RESUMEN
BACKGROUND: This study aimed to evaluate the demographic," clinicopathologic, and prognostic characteristics of malignant peritoneal mesothelioma (MPeM), as well as the treatment options for the rare and heterogeneous MPeM population. METHODS: A retrospective multi-center observational cohort study was conducted to evaluate patients with MPeM. Due to the heterogeneity of the study population, the study divided them into two main groups in terms of treatments, follow-up periods, and prognostic features. The first group comprised the patients who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and the second group included the patients with metastatic disease for whom curative intent surgery was not possible. The patients' diagnostic procedures and treatments were identified from medical records. Patients older than 18 years old were included in the study regardless of asbestos exposure. Well-differentiated papillary and multicystic mesothelioma histologic types were not included in the study. RESULTS: The study evaluated 118 patients from five centers. Survival times, prognosis, and treatment responses were analyzed in both groups. The study showed that CRS-HIPEC was associated with longer overall survival (OS) and progression-free survival (PFS). Perioperative therapy was evaluated in subgroup analyses of this population and shown to provide survival benefits. The patients treated with chemotherapy (metastatic and medically inoperable patients and those for whom complete cytoreduction was not achievable) had a poorer prognosis than the surgery group. The study showed that life expectancy decreased significantly for the patients not suitable to undergo surgery for any reason. CONCLUSIONS: According to data from experienced centers, CRS-HIPEC is a treatment option recognized as effective, cost-effective, and safe, with better OS and PFS , as well as low morbidity and mortality rates similar to those in the literature. In addition, the platinum-pemetrexed combination continues to be an effective and acceptable treatment option for metastatic patients, those who are medically inoperable, and those for whom complete or near-complete cytoreduction is not achievable.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Procedimientos Quirúrgicos de Citorreducción , Quimioterapia Intraperitoneal Hipertérmica , Mesotelioma Maligno , Neoplasias Peritoneales , Humanos , Neoplasias Peritoneales/terapia , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/mortalidad , Femenino , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Mesotelioma Maligno/terapia , Mesotelioma Maligno/patología , Tasa de Supervivencia , Pronóstico , Anciano , Estudios de Seguimiento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Adulto , Terapia Combinada , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/mortalidadRESUMEN
Introduction: The current study aims to evaluate the OX40, TIM-3, LAG-3, and PD-L1 targeted pathways in the regulation of T-cell activity in sarcoma patients to determine their relationship with overall survival (OS). Method: This study included one hundred and eleven patients with bone and soft tissue sarcoma diagnosed in two centers between 2010 and 2020. OX40, LAG-3, TIM-3 and PD-L1 expression levels were evaluated immunohistochemically from pathology preparations. Results: PD-L1 staining was detected in tumor cells, OX40, LAG-3, TIM-3 staining was detected in inflammatory cells in tumor tissue. In univariate analysis, no significant relationship was found between OX40, TIM-3, LAG-3, and PD-L1 staining and overall survival (respectively: p = 0.12, p = 0.49, p = 0.31, p = 0.95). When grade and stage at diagnosis, which were found to be significant in univariate analysis, along with OX-40, TIM-3, LAG-3, and PD-L1, were evaluated in multivariate analysis, a positive effect of OX-40 staining on overall survival was determined (p = 0.009). Considering the correlation between PDL-1 and OX40, TIM-3, and LAG-3 staining, a significant positive correlation was found between PDL-1 and TIM-3 and LAG-3 staining (respectively; p = 0.002, p = 0.001). Conclusions: There was no significant relationship between the PDL-1 staining percentage of tumor cells and OX40, TIM-3, and LAG-3 staining in inflammatory cells with the OS of sarcoma patients. However, detecting a significant positive correlation between PDL-1 staining and TIM-3 and LAG-3 staining also holds promise for finding effective targetable combination therapies that can prolong survival in sarcoma patients in the future.
RESUMEN
Resumen Introducción: La intervención más crítica para controlar la infección por SARS-CoV-2 requiere el conocimiento y la actitud correctos hacia el virus. Objetivo: Determinar el conocimiento, las actitudes y las prácticas de los estudiantes de una escuela vocacional de servicios de salud respecto a COVID-19. Métodos: Estudio transversal realizado entre mayo y junio de 2020 en una universidad de la región de Turquía. Los datos se recopilaron mediante un portal de encuestas en línea. Resultados: Se completaron y devolvieron 454 cuestionarios. Los estudiantes de técnicas de laboratorio médico y primeros auxilios y emergencias tuvieron puntuaciones de conocimiento significativamente más altas (p < 0.001). Más de 43 % de los estudiantes (n = 201) usaron televisores como su principal fuente de información sobre COVID-19. Se manifestó una actitud positiva hacia las aplicaciones, así como evitar lugares concurridos y mantener la higiene de las manos y la distancia social. Conclusiones: Los estudiantes de la escuela vocacional de servicios de salud tienen buen conocimiento y actitud positiva hacia COVID-19. Las principales fuentes de información fueron la televisión y las redes sociales, por lo que se debe prestar más atención a estos temas en el plan de estudios para utilizar fuentes de información basadas en la ciencia.
Abstract Introduction: The most critical intervention to control SARS-CoV-2 infection requires appropriate knowledge and attitude towards the virus. Objective: To determine the level of knowledge, attitudes and practices of students of a health services vocational school with regard to COVID-19. Methods: Cross-sectional study carried out between May and June 2020 in a university of the Turkish region. Data were collected through an online survey portal. Results: Four hundred and fifty-four questionnaires were completed and returned. Students of medical laboratory techniques and first aid and emergency medicine had significantly higher knowledge scores (p < 0.001). More than 43 % of the students (n = 201) used the TV as their main source of information on COVID-19. There was a positive attitude towards preventive measures such as avoiding crowded places and maintaining hand hygiene and social distance. Conclusions: Health services vocational school students have good knowledge and positive attitude towards COVID-19. The main sources of information were the TV and social media. For this reason, more attention should be given to these issues in the curriculum in order for science-based information sources to be used.