ABSTRACT
Sarcoidosis is a systematic, granulomatous disease of unknown cause which can affect any organ in the body. Pulmonary involvement is the most common. Musculoskeletal manifestations of sarcoidosis are less common affecting 10-25% of patients and chronic arthritis occurs rarely. We report the case of sarcoidosis revealed by left knee chronic and destructive monoarthritis with only asymptomatic pulmonary involvement in a Caucasian male miner exposed to silica. The patient was treated with corticosteroids during 2 years after diagnosis. In addition, arthroplasty with total left knee prosthesis was performed. The patient is well without any recurrence of symptoms of the musculoskeletal system for a 2 years follow-up period after surgery.
Subject(s)
Arthritis/diagnosis , Occupational Diseases/diagnosis , Sarcoidosis/chemically induced , Sarcoidosis/diagnosis , Silicon Dioxide/toxicity , Aged , Arthritis/chemically induced , Arthritis/pathology , Humans , Male , Miners , Occupational Diseases/complications , Occupational Exposure , Osteoarthritis, Knee/chemically induced , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/pathologyABSTRACT
BACKGROUND: Malnutrition is so commonly associated with cancer disease. Our work aims to highlight the impact of malnutrition on the survival and toxicity of chemotherapy in patients with advanced stages of non-small cell lung cancer (NSCLC). METHODS: A retrospective study including 60 patients followed for NSCLC stage IIIB and IV, between January 2007 and December 2013. An evaluation of the impact of malnutrition was carried out according to different markers (weight loss, body mass index (BMI), albumin and NRI score). RESULTS: The mean age was 59. Taking Weight loss> 10 % as a criterion of malnutrition, 22% of patients were malnourished. Based on a BMI lower than 18.5 Kg/m², 14% of patients were malnourished. Ganglionic extension, anemia and hypoalbuminaemia were associated with malnutrition (p=0.016; p=0.02 and p=0.03 respectively). The Overall survival (OS) was 2.65 months and 6.95 months (p <0.0003) in malnourished and non-malnourished groups. The definition of malnutrition can also be based on an albumin level <35 g/l. According to this criterion, 55% of the patients were undernourished. Anemia and lymphopenia were associated with malnutrition respectively (p=0.002; p=0.001). The OS was 4.45 months and 8.42 months respectively in malnourished and non-malnourished groups (p <0.0002). NRI score<100 and <97.5 (moderate to severe malnutrition) was found in respectively 100% and 74 % of patients. The OS was 4.67 months and 9.12 months respectively in moderate to severe malnutrition (NRI<97.5) and mild malnutrition groups (NRI≥97.5) (p<0.001). CONCLUSION: Malnutrition was common in patients with advanced stage of NSCLC and was associated with poor prognosis.
Subject(s)
Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/diagnosis , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Malnutrition/complications , Malnutrition/diagnosis , Aged , Biomarkers/analysis , Biomarkers/blood , Body Mass Index , Carcinoma, Non-Small-Cell Lung/epidemiology , Female , Humans , Lung Neoplasms/epidemiology , Male , Malnutrition/epidemiology , Middle Aged , Nutrition Assessment , Nutritional Status , Prognosis , Retrospective Studies , Risk Factors , Weight Loss/physiologyABSTRACT
BACKGROUND: Few studies have been conduct¬ed to determine prognostic factors of second-line chemotherapy. The aim of this study was to determine the prognostic factors for survival in patients receiving second-line treatment for advanced NSCLC. METHODS: We retrospectively reviewed the records of 71 patients with metastatic NSCLC who received second-line chemotherapy from January 2006 to January 2013. RESULTS: The mean age was 57 years. All patients were male. The performance status was 0 or 1 in 90.1% of cases. Sixty-four patients received a first line platinum-based chemotherapy. The second line chemotherapy regimen was docetaxel in 31 cases and pemetrexed in 18 cases. Fourteen patients (19.71%) had received third-line chemotherapy. The median overall survival was 13.5 months. Age older than 65 years (p=0.025), advanced T stage (T4 versus T3 and T2; p=0.01), advanced N stage (N3 versus N2 and N1; p=0.001), lower level hemoglobin (p=0.05) and non-responders who showed progression with first-line chemotherapy (p=0.04) were significant negative predictors in univariate analysis for overall survival (OS). The multivariate analysis showed that age≥ 65 years (HR=2.15; 95% CI[1.26-2.44]), advanced N stage (HR=2.273; 95% CI [1.26-2.44]) were independent prognostic factors for OS. CONCLUSION: Age and advanced N stage were important factors in predicting the outcome of advanced NSCLC patients who were undergoing second-line chemotherapy.
Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/mortality , Docetaxel/therapeutic use , Lung Neoplasms/drug therapy , Lung Neoplasms/mortality , Pemetrexed/therapeutic use , Age Factors , Aged , Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/pathology , Hemoglobins/analysis , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Prognosis , Retrospective Studies , Tunisia/epidemiologyABSTRACT
INTRODUCTION: Recent studies have identified that inflammation had a significant association with cancer development and progression. AIM: To explore the relationship between ALI score and prognosis of metastatic non-small cell lung cancer (NSCLC). METHODS: we conducted a retrospective study of 41 patients with metastatic NSCLC diagnosed between January2010 and January2012. ALI was calculated as body mass index x serum albumin/neutrophil to lymphocyte ratio. Patients were divided as low inflammation (ALI≥23.2) and high inflammation (ALI<23.2) groups. RESULTS: Mean age was 56.3 years, 100% were male, and 49% had adenocarcinoma. The overall survival was 8.9months. Median ALI was 23.2. The median overall survival was 6.7 months and 11.3 months respectively in patients with ALI score<23.2 and ≥23.2 (p=0.043). On multivariate analysis, ALI score < 23.2 remained significantly associated with worse outcome. CONCLUSION: Lower ALI (<23.2) was significantly associated with worse overall survival in metastatic NSCLC. The assessment of the ALI is inexpensive and widely available; it could help in identifying patients with poor prognosis in clinical routine practice.
Subject(s)
Carcinoma, Non-Small-Cell Lung/diagnosis , Lung Neoplasms/diagnosis , Pneumonia/diagnosis , Severity of Illness Index , Adult , Aged , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Disease Progression , Female , Humans , Lung Neoplasms/complications , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Staging , Pneumonia/etiology , Pneumonia/mortality , Prognosis , Research Design , Retrospective Studies , Survival AnalysisSubject(s)
Diaphragm/pathology , Echinococcosis/diagnosis , Mediastinal Diseases/diagnosis , Muscle Neoplasms/diagnosis , Adult , Diagnosis, Differential , Echinococcosis, Pulmonary/complications , Echinococcosis, Pulmonary/pathology , Humans , Male , Mediastinal Diseases/parasitology , Muscle Neoplasms/pathologyABSTRACT
BACKGROUND: Inflammation markers have been shown to predict prognosis during cancer including non-small cell lung cancer (NSCLC). In particular, C-reactive protein (CRP) and Neutrophil to Lymphocyte Ratio (NLR) have been investigated. The aim of our work is to study the combination of these two markers in optimizing prognostication in advanced NSCLC. METHODS: We conducted a retrospective study that included all patients diagnosed with primary NSCLC stage IIIB or IV in our respiratory department from January 2005 to January 2013. RESULTS: A total of 142 male patients were included. Most of them (80.3%) had a Performance Status (PS) 0-1. Median progression-free survival (PFS) was 4.6 months (95% confidence interval (CI) 3.9-5.3) and median overall survival (OS) was 8.9 months (95%CI7.7-10.1). Survival analysis showed that CRP<10 mg/l and NLR<3.87 were predictive of better prognostic (respectively p= 0.015 and 0.049), along with chemotherapy use (p<0.0001), PS <2 (p=0.009) and age<65 (p=0.013). In addition, combined use of NLR and CRP was significantly associated with OS (p=0.0009). Median OS for patients having both high NLR (≥3.87) and CRP (≥10 mg/l) was 6.7 months. It was significantly shorter than patients having only one elevated inflammatory marker (8.8 months; p=0.025). CONCLUSIONS: High CRP and NLR (≥10 mg/l and ≥ 3.87 respectively) were associated with poorer survival in advanced NSCLC. Their combined use maximizes their prognostic value.