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BACKGROUND: Sinonasal cancer represents a challenging disease because of its difficult diagnosis and different histology. Despite a multidisciplinary evaluation and treatments, a poor prognosis is still present. We retrospectively analyzed patients with sinonasal cancer treated in our institution, paying attention to histology and real-life prognosis. METHODS: A total of 51 consecutive patients were included in the study. Clinical features were described. Overall, disease-free, and disease-specific survival (OS, DFS, DSS) according to histology were calculated. Kaplan-Meyer estimator curves were reported. RESULTS: The most prevalent primary tumor was squamous cell carcinoma, followed by adenocarcinoma. Global 2- and 5-year OS was 68.80% and 54.58%, respectively. Global 2- and 5-year DFS was 48.53% and 29.56%, while global 2- and 5-year DSS was 82.86% and 74.57%, respectively. The median OS was 74 and 43 months for early- and late-stage cancer, respectively. The Cox multivariate regression analysis did not reveal any statistically significant effects of age, stage, or histology on survival outcomes. CONCLUSIONS: The diagnosis is often late and the prognosis poor. An appropriate treatment, which is always quite multimodal, allows us to achieve a global 5-year OS slightly higher than 50%. An adequate diagnosis to increase the percentage of early-stage tumors is mandatory to improve prognosis.
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Aims Hepatocellular carcinoma (HCC) is one of the common liver malignancies that presents a challenge to global healthcare. The impact and outcomes of hypoglycemia in HCC have not been studied in detail before. This study aimed to investigate the outcomes and prognosis associated with hypoglycemia in patients diagnosed with HCC, utilizing a large-scale database approach. Methods Using the Nationwide Inpatient Sample (NIS) database from 2017 to 2020, we conducted a comprehensive retrospective analysis to examine the incidence, risk factors, and clinical implications of hypoglycemia on HCC patients. The patients were divided into two groups: those with hypoglycemia and those without hypoglycemia. Univariate and multivariate logistic regression were used to conduct the analysis. STATA® version 17.0 software (StataCorp LLC, College Station, TX) was used for this purpose. Results Out of a total of 343,895 patients with HCC, the prevalence of hypoglycemia was present in 1.5% of this patient population. We found that hypoglycemia was common in the male population (68%). Compared with patients without hypoglycemia, patients who had hypoglycemia with HCC had higher mortality (42%, p-value < 0.05) and higher risks of secondary outcomes such as hepatic failure, spontaneous bacterial peritonitis (SBP), ascites, and portal vein thrombosis compared to patients who did not have hypoglycemia. The multivariate-adjusted odds ratio for hepatic failure was 2.7 (2.3-3.1), for SBP was 2.9 (1.8-3.0), for ascites was 1.6 (1.4-1.9), and for portal vein thrombosis was 1.2 (0.9-1.4). Conclusion In conclusion, hypoglycemia in HCC is associated with increased mortality and worse outcomes.
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Background Of liver-related disorders, cirrhosis is currently the leading cause of death and has become a significant global public health concern. Aspartate aminotransferase to platelet ratio index (APRI), a newer prognostic modality, is a very effective noninvasive diagnostic for identifying advanced liver fibrosis. Methods A prospective observational study was conducted among individuals with liver disease, 100 cases and 100 controls for two years. All the sociodemographic details, clinical features of the patients, and clinical findings such as prothrombin time (PT), liver function tests, kidney function tests, and total blood count were recorded using a pretested semi-structured questionnaire. Results According to our survey results, 48% of the participants were between the ages of 40 and 60. Regarding aPTT (activated partial thromboplastin time) and liver function test characteristics (serum glutamic-oxaloacetic transaminase(SGOT), serum glutamic pyruvic transaminase (SGPT)), we showed a substantial difference between the patients and controls. Regarding the APRI distribution, we also found a statistically significant variation between the research groups. When we compared the validity of APRI scores in diagnosing cirrhosis, we discovered that the ideal cutoff value of APRI was determined to be 3.99, with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 33%, 86%, 70%, and 56%, respectively. The area under the receiver operating characteristic (ROC) curve for APRI in detecting cirrhosis was also 0.693. Conclusion Thus, our study results conclude that APRI is a crucial noninvasive prognostic tool that can be utilized to prognostize liver cirrhosis.
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Introducción: el adenocarcinoma renal se considera una de las neoplasias más letales entre los cánceres urológicos. Objetivo: caracterizar a los pacientes atendidos por adenocarcinoma renal, con énfasis en aspectos del diagnóstico, el tratamiento y el pronóstico de vida. Métodos: se realizó un estudio descriptivo de los pacientes atendidos por adenocarcinoma renal, desde enero de 1996 hasta diciembre de 2005. Las variables estudiadas fueron: edad, sexo, síntomas y signos, estudios imaginológicos, tamaño de la lesión/estadio tumoral, modalidades terapéuticas empleadas, complicaciones derivadas de estas y la sobrevida a los 5 años del tratamiento. Resultados: en la serie de 94 pacientes prevaleció el grupo de edad de 50-59 años con 41 pacientes (43,6 por ciento); el sexo masculino fue el más afectado con 66 casos (70,2 por ciento); preponderó el diagnóstico incidental en 46 pacientes (48, 9 por ciento); el ultrasonido se empleó en la totalidad de los casos y fue positivo en el 98,9 por ciento; predominaron las lesiones en el estadio I en 49 pacientes (52,1 por ciento); la modalidad terapéutica más empleada fue el tratamiento quirúrgico en 88 pacientes (93,6 por ciento) y de esta, la nefrectomía por vía lumbar se le practicó a 59 pacientes (67,0 por ciento). El 69,3 por ciento de los pacientes no tuvo complicaciones. La sobrevida a los 5 años fue de 97,9 por ciento. Conclusiones: el diagnóstico incidental del adenocarcinoma renal se favorece por la pesquisa en grupos de riesgo, sintomáticos o no, con el empleo del ultrasonido abdominal. Esto trae aparejado el tratamiento quirúrgico oportuno en estadios precoces y la mejoría significativa del pronóstico de vida
Introduction: the renal adenocarcinoma is considered as one of the more lethal neoplasias among urologic cancers. Objective: to characterize the patients treated due to renal adenocarcinoma emphasizing the diagnostic features, the treatment and the life prognosis. Methods: a descriptive study was conducted of patients cared due to renal adenocarcinoma from January, 1996 to December, 2005. Study variables included: age, sex, symptoms and signs, imaging studies, lesion size/tumor stage, therapeutical modalities used, complications derived from these and survival at 5 years of treatment. Results: in series of 94 patients there was predominance of 50-59 age group with 41 patients (43.6 percent); the male sex was the more involved one with 66 cases (70.2 percent) as well as the incidental diagnosis in 46 patients (48.9 percent; ultrasound (US) was used in all the cases and it was positive in the 98.9 percent and predominance of stage I lesions in 49 patients (52.1 percent); the more used therapeutical modality was the surgery in 88 patients (93.6 percent) including the lumbar route nephrectomy carried out in 59 patients (67.0 percent). The 69.3 percent of patients have not complications. The 5-years survival was of 97.9 percent. Conclusions: the incidental diagnosis of renal adenocarcinoma is favored by the screening in risk groups, symptomatic or not, using the abdominal US. This is linked with a timely surgical treatment in early stages and the significant improvement of life prognosis