• Title/Summary/Keyword: all cause survival

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Colorectal Cancer Concealment Predicts a Poor Survival: A Retrospective Study

  • Li, Xiao-Pan;Xie, Zhen-Yu;Fu, Yi-Fei;Yang, Chen;Hao, Li-Peng;Yang, Li-Ming;Zhang, Mei-Yu;Li, Xiao-Li;Feng, Li-Li;Yan, Bei;Sun, Qiao
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4157-4160
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    • 2013
  • Objectives: Understanding the situation of cancer awareness which doctors give to patients might lead to prognostic prediction in cases of of colorectal cancer (CRC). Methods: Subsets of 10,779 CRC patients were used to screen the risk factors from the Cancer Registry in Pudong New Area in cancer awareness, age, TNM stage, and gender. Survival of the patients was calculated by the Kaplan-Meier method and assessed by Cox regression analysis. The views of cancer awareness in doctors and patients were surveyed by telephone or household. Results: After a median observation time of 1,616 days (ranging from 0 to 4,083 days) of 10,779 available patients, 2,596 of the 4,561 patients with cancer awareness survived, whereas 2,258 of the 5,469 patients without cancer awareness and 406 of the 749 patients without information on cancer awareness died of the disease. All-cause and cancer-specific survival were poorer for the patients without cancer awareness than those with (P < 0.001 for each, log-rank test). Cox multivariate regression analysis showed that cancer concealment cases had significantly lower cancer-specific survival (hazard ratio (HR) = 1.299; 95 % confidence interval (CI): 1.200-1.407)and all-cause survival (HR = 1.324; 95 % CI: 1.227-1.428). Furthermore, attitudes of cancer awareness between doctors and patients were significantly different (P < 0.001). Conclusion: Cancer concealment, not only late-stage tumor and age, is associated with a poor survival of CRC patients.

Significance of Proliferation Markers and Prognostic Factors in Egyptian Patients with Multiple Myeloma

  • Abdelgawad, Iman A;Radwan, Noha H;Shafik, Roxan E;Shokralla, Hala A
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1351-1355
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    • 2016
  • Background: Multiple myeloma (MM) is influenced by genetic and micro-environmental changes. Malignant plasma cells produce an abnormal monoclonal immunoglobulin, as well as cytokines, such as IL-10 and IL-6 which stimulate cells of the bone marrow microenvironment (BMM) and cause dysfunction and failure of many organs. B cell activating factor (BAFF), IL6 and IL10 are known to influence the growth and survival of malignant clones. Aim: The objectives of the present study were to investigate the circulating levels of BAFF, IL-10 and IL-6, correlate them with well-known parameters of disease activity in patients with MM, and to detect their impact on patients' survival. Materials and Methods: This study was conducted on 89 newly diagnosed MM patients and seventy apparently healthy volunteers as a normal control group. BAFF, IL6, IL10 were measured by ELISA for both groups and survival analysis was performed for all patients. Results: Studied markers were higher in the MM patients compared to the normal control subjects. Patients survival was improved by high serum BAFF levels. Conclusions: High levels of BAFF were found to improve patients' survival. BAFF and IL-6 can be considered probable diagnostic markers for MM.

Metastatic Pancreatic Carcinoma and Experience with FOLFIRINOX - a Cross Sectional Analysis From a Developing Country

  • Zahir, Muhammad Nauman;Jabbar, Adnan Abdul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6001-6006
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    • 2015
  • Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

Outcomes of chronic dialysis in Korean children with respect to survival rates and causes of death

  • Chang, Hye Jin;Han, Kyoung Hee;Cho, Min Hyun;Park, Young Seo;Kang, Hee Gyung;Cheong, Hae Il;Ha, Il Soo
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.135-139
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    • 2014
  • Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

Prognostic Factors of Acute Poisoning in Elderly Patients (65세 이상 노인 약물 중독 환자의 예후 인자)

  • Kim, Ji-Yoon;Jung, Hyun-Min;Kim, Ji-Hye;Han, Seung-Baik;Kim, Jun-Sig;Paik, Jin-Hui
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.81-87
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    • 2011
  • Purpose: Incidents of suicide attempt and acute poisoning in the elderly population is rising. This study investigated the clinical nature of acute poisoning and differences between the survival and mortality groups in the elderly. Methods: We retrospectively investigated 325 patients with acute poisoning who visited the emergency department. Patients were divided into two groups, one survival and one death group. Information regarding patient sex, age, root cause of poisoning, time of year of poisoning, type of intoxicant, duration of time between intoxicant ingestion and arrival at the emergency department, total length of hospital stay, and any previous suicide attempts and subsequent hospitalization were collected. An initial Glasgow Coma Scale (GCS) and an initial and final Poison Severity Score (PSS) for each patient was calculated. Results: The survival rate for men was higher than for women in this study. The most common reason of drug intoxication was suicide, with accidental ingestion and substance abuse occurring in descending frequency. Seasonal factors were reflected in the data with the highest number of incidents occurring in spring and the lowest number in winter. Compared with the mortality group, the survival group had a lower initial PSS with a higher GCS. Conclusion: We conclude that being female, having suicide as a root cause, agrochemicals as an intoxicant, low initial Glasgow Coma Scale and high initial Poisoning Severity Score, are all associated with poor prognosis.

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Association Between the Frailty Index and Clinical Outcomes after Coronary Artery Bypass Grafting

  • Kim, Chan Hyeong;Kang, Yoonjin;Kim, Ji Seong;Sohn, Suk Ho;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.189-196
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    • 2022
  • Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

Survival and growth of the red tide organism Cochlodinium polykrikoides after the addition of yellow loess

  • Lee, Young-Sik;Lim, Wol-Ae;Lee, Sam-Geun
    • Proceedings of the Korean Environmental Sciences Society Conference
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    • 2008.11a
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    • pp.282-285
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    • 2008
  • At least 15% of the C polykrikoides cells that precipitated to the bottom layer either by the addition of loess or no addition survived for 1 week at all growth phases, rather than disappearing immediately after precipitating. However, no live cells were observed after 20 days, regardless of phase or loess addition. In the exponential phase, the number of C polykrikoides cells increased to >2886 cells/ml after loess was added. However, in the stationary phase, the number of cells did not increase until 18 days. In the exponential phase, those C polykrikoides that survived precipitation caused by scattering loess on cultures did not appear to have the ability to cause red tides again because of the short red tide periods in the field, long lag time after loess addition, and low survival rate after loess addition.

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Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients (소아 백혈병 환자의 동종 조혈모세포이식 전처치로서 전신방사선 조사 포함군과 비포함군의 비교)

  • Kim, Sang-Jeong;Han, Dong-Kyun;Baek, Hee-Jo;Kim, Dong-Yeon;Nam, Taek-Keun;Hwang, Tai-Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.538-547
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    • 2010
  • Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.

Effects of the Red Tide and Toxic Dinoflagellates on the Survival and Growth of Larvae of the Mussel, Mytilus galloprovincialis

  • Lee, Chang-Hoon
    • The Korean Journal of Malacology
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    • v.19 no.1
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    • pp.25-32
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    • 2003
  • To know the effects of the red tide and toxic dinoflagellates on survival and growth of larvae of the mussel, Mytilus galloprovincialis, laboratory experiments were conducted by incubating larvae with either unialgal culture of 4 dinoflagellate species (Amphidinium carterae, Prorocentrum triestinum, Gymnodinium impudicum, or Akashiwo sanguinea) or a standard food (Isochrysis galbana) for 10 days. The survival of larvae was higher than 80% when the food was A. carterae, G. impudicum, or A. sanguinea. The lowest survival (20%) was found when the food was P. triestinum. When the food was P. triestinum, the survival of larvae rapidly decreased from 87% at day 4 down to ca. 50% at day 6, and 20% at day 10. This implies that the larval population of M. galloprovincialis can seriously be affected if they are exposed to the red tide water dominated by P. triestinum for more than 4 days. Shell length of larvae either increased or decreased according to the food species. When the food was A. carterae, G. impudicum, or A. sanguinea, shell length of larvae increased. But, it decreased when the food was P. triestinum. Though shell length increased in 3 treatments, the daily increments (0.63 $\mu$ m for A. carterae, 0.46 m for $\mu$ G. impudicum, and 1.10 m for $\mu$ A. sanguinea) were smaller than that of the standard food (3.79 m for $\mu$ I. galbana). Correlation analyses chowed that the change in shell length was not significant when the food was A. carterae or G. impudicum. Therefore, all of 4 dinoflagellates affected the growth of M. galloprovincialis larvae: growth was negative for P. triestinum, nil for A. carterae and G. impudicum, and positive but lower than standard food for A. sanguinea. These imply that the dinoflagellates are less valuable as foods for M. galloprovincialis larvae. So, decreased growth rate of larvae is expected during red tides, which will consequently cause delayed metamorphosis or failure to recruitment to the adult populations. In considering the harmful effects of red tides on the aquatic ecosystem, not only the effects on adult populations of fish and shellfish, but also the effects on larval populations should be included.

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Risk Factors Affecting the Graft and Patient Survival in Kidney Transplant Patients (신이식환자에서 이식과 환자의 생존에 영향을 끼치는 위험요인 분석)

  • Kim, Joo-Young;Han, Duck-Jong;Shin, Hae-Young;Shin, Whan-Gyun;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.1
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    • pp.14-22
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    • 2006
  • Purpose: To determine the short (1 year of transplant) and long-term (1-5 years of transplantation) risk factors affecting the graft and patient survival in kidney transplantation recipients. Methods: Records of 149 patients who received kidney transplantation in 1996 from Asan Medical Center were followed for 5 years retrospectively. Results: All patients initiated triple immunosuppressive therapy with cyclosporine, prednisone and azathioprine. One, two, three, four, five year patient and graft survival rates were 98.7%, 98.0%, 98.0%, 97.3%, 97.3%, and 96.6%, 95.2%, 94.6%, 92.5%, 91.8%, respectively. There were 30 cases of acute rejection (AR) and 6 cases of chronic rejection (CR) within $2.1{\pm}3.2$ months and $42.1{\pm}13.2$ months of transplantation, respectively. The risk factors for AR were donor's age older than 30 years (p=0.02) and cardiovascular disease (p=0.05). The risk factors for CR were AR (p=0.0169) and episode of complications (p=0.0330). Increasing period of dialysis (p=0.0473), episodes of AR (p<0.0001) and complication (p=0.0317) were significant factors for graft loss. Seven grafts were lost from noncompliance during 1-5 year period. The most com- mon cause of the graft loss for both periods was the graft rejection. The graft survival rate was significantly lower in patients with than without rejection episodes (77.4% vs. 90.0%, p=0.002). Conclusions: Survival rate of the graft with rejection was significantly lower. The risk factors affecting AR were donor's age older than 30years and CVD. AR and episode of complications within 1year were the risk factors for CR and graft loss.

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