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Recurrence Patterns (recurrence + pattern)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Chemoradiotherapy in gallbladder cancer

JOURNAL OF SURGICAL ONCOLOGY, Issue 8 2006
FACS, Xabier de Aretxabala MD
Abstract Gallbladder cancer (GC) is considered a rare disease associated with a poor prognosis. Unfortunately, the low number of cases makes the performance of trials addressing the role of adjuvant, neoadjuvant, and/or palliative therapy difficult. For a long time, the majority of trials were 5-fluorouracil (5 FU)-based, and results were uniformly poor. Since the introduction of Gemcitabine, response rates of approximately 30% have been observed through the use of this drug and new approaches have been tested. In this sense, drugs such as Cisplatin and Capecitabine have been employed concurrently with gemcitabine and/or radiation. Since a recurrence pattern is both distant and local, chernoradiation seems a logical option to deal with the disease. However, at the present time, the lack of valid and scientific evidence means that most of the recommendations originate from trials dealing with other tumors, such as pancreas cancer and biliary tract cancer (BTC). The aforementioned treatment alternatives warrant further evaluation focusing on GC. J. Surg. Oncol. 2006;93:699,704. © 2006 Wiley-Liss, Inc. [source]

Recurrence following curative resection for gastric carcinoma

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2000
C. H. Yoo
Background: The diagnosis and treatment of recurrent gastric cancer remains difficult. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the prognosis for these patients. Methods: Of 2328 patients who underwent curative resection for gastric cancer from 1987 to 1995, 508 whose recurrence was confirmed by clinical examination or reoperation were studied retrospectively. The risk factors that determined the recurrence patterns and timing were investigated by univariate and multivariate analysis. Results: The mean time to recurrence was 21·8 months and peritoneal recurrence was the most frequent (45·9 per cent). Logistic regression analysis showed that serosal invasion and lymph node metastasis were risk factors for all recurrence patterns and early recurrence (at 24 months or less). In addition, independent risk factors involved in each recurrence pattern included younger age, infiltrative or diffuse type, undifferentiated tumour and total gastrectomy for peritoneal recurrence; older age and larger tumour size for disseminated, haematogenous recurrence; and older age, larger tumour size, infiltrative or diffuse type, proximally located tumour and subtotal gastrectomy for locoregional recurrence. Other risk factors for early recurrence were infiltrative or diffuse type and total gastrec-tomy. Reoperation for cure was possible in only 19 patients and the mean survival time after conservative treatment or palliative operation was less than 12 months. Conclusion: The risk factors for each recurrence pattern and timing of gastric cancer can be predicted by the clinicopathological features of the primary tumour. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted. © 2000 British Journal of Surgery Society Ltd [source]

Clustering of Ventricular Tachyarrhythmias in Heart Failure Patients Implanted with a Biventricular Cardioverter Defibrillator

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2006
MAURIZIO LUNATI M.D.
Background: Temporal patterns of ventricular tachyarrhythmia (VT/VF) have been studied only in patients who have received implantable cardioverter defibrillators (ICD) for secondary prevention of sudden death, and mainly in ischemic patients. The aim of this study was to evaluate VT/VF recurrence patterns in heart failure (HF) patients with biventricular ICD and to stratify results according to HF etiology and ICD indication. Methods and Results: We studied 421 patients (91% male, 66 ± 9 years). HF etiology was ischemic in 292 patients and nonischemic in 129. ICD indication was for primary prevention in 227 patients and secondary prevention in 194. Baseline left ventricular ejection fraction (LVEF) was 26 ± 7%, QRS duration 168 ± 32 msec, and NYHA class 2.9 ± 0.6. In a follow-up of 19 ± 11 months, 1,838 VT/VF in 110 patients were appropriately detected. In 59 patients who had ,4 episodes, we tried to determine whether VT/VF occurred randomly or rather tended to cluster by fitting the frequency distribution of tachycardia interdetection intervals with exponential functions: VT/VF clusters were observed in 46 patients (78% of the subgroup of patients with ,4 episodes and 11% of the overall population). On multivariate logistic analysis, VT/VF clusters were significantly (P < 0.01) associated with ICD indication for secondary prevention (odds ratio [OR]= 3.12; confidence interval [CI]= 1.56,6.92), nonischemic HF etiology (OR = 4.34; CI = 2.02,9.32), monomorphic VT (OR = 4.96; CI = 2.28,10.8), and LVEF < 25% (OR = 3.34; CI = 1.54,7.23). Cardiovascular hospitalizations and deaths occurred more frequently in cluster (21/46 [46%]) than in noncluster patients (63/375 (17%), P < 0.0001). Conclusions: In HF patients with biventricular ICDs, VT/VF clusters may be regarded as the epiphenomenon of HF deterioration or as a marker of suboptimal response to cardiac resynchronization therapy. [source]

Recurrence following curative resection for gastric carcinoma

Ocular toxoplasmosis recurrences: a single center case report

ACTA OPHTHALMOLOGICA, Issue 2009
U SERRA
Purpose To describe recurrence patterns in a cohort of patients with aqueous humor proven ocular toxoplasmosis, followed during 3 years, at a single referral center. Methods Retrospective, observational, non comparative case series including 43 patients who suffered from an active episode of toxoplasmic retinochoroiditis during 2005, confirmed by aqueous humour polymerase chain reaction (PCR) positivity and assisted at the Ophthalmology Department of the Pitié-Salpêtrière Hospital in Paris, France. Clinical files were analyzed in terms of signs of intraocular inflammation, number, size and location of retinochoroidal active lesions and scars, presence of ocular complications related to toxoplasmic retinochoroiditis, angiographic and visual field findings and therapeutic management. Results 20 males and 23 females (mean age 37 year-old) were followed after an episode of toxoplasmic retinochoroiditis confirmed by analysis of ocular fluids. Five of them were immunocompromised and twelve have already experienced at least a previous episode of active toxoplasmic retinochoroiditis. Recurrences occurred in 13 patients (28%) with a mean age of 48 years. These episodes were noted during the first year of follow-up, between 12 and 24 months and between 24 and 36 months in 4, 5 and 3 patients respectively. Conclusion Recurrences seem to be more frequent if they occur during the first year after the initial episode of retinochoroiditis, especially in older patients. Prospective studies are needed in order to confirm these preliminary data. [source]