Background: Abiraterone acetate (AA) increases overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel. However, survival time varies substantially between individuals. Our goal was to identify prognostic factors that better estimate OS.
Materials And Methods: This is a retrospective multicentric analysis of 368 patients with mCRPC starting AA with prednisone after docetaxel. Cox proportional hazards statistics were applied. A multivariate model was constructed based on significant univariate predictors by using a manual stepwise forward and backward selection strategy. Model performance was determined by using receiver operating characteristic (ROC) curves.
Results: Univariate analysis identified 20 significant OS predictors. A multivariate model was constructed, based on 220 patients, incorporating 5 independent risk factors for decreased OS at the time of AA initiation: hemoglobin < 12 g/dL (hazard ratio [HR] 2.02), > 10 metastases (HR 1.80), ECOG performance status ≥ 2 (HR 1.88), radiographic progression (HR 1.50), and time since diagnosis < 90 months (HR 1.66, all P < .05). Patients were stratified into 3 groups: good (0-2 risk factors, median OS 22.6 months), intermediate (3 risk factors, median OS 13.9 months), and poor prognosis (4-5 risk factors, median OS 6.2 months). The area under the ROC curve based on the event "death by the time of median OS (13.3 months)" was 0.736 (95% confidence interval 0.670-0.803).
Conclusion: We identified 5 readily available risk factors independently associated with decreased OS. The resulting model may be used for patient counseling in daily clinical practice, as well as patient stratification in clinical trials.
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http://dx.doi.org/10.1016/j.clgc.2017.01.019 | DOI Listing |
Abdom Radiol (NY)
January 2025
Department of Radiology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China.
Background: To develop and validate a clinical-radiomics model for preoperative prediction of lymphovascular invasion (LVI) in rectal cancer.
Methods: This retrospective study included data from 239 patients with pathologically confirmed rectal adenocarcinoma from two centers, all of whom underwent MRI examinations. Cases from the first center (n = 189) were randomly divided into a training set and an internal validation set at a 7:3 ratio, while cases from the second center (n = 50) constituted the external validation set.
Eur J Trauma Emerg Surg
January 2025
Department of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK, The Hague, The Netherlands.
Background And Importance: Traumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.
View Article and Find Full Text PDFPain Med
January 2025
IRCCS IstitutoOrtopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy.
Objective: To assess the effectiveness of cognitive functional therapy (CFT) in reducing disability and pain compared to other interventions in chronic spinal pain patients.
Methods: Five databases were queried to October 2023 for retrieving randomized controlled trials (RCTs), including patients with chronic spinal pain and administering CFT. Primary outcomes were disability and pain.
QJM
January 2025
Tallaght hospital, Dept. of Age Related Healthcare; Trinity College Dublin, Dept. of Medical Gerontology.
Background: Falls are frequently reported within the HSE. The Irish Longitudinal Study on Ageing(TILDA) found that 40% of over 50 s experience a fall in a two year period, with 20% requiring hospital attendance (1). It has been estimated that the cost of injuries related to falls in older people will increase exponentially over the coming years (2).
View Article and Find Full Text PDFCell Mol Biol (Noisy-le-grand)
January 2025
Université Joseph KI-ZERBO, Laboratoire de Biologie Moléculaire et de Génétique (LABIOGENE), 03 BP 7021 Ouagadougou 03, Burkina Faso.
Hepatitis B virus (HBV) is a significant cause of liver disease and cancer worldwide. Understanding the genetic factors influencing HBV evolution is crucial for developing effective prevention and treatment strategies. Host genetic and environmental factors particularly influence the evolution of this infection.
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