[Assessment of the survival risk factors in patients with gastric cancer in cancer institute of Imam Khomeni hospital between 2003-2007]

Gastric cancer [GC] is one the most common causes of death worldwide. Despite the decreasing rate for GC in the world during recent years, it remains the most common cancer in our country, especially among men. This study aimed to assess the survival of the patients with GC and to determine the risk factors involved. A total of 400 patients with GC in the Cancer Institute of Imam Khomeini Hospital, were entered in the study during 2003 - 2007. Patients were followed up through periodical referrals and hospital visits and/or phone calls. The survival time was considered as the time period from diagnosis to either death or the end of study. The effects of various risk factors such as gender, age at diagnosis, tumor site, pathologic stage, type of treatment, and tumor size were evaluated by Cox Proportional Hazard [PH] model. Data were analyzed using SPSS16 statistical software. Of the total of 400 cases studied, 303 [75.8%] were males. About one third of the patients [130; 32.5%] experienced death. The survival mean and median were 41.8 +/- 3.1 and 26 months, respectively. The percentages of one-, three-, and five-year survivals were 74%, 31% and 23%, respectively. Gender, age at diagnosis, pathologic stage, and tumor size appear to be the most significant factors affecting the survival rate among GC patients. The majority of the risk factors, affecting the survival rate in this study, were related to the delayed diagnosis. Therefore, it seems that if the cancer is diagnosed at early stages, it may lead to better prognosis

Refractory anemia after epoetin therapy in patients with chronic renal failure

Anemia is the most frequent complication of chronic renal failure. Epoetin therapy reveals to be an effective therapy; however, development of anti-erythropoietin antibodies has been reported. The present study was conducted to determine the etiology of refractory anemia after Epoetin therapy in patients with chronic renal failure. All adult patients [530 patients] who had been prescribed regular hemodialysis and rHUEPO for at least three months were followed in seven hemodialysis units in Tehran. During a 6- month period, Venofer-Eprex dose and hemoglobin was recorded monthly. Having ruled out hemolysis and iron deficiently state in severe anemic patients, bone marrow examination was ordered. Of 530 patients, 58% were men with median age of 59 years. About%80 of patients had received baseline dose of at least 4000 units Eprex per week, prescribed subcutaneously after hemodialysis. Approximately, 21% were not anemic, while 19% did suffer from severe anemia [Hb<8]. There were statistically significant associations between severity of anemia and age [p<0.001], longer Epoetin therapy [p<0.001], co-treatment with Venofer [p<0.011] and lack of underlying disease [p<0.04]. Bone marrow aspiration was performed for 30 patients and the most frequent findings were anemia due to chronic disease, bone marrow dysplasia, amd megaloblastic anemia. In case of poor response to Epoetin therapy, discontinuing the drug is strongly recommended. Bone marrow examination is an appropriate tool to find the cause of refractoriness to Epoetin therapy in hemodialysis patients

Multiple primary extramedullary plasmacytomas: an unusual presentation

Extramedullary plasmacytoma [EMP] is a rare neoplasm of soft tissue which usually arises in the respiratory tract, nasal cavity, sinuses and nasopharynx. Multiple extramedullary plasmacytomas are extremely rare, especially those that are associated with multiple myeloma. We describe multiple primary EMP in a 37 year old man, without involvement of bone or bone marrow. EMP usually has a good prognosis but our patient survived only 15 months after diagnosis