Evaluation of prognostic factors in patients with Netastatic Breast Cancer

Metastatic breast cancer has remained as an incurable disease. The main objectives of treatments include alleviating of symptoms, delaying disease progression and increasing survival without any adverse effect on the quality of life. The main purpose of this study was to investigate the effects of some clinocopathological factors on the survival of patients with metastatic breast carcinoma in our institute. In this retrospective cohort study, we reviewed the files of patients who were metastatic at presentation or became metastatic during follow-up and were referred to oncology department of Omid Hospital affiliated to Mashhad University of Medical Sciences from 1997 to 2007. The information regarding clinicopathological characteristics were recorded. The first line chemotherapy regimen was as follows: 79 CAF [cyclophosphamide, doxurobicine, 5FU], 25 CMF [cyclophosphamide, methotrexate, 5FU] and 11 Taxene based; AT [doxorubicin, paclitaxol] or TAC [taxene, doxurobicine, cyclophosphamide]. 115 patients with a median age of 45 [range, 25-78] were investigated. The median follow-up time for all patients from diagnosis was 21 months [range, 5-74 months] and from metastatic manifestation was 12 months [5-36 months]. The sites of recurrence or metastasis were as follows: 18 [15.7%] local recurrence, 23[20%] bone and 74 [64.3%] visceral metastases. The median and 2- year overall survival for all patients with metastatic disease were 15 months and 44.6% +/- 6% respectively. Patients with bone metastasis had a significantly better overall survival compared to those with visceral metastasis. [74.2% vs.36.1%, P = 0.04] Among those patients who were non-metastatic at the time of referral, the time left to metastasis had a significant effect on the overall survival from metastasis manifestation. In comparison with premenopausal patients, the overall survival was relatively better in postmenopausal cases. [59.4% vs. 38.5%, P = 0.1]. In our study, disease free survival [DFS] was the most important factor for overall survival in patients with metastatic breast cancer. The patients with longer DFS [> 18month] had better overall survival. Overall the patients with bone metastasis had better survival than visceral metastasis

Treatment outcome of Brain Astrocytoma

Astrocytoma is the most common primary brain tumor, which comprises a wide range of neoplasms with different clinical courses. This study was performed to determine some epidemiological and clinical characteristics and treatment results of patients with astrocytoma. Some presumed prognostic factors were also evaluated. In this descriptive study we evaluated 324 patients with histological proven brain Astrocytoma who were treated in Qaem and Omid hospitals, Mashhad, between April 1991 and April 2001. Information regarding individual characteristics, age. Sex, clinical presentation, type of treatment and surgry, side effects, imaging finding, histological grad and follow up were collected. WHO classification was used for the uniforming of histological reports. The collected information were analyzed using chi-square and Kaplan-Meier tests and SPSS software. 189 male and 135 female patients entered the study. There were 31 cases with grade I, 118 with grade II, 54 with grade III and 121 cases with grade IV astrocytoma. The median age for low grade and high-grade astrocytomas was 25 and 45 years respectively. The 3-year survival rate for grade I to IV was 94.7%, 74.9%, 52.7% and 6.7% respectively. In rnultivariate analysis, for low grade astrocytomas, grade II, age > 50 and biopsy only and for high grade astrocytomas, grade IV and biopsy only were associated with adverse prognosis. The survival rate for grade I astrocytomas is excellent and for grade II astrocytomas is satisfactory. But high grade astrocytomas especially gelioblastoma multiform, have dismal prognosis. For both low and high-grade astrocytomas, tumor grade and extent of surgery had significant impact on prognosis. Age over 50 was associated with adverse prognosis for low-grade astrocytomas