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.
Objectives: The aim is to perform prognostic evaluation with overall survival (OS) and progression-free survival (PFS) in hematological parameter-based groups in patients with metastatic colorectal ...cancer (mCRC). Methods: In a single institution, 51 patients were retrospectively analyzed mCRC diagnosed between 2019 and 2022. Pretreatment hematological parameters of patients with mCRC receiving first-line chemotherapy in a single center were examined. The receiver operating characteristic curve was used to predict the tests. Median OS was calculated by the Kaplan-Meier method and compared with the log-rank test. Multivariate analyses were performed using a Cox regression model. Results: The median OS of the patients included in the study was 27 months (3-88 months) by statistical calculation; the median PFS was 19 months (2-84 months). The median could not be reached. Among the risk factors affecting OS, it was found effective to have a bone metastasis site and a pancreatic metastasis site (p values 0.003 and 0.027, respectively). In the analysis of the risk factors affecting PFS, bone and pancreatic metastases were found to be significant (p values 0.001 and 0.004, respectively). Patients receiving chemotherapy and anti-VEGF therapy have a significantly reduced risk of death of 0.06 times compared to those who do not receive chemotherapy, which indicates that OS is significantly longer in people receiving chemotherapy in question (p=0.020). It was observed that blood cell marker levels were not statistically significant in PFS and OS. Of the 51 patients included in the study, 30 of them were still being followed up, while 21 of them died. Conclusions: Chemotherapy plus anti-VEGF therapy is a treatment whose effectiveness has been determined in metastatic colorectal cancer. In the future, there is a need for more prospective and large patient group studies on this topic to measure the prognostic value of hematological parameters in metastatic colorectal cancer.
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.
Amaç: Düşme riski yaşlı hastalarda ileri yaşa eşlik eden komorbid hastalıklar nedeni ile yüksektir. Sensörimotor bir bozukluk olan huzursuz bacak sendromu (HBS) parestezi ve motor semptomlar ile ...karakterize olup uyku bozukluklarına yol açar. Bu çalışmanın amacı geriatrik hastalarda huzursuz bacak sendromunun düşmeler üzerine etkisini ve düşmelerle ilişkili diğer risk faktörlerini araştırmaktır.Materyal ve Metot: Çalışmamız kesitsel olup, 65 yaş ve üzeri hastaları kapsamaktadır. HBS tanısı Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu, 2012 kriterlerine göre konulmuştur. Hastalar kapsamlı geriatrik muayene ile değerlendirilmiştir. HBS, geriatrik problemler ve düşmeler arasındaki ilişki binominal lojistik regresyon ile analiz edilmiştir.Bulgular: Çalışmaya toplam 70 hasta alınmıştır. Hastaların otuz yedisi kadın olup, %44.3’ü yaşlı bakım evinde kalmaktadır. Huzursuz bacak sendromu oranı %15.7’dir. Bir önceki yılda düşme oranı %24.3’tür. Komorbidite ve polifarmasi oranları sırasıyla %37.1 ve % 65.7’dir. Çalışmaya katılanların %21.4’ü günlük yaşam aktivelerinde (GYA) bağımlı bulunmuşken; %40’ında kalk ve yürü testi pozitiftir. Depresyon ve kognitif bozukluk tarama testleri sırasıyla %47.1 ve %38.6’sında pozitiftir. Huzursuz bacak sendromu, kalk ve yürü testi ile düşmeler arasındaki ilişki istatiksel olarak anlamlı bulunmuştur (p=0.041, OR=6.59 ve p=0.046, OR=6.31).Sonuç: Çalışmamız huzursuz bacak sendromunun yaşlı hastalarda düşmeler için bir risk faktörü olduğunu göstermiştir. Bu çalışma klinisyenlerin huzursuz bacak sendromunun bir düşme riski olabileceği konusundaki duyarlılığını arttıracaktır. Yaşlı hastalarda düşmelere sebep olan risk faktörleri araştırılıp, modifiye edilirken huzursuz bacak sendromu da göz önünde bulundurulmalıdır. Ayrıca düşme ve pozitif kalk ve yürü testi ilişkisi de anlamlı bulunmuştur. Bu bağlamda kalk ve yürü testi düşme değerlendirmesinin önemli bir parçası olarak ele alınmalıdır.
Skeletal-related events (SREs) for nonsmall cell lung cancer (NSCLC) patients with bone metastasis lead to serious morbidity. The aim of this study was to determine risk factors for SREs in NSCLC ...patients with bone metastasis and the factors influencing SRE-free survival and overall survival (OS). From 2000 to 2012, we evaluated retrospectively 835 NSCLC patients. Three hundred and thirty-five of them with bone metastasis were included in the study. SREs and the other prognostic factors were evaluated by univariate and multivariate analysis for SRE-free survival and OS. SREs were detected in 244 patients (72.8 %). The most common SREs were the need for radiotherapy (43.2 %) and malignant hypercalcemia (17.6 %). The median time to first SRE was 3.5 months at the median follow-up of 17 months. A multivariate analysis showed that the presence of bone metastasis at diagnosis (
p
< 0.001), the number of bone metastasis (
p
= 0.001), baseline hypercalcemia (
p
= 0.004), and the presence of palliative radiotherapy (
p
= 0.04) were independent prognostic factors for SRE-free survival. A logistic regression analysis identified that the presence of bone metastasis at diagnosis odds ratio (OR), 12.6, number of bone metastasis (OR, 3.05), and baseline hypercalcemia (OR, 0.33) were found to be predictive factors in the developing of SRE. The median OS time for patients with SRE was worse than that for patients without SRE (7 vs 12 months, respectively). For OS, male gender, ECOG performance status (PS), high lactate dehydrogenase (LDH) level, hypoalbuminemia, the presence of bone metastasis at diagnosis, the number of bone metastasis, the presence of SREs, the presence of bisphosphonate therapy, and palliative radiotherapy were independent prognostic indicators for OS by the multivariate analysis. Our results indicated that the frequency of SREs was high and the presence of bone metastasis at the time of diagnosis, baseline hypercalcemia, and multiple bone metastases were significant factors predicting the occurrence of SREs. If bone metastases diagnose earlier, treatments for the prevention of SREs may be initiated earlier; thus, the deterioration of quality of life may be preserved.
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