SCLC. Methods: Patients with SCLC followed up in our clinic between 2019 and 2021 were retrospectively reviewed. Univari?ate and multivariate analyses were performed to identify the prognostic factors. Kaplan-Meier method was used for survival analysis. Results: The 60 patients comprised 50 (83.3%) men and 10 (16.7%) women with a median age of 61 (53.3-67) years. 40 (66.7%) patients were in extensive stage, 13 (21.7%) patients had brain metastases at the time of diagnosis, and 41 (68.3%) patients had extracranial metastases. There were 18(45%) patients with high serum carcinoembryonic antigen levels and 33 (63%) patients with high lactate dehydrogenase levels at the time of diagnosis. Primer disease control control was achieved in 30 (63%) patients, while Progression developed in 26 (45.6%) patients. Median overall survival was 13 months and it was revealed that survival was better in patients who received ?4 cycles of chemotherapy, whole?brain radiotherapy, thoracic radiotherapy and disease control. Conclusion: The success of systemic and local treatment was found to be the most important factor affecting survival in patients with SCLC.
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