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Mean Survival (mean + survival)
Terms modified by Mean Survival Selected AbstractsThe use of self-expandable metallic stents for palliative treatment of inoperable esophageal cancerDISEASES OF THE ESOPHAGUS, Issue 1 2010A. Eroglu SUMMARY Most patients with esophageal carcinoma present in the advanced stage die from tumor invasion and widespread metastases. Because radical regimens are not appropriate for the majority of patients, and their expected survivals are as short as to be measured by months, the main aim of therapy is palliation with minimum morbidity and mortality. Among the palliative modalities are surgery, external radiotherapy or brachytherapy, dilatation, laser, photodynamic therapy, bipolar electrocoagulation tumor probe, and chemical ablation. The placement of self-expandable metallic stents is another method that improves dysphagia for these patients. In this study, the aim was to evaluate retrospectively the effectiveness of metallic stents deployed because of inoperable malignant esophageal stenosis and esophagotracheal fistulas. The results of 170 patients with 202 stents administered because of inoperable malignant esophageal stenosis and esophagorespiratory fistula between January 2000 and October 2008 at the Ataturk University, Department of Thoracic Surgery, were investigated. Despite epidemiological and clinical data, information regarding relief of dysphagia and quality of life were also examined. One hundred seventy patients with stents were between 28 and 91 years old (mean age 63.7 years ± 11.4 years). Ninety-seven were male and 73 were female. Stent indications were advanced tumors with distant metastasis (82 cases, 48.2%), unresectable tumors (51 cases, 30%), patients who cannot tolerate surgery or chemoradiotherapy (18 cases, 10.5%), local recurrence after primary therapy (1 case, 0.5%), esophagorespiratory fistulas from tumor or therapy (14 cases, 8.2%), and refusal of surgery (4 cases, 2.3%). Dysphagia scores evaluated by a modified Takita's grading system improved from 3.4 before the procedure to 2.6 afterward. The overall complication rate without chest pain was 31.7% (occurring in 64 cases). Mean survival was 177.7 days ± 59.3 days (2,993 days). Quality-of-life scores (The European Organization of Research and Treatment of Cancer QLQ C30) improved from 73 ± 10.3 (57,85) to 112 ± 12.6 (90,125). In therapy of malignant esophageal obstructions, metallic stents provide a significant improvement in dysphagia and require less frequent re-intervention according to other methods of dysphagia palliation such as dilatation, laser, and photodynamic therapy, nearly completely relieve esophagotracheal fistulas and improve quality of life to an important degree. [source] Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2006B. Zach Fowler MD Abstract Background. This retrospective study investigated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center. Methods. A chart review yielded 64 patients with STL: 53 with RT failures, six with CS failures, and five after RT + CS. Median potential follow-up after STL was 9.4 years (mean, 9.2 years; range, 0.3,17.4 years). Results. Five- and 10-year actuarial overall survival (OS) after STL was 65.2% and 37.7%, respectively. Mean survival after STL was 7.2 years (median, 6.8 years; range, 0.2,17.4 years). No significant survival difference was found between the three treatment groups (p = .50). For 21 patients with nodes assessed at STL, 9-year OS was 45.4% for patients with N0 disease versus 26.7% for patients with N+ disease (p = .25). Conclusion. These data suggest that STL after radiation failure is associated with equivalent long-term survival as STL after RT + CS or after failure of CS alone. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Adenoid cystic carcinoma: A retrospective clinical reviewINTERNATIONAL JOURNAL OF CANCER, Issue 3 2001Atif J. Khan M.D. Abstract Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors of outcome. All patients registered with the tumor registry as having had ACC were identified. Demographic and survival variables were retrieved from the database. Additionally, a chart review of all patients was done to obtain specific information. Minor gland tumors were staged using the American Joint Committee on Cancer's criteria for squamous cell carcinomas in identical sites. Histopathologic variables retrieved included grade of the tumor, margins, and perineural invasion. Treatment modalities, field sizes, and radiation doses were recorded in applicable cases. An effort to retrieve archival tumor specimens for immunohistochemical analysis was undertaken. A total of 69 patients were treated for ACC from 1955 to 1999. One patient, who presented with fatal brain metastasis, was excluded from further analysis. Of the remaining 68 patients, 30 were men and 38 were women. The average age at diagnosis was 52 years, and mean follow-up was 13.2 years. Mean survival was 7.7 years. Overall survival (OS) rates at 5, 10, and 15 years were 72%, 44%, and 34%, and cause-specific survival was 83%, 71%, and 55%, respectively. Recurrence-free survival rates were 65%, 52%, and 30% at 5, 10, and 15 years, with a total of 29 of 68 (43%) eventually suffering a recurrence. Overall survival was adversely affected by advancing T and AJCC stage. Higher tumor grades were also associated with decreased OS, although the numbers compared were small. Primaries of the nasosinal region fared poorly when compared with other locations. Total recurrence-free survival, local and distant recurrence rates were distinctly better in primaries of the oral cavity/oropharynx when compared with those in other locations. Reduced distant recurrence-free survival was significantly associated with increasing stage. No other variables were predictive for recurrence. Additionally, we found that nasosinal tumors were more likely to display higher stage at presentation, and were more often associated with perineural invasion. Also of interest was the association of perineural invasion with margin status, with 15 of 20 patients with positive margins displaying perineural invasion, while only 5 of 17 with negative margins showed nerve invasion (P = 0.02). On immunohistochemistry, 2 cases of the 29 (7%) tumor specimens found displayed HER-2/neu positivity. No correlation between clinical behavior and positive staining could be demonstrated. Our data concur with previous reports on ACC in terms of survival and recurrence statistics. Stage and site of primary were important determinants of outcome. Grade may still serve a role in decision making. We could not demonstrate any differences attributable to primary modality of therapy, perhaps due to the nonrandomization of patients into the various treatment tracks and the inclusion of palliative cases. Similarly, perineural invasion, radiation dose and field size, and HER-2/neu positivity did not prove to be important factors in our experience. © 2001 Wiley-Liss, Inc. [source] Production and Processing Trait Comparisons of Channel Catfish, Blue Catfish, and Their Hybrids Grown in Earthen PondsJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 6 2008Mingkang Jiang Fingerling HS-5 channel catfish, Ictalurus punctatus, NWAC 103 channel catfish, D&B blue catfish, Ictalurus furcatus, HS-5 female channel × D&B male blue catfish F1 hybrids, and NWAC 103 female channel × D&B male blue catfish F1 hybrids were stocked into twenty-five 0.04-ha earthen ponds at 12,500 fish/ha and grown for 277 d. Fish were fed daily at rates from 1.0 to 3.0% biomass based on feeding activity and temperature and adjusted weekly assuming a feed conversion ratio (FCR) of 1.8 and 100% survival. At harvest, 40 fish from each pond were sampled, and all other counted and weighed. Mean survival, growth rate indexes (a), FCR, and skin-on fillet percentages were not significantly different. Mean harvest weights and net production were higher for HS-5 channel and its hybrid than for the NWAC 103 channel, NWAC 103 hybrid, and D&B blue catfish, partially because of their larger mean stocking weights. D&B blue catfish was more uniform in size than NWAC 103 channel and NWAC 103 hybrid. D&B blue catfish was the easiest to seine. HS-5 hybrids and NWAC 103 hybrids had lower mean head percentage and a better processing yield than their parent channel catfish. [source] Effects of an Extended Hatchery Phase and Vaccination against Enteric Septicemia of Catfish on the Production of Channel Catfish, Ictalurus punctatus, FingerlingsJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 2 2008Abel A. Carrias The present study was conducted to evaluate production management methods to improve overall survival of channel catfish, Ictalurus punctatus, fry to the fingerling stage by incorporating the use of a live, attenuated vaccine against Edwardsiella ictaluri and employing an extended hatchery phase. In this experiment, four treatments were used. In Treatment 1, 10-d posthatch (PH) fry were vaccinated and then directly stocked into earthen ponds. In Treatments 2 and 3, 10-d PH fry were sham-vaccinated (control) and vaccinated, respectively, kept in nursery tanks for 22 d, and then stocked into earthen ponds. Fry in Treatment 4 were sham-vaccinated at 10 d PH, kept in nursery tanks for 22 d, and then vaccinated prior to stocking into earthen ponds. Mean fingerling yield at harvest ranged from 4716 kg/ha in Treatment 1 to 8112 kg/ha in Treatment 4. Mean individual fish weight ranged from 38.8 g in Treatment 1 to 40.9 g in Treatment 4, and feed conversion ratios (FCR) ranged from 1.15 in Treatment 4 to 1.51 in Treatment 1. Mean survival ranged from 47.5% in Treatment 1 to 73.4% in Treatment 4. In specific comparisons to evaluate the nursery effect (Treatments 1 and 3), yield and overall survival were significantly different (P < 0.05) between these two treatments. In specific comparisons to evaluate the effect of the use of the vaccine (Treatments 2, 3, and 4), overall survival was significantly different (P < 0.05) between Treatment 2 (sham-vaccinated control with nursery phase) and Treatment 4 (vaccinated at 32 d PH with nursery phase). No significant differences (P > 0.05) in yield, average weight, and FCR were observed between treatments. Results indicate that implementing an extended hatchery phase and vaccination strategy with older fry can improve overall survival of fingerling fish. [source] Effects of Artificial Substrate and Stocking Density on the Nursery Production of Pacific White Shrimp Litopenaeus vannameiJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 4 2004Komarey R. K. Moss Nursery production may be enhanced by the addition of artificial substrate to increase the surface area upon which shrimp graze and to serve as refuge. The objective of this study was to assess the effects of the artificial substrate, AquaMatsTM, on the performance of postlarval Pacific white shrimp Litopenaeus vannamei stocked at three densities. Eighteen 230-L tanks were stocked with 10-d postlarvae (mean weight < 0.01 g). Six treatments were evaluated and consisted of shrimp stocked at three densities (778 shrimp/m2, 1,167 shrimp/ m2, and 1,556 shrimp/m2) with and without access to artificial substrate. Shrimp in all treatments received a commercial diet ad libitum. After 6 wk, shrimp were harvested from each nursery tank, counted, and batch weighed. Mean final weight, survival, production, feed conversion ratio, and water quality parameters were analyzed by 2-way ANOVA. There were highly significant (P < 0.001) density and substrate effects on final weight, but there was no significant interaction effect. Final weight was 26.0, 17.4, and 34.5% greater in treatments with substrate than without substrate when stocked at 778, 1,167, and 1,556 shrimp/m2, respectively. There was no significant density, substrate, or interaction effect on survival or water quality. Mean survival was ± 89.1% for all treatments. Increased shrimp growth in the presence of added substrate was likely due to the availability of attached particulate organic matter on the AquaMatsTM that served as an additional food source. Results from this study indicate that artificial substrate can be used to mitigate the potential negative effects of high stocking density on growth of L. vannamei in nursery systems. [source] Epidemiology of Necrotizing Meningoencephalitis in Pug DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2008J.M. Levine Background: Although the histopathologic features of necrotizing meningoencephalitis (NME) have been described previously, little information is available concerning the signalment, geographic distribution, seasonal onset, treatment, and survival of affected dogs. Animals: Sixty Pugs with NME and 14 contemporaneous control Pugs with other intracranial diseases (non-NME group). Methods: Pugs that were euthanized or died because of intracranial disease were prospectively obtained. All dogs had necropsy, histopathology, and testing for various infectious diseases and were subsequently divided into NME and non-NME groups. Signalment, geographic distribution, seasonal onset, treatment, and survival were compared between groups. Results: In Pugs with NME, median age at onset of clinical signs was 18 months (range, 4,113 months). A greater proportion of female dogs were present in the NME group (40/60) compared with the control group (6/14). Pugs with NME had a significantly lower mean weight (7.81 kg) than control Pugs (9.79 kg) (P= .012). Mean survival in Pugs with NME was 93 days (range, 1,680 days), with dogs receiving any form of treatment living significantly longer than those that were not treated (P= .003). Anticonvulsive drugs were the only treatment significantly associated with longer survival (P= .003). Conclusions and Clinical Importance: NME appears to be a common cause of intracranial signs in Pugs, based on the high proportion of NME dogs reported in this population. Pugs with NME are most commonly young adult female dogs. Although further investigation is needed to determine the optimal treatment of NME, anticonvulsive drugs appear to beneficially affect duration of survival. [source] The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancerINTERNAL MEDICINE JOURNAL, Issue 12 2009S. Bydder Abstract Patients with inoperable non-small cell lung cancer diagnosed and managed at a single institution over a one-year period were identified. Those whose case had been discussed at a multidisciplinary meeting had better survival than those whose case was not discussed (mean survival; 280 days vs. 205 days, log-rank P= 0.048). [source] A 5-year audit of haemodialysis accessINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2005J. A. Akoh Summary This is a review of our experience with vascular access procedures over a 5-year period at Derriford Hospital, Plymouth, UK. The aims of the study were to examine the outcome of vascular access procedures and factors influencing access survival. Between April 1995 and March 2000, 151 patients who underwent 221 vascular access procedures were studied. Of these, 136 had autogenous arteriovenous fistulae, whereas 85 had prosthetic AV grafts (41% in the thigh). The overall primary failure rate was 21% whereas the 1- and 5-year cumulative access survival rates were 60 and 41%, respectively. Thigh grafts have a mean survival of 36 months compared with 32 months for prosthetic upper limb and 43 months for autogenous fistulae. Age, diabetes and predialysis status did not significantly influence access survival. Thrombosis was responsible for access failure in 62 cases (28%). Avoiding subclavian vein canulation and performing vessel mapping prior to access placement should reduce the risk of access failure due to outflow obstruction. [source] Regression modelling of correlated data in ecology: subject-specific and population averaged response patternsJOURNAL OF APPLIED ECOLOGY, Issue 5 2009John Fieberg Summary 1.,Statistical methods that assume independence among observations result in optimistic estimates of uncertainty when applied to correlated data, which are ubiquitous in applied ecological research. Mixed effects models offer a potential solution and rely on the assumption that latent or unobserved characteristics of individuals (i.e. random effects) induce correlation among repeated measurements. However, careful consideration must be given to the interpretation of parameters when using a nonlinear link function (e.g. logit). Mixed model regression parameters reflect the change in the expected response within an individual associated with a change in that individual's covariates [i.e. a subject-specific (SS) interpretation], which may not address a relevant scientific question. In particular, a SS interpretation is not natural for covariates that do not vary within individuals (e.g. gender). 2.,An alternative approach combines the solution to an unbiased estimating equation with robust measures of uncertainty to make inferences regarding predictor,outcome relationships. Regression parameters describe changes in the average response among groups of individuals differing in their covariates [i.e. a population-averaged (PA) interpretation]. 3.,We compare these two approaches [mixed models and generalized estimating equations (GEE)] with illustrative examples from a 3-year study of mallard (Anas platyrhynchos) nest structures. We observe that PA and SS responses differ when modelling binary data, with PA parameters behaving like attenuated versions of SS parameters. Differences between SS and PA parameters increase with the size of among-subject heterogeneity captured by the random effects variance component. Lastly, we illustrate how PA inferences can be derived (post hoc) from fitted generalized and nonlinear-mixed models. 4.,Synthesis and applications. Mixed effects models and GEE offer two viable approaches to modelling correlated data. The preferred method should depend primarily on the research question (i.e. desired parameter interpretation), although operating characteristics of the associated estimation procedures should also be considered. Many applied questions in ecology, wildlife management and conservation biology (including the current illustrative examples) focus on population performance measures (e.g. mean survival or nest success rates) as a function of general landscape features, for which the PA model interpretation, not the more commonly used SS model interpretation may be more natural. [source] Risk of gastric cancer is not increased after partial gastrectomyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2000R Bassily Abstract Background: It has been suggested that there is an increased risk of gastric cancer following partial gastrectomy. This question has not been studied in an Australian population. Methods: The records of a total of 569 patients who had a partial gastrectomy for peptic ulcer disease at Repatriation General Hospital, Heidelberg, between 1957 and 1976 were reviewed. All were followed to date of death or 31 December 1996. The expected rate of gastric cancer for this population was estimated from published Australian age-and sex-specific gastric cancer mortality rates over this period, and a standardized incidence ratio was calculated. Results: The mean age at surgery was 53.5 years (range 27,83 years). There were 547 male (96.4%) and 22 female (3.6%) patients. Five hundred and seven (83.5%) had a Billroth II procedure. Thirty-eight patients (6.3%) were lost to follow up and were not included in the analysis. From the records of the Department of Veterans' Affairs, it was established that 125 (20.6%) were alive in December 1996, a mean survival after surgery of 18.8 years. The mean documented duration of follow up was 17.3 years (range 1,41 years). Nine patients developed cancer in the gastric remnant. The expected number of cancers in this population was 6.5. Assuming all survivors were free of gastric cancer, the standardized incidence ratio was 1.39 (95% confidence intervals 0.64,2.65, P = 0.313). Conclusion: The risk of gastric cancer was not increased after partial gastrectomy in this Australian population. [source] Effect of Stocking Weight and Stocking Density on Production of Hybrid Striped Bass (Sunshine) in Earthen Ponds in the Second Phase of a 2-Phase SystemJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 1 2004Louis R. D'Abramo Sunshine bass from Phase I or pond production were graded into two weight classes, 3 and 5 g, and stocked into experimental earthen ponds at a density of either 8,649/ha or 11,120/ ha in a 2 × 2 factorial design. After stocking, the fish were fed a commercially manufactured feed (43.0-45.5% crude protein) twice daily to satiation for 17 mo. At harvest, mean survival ranged from 67.4 to 84.8% but was highest for the fish stocked at 5g. Average production Tor ponds stocked at 8,649/ha and 11,120/ha, regardless of stocking weight, was 4,506 kg/ha and 5350 kg/ha, respectively. Production and percentages of assigned weight classes were not significantly different among treatments as a result of wide variation among replicates. Using size-dependent market prices assigned to the different harvest size groups, an economic analysis revealed gross receipts, variable costs, and total costs for the 11,120/ha 5-g treatment. Net returns were not significantly different among the four treatments due to large variation among replicates per treatment. These results confirm that the traditional phase II of pond production can be eliminated in favor of a direct stocking of phase I fish into a single production phase and economically competes very well with traditional three-phase growout management. The potential reduction in turnover time of production units achieved through the direct stock practice is an efficiency trait that should translate into significantly higher returns and a greater profit over the long term. Further reduction of stocking density combined with a stocking weight greater than 5 g should translate into greater proportion of larger, higher valued fish at harvest and a growout period of 18-20 mo, rather than the 24-30 mo traditionally needed for the combined phase II and phase III of production. [source] Predictors of outcome in patients with unresectable hepatocellular carcinoma receiving transcatheter arterial chemoembolizationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2007H. SHEN Summary Background, Transcatheter arterial chemoembolization (TACE) has been shown to improve survival in patients with unresectable hepatocellular carcinoma (HCC). Aim, To identify pretreatment factors that predicts increased mortality in HCC patients receiving TACE. Methods, Retrospective review of all patients who underwent TACE for HCC from January 1999 to November 2004. Patient demographics, aetiology of liver disease, laboratory and imaging data regarding tumour characteristics were obtained. Results, Eighty-eight patients (57 ± 1 years age) received 1,4 sessions of TACE (1.4 ± 0.1). Tumour size was 3.3 ± 0.2 cm (range 1,13 cm, median 3 cm) with mean number of lesions 1.9 ± 0.1 (range 1,7). Mean model for the end stage liver disease score: 11 ± 0.4; cancer of the liver Italian program score: 1.3 ± 0.1. Survival post-TACE (excluding those underwent orthotopic liver transplantation) was 12 ± 0.3 months. By multivariate analysis, tumour size (HR = 1.37, 95% CI: 1.11,1.68, P = 0.003), hypovascularity (HR = 12.62, 95% CI: 1.79,88.92, P = 0.01) and elevated international normalized ratio (HR = 1.46, 95% CI: 1.10,1.92 P = 0.008) are shown to be significant risk factors for increased mortality. Conclusion, TACE therapy leads to a mean survival of 12 months in patients not receiving orthotopic liver transplantation. Tumour size, hypovascularity on imaging, and elevated international normalized ratio are predictors of increased mortality after TACE therapy for HCC. [source] Italian experience of pediatric liver transplantationPEDIATRIC TRANSPLANTATION, Issue 7 2007Graziella Guariso Abstract:, The SIGENP Group has created an Italian Liver Transplantation database. The study considers all patients under 18 yr of age on the waiting list or transplanted between 1984 and 2005. Demographic and clinical data were collected and a descriptive analysis was conducted. Kaplan,Meier survival curves were calculated and Cox's proportional-hazards regression analysis were performed to identify predictors of death after transplantation. Twenty-two Italian centers took part and data were collected on 622 cases: only 53.8% of the transplants performed up until 1998 were carried out in Italy, while this was true of 97.7% of the operations performed between 1999 and 2005. Recipient survival curve analysis revealed one-, two- and five-yr survival rates of 88, 87 and 84%, respectively, and a significant improvement in survival after 1998 (p = 0.0322). Cox's analysis identified the following risk factors for death after liver transplantation, i.e. transplantation before 1998, neoplasms or fulminant hepatic failure as indications, being in intensive care at the time of transplantation and retransplantation. The center where the transplant is performed also revealed an influence on patient survival. Thanks to a better patient follow-up and more cooperation between specialists, the mean survival after liver transplantation is improving and Italian children can be transplanted in Italy. [source] Post-transplant lymphoproliferative disorder following pediatric heart transplantationPEDIATRIC TRANSPLANTATION, Issue 1 2006Fernando Mendoza Abstract:, Immunosuppression after heart transplantation is implicated in development of post-transplant lymphoproliferative disorder (PTLD). Despite a higher prevalence of PTLD in children, there is scarce knowledge about incidence, pathophysiologic mechanisms and risk factors for PTLD in pediatric recipients of cardiac allografts. We examined retrospectively the medical records of all 143 pediatric patients (mean age 9.2 ± 6.1 yr) who received donor allografts between 1984 and 2002 and survived over 30 days. Five children (3.5%) developed PTLD over a mean follow-up period of 41.1 ± 46.0 months. Time from transplant to diagnosis of PTLD ranged from 3.9 to 112 months (mean 48.0 ± 41.9 months). Excluding PTLD, no other malignancies were found in this population. Actuarial freedom from PTLD was 99.2%, 99.2% and 96.2% at 1, 2, and 5 yr, respectively. Children who developed PTLD were more likely (by univariate analysis) to have been Rh negative (p = 0.01), Rh mismatched (p = 0.003), Epstein,Barr virus (EBV) seronegative (p = 0.001) and transplanted for congenital heart disease (p < 0.02). PTLD was associated with significant morbidity and mortality with a mean survival following diagnosis of 21.2 months. PTLD is a serious complicating outcome of cardiac transplantation that occurs in approximately 3.5% of children. Aside of immunosuppression, risk factors in this series for developing PTLD include EBV seronegativity and Rh negative status and mismatch. Non-hematogenous malignancies are rare in light of short allograft half-life. [source] Management of Stage IV Glottic Carcinoma: Therapeutic OutcomesTHE LARYNGOSCOPE, Issue 8 2004Gershon J. Spector MD Abstract Objectives/Hypothesis: The best therapeutic approach for the treatment of stage IV glottic carcinoma is controversial. Study Design: A retrospective study. Methods: A retrospective study of Tumor Research Project data was performed using patients with stage IV glottic squamous cell carcinoma treated with curative intent by five different treatment modalities from 1955 to 1998 at Washington University School of Medicine and Barnes-Jewish Hospital (St. Louis, MO). Results: Ninety-six patients with stage IV glottic carcinoma were treated by five modalities: total laryngectomy (TL) (n = 13), total laryngectomy with neck dissection (TL/ND) (n = 18), radiation therapy alone (RT) (n = 7) (median dose, 69.5 Gy), total laryngectomy combined with radiation therapy (TL/RT) (n = 10), and total laryngectomy and neck dissection combined with radiation therapy (TL/ND/RT) (n = 48). The overall 5-year observed survival (OS) rate was 39%, and the 5-year disease-specific survival (DSS) rate was 45%. The 5-year DSS rates for the individual treatment modalities included the following: TL, 58.3%; TL/ND, 42.9%; RT, 50.0%; TL/RT, 30.0%; and TL/ND/RT, 43.9%. There was no significant difference in DSS for any individual treatment modality (P = .759). The overall locoregional control rate was 69% (66 of 96). The overall recurrence rate was 39% with recurrence at the primary site and in the neck at 19% and 17%, respectively. Recurrence was not related to treatment modality. The 5-year DSS after treatment of locally recurrent cancer (salvage rate) was 30% (3 of 10) and for recurrent neck disease (28 of 67) was 42%. The incidence of delayed regional metastases was 28%; of distant metastasis, 12%; and of second primary cancers, 9%. There was no statistically significant difference in survival between node-negative (N0) necks initially treated (5-y DSS, 31%) versus N0 necks observed and later treated if necessary (5-y DSS, 44%) (P = .685). Conclusion: The five treatment modalities had statistically similar survival, recurrence, and complication rates. The overall 5-year DSS for patients with stage IV glottic carcinoma was 45%, and the OS was 39%. The cumulative disease-specific survival (CDSS) was 0.4770 with a mean survival of 10.1 years and a median survival of 3.9 years. Patients younger than age 55 years had better survival (DSS) than patients 56 years of age or older (P = .0002). Patients with early T stage had better survival than patients with more advanced T stage (P = .04). Tumor recurrence at the primary site (P = .0001) and in the neck (P = .014) and distant metastasis (P = .0001) had a deleterious effect on survival. Tumor recurrence was not related to treatment modality. Patients with clear margins of resection had a statistically significant improved survival (DSS and CDSS) compared with patients with close or involved margins (P = .0001). Post-treatment quality of life was not significantly related to treatment modality. Patients whose N0 neck was treated with observation and appropriate treatment for subsequent neck disease had statistically similar survival compared with patients whose N0 neck was treated prophylactically at the time of treatment of the primary. A minimum of 7 years of follow-up is recommended for early identification of recurrent disease, second primary tumors, and distant metastasis. None of the standard treatment modalities currently employed has a statistical advantage regarding survival, recurrence, complications, or quality of life. [source] NOS2 (iNOS) Deficiency in Kidney Donor Accelerates Allograft Loss in a Murine ModelAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2007C. Du Renal NOS2 is expressed and produces abundant nitric oxide (NO) in various renal cells in response to proinflammatory cytokines. However, the role of this enzyme in renal allograft survival remains unknown. Kidney allotransplantation was performed in the murine model of C57BL/6J (H-2d) to nephrectomized Balb/c (H-2b) mice. Here we show that deficiency in NOS2 expression in kidney donors significantly advanced allograft failure, indicated by decreasing mean survival of recipients receiving NOS2 null grafts (15.4 ± 6.4 days) as compared to those with wild type grafts (65.4 ± 28.1 days) (p = 0.0005). Consistent with survival results, NOS2 null grafts had more severe renal tubule injury and decreased renal function compared to wild type grafts. In vitro NOS2 expressing TEC had greater resistance to allogeneic lymphocyte-mediated apoptosis. The addition of exogenous NO inhibited Fas-mediated TEC apoptosis and reduced proliferation of allogeneic lymphocytes. These data suggest that endogenous production of NO through renal NOS2 activity can play a protective role in kidney grafts through attenuating Fas-mediated donor cell apoptosis as well as by inhibiting proliferation of inflammatory infiltrating lymphocytes. Enhanced donor NOS2 expression may be a useful strategy to improve kidney transplant survival. [source] Feline Immunodeficiency Virus-Mediated Viral Interleukin-10 Gene Transfer Prolongs Non-Vascularized Cardiac Allograft SurvivalAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2003Shuang Fu Previous experiments demonstrated plasmid-, retroviral-, or adenoviral-mediated vIL-10 gene transfer could prolong allograft survival, but transgene expression was rapidly extinguished. Feline immunodeficiency virus (FIV) can integrate into genomic DNA of nondividing cells, resulting in indefinite transgene expression. We hypothesized FIV-mediated gene transfer could provide long-term gene expression, and improved allograft survival. FIV-vIL-10 and FIV-,-gal were produced using the FELIX vector system. With vector transfer to syngeneic cardiac grafts, ,-galactosidase reporter gene expression was noted as early as day 5, was strongly expressed at days 10 and 20, and persisted for 50 days after transplantation. For allografts, FIV-vIL-10 gene transfer more than doubled mean survival from 10 ± 1.6 to 22.3 ± 3 days. When combined with other immunosuppressants, such as anti-CD40L mAb, FTY720, or anti-CD3 mAb, the mean survival times were prolonged to 27 ± 4.6 days, 27.8 ± 4.6 days, and 45.5 ± 4.9 days, respectively. Multiple chemokine and chemokine receptor genes were induced by ischemia-reperfusion injury in syngeneic grafts, and in allogeneic grafts more genes were induced and to a greater degree. In allogeneic grafts transduced with FIV-IL-10, a number of the chemokine genes were suppressed. Therefore, FIV virus-mediated vIL-10 gene transfer prolongs allograft survival and, in combination with other agents, produces an additive effect. [source] Copper(II),Girard's T complex as a promising anti-tumor agentAPPLIED ORGANOMETALLIC CHEMISTRY, Issue 6 2010A. M. A. El-Sokkary Abstract A copper(II) complex was evaluated for its anti-tumor activity. Firstly, electrophoretic studies were applied on the complex. These studies revealed the binding of the complex to calf thymus DNA, leading to a delay in electrophoretic mobility of the DNA molecule. Secondly, spectroscopic data pointed out that the ,max of DNA was shifted to a longer wavelength, which was accompanid by a hyperchromic shift. Moreover, the ,max of copper(II) complex was shifted to a shorter wavelength. The favorable reaction conditions between the DNA molecule and the copper(II) complex were studied. Thirdly, The effects of the ligand and the Cu(II) ion were tested separately on the DNA molecule by electrophoresis technique. Furthermore, the fluorescence quenching of DNA bound ethidium ion by Cu(II)-Girard's T complex was noticed. The IR spectral data of DNA before and after the reaction with the copper(II) complex indicated that the interaction takes place through the carbonyl group of DNA nucleobases. Finally, a significant increase in the mean survival of EAC (Ehrlich ascites carcinoma) tumor-bearing mice was observed when treated with the copper(II) complex. The tumor volume was also significantly reduced (p < 0.0001). Electrophoretic studies showed that the DNA pattern extracted from EAC cells of tumor-bearing mice was affected after treatment with the copper(II) complex. Flow cytometric studies showed that this complex may be taken into consideration in seeking novel anti-tumor agents. Copyright © 2010 John Wiley & Sons, Ltd. [source] Outcome and survival with nonsurgical management of renal cell carcinomaBJU INTERNATIONAL, Issue 7 2003A.D. Baird OBJECTIVE To document long-term survival in patients with renal cell carcinoma (RCC) in whom the primary tumour was left in situ and treatment limited to palliative and symptomatic measures. PATIENTS AND METHODS All patients with a diagnosis of RCC from January 1994 to January 1999 and in whom the primary tumour was left in situ were identified from hospital records (nine women and 16 men, mean age 69 years). The tumour stage was T1,T4. RESULTS The mean survival overall was 19.3 months; patients with locally advanced disease, i.e. stage , T3a, had a mean survival of 16.9 months. CONCLUSIONS There is renewed interest in the management of advanced RCC, with data supporting cytoreductive nephrectomy with systemic biological therapy. These results confirm that such patients with or without metastatic disease can survive for a considerable period with no aggressive surgical or systemic measures, and such intervention may offer no significant advantage in outcome and survival over supportive treatment alone. [source] Elevated serum heparanase-1 levels in patients with pancreatic carcinoma are associated with poor survivalCANCER, Issue 3 2006Roderick M. Quiros M.D. Abstract BACKGROUND It has previously been shown that heparanase-1 (HPR1), an endoglycosidase, is up-regulated in pancreatic carcinoma. The purpose of this study was to test whether serum HPR1 levels in pancreatic carcinoma patients are elevated, and whether higher serum HPR1 levels are associated with a shortened survival. METHODS Serum HPR1 levels in 40 healthy donors, 31 pancreatic carcinoma patients, and 11 patients treated with gemcitabine were measured by a novel enzyme-linked immunoadsorbent assay. HPR1 expression in tumors was analyzed by immunohistochemical staining. Patient overall survival time was determined according to the Kaplan,Meier method, and their difference was evaluated by the log-rank test. A P value < 0.05 was considered statistically significant. RESULTS The mean serum HPR1 activity in pancreatic carcinoma patients was 439 ± 14 units/mL, compared with 190 ± 4 units/mL in the control serum samples from healthy donors. Serum HPR1 levels were significantly higher in patients with HPR1-positive tumors (660 ± 62 units/mL) compared with those with HPR1-negative tumors (241 ± 14 units/mL). The mean survival of 19 pancreatic carcinoma patients with serum HPR1 activity > 300 units/mL was 7.9 ± 0.2 months, whereas the mean survival of 12 patients with serum HPR1 activity < 300 units/mL was 13.3 ± 0.6 months. A Kaplan,Meier plot of the patient survival curve followed by log-rank test revealed that patients in the high serum HPR1 group had a significantly shorter survival compared with those in the low serum HPR1 group. Mean serum HPR1 activity decreased by 64% in 11 pancreatic carcinoma patients after 2 weeks of treatment with gemcitabine. CONCLUSIONS Serum HPR1 activity in pancreatic carcinoma patients was found to be significantly elevated, in particular in those with HPR1-positive tumors. Increased serum HPR1 activity was associated with a shorter survival in patients with pancreatic carcinoma patients. Cancer 2006. © 2005 American Cancer Society. [source] Temporal variation in breeding and cone size selection by three species of crossbills Loxia spp. in a native Scots pinewoodJOURNAL OF AVIAN BIOLOGY, Issue 3 2010Ron W. Summers The breeding biology and cone size selection of crossbills was studied mainly during 1995 to 2002 at Abernethy Forest, Scotland, an ancient native Scots pine Pinus sylvestris wood, where only a single crossbill species, the Scottish crossbill Loxia scotica, was assumed to occur and to be adapted to feed on seeds in Scots pine cones. However, three crossbill species (common Loxia curvirostra, Scottish and parrot crossbills Loxia pytyopsittacus) nested in some years, with the parrot crossbill being the most abundant. Most nests were in old large pines, with the three crossbill species not differing in their use of tree size or stand density for nesting. The mean clutch and brood sizes were 3.8 and 2.9, and their mean survivals were 86 and 74%, respectively, with no significant differences among species. The timing of breeding differed between species, with parrot crossbills breeding earliest (median date 21 March, including second attempts) and common crossbills breeding last (median date 21 April), probably in response to the differing accessibility of Scots pine seeds to these species. The difference in the time of breeding may reduce mixed mating. Crossbills foraged preferentially on trees with small cones when the cones were closed. Small cones had thinner scales than large cones, suggesting that the preference for small cones was related to higher feeding rates on these cones when cones are closed. Such a preference was also found for captive crossbills with the Scottish crossbill showing a more pronounced preference for smaller cones than the larger-billed parrot crossbill. However, crossbills selected larger cones within trees and trees with larger cones once the cones opened in April. Such a shift occurred presumably because variation in scale thickness has little impact on seed accessibility once cones open, and larger cones have larger and more seeds. The greater ability of parrot crossbills to exploit seeds in closed Scots pine cones allowed parrot crossbills to start breeding earlier and to have young when seeds were most accessible. Only after the cones opened were the smaller-billed common crossbills able to easily access seeds and to start breeding. The time of breeding of Scottish crossbills was intermediate between common and parrot crossbills, and they probably had an intermediate ability to exploit Scots pine cones. The reason why there were few Scottish crossbills nesting in Abernethy Forest remains a puzzle, considering that native pine wood is assumed to be the ancestral habitat to which the Scottish crossbill is adapted. The breeding season for all crossbills ended in June, when most of the seed from a given cone cohort was shed. This is when starved broods were found, not associated with bad weather. [source] | ||||||||||||||||||||||||||||