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1.
Rev. ecuat. pediatr ; 23(3): 208-216, 12 de Diciembre del 2022.
Article in Spanish | LILACS | ID: biblio-1411244

ABSTRACT

Introducción: La fibrosis quística (FQ), afecta el epitelio exocrino, formando una mucosidad espesa que obstruye los conductos de los diferentes órganos, siendo el pulmón y páncreas los más afectados. El objetivo del presente estudio fue determinar la asociación entre los factores clínicos y las complicaciones, así como la supervivencia de pacientes con FQ atendidos en un centro de referencia pediátrica en México. Métodos: El presente estudio observacional, longitudinal, fue realizado en el Instituto Nacional de Pediatría en México, de abril del 2012, a abril del 2022. Con una muestra no probabilística ingresaron al estudio niños con fibrosis quística. Las variables fueron: demográficas, complicaciones pulmonares, extrapulmonares y mortalidad. Se realiza la asociación con chi-cuadrado y la supervivencia con Kaplan-Meir. Resultados: Se analizan 71 pacientes, lactantes menores 41 casos (62%), pre-escolares 12 casos (16.9%). Fueron 40 hom-bres (56.3%). 57 casos (80.3%) tuvieron exacerbación infecciosa, 11 casos (15.5%) aspergi-losis broncopulmonar, 9 casos (12.7%) con hipertensión pulmonar, 5 casos (7%) con neumotórax, 12 casos (16.9%) con ventilación mecánica, 70 casos (98.5) con insuficiencia pancreática, 10 casos (14%) con enfermedad hepatobiliar. Hubo asociación de complica-ciones extrapulmonares con el fenotipo F508. La supervivencia global fue de 150 meses. En pacientes con ventilación mecánica invasiva la supervivencia fue de 55 meses (P<0.001), en pacientes con ventilación mecánica no invasiva fue de 106 meses (P<0.001), en pacientes con neumotórax fue de 25 meses P<0.001, en pacientes con aspergilosis bronco-pulmonar alérgica fue de 125 meses P<0.01. Conclusión: la mayor compli-cación extrapulmonar de pa-cientes con FQ es la insuficien-cia pancreática. La presencia de neumotórax disminuye la supervivencia.


Introduction: Cystic fibrosis (CF) affects the exocrine epithelium, forming a thick mucus that obstructs the ducts of the different organs, with the lungs and pancreas being the most affected. This study aimed to determine the association between clinical factors and complications, as well as the survival of CF patients treated at a pediatric reference center in Mexico. Methods: This observational, longitudinal study was conducted at the National Institute of Pediatrics in Mexico from April 2012 to April 2022. Children with cystic fibrosis were entered into the study with a nonprobabilistic sample. The variables were demographic, pulmonary and extrapulmonary complications and mortality. The association was made with chi-square and survival with Kaplan- Meir. Results: Seventy-one patients were analyzed, including 41 infants (62%) and 12 preschoolers (16.9%). There were 40 men (56.3%). Fifty-seven cases (80.3%) had an infectious exacerbation, 11 cases (15.5%) had allergic bronchopulmonary aspergillosis, 9 cases (12.7%) had pulmonary hypertension, 5 cases (7%) had pneumothorax, 12 cases (16.9%) had mechanical ventilation, 70 cases (98.5%) had pancreatic insufficiency, and 10 cases (14%) had hepatobiliary disease. There was an association of extrapulmonary complications with the F508 phenotype. Overall survival was 150 months. In patients with invasive mechanical ventilation, survival was 55 months (P<0.001); in patients with noninvasive mechanical ventilation, it was 106 months (P<0.001); in patients with pneumothorax, it was 25 months (P<0.001); and in patients with allergic bronchopulmonary aspergillosis, it was 125 months (P<0.01). Conclusion: The most significant extrapulmonary complication in CF patients is pancreatic insufficiency. The presence of pneumothorax markedly decreases survival.


Subject(s)
Humans , Infant , Child, Preschool , Child , Child , Survival Rate , Cystic Fibrosis , Exocrine Pancreatic Insufficiency , Pneumothorax
2.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 9(2): e201, dic. 2022. graf, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1403135

ABSTRACT

La cirugía del cáncer de recto y ano se ha desarrollado considerablemente en las últimas décadas. En función de dichos avances, se ha observado una disminución en la morbimortalidad operatoria, así como también una mejoría en el pronóstico de estos pacientes. El objetivo del presente estudio es exponer y analizar los resultados del tratamiento quirúrgico del cáncer de recto y ano en un servicio universitario. Se realizó un estudio observacional, descriptivo y retrospectivo de todos los pacientes intervenidos por cáncer de recto y ano en el Hospital Español entre 2016 y 2020. Las variables registradas fueron: variables demográficas, clínico-oncológicas, relacionadas a la morbimortalidad operatoria y a la recidiva locorregional, y la sobrevida a 5 años. El procedimiento más realizado fue la resección anterior de recto (RAR) en 11 intervenciones (58%), mientras que las 8 restantes correspondieron a amputaciones abdominoperineales (AAP) (42%). Se diagnosticaron un total de 6 complicaciones intraoperatorias en 5 pacientes, siendo la perforación del tumor la más frecuente, y un total de 18 complicaciones postoperatorias en 11 pacientes, siendo la más frecuente la infección de la herida quirúrgica abdominal. La morbilidad operatoria mayor fue de 31,6% y la mortalidad operatoria a 90 días fue de 0%. La sobrevida global a 5 años fue de 63,2%. Los resultados quirúrgicos en la presente casuística fueron comparables con los de la bibliografía consultada. Destacamos la nula mortalidad a 90 días, con resultados oncológicos similares a los reportados en la literatura.


Rectal and anus surgery have been developed considerably in the last decades. Based on these advancements, it has been observed a decrease in the surgical morbidity and mortality, as well as an improved prognosis of these patients. The aim of the present study is to expose and analyze the results of the anus and rectal surgical treatment in a university service. An observational, descriptive and retrospective study was performed of all the intervened patients for rectum and anus cancer in the Hospital Español between 2016 and 2020. We recorded data about demographic, clinical-oncologic, related to the surgical morbidity and mortality, locoregional relapse and overall 5 year survival. The most performed procedure was the rectum anterior resection in 11 interventions (58%), while the 8 left corresponded to abdominoperineal resection (42%). There was a total of 6 intraoperative complications diagnosed in 5 patients, being the tumor perforation the most frequent one, and a total of 18 postoperative complications diagnosed in 11 patients, being the surgical wound infection the most frequent one. The serious surgical morbidity was 31,6%, while the surgical mortality rate at 90 days was 0%. Overall 5 year survival was 63,2%. The surgical results in the present study about the rectum and anal cancer were comparable with the results reported on the consulted bibliography. We highlight the null mortality within 90 days, with oncologic results similar to the ones reported in the literature.


A cirurgia do câncer retal e anal desenvolveu-se consideravelmente nas últimas décadas. Com base nesses avanços, observou-se diminuição da morbimortalidade operatória, bem como melhora no prognóstico desses pacientes. O objetivo deste estudo é apresentar e analisar os resultados do tratamento cirúrgico do câncer de reto e anal em um serviço universitário. Foi realizado um estudo observacional, descritivo e retrospectivo de todos os pacientes operados por câncer de reto e ânus no Hospital Espanhol entre 2016 e 2020. As variáveis ​​registradas foram: variáveis ​​demográficas, clínico-oncológicas, relacionadas à morbidade e mortalidade operatórias e recorrência locorregional. , e sobrevida em 5 anos. O procedimento mais realizado foi a ressecção anterior do reto (RAR) em 11 intervenções (58%) e as 8 restantes corresponderam a amputações abdominoperineais (AAP) (42%). Foram diagnosticadas 6 complicações intraoperatórias em 5 pacientes, sendo a perfuração tumoral a mais frequente, e um total de 18 complicações pós-operatórias em 11 pacientes, sendo a infecção da ferida operatória abdominal a mais frequente. A morbidade operatória maior foi de 31,6% e a mortalidade operatória em 90 dias foi de 0%. A sobrevida global em 5 anos foi de 63,2%. Os resultados cirúrgicos da presente casuística foram comparáveis ​​aos da bibliografia consultada. Destacamos a mortalidade nula em 90 dias, com resultados oncológicos semelhantes aos relatados na literatura.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Anus Neoplasms/surgery , Postoperative Complications/epidemiology , Rectal Neoplasms/surgery , Digestive System Surgical Procedures/methods , Intraoperative Complications/epidemiology , Survival Rate , Retrospective Studies , Treatment Outcome , Octogenarians , Neoplasm Recurrence, Local
3.
J. coloproctol. (Rio J., Impr.) ; 42(2): 131-139, Apr.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1394418

ABSTRACT

Background: The relative rarity of synchronous para-aortic lymph node (PALN) metastasis (SPM) and metachronous PALN recurrence (MPR) in colorectal carcinoma (CRC) patients leads to a limited number of studies on patient management, and no treatment guidelines have been established to date. Objective: To assess the prognostic, predictive roles, and long-term outcomes of different management strategies for isolated MPR and SPM in CRC patients to establish the best one. Materials and Methods: We included 35 CRC patients with isolated MPR and 25 patients with isolated SPM who underwent curative R0 resection. We performed PALN dissection (PALND) in 15 cases in MPR group and in 10 cases in the SPM group; all remaining patients in both groups underwent chemoradiotherapy (CRT) without further surgical intervention. During the study period of about 5 years, we compared the patients who underwent PALND and those who underwent CRT. Results: The overall survival and recurrence-free survival rates were significantly longer in patients who underwent PALND (p = 0.049 and 0.036 respectively). (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Colorectal Neoplasms/therapy , Lymphatic Metastasis/diagnosis , Prognosis , Recurrence , Colorectal Neoplasms/surgery , Survival Rate , Prospective Studies , Treatment Outcome , Lymphatic Metastasis/pathology , Neoplasm Staging
4.
J. coloproctol. (Rio J., Impr.) ; 42(1): 47-53, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1375755

ABSTRACT

Background: There are many surgical approaches which described extent of resection of the colon for adequate surgicalmanagement of splenic flexure cancer, but up till now there is no established surgical procedure, this is because the presence of double lymphatic drainage of themesenteric vessels. Segmental resection of the colon for the management of splenic flexure cancer was a recently accepted surgical procedure. Objective: In the present study, we aimed to compare three surgical management techniques to clarify the best management approach of Egyptian patients with splenic flexure cancer regarding operative, clinical, and oncological outcomes: segmental resection, and extended left or right hemicolectomy,. Materials and Methods In the present study, we included 90 patients with splenic flexure cancer. Cases were divided into 3 groups. Each group included 30 patients in order to compare three surgical techniques: segmental resection, extended left hemicolectomy, and extended right hemicolectomy. Results: We have found no statistically significant differences between the three included groups regarding operative findings, postoperative complications, local recurrence, distant recurrence, disease progression, recurrence-free survival rate, progression-free survival rate, and overall survival rate. The operative time was longer, and the number of lymph nodes was higher in the extended right hemicolectomy group (p<0.001). Conclusion: We have shown that segmental resection of the splenic flexure is surgically and clinically suitable for the adequate management of operable cases of carcinoma of the splenic flexure. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Digestive System Surgical Procedures/methods , Colonic Neoplasms/surgery , Postoperative Period , Survival Rate , Treatment Outcome
5.
Rev. Odontol. Araçatuba (Impr.) ; 43(supl): 18-29, 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1399239

ABSTRACT

A busca por naturalidade dos procedimentos restauradores em reabilitação oral tem contribuído para o desenvolvimento de vários tipos de materiais livres de metal ("metal free"). A confecção de próteses com estes sistemas totalmente puros, mostra-se como excelente alternativa restauradora, com potencial estético superior às próteses metalocerâmicas. É indiscutível que a tecnologia CAD/CAM (Computer-aided design/ Computer-aided manufacturing) vem se tornando realidade nos consultórios e laboratórios de Prótese Dentária de todo o mundo. Esta tecnologia possibilita o uso de cerâmicas e polímeros na fabricação de próteses, com qualidade e resistência mecânica satisfatórias, padronizando os processos, reduzindo custos e tempo clínico-laboratorial. A grande diversidade destes novos materiais restauradores livres de metal, com suas distintas propriedades estéticas e mecânicas, faz com que seja necessária uma seleção racional desses materiais, a fim de se alcançar a longevidade desejada do tratamento protético reabilitador. Dentre estes materiais, destacam-se as cerâmicas vítreas, as zircônias monolíticas, as cerâmicas infiltradas por polímeros e as resinas nanocerâmicas. O objetivo do trabalho foi avaliar os dados mais relevantes e atuais sobre as propriedades destes novos materiais, os sistemas disponíveis, suas indicações, limitações e seu uso associado com a tecnologia CAD/CAM. Esta revisão consistiu em uma pesquisa eletrônica da literatura publicada nos últimos 15 anos, nas bases de dados: Medline/Pubmed, Embase, Scielo, Bireme, Lilacs e BBO, utilizando-se os seguintes descritores do MESH: [CADCAM AND restorative materials AND monolitic] OR [Monolitic CAD-CAM restorative materials]. Concluiu-se que os materiais monolíticos obtidos pelo sistema CAD/CAM foram desenvolvidos para oferecer uma melhor adaptação e durabilidade das peças, com ótimas taxas de sobrevida e redução de tempo clínico e laboratorial, oferecendo ao paciente conforto, sessões clínicas mais curtas e restaurações de qualidade superior aos sistemas convencionais. Todos os materiais citados nesta revisão apresentaram vantagens e desvantagens, cabendo ao profissional selecionar o melhor material para cada situação clínica em específico, levando em conta os prós e contras de cada um(AU)


The naturalness of restorative procedures in oral rehabilitation has contributed to the development of various types of metal-free materials ("metal free"). The manufacture of prostheses with these totally pure systems is shown to be an excellent restorative alternative, with an aesthetic potential superior to metal-ceramic prostheses. It is indisputable that CAD/ CAM (Computer-aided design/Computer-aided manufacturing) technology is becoming a reality in dental practices and laboratories around the world. This possibility of manufacturing ceramic materials and polymers in strength manufacturing, with strength technology, manufacturing processes, standardizing quality clinical time, higher cost and clinical time. These new aesthetic properties of metal, these dif ferences with aesthetic and mechanical characteristics, these differences are necessary for a rational selection of materials with a choice of rehabilitative prosthetic treatment. Among these materials, they stand out as glass ceramics, as monolithic zirconia, as polymer-infiltrated ceramics and as nanoceramic resins. The purpose of working with your materials, and their associated use with CAD/CAM technology. This review consists of an electronic search of the literature published in the last 15 years, in the following databases: Medline/ Pubmed, Embase, Scielo, Bireme, Lilacs and BBO, using the following MESH descriptors: [CAD-CAM AND restorative materials AND monolithic] OR [CADCAM monolithic restorative materials]. It is concluded that the CAD/CAM materials were designed with comfort for a better adaptation and durability of the parts, with excellent survival rates and reduction of clinical and laboratory time, offering the patient, shorter clinical sessions and superior quality restorations to the systems conventional. All those mentioned in this review present advantages and advantages of each material, and it is up to the professional to select the best one for each specific clinic, in each situation of materials and against indications of materials(AU)


Subject(s)
Ceramics , Dental Prosthesis , Computer-Aided Design , Polymers , Survival Rate , Resins , Mouth Rehabilitation
6.
Article in Chinese | WPRIM | ID: wpr-936193

ABSTRACT

Objective: To investigate the survival outcomes and prognostic factors of patients with salvage surgery for hypopharyngeal carcinoma after radiotherapy. Methods: A retrospective analysis was performed, including 26 patients treated in Ningbo Medical Center Lihuili Hospital between January 2010 and December 2015. All patients were males, aged 48-83 years, of whom 8 cases were local residual after radiotherapy alone, 8 cases were local recurrence after postoperative radiotherapy, 2 cases were residual of cervical lymph nodes after radiotherapy alone, 2 cases were recurrence of cervical lymph nodes after radiotherapy alone, 2 cases were recurrence of cervical lymph nodes after postoperative radiotherapy and 4 cases were recurrence of tracheal stoma. The salvage operations included: local resection, local resection with neck dissection, simple neck dissection, tumor resection of tracheostomy, and additional repair according to the defect. Chi square test was used for recurrence and metastasis analysis, Kaplan-Meier method for survival analysis, Log-rank test for univariate analysis, and Cox regression model for multivariate analysis. Results: The complication rate of salvage surgery was 23.1% (6/26). The recurrence rate was 65.4% (17/26) and the distant metastasis rate was 42.3% (11/26) in the 5-year follow-up after salvage surgery. Patient's age and tumor invasion extent were correlated with recurrence. Initial treatment, tumor persistence or recurrence after radiotherapy, recurrence location and tumor invasion extent were correlated with distant metastasis (all P<0.05). Overall, 3 year and 5 year survival rates were 42.3% and 23.1% respectively. Age, recurrence location, surgical margin and tumor invasion extent were related to prognosis (χ²=6.56, 10.68, 9.32, and 7.90 respectively, all P<0.05). Multivariate analysis showed that surgical margin and tumor invasion extent were independent risk factors for prognosis (OR (95%CI) = 3.19 (1.03-9.84), 14.37 (2.46-84.08), both P<0.05). Conclusion: Salvage surgery is the first choice for patients with recurrence after radiotherapy for hypopharyngeal carcinoma. Safe surgical margin should be ensured, especially in tumors invading muscle, bone tissue or lymph node capsule.


Subject(s)
Aged , Aged, 80 and over , Carcinoma, Squamous Cell/surgery , Humans , Hypopharyngeal Neoplasms/surgery , Male , Middle Aged , Neoplasm Recurrence, Local/surgery , Neoplasm Staging , Prognosis , Retrospective Studies , Salvage Therapy , Survival Rate
7.
Article in English | WPRIM | ID: wpr-929056

ABSTRACT

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.


Subject(s)
Biomarkers, Tumor/genetics , Head and Neck Neoplasms/genetics , Humans , Kaplan-Meier Estimate , RNA , Squamous Cell Carcinoma of Head and Neck , Survival Analysis , Survival Rate
8.
Article in English | WPRIM | ID: wpr-929048

ABSTRACT

Ovarian cancer is the third-most-common malignant reproductive tumor in women. According to the American Cancer Society, it has the highest mortality rate of gynecological tumors. The five-year survival rate was only 29% during the period from 1975 to 2008 (Reid et al., 2017). In recent decades, the five-year survival rate of ovarian cancer has remained around 30% despite continuous improvements in surgery, chemotherapy, radiotherapy, and other therapeutic methods. However, because of the particularity of the volume and location of ovarian tissue, the early symptoms of ovarian cancer are hidden, and there is a lack of highly sensitive and specific screening methods. Most patients have advanced metastasis, including abdominal metastasis, when they are diagnosed (Reid et al., 2017). Therefore, exploring the mechanism of ovarian cancer metastasis and finding early preventive measures are key to improving the survival rate and reducing mortality caused by ovarian cancer.


Subject(s)
B7-H1 Antigen/biosynthesis , Cell Proliferation/drug effects , Chemokines/biosynthesis , Female , Humans , Ovarian Neoplasms/pathology , Survival Rate , Up-Regulation
9.
Article in Chinese | WPRIM | ID: wpr-943028

ABSTRACT

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.


Subject(s)
Adenocarcinoma, Mucinous/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/surgery , Colorectal Neoplasms/pathology , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Female , Humans , Hyperthermia, Induced/methods , Male , Middle Aged , Peritoneal Neoplasms/secondary , Retrospective Studies , Survival Rate
10.
Chinese Journal of Surgery ; (12): 79-83, 2022.
Article in Chinese | WPRIM | ID: wpr-935583

ABSTRACT

Objective: To compare the effects of preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the long-term survival of patients with radical resection for esophageal squamous cell carcinoma. Methods: Totally 1 082 patients with stage T3-4aN0-3M0 thoracic esophageal squamous cell carcinoma were recruited in this study who underwent radical resection at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University from January 2005 to January 2015. There were 798 males and 284 females, with a median age of 61 years (range: 37 to 86 years). There were 138 patients undergoing preoperative neoadjuvant chemotherapy, 392 patients postoperative adjuvant chemotherapy, and 552 patients surgery alone. The neoadjuvant chemotherapy group was used as the benchmark group to match the propensity score with the adjuvant chemotherapy group and the surgery-only group respectively at a ratio of 1∶3. A total of 7 covariates including tumor location, number of positive lymph nodes, tumor invasion depth, tumor differentiation degree, surgical procedure, vascular tumor thrombus and nerve invasion were included, and the caliper value was taken as 0.1. After matching, a total of 699 patients were included for the analysis, including 128 patients in the neoadjuvant chemotherapy group, 267 patients in the adjuvant chemotherapy group, and 304 patients in the surgery alone group. The Kaplan-Meier method was used to generate the survival curves which was tested by the Log-rank method for survival analysis. Results: After matching analysis, the 5-year overall survival rate was 41.5% in the neoadjuvant chemotherapy group with a median overall survival time of 43 months (95%CI: 27 to 59 months), 57.6% in the adjuvant chemotherapy group with a median overall survival time unreached, and 24.9% in the surgery alone group with a median overall survival time of 28 months (95%CI: 25 to 31 months) (χ²=60.475, P<0.01). For overall survival after matching, the adjuvant chemotherapy group was better than the neoadjuvant chemotherapy group (χ²=11.384, P=0.001), the neoadjuvant chemotherapy group was better than the surgery alone group (χ²=8.654, P=0.003), and the adjuvant chemotherapy group was better than surgery alone group (χ²=60.234, P<0.01). Conclusion: Both preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy can improve the long-term survival of patients with locally advanced esophageal squamous cell carcinoma undergoing radical resection, and the improvement effect of postoperative adjuvant chemotherapy is more obvious.


Subject(s)
Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Esophageal Neoplasms/pathology , Esophageal Squamous Cell Carcinoma , Female , Humans , Male , Middle Aged , Neoadjuvant Therapy , Neoplasm Staging , Prognosis , Propensity Score , Retrospective Studies , Survival Rate
11.
Chinese Journal of Oncology ; (12): 73-78, 2022.
Article in Chinese | WPRIM | ID: wpr-935184

ABSTRACT

Colorectal cancer is one of the common malignant tumors in China, and its incidence is increasing with years. As the second most common metastatic site of colorectal cancer, peritoneum is difficult to diagnose early and with a poor prognosis. Systemic intravenous chemotherapy was used as the main treatment strategy for peritoneal metastasis in the past, but its systemic toxic and side effects were obvious, and it could not effectively control tumor progression. In recent years, the continuous development of surgical techniques, concepts, and equipment, as well as the introduction of new chemotherapy drugs and targeted drugs have significantly improved the quality of life and prognosis of patients with peritoneal metastasis of colorectal cancer. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can effectively eradicated the intraperitoneal free cancer cells and subclinical lesions, while reducing systemic side effects of chemotherapy drugs, and achieve the radical cure of the tumor at the macro and micro levels to the greatest extent. It has been used as the first-line treatment program for peritoneal metastasis of colorectal cancer at home and abroad. This article focuses on the analysis and summary of the survival efficacy, prognostic factor analysis, and chemotherapy safety of CRS+ HIPEC in the treatment of colorectal cancer peritoneal metastasis. The existing problems and controversies of HIPEC therapy are discussed simultaneously.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms/drug therapy , Combined Modality Therapy , Cytoreduction Surgical Procedures , Humans , Hyperthermia, Induced , Hyperthermic Intraperitoneal Chemotherapy , Peritoneal Neoplasms/drug therapy , Peritoneum , Prognosis , Quality of Life , Survival Rate
12.
Chinese Journal of Hematology ; (12): 203-208, 2022.
Article in Chinese | WPRIM | ID: wpr-929558

ABSTRACT

Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , HIV Infections , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Male , Middle Aged , Prednisone/therapeutic use , Prognosis , Retrospective Studies , Rituximab/therapeutic use , Survival Rate , Vincristine/therapeutic use
13.
HU rev ; 48: 1-9, 2022.
Article in Portuguese | LILACS | ID: biblio-1371597

ABSTRACT

Introdução: O diagnóstico precoce e referenciamento ao serviço especializado são essenciais para melhorar as taxas de cura e sobrevida das mulheres acometidas pelo câncer de colo de útero. Assim, a realização deste estudo tornará possível o levantamento de informações que serão essenciais para o desenvolvimento de medidas preventivas, que almejam contribuir com o desenvolvimento de ações de educação em saúde e o diagnóstico precoce para reduzir a morbimortalidade dessa enfermidade. Objetivo: Identificar o perfil dos resultados dos exames citopatológicos do colo do útero de mulheres residentes no estado de Minas Gerais a partir dos dados de exames correspondentes ao ano de 2019, utilizando as variáveis disponibilizadas pelo Sistema de Informação do Câncer. Métodos: Trata-se de um estudo retrospectivo, exploratório, quantitativo realizado por meio de base de dados secundários. Os dados foram submetidos à análise no software SPSS, versão 20.0. Realizou-se estatística descritiva (frequência absoluta, porcentagem, média e desvio padrão). Para verificar associação entre variáveis qualitativas foi utilizado teste qui-quadrado (x²) e exato de Fisher. A força das associações entre as variáveis foi aferida pelo risco relativo (RR) e intervalos de confiança (IC 95%). Resultados: As principais alterações presentes nos exames foram: alterações por células escamosas atípicas de significado indeterminado e lesão intraepitelial de baixo grau. Após análises estatísticas, notou-se que algumas alterações possuem risco maior de se desenvolverem no público fora da faixa etária preconizada, ou seja, entre mulheres com idade <25 anos ou >64 anos. Conclusão: O estudo realizado contribui para identificação do perfil atual vivenciado na área da saúde da mulher e possibilita a criação de condutas e ações que visem intervir frente aos resultados obtidos, impactando positivamente na realidade de Minas Gerais


Introduction: Early diagnosis and referral to a specialized service are essential to improve the cure and survival rates of women affected by cervical cancer. Thus, carrying out this study will make it possible to collect information that will be essential for the development of preventive measures, which aim to contribute to the development of health education actions and early diagnosis to reduce the morbidity and mortality of this disease. Objective: Identify the profile of the results of cervical cytopathological examinations of women residing in the State of Minas Gerais from the data of examinations corresponding to the year 2019, using the variables made available by the Cancer Information System.Methods: This is a retrospective, exploratory, quantitative study carried out by means of a secondary database. The data were submitted to analysis using the SPSS software, version 20.0. Descriptive statistics (absolute frequency, percentage, mean and standard deviation) were performed. To verify the association between qualitative variables, the chi-square test (x²) and Fisher's exact test were used. The strength of the associations between the variables was measured by the relative risk (RR) and confidence intervals (95% CI). Results: The main alterations present in the cytopathological exams performed were: changes due to atypical squamous cells of undetermined significance and low- grade intraepithelial lesion. After statistical analysis, it was noted that some changes have a higher risk of developing in the public outside the recommended age range, that is, among women aged <25 years or> 64 years. Conclusion: The study carried out contributes to the identification of the current profile experienced in the area of women's health and enables the creation of conducts and actions that aim to intervene in view of the results obtained, positively impacting the reality of Minas Gerais.


Subject(s)
Uterine Cervical Neoplasms , Uterus , Cervix Uteri , Indicators of Morbidity and Mortality , Health Education , Survival Rate , Colonic Neoplasms , Disease Prevention , Papanicolaou Test , Atypical Squamous Cells of the Cervix
14.
Yenagoa Medical Journal ; 4(2): 1-9, April 2022. Figures, Tables
Article in English | AIM | ID: biblio-1392473

ABSTRACT

Stroke is the second leading cause of death, accounting for 11.13 % of total deaths, and the main cause of disability worldwide. Objective: To determine the prevalence of stroke, its associated risk factors and survival rate among patients admitted to the neurological ward of University of Benin Teaching Hospital, Benin City, Edo State. Methods: A retrospective descriptive survey of patients admitted to the neurological ward of University of Benin Teaching Hospital, Benin City, Edo State from 2015 to 2020. A proforma was used to collect relevant data from medical records. Data was analyzed with IBM SPSS Statistics version 23, using descriptive and inferential statistics at 5% level of significance. Result: The average prevalence of cerebrovascular accident over the six years under review was 58.9%. Highest (69.3%) prevalence was recorded in 2018. Males (52.9%) were more affected than females and the age range 70-89 years was most affected (47.6%). The commonest comorbidities were hypertension and diabetes mellitus. Survival rate was high during the period under review, it was at the least in 2016 at 67.1% and highest in 2019 at 76%. Multiple logistic regression shows that patients who had CVA at below 30 years old were less likely to survive (OR;0.06: CI: 0.000-0.114; p = 0.001). Being married conferred a greater likelihood of surviving a CVA (OR;5.34: CI: 1.135 -25.135; p = 0.034) than being unmarried (OR;2.89: CI: 2.702-49.673; p = 0.004). Tertiary level of education conferred the greatest likelihood of surviving a CVA (OR;8.00: CI: 24.401-1168.674; p = 0.000). Conclusion: The prevalence of stroke from this study was high. Hypertension and diabetes mellitus were the most common risk factors associated with stroke. In-hospital stroke survival rate was high. The findings from this study can support advocacy for more efficient community-based programs geared towards awareness creation about stroke, its risk factors and prevention.


Subject(s)
Prevalence , Risk Factors , Stroke , Survival Rate
15.
J. coloproctol. (Rio J., Impr.) ; 41(4): 393-405, Out.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1356431

ABSTRACT

Background: Anatomopathological staging is the primary method to determine the prognosis of patients with colorectal carcinoma (CRC). However, new tools have been developed that can complement it, such as the analysis of the elevation of systemic inflammatory markers. Objective: To evaluate the impact of the elevation of scores based on inflammatory markers (the neutrophil-to-lymphocyte ratio [NLR], the Glasgow Prognostic Score [GPS], and isolated C-reactive protein [CRP]) in the prognosis of patients diagnosed with CRC and submitted to potentially curative surgery in Hospital de Braga, Portugal, between January 1st, 2005, and December 31st, 2010. Methods: A retrospective analysis of the data of 426 patients was performed, with a collection of several clinico-pathological variables, as well as the levels of lymphocytes, neutrophils, albumin and CRP, in the pre- and postoperative periods, to apply the different scores to the sample. Results: From the analysis of the survival curves, we concluded that patients with increased NLR in the pre- and postoperative periods present a lower cancer-related survival than patients with normal NLR (preoperative period: 93.7 versus 122 months; p<0.001; postoperative period: 112 versus 131 months; p=0.002). Patients with increased NLR in the pre- and postoperative periods also had a lower disease-free survival (preoperative period: 88.0 versus 122 months; p<0.001; postoperative period: 111 versus 132 months; p=0.002). In addition, increased pre- and postoperative NLR was associatedwith a higher risk of death due to CRC (preoperatively: hazard ratio [HR]=2.25; p<0.001; postoperatively: HR=2.18; p=0.003). However, the multivariate analysis shows that only postoperative NLR (ajusted HR =2.66; p=0.002) does so independently of the remaining variables. Conclusion: Regarding the scores applied to the sample, the NLR was the one that most consistently related to the prognosis of the patients. However, it would be useful to develop a prospective study that could confirm this relationship. (AU)


Subject(s)
Humans , Male , Female , Prognosis , Colorectal Neoplasms/mortality , C-Reactive Protein/analysis , Colorectal Neoplasms/therapy , Survival Rate , Disease-Free Survival , NLR Proteins/analysis
16.
J. coloproctol. (Rio J., Impr.) ; 41(4): 335-339, Out.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1356437

ABSTRACT

Objective: To assess the survival rate of patients with colorectal cancer at Hospital Universitário Alzira Vellano, in the municipality of Alfenas, state of Minas Gerais (MG), Brazil, from 2007 to 2016. Methodology: A search was conducted in the laboratory files and medical records of patients diagnosed with colorectal cancer and cared for during the aforementioned period. Results: In total, 128 cases were found: 52.3% were men, and 47.7% were women, with ages ranging from 25 to 91 years. The most common types of cancer in both genders were of the colon, rectum and sigmoid. The most common stages were T3N1Mx, followed by T3N0Mx and T3N2Mx. Patients with T1 or T2 cancers had a 100% survival rate, whereas the rate for those with grade 4 (T4) was of 0%. An association (p<0.05) of the location of the tumor with the survival rate was confirmed. Conclusion: There was a high mortality rate among patients diagnosed with colorectal cancer at Hospital Universitário Alzira Vellano from 2007 to 2016. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Intestinal Neoplasms/mortality , Survival Rate
17.
Infectio ; 25(3): 176-181, jul.-set. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1250089

ABSTRACT

Abstract Objective: To determine the mortality and survival of COVID-19 cases in Colombia between March and July 2020. Materials and methods: A retrospective cohort study in the Colombian population between March 6 to July 8, 2020, with the data reported to the National Institute of Health. Survival analysis was performed considering the real-time PCR results, died or recovered, the onset of symptoms until the date of death, or the final time of the cohort. The actuarial variation and Long-Rank test were applied for survival. Risk factors were determined by Cox regression. Results: The overall survival rate was 100%, 98%, 97%, and 95% for day 1, 10, 20 and 30, respectively. Differences were found in survival in age, sex, region, and hospitaliza tion time spending (p <0.01), the 30-day survival rate was 96% and 95% for females and males, respectively. The region with the highest survival was Antioquia with 99% and the lower Barranquilla with 93%. The age group with the lowest survival was ≥80 years of age with 60%, and being hospitalized represented a survival rate of 68%. Conclusions: This study is one of the first to estimate survival in the Colombian population diagnosed with COVID-19.


Resumen Objetivo: determinar la mortalidad y supervivencia de casos de COVID-19 en Colombia entre marzo y julio de 2020. Materiales y métodos: Estudio de cohorte retrospectivo en población colombiana entre el 6 de marzo al 8 de julio de 2020, con los datos reportados al Instituto Nacional de Salud. El análisis de supervivencia se realizó considerando los resultados de la PCR en tiempo real, fallecido o recuperado, el inicio de los síntomas hasta la fecha del fallecimiento o el momento final de la cohorte. Para la supervivencia se aplicó la variación actuarial y la prueba de rango largo. Los factores de riesgo se determinaron mediante regresión de Cox. Resultados: La tasa de supervivencia general fue del 100%, 98%, 97% y 95% para los días 1, 10, 20 y 30, respectivamente. Se encontraron diferencias en la su pervivencia en cuanto a edad, sexo, región y tiempo de hospitalización (p <0,01), la tasa de supervivencia a 30 días fue del 96% y 95% para mujeres y hombres, respectivamente. La región con mayor supervivencia fue Antioquia con 99% y la Baja Barranquilla con 93%. El grupo de edad con menor supervivencia fue el ≥80 años con 60%, y la hospitalización representó una tasa de supervivencia del 68%. Conclusiones: Este estudio es uno de los primeros en estimar la supervivencia en la población colombiana diagnosticada con COVID-19.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Survival Analysis , COVID-19 , Survival Rate , Risk Factors , Cohort Studies , Mortality , Colombia , Survivorship , Methods
18.
J. health med. sci. (Print) ; 7(3): 183-188, jul.-sept. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1381664

ABSTRACT

El cáncer de cérvix sigue siendo un problema de salud pública a nivel mundial en las mujeres que se presenta mayormente en los países en desarrollo y en niveles de estrato socio económico bajo. Objetivo. Realizar un análisis epidemiológico del cáncer de cérvix in situ e invasor, atendidos en el hospital de SOLCA Guayaquil. Metodología. Estudio observacional, de diseño de investigación tipo corte transversal, descriptivo. Lugar: hospital SOLCA en Guayaquil, período 2015 a 2019. Los sujetos fueron las pacientes con cáncer de cérvix in situ e invasor. Aplicando estadísticas descriptivas como porcentaje y comparación entre variables. Resultados. Cáncer invasor tuvo un incremento entre 2015 al 2019 del 4% e in situ del 4,7%; corroborado al aplicar el modelo de tendencia polinomial. El invasor tuvo topográficamente de mayor frecuencia al Tumor maligno de cuello de útero sin otra especificación (79,59%), mientras en el cáncer in situ al Carcinoma in situ de otras partes especificadas del cuello del útero (53,13%); el invasor se observó en edades de 45 a 54 años e in situ de 30 a 39 años; morfológicamente el invasor tuvo al Carcinoma de células escamosas SAI (38,36%) e in situ al Carcinoma in situ de células escamosas SAI (83,07%). Conclusiones. El cáncer de cérvix presentado en este quinquenio se ha incrementado, siendo el cáncer invasor más frecuente en edades entre 45-54 años y el cáncer in situ en edades más tempranas, considerando que está patología se puede detectar oportunamente, se recomienda fortalecer las campañas de tamizaje para su prevención y control.


Cervical cancer continues being a public health problem worldwide in women, which occurs mainly in developing countries and at low socio-economic levels. Target. Carry out an epidemiological analysis of in situ and invasive cervical cancer treated at the SOLCA Guayaquil hospital. Methodology. Observational, descriptive, cross-sectional research design study. Place: SOLCA hospital in Guayaquil, period 2015 to 2019. The subjects were patients with in situ and invasive cervical cancer. Applying descriptive statistics as a percentage and comparison between variables. Results. Invasive cancer had an increase between 2015 and 2019 of 4% and in situ of 4,7%; corroborated by applying the polynomial trend model. The invader had a topographically higher frequency of malignant neoplasm of the cervix without other specification (79,59%), while in cancer in situ it had Carcinoma in situ of other specified parts of the cervix (53,13%); the invader was observed in ages 45 to 54 years and in situ from 30 to 39 years; Morphologically, the invader had squamous cell carcinoma NOS (38,36%) and in situ squamous cell carcinoma in situ NOS (83,07%). Conclusions. Cervical cancer presented in this five-year period has increased, being the most frequent invasive cancer in ages between 45-54 years and in situ cancer in younger ages, considering that this pathology can be detected in a timely manner, it is recommended to strengthen the campaigns of screening for its prevention and control.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carcinoma in Situ , Uterine Cervical Neoplasms/epidemiology , Tertiary Care Centers/statistics & numerical data , Topography , Medical Records , Cross-Sectional Studies , Survival Rate , Hospitals, Teaching/statistics & numerical data
19.
J. health med. sci. (Print) ; 7(3): 189-194, jul.-sept. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1381667

ABSTRACT

Quimioterapia neoadyuvante (NAC) en cáncer de mama permite conocer la sensibilidad del tumor al tratamiento, alcanzar respuesta patológica completa (pRC), está asociada a mejor supervivencia en cáncer de mama localmente avanzado. El objetivo de este estudio fue conocer el impacto de la pRC en la supervivencia en una cohorte de pacientes tratadas con NAC y cirugía. Se realizo un estudio de diseño observacional de tipo retrospectivo, correlacional, con un seguimiento promedio de 90 meses, de una cohorte de pacientes tratadas con NAC y cirugía desde enero del 2009 a diciembre del 2011. El análisis de datos se realizó mediante el software estadístico SPSS v22.0, para el análisis de supervivencia se utilizó el método de Kaplan Meier, para comparar supervivencias se consideró significativa una p<0,05. Entre las características principales de 199 pacientes, se destacan: edad joven a la presentación, elevado índice de proliferación y alta frecuencia del tipo inflamatorio. pRC ocurrió en el 14,1% de pacientes y la supervivencia global (SG) de acuerdo con la respuesta patológica se comparó entre aquellas pacientes que obtuvieron pRC, con las que tuvieron enfermedad residual, con una SG del 71,4% vs 45% respectivamente, con una diferencia significativa (p:0.009). En esta cohorte de pacientes la pRC impactó en la supervivencia en todos los subtipos clínico-patológicos, sobre todo en el subtipo triple negativo. Evaluar los datos en el entorno real es importante para definir estrategias y mejorar los resultados.


Neoadjuvant chemotherapy (NAC) in breast cancer allows knowing the sensitivity of the tumor to treatment, achieving pathological response complete (pRC), and is associated with better survival in locally advanced breast cancer. The objective of this study was to determine the impact of pRC on survival in a cohort of patients treated with NAC and surgery. A retrospective, correlational observational design study was carried out, with an average follow-up of 90 months, of a cohort of patients treated with NAC and surgery from January 2009 to December 2011. Data analysis was performed using the software SPSS v22.0 statistic, for the survival analysis the Kaplan Meier method was used, to compare survivals a p <0.05 was considered significant. Among the main characteristics of 199 patients, the following stand out: young age at presentation, high proliferation index and high frequency of the inflammatory type. pRC occurred in 14.1% of patients and overall survival (OS) according to the pathological response was compared between those patients who obtained pRC, with those who had residual disease, with an OS of 71.4% vs 45% respectively, with a significant difference (p: 0.009). In this cohort of patients, pRC impacted on survival in all clinicopathological subtypes, especially in the triple negative subtype. Evaluating data in the real environment is important to define strategies and improve results.


Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant/methods , Neoadjuvant Therapy/methods , Prognosis , Survival Rate , Retrospective Studies , Treatment Outcome , Correlation of Data
20.
Rev. invest. clín ; 73(4): 259-264, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1347573

ABSTRACT

Background: Patients with monoclonal gammopathy of undetermined significance (MGUS) have clinical features including older age, presence of medical comorbidities, susceptibility to infections, and thrombotic tendencies which are relevant when assessing their risk during the coronavirus disease (COVID-19) pandemic. Objective: To study the vulnerability of patients with MGUS during the COVID-19 pandemic, we assessed the local management of MGUS patients and their clinical outcomes. Methods: Retrospective chart reviews were performed for all patients with MGUS seen at a university medical center clinic (2014-2020). Results: A total of 228 MGUS patients were included; 211 patients are alive, 7 patients died before the pandemic, and 10 patients died since the pandemic declaration. The mean age and the overall survival (OS) of the patients who died before versus during the pandemic were 83.0 versus 75.2 years, p = 0.4, and OS 40.6 versus 53.2 months, p = 0.3, respectively. One patient died of COVID-19. Nine patients had venous thromboembolisms (VTE), all of which occurred before the pandemic onset. Conclusions: There were no significant differences found in the mean age or OS of the MGUS patients who died before versus after the pandemic onset. An increase in VTE rates was not seen. Study results are limited by small patient numbers.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Monoclonal Gammopathy of Undetermined Significance/therapy , Venous Thromboembolism/epidemiology , COVID-19 , Monoclonal Gammopathy of Undetermined Significance/mortality , Monoclonal Gammopathy of Undetermined Significance/epidemiology , Survival Rate , Retrospective Studies , Age Factors , Vulnerable Populations , Academic Medical Centers , Venous Thromboembolism/etiology
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