RESUMEN
AIMS: We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres. MATERIALS AND METHODS: This multi-institutional retrospective cohort study included 226 metastatic NSCLC patients. Outcomes were number and severity of immune-related adverse events (irAEs), median progression-free survival (mPFS) and median overall survival (mOS). RESULTS: Within our cohort, 119/226 (53%) patients developed irAEs. Of these, 54/119 (45%) experienced irAEs affecting two or more organ systems. The most common irAEs were diarrhoea and rash. The development of an irAE was associated with better mOS (20.7 versus 8.0 months; P < 0.001) and mPFS (12.0 versus 3.9 months; P < 0.001). The development of grade 3/4 toxicities was associated with worse outcomes compared with the development of grade 1/2 toxicities (mOS 6.1 months versus 25.2 months, P < 0.01; mPFS 5.6 months versus 19.3 months, P = 0.01, respectively). Females had a higher proportion of reported grade 3/4 toxicities (13/44 [29.5%] versus 10/74 [13.5%], P = 0.03). Using a multiple Cox regression model, the presence of irAEs was associated with a better overall survival (hazard ratio = 0.42, 95% confidence interval 0.29-0.61; P < 0.01) and better PFS (hazard ratio 0.38, 95% confidence interval 0.27-0.53; P < 0.001). CONCLUSION: In this multicentre retrospective cohort study, the development of at least one irAE was associated with significantly longer mPFS and mOS; however, more severe grade 3 and 4 irAEs were associated with worse outcomes. Delayed-onset irAEs, after the 3-month timepoint, were associated with better clinical outcomes.
Asunto(s)
Anticuerpos Monoclonales Humanizados , Antineoplásicos Inmunológicos , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Femenino , Humanos , Carcinoma de Pulmón de Células no Pequeñas/patología , Estudios Retrospectivos , Neoplasias Pulmonares/patología , Nivolumab/efectos adversos , Antineoplásicos Inmunológicos/efectos adversosRESUMEN
Purpose: The aim of this study was to investigate the effects of the COVID-19 pandemic on the referral, diagnosis, treatment, and follow-up of germ cell tumor (GCT). Methods: A retrospective single-center analysis of all patients who underwent diagnostic and surgical procedures due to GCT was performed from September 2018 to September 2021. Results: 65 patients were enrolled into the study by dividing them into two groups as before pandemic (Pre-CovGCT) and during the pandemic (CovGCT). 33 patients in the Pre-CovGCT group and 32 patients in the CovGCT group were evaluated and compared. A significant increase was observed for symptom duration (p = 0.018), the duration between diagnosis and surgical procedure (p = 0.028), and occult metastasis risk of stage 1 tumors (p = 0.05) during the pandemic period. Conclusions: The duration of symptoms and the duration between the diagnosis and surgical procedure were prolonged in GCT patients diagnosed during the pandemic. Furthermore, an increased risk of occult metastasis has been observed in stage 1 GCT patients. We underline the importance of raising the awareness of patients about admission to the hospital without delay in the presence of testicular cancer symptoms and recommend to be careful not to delay the treatment process.
Asunto(s)
COVID-19 , Neoplasias de Células Germinales y Embrionarias , Neoplasias Testiculares , Humanos , Masculino , Neoplasias de Células Germinales y Embrionarias/cirugía , Orquiectomía , Pandemias , Estudios Retrospectivos , Neoplasias Testiculares/epidemiología , Neoplasias Testiculares/cirugíaRESUMEN
OBJECTIVE: We aimed to investigate the significance of time to re-staging transurethral resection (re-TUR) on recurrence and progression rates in patients with high-risk non-muscle-invasive bladder cancer as a prospective randomized study. METHODS: The patients were randomly separated into three groups according to Re-TUR timing. In Groups 1, 2, and 3, the time interval between initial and re-TUR was 14-28 days, 29-42 days, and 43-56 days, respectively. Cox regression analysis was used to assess the effect of time from initial TUR to re-TUR on oncological outcomes. RESULTS: Twenty patients in Group 1 (14-28 days), 22 patients in Group 2 (29-42 days), and 29 patients in Group 3 (43-56 days) completed the study. Kaplan-Meier plots showed no differences in recurrence-free survival (RFS) and progression-free survival (PFS) rates between the three groups. Cox regression analysis demonstrated that only tumor number was found to be a prognostic factor on RFS rates. CONCLUSION: Our prospective study demonstrated that time laps from initial TUR to re-TUR did not significantly affect on RFS and PFS rates.
OBJETIVO: Nuestro objetivo fue investigar la importancia del tiempo para volver a estadificar la resección transuretral (re-RTU) en las tasas de recurrencia y progresión en pacientes con cáncer de vejiga no músculo invasivo de alto riesgo como un estudio prospectivo aleatorizado. MÉTODO: Los pacientes se separaron aleatoriamente en 3 grupos de acuerdo con el tiempo de Re-TUR. En el grupo 1, 2 y 3, el intervalo de tiempo entre la RTU inicial y la nueva fue de 14 a 28 días, 29 a 42 días y 43 a 56 días, respectivamente. Cox para evaluar el efecto del tiempo desde la RTU inicial hasta la nueva RTU sobre los resultados oncológicos. RESULTADOS: Veinte pacientes del grupo 1, 22 pacientes del grupo 2, 29 pacientes del grupo 3 completaron el estudio. Los gráficos de Kaplan-Meier no mostraron diferencias en las tasas de SLR y SLP entre los tres grupos. El análisis de regresión de Cox demostró que solo se encontró que el número de tumores era un factor pronóstico en las tasas de RFS. CONCLUSIÓN: Nuestro estudio prospectivo demostró que los lapsos de tiempo desde la RTU inicial hasta la nueva RTU no afectaron significativamente las tasas de SLR y SLP.
Asunto(s)
Neoplasias Vesicales sin Invasión Muscular , Humanos , Estudios ProspectivosRESUMEN
OBJECTIVES: In the present study, we aimed to investigate the effect of dexpanthenol on wound healing at the histopathological level on cavernous tissue. MATERIALS AND METHODS: Forty-four Wistar albino rats weighing 220-250 g were used. The rats were randomly divided into four groups as Group B, Group S, Group LD, and Group SD. In Group B, the incision was not repaired and left to secondary healing. In Group S, the incision line was repaired with 5/0 polyglactin suture. In Group LD, 0.25 mg/kg dexpanthenol was applied subcutaneously below the repaired wound region once a day during 14 days. In Group SD, 500 mg dexpanthenol was applied intraperitoneally once a day during 14 days. RESULTS: No fibrosis was observed in 8 (80%) rats in group SD. Fibrosis rates were significantly lower in Group SD compared to Group B, Group S, and Group LD (p = 0.013, p = 0.005, and p = 0.003, respectively). CONCLUSION: Systemic dexpanthenol administration significantly decreased fibrosis in penile fracture model on rats.
OBJETIVO: En el estudio actual nuestro objetivo fue investigar el efecto del dexpantenol en la cicatrización de heridas a nivel histopatológico en el tejido cavernoso. MÉTODOS: se utilizaron 44 ratas Wistar albinas con un peso de 220-250 g. Las ratas se dividieron aleatoriamente en 4 grupos como grupo B, grupo S, grupo LD y grupo SD. En el grupo B, la incisión no se reparó y se dejó para la cicatrización secundaria. En el grupo S, la línea de incisión se reparó con sutura de poliglactina 5/0. En el grupo LD, se aplicaron 0.25 mg/kg de dexpentanol por vía subcutánea debajo de la región de la herida reparada una vez al día durante 14 días. En el grupo SD se aplicaron 500 mg de dexpentanol por vía intraperitoneal una vez al día durante 14 días. RESULTADOS: No se observó fibrosis en 8 (80%) ratas del grupo SD. Las tasas de fibrosis fueron significativamente más bajas en el grupo SD en comparación con el grupo B, el grupo S y el grupo LD (todos p < 0.05). CONCLUSIÓN: La administración sistémica de dexpantenol disminuyó significativamente la fibrosis en el modelo de fractura de pene en ratas.
Asunto(s)
Fibrosis , Animales , Ratas , Ratas Wistar , Fibrosis/prevención & controlAsunto(s)
Ojo/patología , Retinopatía de la Prematuridad/patología , Ultrasonografía , Biometría , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Cristalino/patología , MasculinoRESUMEN
Examinations of retinograms of premature infants by the authors showed a time lag, changes in the wave form and reduction of the bioelectric activity of the retina (which shows itself very early) in association with the first signs of retrolental fibroplasia. In their experience the ERG becomes normal when the fibroplasia stabilizes itself early or when the retinal changes regress. In conclusion it must be stressed that with progression of the fibroplasia and retinal changes the biological activity of the retina also suffers.