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Search Results: 1 - 10 of 3053 matches for " Overall Survival "
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Association between Pretreatment Levels of Serum Vascular Endothelial Growth Factor (VEGF) and Survival Outcomes in Locally Advanced Cervical Cancer Patients  [PDF]
Kanyarat Katanyoo, Kanisa Rongsriyam, Marisa Chongtanakon
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.410178
Abstract:

Objective: To evaluate the association between pretreatment levels of serum vascular endothelial growth factor (VEGF) and long-term treatment outcomes in patients with locally advanced cervical cancer (LACC). Methods: Thirty-nine patients diagnosed with LACC (stage IIB-IVA) and obtaining blood for serum VEGF were identified. All patients received complete treatment as radical radiotherapy with or without concurrent chemotherapy. Surveillance for all patients was every 3 months during the first 2 years, and every 6 months later. Results: Mean age of 39 patients was 52.3 ± 10.8 years old. Twenty-three patients (59.0%) had stage IIB, and 16 patients (41.0%) had stage IIIB. Histological cell type was mostly squamous cell carcinoma (89.7%). The median and 75th percentile level of serum VEGF were 610.2 pg/ml (0.0 - 4067.2 pg/ml) and 825.6 pg/ml, respectively. At median follow-up of 37.0 months (range, 26.8 - 46.3 months), the 3-year OS rate was 78.6%. Clinical stage (p = 0.04) and 75th percentile of VEGF level (p = 0.04) were impacted on OS in univariable analysis. The 3-year OS of patients in stage IIB with serum VEGF of ≤825.6 pg/ml and of > 825.6 pg/ml was slightly different,

Time to Progression of AFP (TPA) as a Predictor of Survival in Hepatocellular Carcinoma Treated with Sorafenib (SOR)  [PDF]
Maria Varela, Olegario Casta?o-Fernández, Marcelo Garrido, Lorena Blanco-García, Pablo Martínez-Camblor, Alicia Mesa-álvarez, Carmen Navascués, Valle Cadahía-Rodrigo, Rafael Menéndez de Llano, Ramon Pérez-álvarez, Maria Luisa González-Diéguez, Manuel Rodríguez
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.514133
Abstract: Background: The standard therapy in advanced hepatocellular carcinoma (HCC) is sorafenib (SOR), which has the inconvenience of toxicity and discontinuation. Patient selection and the use of early markers are critical for optimizing the potential benefit of SOR. Alpha-fetoprotein (AFP) has an established role in HCC prognosis. The objective was to evaluate whether AFP variation during SOR treatment reflects the lack of progression to SOR and can be used as a prognostic factor. Methods: AFP levels were prospectively analyzed in 114 patients to determine whether the time to progression of AFP (TPA) at 3 months had a prognostic value for survival. Results: Between July 2007 and October 2012, 114 patients were included (mean age 64 years, 97 male, 96 with cirrhosis). Etiology was alcohol 47 (41%) and hepatitis C virus (HCV) 31 (27%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system: A (one case), B (24 cases) and C (89 cases). The Child-Pugh was Class A in 89 cases. The general condition of the patient according to ECOG-PS was 0 in 73 cases. The median duration of treatment was 5 months (3.47 - 6.53, 95% CI). The median overall survival (OS) was 9.23 months. The standard dose was maintained in 26 patients (22.8%). Sixty-seven percent of patients experienced at least one adverse event grade 3-4. The time to progression of AFP lower or higher than 3 months was an independent prognostic factor of OS (univariate and multivariate analysis): 8.10 vs. 18.85 months, P < 0.001. Conclusion: HCC treated with SOR with TPA > 3 months had longer OS, and TPA was an independent prognostic factor.
A Real-World Observational Study of Patients with Advanced Melanoma Receiving First-Line Ipilimumab in a Community Practice Setting  [PDF]
Debra A. Patt, Debra Rembert, Menaka Bhor, Debajyoti Bhowmik, Sumati A. Rao
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.512110
Abstract: Background: Following approval of ipilimumab, this observational cohort study (CA184-332) was initiated to describe patient and disease characteristics, patterns of care, survival, and adverse events (AEs) in advanced melanoma (AM) patients treated with first-line ipilimumab in realworld US community practice. Methods: Adult patients with treatment-naive AM who received ≥1 dose of ipilimumab 3 mg/kg between April 2011 and September 2012 were retrospectively identified at US Oncology sites. Clinical data were abstracted from patient medical records. Results: Median age of the 157 patient cohorts was 66 years (range 21 - 91). 68.2% were male, and 90.5% had a cutaneous primary site. At ipilimumab initiation, 80.9% of patients had an ECOG performance status of 0 or 1; 54.1% were stage M1c; 34.4% had brain metastases; 24.8% had elevated lactate dehydrogenase, and 13.4% were positive for BRAF mutation. All 4 cycles of ipilimumab were completed by 55.8% of patients. At a median follow-up of 8.5 months (range 2.9 - 15.0), median overall survival was 11.5 months (95% CI: 8.9 - 16.6) and 1-year survival was 46.7% (95% CI: 38.1 - 54.9). During ipilimumab treatment, AEs were experienced by 63.7% of patients. The most frequent AEs were gastrointestinal (41.4%; diarrhea in 19.1%) and skin-related (28.0%; rash in 17.8%); 17.8% of patients had an AE that led to ipilimumab discontinuation. Conclusions: These real-world results are consistent with those from clinical trials and provide evidence supporting the effectiveness and safety of first-line ipilimumab 3 mg/kg monotherapy in patients with AM treated in a community practice setting.
Bone Scan Index Is a Prognostic Factor for Breast Cancer Patients with Bone Metastasis Being Treated with Zoledronic Acid  [PDF]
Yukinori Okada, Tatsuyuki Abe, Yasuo Nakajima, Itsuko Okuda, Brandon D. Lohman, Yoshihide Kanemaki, Yasuyuki Kojima, Kouichirou Tsugawa
Open Journal of Radiology (OJRad) , 2015, DOI: 10.4236/ojrad.2015.53022
Abstract: Bone scan index (BSI) has been used to quantify the spread of bone metastasis and be a prognostic indicator in prostate cancer with bone metastases. However, the utility of BSI in breast cancer patients with bone metastasis has not been yet established. We retrospectively reviewed 57 female breast cancer patients with osteoblastic/lytic combined type bone metastases and treated with zoledronic acid after bone metastasis was identified. Serial bone scintigrams were taken at the time of bone metastasis detection and during the 6- and 12-month follow-ups. The scintigrams were analyzed by BONE NAVITM version 1 and the BSI value was calculated. Additionally, serum cancer antigen 15-3 (CA15-3) and carcinoembryonic antigen (CEA) were measured. The patients were divided in 2 distinct groups—group A representing all follow-up BSI values ≤ initial BSI values and group B representing all follow-up BSI values ≥ initial BSI values. The interval changes of CA15-3 and CEA were divided in the same fashion. Kaplan-Meier method and log-rank test revealed that the overall survival rate was significantly greater in group A than those of group B after 6 months (p = 0.011) and 12 months (p = 0.016). Univariate analysis revealed that the overall survival rate was significantly greater in group A than those of group B, after a 6 month period (Hazard Ratio [HR] 5.841; 95% confidence interval [CI] 1.248 - 27.34; p = 0.025) and 12 month period (HR: 4.22; 95% CI 1.17615.15; p = 0.027). Multivariate analysis demonstrated that BSI changes after 6 and 12 months trended toward significance regarding parameters affecting survival rate (age and CA15-3) with a HR = 12.760 (95%CI 1.8110 - 89.850) at 6 months with a p = 0.010 and a HR = 5.0640 (95%CI 1.0590 - 24.220) at 12 months with a p = 0.042. BSI changes after 6 and 12 months appear to be a prognostic factor in breast cancer patients with bone metastasis treated with zoledronic acid.
Visceral Fat Accumulation Is Associated with Increased Mortality Rate after Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma  [PDF]
Masaya Saito, Yoshihiko Yano, Hirotaka Hirano, Kenji Momose, Yuki Kawano, Masaru Yoshida, Takeshi Azuma
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.613122
Abstract: Aim: Transcatheter arterial chemoembolization (TACE) is thought to be a safe and effective treatment for hepatocellular carcinoma (HCC). However, in some HCC patients, it potentially shortens survival due to liver damage. We aimed to identify independent factors to predict overall survival of HCC after TACE. Methods: We included a total of 96 consecutive HCC patients who underwent TACE at Kobe University Hospital. Areas of skeletal muscle and fat tissue were measured by computed tomography (CT) scan before TACE. We divided the patients into two groups in terms of the presence or absence of 1-year mortality after TACE. Factors associated with 1-year mortality after TACE were assessed by multivariate analyses, and the optimal cut-off values were evaluated using a propensity score. Results: Multivariate analyses showed that visceral fat accumulation on CT was an independent factor associated with 1-year mortality after TACE (p = 0.033). There were no differences in skeletal muscle area and subcutaneous and intermuscular fat area between the two groups. Cut-off values for visceral fat area associated with 1-year mortality after TACE were defined as 33.3 cm2/m2 for males and 24.4 cm2/m2 for females. Conclusions: High visceral fat area was a prognostic factor associated with increased mortality rate in HCC patients undergoing TACE. Using this value, 1-year mortality risk after TACE would be better estimated before the day TACE was performed.
Outcome of match related allogeneic stem cell transplantation procedures performed from 2004 till 2011
Natasha Ali, Salman Adil, Mohammad Shaikh, Munira Moosajee, Nehal Masood
Experimental Hematology & Oncology , 2012, DOI: 10.1186/2162-3619-1-13
Abstract: Haematopoietic stem cell transplant is now the standard of care in many congenital or acquired, malignant and non-malignant haematological diseases. The last few years have seen rapid increases in volumes of the procedure. In 2006, approximately 60,000 transplants were performed worldwide [1]. Although the history of transplant began in the late 1940s and 1950s when animal studies revealed the ability of donor bone marrow to restore hematopoieis after irradiation, in Pakistan, stem cell transplant was started in 1995[2].In a country like ours where consanguinity prevails, β- thalassemia major is the most common genetic haematological disorder requiring stem cell transplant as a curative treatment option [3]. Pakistan is also included in the list of countries where prevalence of aplastic anaemia is high. This is second most common indication for transplant in our setting [4]. Apart from these two disorders, rest of the allogeneic procedures mainly revolve around chronic and acute leukaemia. Due to the large family sizes, in 70% of the patients an HLA identical sibling donor is available as compared to the western population. Autologous stem cell transplant is mainly indicated in lymphomas and myeloma but frequency is lower as compared to allogeneic procedures.With a per capita income of $1051 (2009–2010), the affordability of stem cell transplant procedure by an average man is prohibited by its cost which ranges from $100,000 -$150,000. Although the cost is cheaper locally, majority of our transplants are funded mainly by nongovernmental organisations and philanthropists.Currently, stem cell transplant is being performed in three centres. Our centre was established in April 2004. Initially it was a two bedded unit which was upgraded to four bedded in 2006. With this background, we present our initial experience between April 2004 and August 2011 of allogeneic haematopoietic stem cell transplant for various haematological disorders.All patients with non-malignant and
Postrecurrence Clinical Outcome of Patients with Stage I Epithelial Ovarian Cancer Who Underwent Fertility-Sparing Surgery Compared to Those with Radical Surgery  [PDF]
Hiroaki Kajiyama, Kiyosumi Shibata, Mika Mizuno, Eiko Yamamoto, Michiyasu Kawai, Tetsuro Nagasaka, Fumitaka Kikkawa
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41022
Abstract:

Background: To examine the difference in the survival of patients with recurrent ovarian cancer who received fertility-sparing surgery (FSS) and those receiving radical surgery. Methods: Clinicopathologic data on a total of 90 patients with stage I recurrent ovarian cancer collected under the central pathological review system were subjected to survival analyses. Patients were divided into 2 groups: 1) FSS (N = 11), 2) Radical (N = 79). Results: Five-year overall survival rates of patients in the two groups were as follows: 40.8% (FSS)/44.2% (Radical), respectively. There was no significant difference in overall survival among the groups (P = 0.887). Additionally, three-year postrecurrence survival rates of patients in the two groups were 24.8% (FSS) and 25.3% (Radical) (P = 0.730). Furthermore, we accumulated 137 patients {FSS (N = 58), Radical group (N = 79)} with stage I recurrent ovarian cancer from the current study and six representative reports in the literature. Patients who experienced recurrence in the remaining ovary alone (FSS) showed a more favorable prognosis than those who had extra-ovarian site recurrence (overall survival: P = 0.021, postrecurrence survival: P = 0.069). Conclusions: Although our retrospective analysis was very preliminary, we could propose the hypothesis that patients with stage I recurrent ovarian cancer who undergo FSS may not show poorer survival rates than patients who receive radical surgery.

High Dose-Volume SBRT Following TACE Improves Clinical Outcomes of Patients with Unresectable Hepatocellular Carcinoma  [PDF]
Nanbao Zhong, Guangming Lv, Zhonghua Chen
Journal of Cancer Therapy (JCT) , 2016, DOI: 10.4236/jct.2016.72016
Abstract: This study aimed to investigate the dose-volume effects of γ-ray stereotactic body radiotherapy (SBRT) on clinical outcomes of patients with huge-size (≥10 cm) unresectable hepatocellular carcinoma (HCC). A total of 59 patients with huge-size unresectable HCC were treated with SBRT following TACE between May 2006 and Dec. 2009. The analyzed parameters included fractional dose, marginal dose, maximal dose, and mean dose that the target received, as well as percentages of tumor volume encompassed by 60% (P60), 70% (P70), and 80% (P80) of isodose curves in entire tumor. The clinical outcomes included objective response rate (ORR), disease-free survival (DFS), overall survival (OS), and adverse event (AE). During median follow-up of 18.4 months, 81.4% of ORR (8.5% CR and 72.9% PR) was achieved, higher than 28.9% of ORR recently reported for TACE alone. 1- and 3-year DFS rates were 31.1% and 2.6% with median DFS of 8.7 months; 1-, 3-, and 5-year OS rates were 46.5%, 13.7%, and 2.9%, with median OS of 11.8 months. P70 was the only factor significantly correlating to DFS (P = 0.009) and OS (P = 0.01). Neither severe radiation-related liver disease nor > grade 3 AE was observed. In conclusion, SBRT was a safe and effective option for treatment of huge-size unresectable HCC. P70 represented a parameter for predicting DFS and OS, and high dose-volume (e.g., P70) might be required to achieve improved clinical outcomes of patients with this type of HCC.
Study of Minimal Residual Disease in Adults with B-Lineage Acute Lymphoblastic Leukemia by Flowcytometry  [PDF]
Rania A. Ghonaim, Tarek A. Elgohary
Journal of Cancer Therapy (JCT) , 2017, DOI: 10.4236/jct.2017.84033
Abstract: Background: After achieving morphological remission, existence of few number of leukemic cells in the patient’s blood represents the minimal residual disease (MRD) and its monitoring helps in evaluating early treatment response and future relapse. Patients and methods: Eighty seven newly diagnosed (B-ALL) cases were enrolled in the present study in the time period from October 2013 to October 2016. A panel of 4 monoclonal antibodies (CD10FITC, CD19PE, CD34PercP and CD45APC) were defined at diagnosis and after morphological remission for tracing of minimal residual disease (MRD). Results: Eighty seven newly diagnosed B-ALL cases were included in the present study of which 73 (84%) showed positive expression to CD45 in combination with (CD10, CD19 and CD34) at diagnosis, which allow us to use this combination for further assessment of MRD after morphological remission. In our study 65% of patients had negative MRD (<0.01), while 35% of patients had positive MRD (≥0.01). The DFS and OS for patients with MRD-ve were significantly higher than those with MRD + ve (P = 0.01 & P = 0.04) respectively. Conclusion: MRD detection by flow cytometry using the combination of CD45 with CD10, CD19 & CD34 is an easy and reliable method. Patients with positive MRD are at higher risk of relapse and have inferior overall survival rates compared to those with MRD-ve. Future studies focusing on treatment intensification for the group of patients with +ve MRD aiming to improve the treatment outcome are warranted.
Biopsia del ganglio centinela en el melanoma: camino a la desaparición
Achenbach,RE; Monroy,S;
Revista argentina de dermatolog?-a , 2011,
Abstract: sentinel node biopsy and selective lymph node dissection are still a frequent tool for therapeutic management of melanoma without scientific support. prospective-randomized trials have failed to show overall survival - the main goal in such trials in invasive melanoma. some articles proving that the opposite point of view to its standard use is correct have been reviewed, in order to offer to the dermatologist the different alternatives so as to discuss such procedures with amplitude of criteria at the time of discussing such procedure with the potential patient.
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