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2.
J Gastrointest Cancer ; 51(3): 998-1005, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32519232

RESUMEN

Survival was examined from a Turkish liver transplant center of patients with HCC, to identify prognostic factors. Data from 215 patients who underwent predominantly live donor liver transplant for HCC at our institute over 12 years were included in the study and prospectively recorded. They were 152 patients within and 63 patients beyond Milan criteria. Patients beyond Milan criteria were divided into two groups according to presence or absence of tumor recurrence. Recurrence-associated factors were analyzed. These factors were then applied to the total cohort for survival analysis. We identified four factors, using multivariate analysis, that were significantly associated with tumor recurrence. These were maximum tumor diameter, degree of tumor differentiation, and serum AFP and GGT levels. A model that included all four of these factors was constructed, the 'Malatya criteria.' Using these Malatya criteria, we estimated DFS and cumulative survival, for patients within and beyond these criteria, and found statistically significant differences with improved survival in patients within Malatya criteria of 1, 5, and 10-year overall survival rates of 90.1%, 79.7%, and 72.8% respectively, which compared favorably with other extra-Milan extended criteria. Survival of our patients within the newly defined Malatya criteria compared favorably with other extra-Milan extended criteria and highlight the usefulness of serum AFP and GGT levels in decision-making.


Asunto(s)
Carcinoma Hepatocelular/mortalidad , Neoplasias Hepáticas/mortalidad , Trasplante de Hígado/mortalidad , Donadores Vivos/provisión & distribución , Recurrencia Local de Neoplasia/mortalidad , alfa-Fetoproteínas/análisis , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
3.
J Crit Care ; 24(3): 318-21, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19327301

RESUMEN

PURPOSE: The present study was undertaken to evaluate urinary neopterin in intensive care unit patients. MATERIALS AND METHODS: Urinary neopterin levels were determined in systemic inflammatory response syndrome (n = 10), sepsis (n = 18), septic shock (n = 9), and multiple organ dysfunction syndrome (n = 5). It was tested whether neopterin is a differential parameter among the patient groups. Furthermore, the results were also evaluated by comparing with a healthy control group (n = 30), and the relationship between neopterin and mortality or Acute Physiology and Chronic Health Evaluation II scores were investigated. RESULTS: Neopterin levels of the control group and patients were detected as 111 +/- 11 and 3850 +/- 1081 mumol/mol creatinine, respectively (P < .05). It was significantly increased in the sepsis and septic shock groups compared to the systemic inflammatory response syndrome group (P < .05). Neopterin levels were significantly higher in the patients with mortality and lower Acute Physiology and Chronic Health Evaluation II scores. CONCLUSION: This study showed that monitoring of urinary neopterin profile can be used in intensive care units to show the degree and prognosis of the disease.


Asunto(s)
Insuficiencia Multiorgánica/orina , Neopterin/orina , Síndrome de Respuesta Inflamatoria Sistémica/orina , APACHE , Adulto , Anciano , Biomarcadores/orina , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/diagnóstico , Insuficiencia Multiorgánica/mortalidad , Pronóstico , Sepsis/diagnóstico , Sepsis/mortalidad , Sepsis/orina , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/mortalidad
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