1.Retinoblastoma in the Southern Philippines: Clinical outcomes of retinoblastoma patients in a Davao Tertiary Hospital
Charmaine Grace P. Malabanan-Cabebe ; Melissa Anne Santos-Gonzales ; Adriel Vincent R. Te ; Roland Joseph D. Tan ; Jocelyne Gonzales-Sy
Acta Medica Philippina 2024;58(6):45-51
Background:
Retinoblastoma is the most common intraocular cancer in childhood in the Philippines. Most data
though on demographics, clinical profile, treatment options, and outcomes in the country are from the National
Capital Region.
Objectives:
This study aimed to describe the demographics, clinical profile, treatment done, and outcomes of
retinoblastoma patients seen in a public tertiary referral center in Davao from 2011-2020 to make available literature more representative of the status of retinoblastoma in the Philippines.
Methods:
An analytical cross-sectional study was conducted using the records of retinoblastoma patients seen in a tertiary government hospital located in Davao Region from January 2011 to December 2020.
Results:
There were 157 patients included in the analysis. Seventy-three (46%) were female with 44% coming from the Davao Region. One hundred seven (69%) patients had unilateral disease. Median age at initial consultation for patients with unilateral disease was significantly older than those with bilateral disease (p<0.003). Tumors were extraocular in 82 (40%) eyes. In the intraocular group, 36% of the eyes belonged to International Classification of Retinoblastoma (ICRB) Groups D and E. Enucleation was the most commonly performed treatment. Survival rate was 28%. This is the first report to provide epidemiologic and clinical data on retinoblastoma in the literature, including survival data, from Mindanao. Advanced stages and extraocular cases of retinoblastoma remain high. Delay of consultation contributed to the prognosis and clinical outcome of the disease.
Conclusion. Advanced stages and extraocular cases of retinoblastoma remain significantly high in the country, even in Mindanao.
Retinoblastoma
;
Therapeutics
;
Survival Rate
2.Association of treatment delays with survival for patients with head and neck cancer undergoing surgery and radiotherapy at the Philippine General Hospital
Nicole D. Sacayan-Quitay ; Sean Patrick C. De Guzman ; Johanna Patricia A. Cañ ; al ; Cesar Vincent L. Villafuerte, III
Philippine Journal of Otolaryngology Head and Neck Surgery 2024;39(2):7-11
Objective:
To identify in what phases in the treatment of head and neck cancer do delays happen at a tertiary hospital and to determine the association between the length of treatment delays and the oncologic outcomes (disease-free survival and overall survival) for patients with head and neck cancer.
:
Methods
Design:
Retrospective Cohort Study
Setting:
Tertiary National University Hospital
Participants:
Sixty-eight (68) patients who had surgery and adjuvant radiotherapy for invasive head and neck cancer at the Philippine General Hospital during the 5-year period of January 2014 to December 2019 were included in the initial consideration. Only 15 had survival data and were thus eligible for inclusion in this study.
Results:
The median treatment package time for head and neck cancers in our institution was 27.6 weeks or 193 days. The treatment package time statistically correlated with both overall survival, F(1,13)=12.952, p <0.005, R2=0.499, and disease-free survival, F(1-13)=12.823, p <0.005, R2= 0.497. However, the independent effects of other predictors such as time interval between first consult to histopathologic diagnosis, diagnosis to surgery, and surgery to post-operative radiotherapy, showed no statistically significant association with overall survival and disease free survival.
Conclusion
All study patients experienced treatment delays from diagnosis to surgery, and surgery to adjuvant radiation therapy, and in their total treatment package time. The positive correlation among treatment package time, and disease-free and overall survival in this study must be further investigated in order to elucidate the true effect of delays across time intervals in the treatment of head and neck cancer in the Philippine General Hospital. Every effort should be made towards timely management of these patients.
Head and Neck Neoplasms
;
Radiotherapy
;
Survival Rate
;
Treatment Outcome
;
Time-to-Treatment
;
Surgery
;
Disease-Free Survival
;
Delayed Diagnosis
;
Retrospective Studies
;
Postoperative Care
3.Survival rates of hepatocellular carcinoma BCLC-B patients who underwent hepatic resection at UP-PGH: A 10-year single-center experience
Teressa Mae D. Bacaro ; Dante G. Ang ; Apolinario Ericson B. Berberabe
Philippine Journal of Surgical Specialties 2024;79(2):83-91
RATIONALE/OBJECTIVE
Hepatic Resection (HR) has emerged as a potentially curative treatment for HCC, particularly in Barcelona Clinic Liver Cancer – B (BCLC-B) patients, even though Transarterial Chemoembolization (TACE) is the standard of care according to the BCLC staging system. This study aimed to investigate the characteristics, survival rates and outcomes of patients who underwent HR for HCC BCLC-B at a single center over a 10-year period.
METHODSPatients who were diagnosed HCC BCLC-B and had undergone HR from January 2011 to December 2021 were analyzed. Only complete records with long-term follow-up were included in the study. The authors described patient characteristics, calculated overall survival rates, and assessed associations between patient, disease factors, and survival.
RESULTSOf 344 patients who underwent HR, 20 of them had complete records with long-term follow-up. This cohort had a median age of 57, predominantly male (70%), exhibiting a median alpha-fetoprotein (AFP) level of 230.5 ng/mL and an average of 4 nodules. Lymphovascular invasion was evident in 65%, with 85% displaying negative primary tumor margins. Major hepatectomy was the primary procedure (50%), followed by bisegmentectomy (40%) and trisegmentectomy (10%). The 1, 2 and 3-year survival rates post-hepatic resection (HR) for HCC BCLC-B stood at 65%, 35% and 25% respectively.
CONCLUSIONThe study shows that the institution’s treatment approach for BCLC-B HCC patients achieved acceptable 3-year survival rates, and the median overall survival rate observed are comparable with global data. This study highlights hepatic resection as a potential curative option for BCLC-B HCC patients.
Human ; Carcinoma, Hepatocellular ; Survival Rate ; Hepatectomy
4.Persistent increase and improved survival of stage I lung cancer based on a large-scale real-world sample of 26,226 cases.
Chengdi WANG ; Jun SHAO ; Lujia SONG ; Pengwei REN ; Dan LIU ; Weimin LI
Chinese Medical Journal 2023;136(16):1937-1948
BACKGROUND:
Lung cancer prevails and induces high mortality around the world. This study provided real-world information on the evolution of clinicopathological profiles and survival outcomes of lung cancer, and provided survival information within stage I subtypes.
METHODS:
Patients pathologically confirmed with lung cancer between January 2009 and December 2018 were identified with complete clinicopathological information, molecular testing results, and follow-up data. Shifts in clinical characteristics were evaluated using χ2 tests. Overall survival (OS) was calculated through the Kaplan-Meier method.
RESULTS:
A total of 26,226 eligible lung cancer patients were included, among whom 62.55% were male and 52.89% were smokers. Non-smokers and elderly patients took increasingly larger proportions in the whole patient population. The proportion of adenocarcinoma increased from 51.63% to 71.80%, while that of squamous carcinoma decreased from 28.43% to 17.60%. Gene mutations including EGFR (52.14%), KRAS (12.14%), and ALK (8.12%) were observed. Female, younger, non-smoking, adenocarcinoma patients and those with mutated EGFR had better survival prognoses. Importantly, this study validated that early detection of early-stage lung cancer patients had contributed to pronounced survival benefits during the decade. Patients with stage I lung cancer, accounted for an increasingly considerable proportion, increasing from 15.28% to 40.25%, coinciding with the surgery rate increasing from 38.14% to 54.25%. Overall, period survival analyses found that 42.69% of patients survived 5 years, and stage I patients had a 5-year OS of 84.20%. Compared with that in 2009-2013, the prognosis of stage I patients in 2014-2018 was dramatically better, with 5-year OS increasing from 73.26% to 87.68%. Regarding the specific survival benefits among stage I patients, the 5-year survival rates were 95.28%, 93.25%, 82.08%, and 74.50% for stage IA1, IA2, IA3, and IB, respectively, far more promising than previous reports.
CONCLUSIONS
Crucial clinical and pathological changes have been observed in the past decade. Notably, the increased incidence of stage I lung cancer coincided with an improved prognosis, indicating actual benefits of early detection and management of lung cancer.
Humans
;
Male
;
Female
;
Aged
;
Lung Neoplasms/genetics*
;
Adenocarcinoma/pathology*
;
Prognosis
;
Survival Rate
;
Mutation
;
ErbB Receptors/genetics*
;
Neoplasm Staging
;
Retrospective Studies
5.Treatment outcomes of retinoblastoma patients at a Tertiary Government Hospital in the Philippines
Jayson T. So ; Fatima G. Regala ; Beltran Alexis A. Aclan
Philippine Journal of Ophthalmology 2023;48(2):52-56
Objective:
This study determined the treatment outcomes of patients with retinoblastoma seen at a Philippine tertiary government hospital from January 2000 to January 2020.
Method:
This is a cohort study. Medical records of patients with histopathologic-proven retinoblastoma were reviewed and pertinent information on clinical profile and presentation, treatment and outcomes were recorded.
Results:
This study included 118 patients (146 eyes) with mean age at symptom onset of 7.4 + 6.6 months and mean age at consult of 11.5 + 13.7 months. There were 69 (47%) eyes with International Classification of Retinoblastoma (ICRB) stage E. The most common primary treatment was enucleation (n=137, 94%). The most common high-risk histopathologic feature was involvement of the optic nerve at the cut-end section (n=27, 34%). Only 14 patients (11%) completed treatment with median follow-up of 30.5 months (range 4- 122).
Conclusion
The rate of overall survival of patients with retinoblastoma is low in this study, similar to other developing countries. This can be due to higher proportion of patients with advanced stage at presentation and lower percentage of treatment completion. Early diagnosis and treatment may lead to better survival rate, visual outcome and quality of life. Due to limited data on follow-up, globe preservation could not be determined.
Retinoblastoma
;
Survival Rate
6.Analysis of relevant factors influencing the 30-day survival rate of patients with cardiac arrest and cardiopulmonary resuscitation: research based on 8-year data of a class III hospital.
Xu MA ; Baoying GUO ; Yun WANG ; Ningkang LI ; Li SHEN ; Wenhua XI ; Kerong HAI
Chinese Critical Care Medicine 2023;35(4):367-370
OBJECTIVE:
To investigate the survival of patients with cardiac arrest and cardiopulmonary resuscitation (CA-CPR), and to analyze the factors influencing survival at 30 days after restoration of spontaneous circulation (ROSC).
METHODS:
A retrospective cohort study was conducted. Clinical data of 538 patients with CA-CPR admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2013 to September 2020 were enrolled. The gender, age, underlying disease, cause of CA, type of CA, initial rhythm, presence or absence of endotracheal intubation, defibrillation, use of epinephrine, and 30-day survival rate of patients were collected. The etiology of CA and 30-day survival rate among patients with different ages were compared, as well as the clinical data between patients who survived and died at 30 days after ROSC were also compared. Multivariate Logistic regression was used to analyze the relevant factors affecting the 30-day survival rate of patients.
RESULTS:
Among 538 patients with CA-CPR, 67 patients with incomplete information were excluded, and 471 patients were enrolled. Among 471 patients, 299 were males and 172 were females. Aged from 0 to 96 years old, 23 patients (4.9%) were < 18 years old, 205 patients (43.5%) were 18 to 64 years old, and 243 patients (51.6%) were ≥ 65 years old. 302 cases (64.1%) achieved ROSC, and 46 patients (9.8%) survived for more than 30 days. The 30-day survival rate of patients aged < 18 years old, 18-64 years old and ≥ 65 years old was 8.7% (2/23), 12.7% (26/205) and 7.4% (18/243), respectively. The main causes of CA in patients younger than 18 years were severe pneumonia (13.1%, 3/23), respiratory failure (13.1%, 3/23), and trauma (13.1%, 3/23). The main causes were acute myocardial infarction (AMI; 24.9%, 51/205), respiratory failure (9.8%, 20/205), and hypoxic brain injury (9.8%, 20/205) in patients aged 18-64 years old, and AMI (24.3%, 59/243) and respiratory failure (13.6%, 33/243) in patients aged ≥ 65 years old. Univariate analysis results revealed that the 30-day survival rate of patients with CA-CPR may be related to the the cause of CA was AMI, initial rhythm was ventricular tachycardia/ventricular fibrillation, endotracheal intubation and epinephrine. Multivariate Logistic regression analysis results showed that CA was caused by AMI [odds ratio (OR) = 0.395, 95% confidence interval (95%CI) was 0.194-0.808, P = 0.011] and endotracheal intubation (OR = 0.423, 95%CI was 0.204-0.877, P = 0.021) was a protective factor for 30 days of survival after ROSC in patients with CA-CPR.
CONCLUSIONS
The 30-day survival rate of CA-CPR patients was 9.8%. The 30-day survival rate of CA-CPR patients with AMI after ROSC is higher than that of patients with other CA causes, and early endotracheal intubation can improve the prognosis of patients.
Female
;
Male
;
Humans
;
Infant, Newborn
;
Infant
;
Child, Preschool
;
Child
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Retrospective Studies
;
Survival Rate
;
Heart Arrest
;
Hospitals
;
Epinephrine
;
Ventricular Fibrillation
7.Clinicopathological features and prognostic factors of patients with lung metastasis of stage Ⅰa~Ⅲb cervical cancer.
Hong LIU ; Guo Nan ZHANG ; Min LUO ; Xu Dong ZHANG ; Ying FAN ; Chun Rong PENG
Chinese Journal of Oncology 2023;45(4):340-347
Objective: To investigate the clinicopathological features and prognostic factors of lung metastasis in patients with cervical cancer after treatment. Methods: The clinicopathological data of 191 patients with lung metastasis of stage Ⅰa-Ⅲb cervical cancer (FIGO 2009 stage) treated in Sichuan Cancer Hospital from January 2007 to December 2020 were analyzed retrospectively. Kaplan Meier method and Log rank test were used for survival analysis, and Cox regression model was used for prognostic factors analysis. Results: Among 191 patients with lung metastasis of cervical cancer, pulmonary metastasis was found in 134 patients (70.2%) during follow-up examination, and 57 patients (29.8%) had clinical symptoms (cough, chest pain, shortness of breath, hemoptysis, and fever). The time from the initial treatment of cervical cancer to the discovery of lung metastasis was 1-144 months in the whole group, with a median time of 19 months. Univariate analysis of the prognosis of lung metastasis after treatment of cervical cancer showed that the diameter of cervical tumor, lymph node metastasis, positive surgical margin, disease-free interval after treatment of cervical cancer, whether it is accompanied by other metastasis, the number, location and maximum diameter of lung metastasis, and the treatment method after lung metastasis are related to the prognosis of patients with lung metastasis of cervical cancer. Multivariate analysis showed that the number of lung metastases and other site metastases in addition to lung metastases were independent factors affecting the prognosis of patients with lung metastases of cervical cancer (P<0.05). Conclusions: For patients with cervical cancer, attention should be paid to chest CT examination during follow-up to guard against the possibility of lung metastasis after treatment. Besides lung metastasis, other site metastasis and the number of lung metastasis are independent factors affecting the prognosis of patients with lung metastasis of cervical cancer. For patients with lung metastasis after treatment of cervical cancer, surgical treatment is an effective treatment. It is necessary to strictly grasp the surgical indications, and some patients can achieve long-term survival. For patients with lung metastasis of cervical cancer who are not suitable for resection of lung metastasis, the remedial treatment of chemotherapy with or without radiotherapy is still a recommended choice.
Female
;
Humans
;
Prognosis
;
Uterine Cervical Neoplasms/pathology*
;
Neoplasm Staging
;
Retrospective Studies
;
Lung Neoplasms/pathology*
;
Survival Rate
8.Focusing on timing selection and whole-course management of liver transplantation treatment for patients with acute-on-chronic liver failure.
Chinese Journal of Hepatology 2023;31(6):561-563
Acute-on-chronic liver failure (ACLF) is a clinical syndrome of acute decompensation accompanied by organ failure that occurs on the basis of chronic liver disease and has a high short-term mortality rate. Currently, there are still differences in relation to the definition of ACLF; thus, baseline characteristics and dynamic changes are important bases for clinical decision-making in patients with liver transplantation and others. The basic strategies for treating ACLF currently include internal medicine treatment, artificial liver support systems, and liver transplantation. Multidisciplinary active collaborative management throughout the whole course is of great significance for further improving the survival rate in patients with ACLF.
Humans
;
Liver Transplantation
;
Acute-On-Chronic Liver Failure/complications*
;
Survival Rate
;
Liver Cirrhosis/complications*
;
Prognosis
9.Long-term trend analysis of liver cancer survival rate in Qidong region, Jiangsu Province, 1972-2019.
Yong Sheng CHEN ; Jun WANG ; Lu Lu DING ; Yuan You XU ; Yong Hui ZHANG ; Jian Guo CHEN ; Jian ZHU ; Jian FAN
Chinese Journal of Hepatology 2023;31(6):634-639
Objective: To analyze the incidence and survival rate of liver cancer cases in the entire population in the Qidong region from 1972 to 2019, so as to provide a basis for prognosis evaluation, prevention, and treatment. Methods: The observed survival rate (OSR) and relative survival rate (RSR) of 34 805 cases of liver cancer in the entire Qidong region population from 1972 to 2019 were calculated using Hakulinen's method with SURV3.01 software. Hakulinen's likelihood ratio test was used for statistical analysis. Age-standardized relative survival (ARS) was calculated using the International Cancer Survival Standard. The Joinpoint regression analysis was performed with Joinpoint 4.7.0.0 software to calculate the average annual percentage change (AAPC) of the liver cancer survival rate. Results: 1-ASR increased from 13.80% in 1972-1977 to 50.20% in 2014-2019, while 5-ASR increased from 1.27% in 1972-1977 to 27.64% in 2014-2019. The upward trend of RSR over eight periods was statistically significant (χ (2) = 3045.29, P < 0.001). Among them, male 5-ASR was 0.90%, 1.80%, 2.33%, 4.92%, 5.43%, 7.05%, 10.78%, and 27.78%, and female 5-ASR was 2.33%, 1.51%, 3.35%, 3.92%, 3.84%, 7.18%, 11.45%, and 29.84%, respectively. There was a statistically significant difference in RSR between males and females (χ (2) = 45.68, P < 0.001). The 5-RSR for each age group of 25-34 years old, 35-44 years old, 45-54 years old, 55-64 years old, 65-74 years old, and 75 years old were 4.92%, 5.29%, 8.17%, 11.70%, 11.63%, and 9.60%, respectively. There were statistically significant differences in RSR among different age groups (χ (2) = 501.29, P < 0.001). The AAPC in Qidong region from 1972 to 2019 for 1-ARS, 3-ASR, and 5-ARS were 5.26% (t = 12.35, P < 0.001), 8.10% (t = 15.99, P < 0.001), and 8.96 % (t = 16.06, P < 0.001), respectively. The upward trend was statistically significant in all cases. The AAPC of 5-ARS was 9.82% in males (t = 14.14, P < 0.001), and 8.79% in females (t = 11.48, P < 0.001), and the upward trend was statistically significant in both. The AAPC of 25-34 years old, 35-44 years old, 45-54 years old, 55-64 years old, 65-74 years old, and 75 years old were 5.37% (t = 5.26, P = 0.002), 5.22% (t = 5.66, P = 0.001), 7.20% (t = 6.88, P < 0.001), 10.00% (t = 12.58, P < 0.001), 9.96% (t = 7.34, P < 0.001) and 8.83% (t = 3.51, P = 0.013), and the upward trend was statistically significant. Conclusion: The overall survival rate of registered cases of liver cancer in the Qidong region's entire population has greatly improved, but there is still much room for improvement. Hence, constant attention should be paid to the study on preventing and treating liver cancer.
Male
;
Humans
;
Female
;
Adult
;
Middle Aged
;
Aged
;
Survival Rate
;
Liver Neoplasms/epidemiology*
;
Prognosis
;
Incidence
;
Software
;
China/epidemiology*
10.Recent progress and future prospects of treatment for peritoneal metastasis in gastric cancer.
Chinese Journal of Gastrointestinal Surgery 2023;26(5):414-418
Peritoneal metastasis is one of the most frequent patterns of metastasis in gastric cancer, and remains a major unmet clinical problem. Thus, systemic chemotherapy remains the mainstay of treatment for gastric cancer with peritoneal metastasis. In well-selected patients, the reasonable combination of cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and neoadjuvant intraperitoneal chemotherapy with systemic chemotherapy will bring significant survival benefits to patients with gastric cancer peritoneal metastasis. In patients with high-risk factors, prophylactic therapy may reduce the risk of peritoneal recurrence, and improves survival after radical gastrectomy. However, high-quality randomized controlled trials will be needed to determine which modality is better. The safety and efficacy of intraoperative extensive intraperitoneal lavage as a preventive measure has not been proven. The safety of HIPEC also requires further evaluation. HIPEC and neoadjuvant intraperitoneal and systemic chemotherapy have achieved good results in conversion therapy, and it is necessary to find more efficient and low-toxicity therapeutic modalities and screen out the potential benefit population. The efficacy of CRS combined with HIPEC on peritoneal metastasis in gastric cancer has been preliminarily validated, and with the completion of clinical studies such as PERISCOPE II, more evidence will be available.
Humans
;
Stomach Neoplasms/pathology*
;
Peritoneal Neoplasms/secondary*
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Hyperthermia, Induced/methods*
;
Peritoneum/pathology*
;
Combined Modality Therapy
;
Cytoreduction Surgical Procedures/methods*
;
Survival Rate


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