Background: Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC.
Patients And Methods: This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival.
Result: There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084-0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020-0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046-0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively.
Conclusion: It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC.
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http://dx.doi.org/10.1016/j.amsu.2020.07.059 | DOI Listing |
Across a series of eight high-powered studies ( = 6,866), we develop a method for assessing impartial intergenerational beneficence, defined as intergenerational concern for all possible future generations. Across our studies, roughly 20% of participants displayed impartial intergenerational beneficence. Participants with impartial intergenerational beneficence expressed greater perceptions that future threats can be resolved, support for policies seeking to protect future generations of people, and a profound sense of responsibility for the long-term survival and prosperity of humanity.
View Article and Find Full Text PDFInt J Gen Med
December 2024
Department of Thyroid and Breast Surgery, Quzhou People's Hospital, Quzhou, 324000, People's Republic of China.
Objective: This study aims to demonstrate the impact of sarcopenia on the prognosis of early breast cancer and its role in early multimodal intervention.
Methods: The clinical data of patients (n=285) subjected to chemotherapy for early-stage breast cancer diagnosed pathologically between January 1, 2016, and December 31, 2020, in our hospital were retrospectively analyzed. Accordingly, the recruited subjects were divided into sarcopenia (n=85) and non-sarcopenia (n=200) groups according to CT diagnosis correlating with single-factor and multifactorial logistic regression analyses.
Front Cardiovasc Med
December 2024
Department of Cardiology, University Hospital 'St. Ekaterina', Medical University of Sofia, Sofia, Bulgaria.
Background: Formation of local type aortic aneurysm years after surgical repair of coarctation (CoA) occurs in 10% of patients independent of the surgical technique and is a potentially life-threatening condition if left untreated with a high risk of aortic rupture. Redo open surgery is associated with 14% in-hospital mortality and a high risk of complications. Endovascular treatment appears to be a feasible alternative with a high success rate and low morbidity and mortality, but data concerning long-term results is still mandatory.
View Article and Find Full Text PDFFront Transplant
December 2024
Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of CHROMETA, KU Leuven, Leuven, Belgium.
Long-term survival after lung transplantation is limited due to chronic lung allograft dysfunction (CLAD), which encompasses two main phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Donor-derived cell-free DNA (dd-cfDNA) is a biomarker for (sub)clinical allograft injury and could be a tool for monitoring of lung allograft health across the (pre)clinical spectrum of CLAD. In this proof-of-concept study, we therefore assessed post-transplant plasma dd-cfDNA levels in 20 CLAD patients (11 BOS and 9 RAS) at three consecutive time points free from concurrent infection or acute rejection, during stable condition, preclinical CLAD, and established CLAD ( = 3 × 20 samples).
View Article and Find Full Text PDFNursing home acquired pneumonia (NHAP), and its subset - aspiration-associated pneumonia, is a leading cause of morbidity and mortality among residents in long-term care facilities (LTCFs). Understanding colonization dynamics of respiratory pathogens in LTCF residents is essential for effective infection control. This study examines the longitudinal trends in prevalence, persistence, bacterial load, and co-colonization patterns of five respiratory pathogens in three LTCFs in Phoenix, Arizona.
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