Purpose: Spine metastases are a major burden of oncologic care, contributing to substantial morbidity. A well-established treatment paradigm for patients with metastatic epidural spinal cord compression includes separation surgery followed by stereotactic body radiotherapy (SBRT). Innovations in implant technology have brought about the incorporation of Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation for spinal fixation. We present our experience of CFR-PEEK instrumentation, comparing outcomes and complication profiles with a matched cohort of titanium instrumented cases for spine metastatic disease.
Methods: Oncology patients who underwent spinal fusion for metastatic spine disease from 2012 to 2023 were retrospectively reviewed. Ninety-nine cases with CFR-PEEK fusions were case-control matched with 50 titanium controls (2:1 ratio) based upon primary tumor type and spinal instability neoplastic score (SINS) location. Demographic, clinical, radiographic and progression free survival (PFS) were analyzed.
Results: In the study years, 263 patients underwent spinal decompression and fusion, for which 148 patients met predetermined inclusion criteria. Of these, 49 had titanium instrumentation, and 99 had CFR-PEEK. Complication profiles, including hardware failure and infection were similar between the groups. There was no significant difference in PFS between all CFR-PEEK and titanium patients (143 days versus 214 days; p = 0.41). When comparing patients in which recurrence was noted, CFR-PEEK patients had recurrence detected two times earlier than titanium patients (94 days versus 189 days; p = 0.013).
Conclusion: In this case matched cohort, CFR-PEEK demonstrated decreased overall PFS suggestive of earlier local recurrence identification. Long-term studies are warranted for better evaluation of the impact on survival and systemic disease progression.
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http://dx.doi.org/10.1007/s11060-024-04842-9 | DOI Listing |
Int J Surg
December 2024
Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, P. R. China.
Background: Many studies have compared lip-splitting mandibulotomy (LSM) and lip-mandible preservation (LMP) techniques in oral and oropharyngeal cancer (OOPC) patients with inconsistent conclusions. Evidence-based recommendations for the optimal surgical approach for treating OOPC are lacking.
Methods: The Cochrane Library, Pubmed, Embase, Web of Science, WAN-FANG, CQVIP, and China National Knowledge Infrastructure were systematically searched to identify studies that compared LSM versus LMP for OOPC.
Int J Surg
December 2024
Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Lishui Hospital, School of Medicine, Zhejiang University, Lishui, China.
Background: Early recurrence in patients with locally advanced gastric cancer (LAGC) portends aggressive biological characteristics and a dismal prognosis. Prediction of early recurrence may help determine treatment strategies for LAGC. To develop a deep learning model for early recurrence prediction (DLER) based on preoperative multiphase computed tomography (CT) images and further explore the underlying biological basis of the proposed model.
View Article and Find Full Text PDFWiad Lek
December 2024
STATE INSTITUTION OF SCIENCE ≪CENTER OF INNOVATIVE HEALTHCARE TECHNOLOGIES≫ STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE; STATE INSTITUTION ≪NATIONAL SCIENTIFIC CENTER OF SURGERY AND TRANSPLANTATION NAMED AFTER O. O. SHALIMOV TO NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE.
Objective: Aim: To investigate the incidence of progression and median time for metastasizing, the development of recurrent localization, and to identify localizations with a high tendency to recurrence of melanoma during 10 years of patient follow-up observation.
Patients And Methods: Materials and Methods: The retrospective data of dynamic observation by dermatovenereologists of SIS ≪CIHT≫ SAD of 183 patients with skin melanoma for the period 2014 - first half of 2024.
Results: Results: Among 183 cases of melanoma, 23 cases (12,6%) were detected in stage III and 11 cases (6,0%) in stage IV, so the neglect rate was 18,6%.
Urogynecology (Phila)
December 2024
Department of Obstetrics and Gynecology, Hackensack Meridian Jersey Shore Medical Center, Neptune, NJ.
Importance: Enterococcus faecalis urinary tract infection (UTI) is common in postmenopausal females and these bacteria create biofilms that may reduce treatment efficacy. The role of local vaginal estrogen therapy in susceptibility to E. faecalis infection is unclear.
View Article and Find Full Text PDFJ Clin Immunol
December 2024
Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.
Background: Activated Phosphoinositide 3-Kinase (PI3K) δ Syndrome (APDS), an inborn error of immunity due to upregulation of the PI3K pathway, leads to recurrent infections and immune dysregulation (lymphoproliferation and autoimmunity).
Methods: Clinical and genetic data of 28 APDS patients from 25 unrelated families were collected from fifteen Italian centers.
Results: Patients were genetically confirmed with APDS-1 (n = 20) or APDS-2 (n = 8), with pathogenic mutations in the PIK3CD or PIK3R1 genes.
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