OBJECTIVES

The influence of weight change on the response to neoadjuvant chemotherapy (NAC) among adult Filipino patients with breast cancer remains unclear. Currently, there has been increasing evidence that weight gain during NAC is associated with increased recurrence risk and decreased survival. This study aimed to investigate this relationship and identify significant predictors of pathologic complete response (pCR), overall survival (OS) and disease-free survival (DFS).

METHODS

This is a retrospective study using data from 52 female patients who received NAC for stage II or III breast cancer and had complete records of weight before and after NAC. Significant predictors of pCR such as host factors and tumor characteristics and associations between weight change and pCR, OS and DFS were examined using univariate and multivariable logistic regression analyses.

RESULTS

The average weight of all patients before NAC was 57.0 kg while the average weight of all patients after NAC was 59.5 kg. The average BMI of all patients before NAC was 25.8 kg/m2. In total, 29 patients (55.8%) were classified in the overweight/obese (OW/OB) group, and the rest were classified in the normal weight/underweight (NW/UW) group. The pCR rate was 51.3% in the OW/OB group versus 48.7% in the NW/UW group (p = 0.11). Initial BMI was a significant factor for achieving pCR (hazard ratio, 3.85; 95% confidence interval [CI], 1.72-8.60, p = 0.001), suggesting that a higher initial BMI was associated with an increased likelihood of achieving pCR. Initial BMI was also an independent prognostic factor for OS (p = 0.0006) and DFS (p = 0.0005). On the other hand, no significant correlation was seen between pCR rates as well as OFS and DFS (p = 0.0551) among patients whose weight changed during the course of treatment.

CONCLUSION

These findings suggest that while initial weight may significantly predict pCR rates and affect DFS and OS, weight change during treatment may not be as influential. Further research is needed to validate these findings in more diverse and larger patient populations.

Human ; Breast Neoplasms ; Neoadjuvant Chemotherapy ; Neoadjuvant Therapy ; Pathologic Complete Response ; Prognostic Factors ; Prognosis

OBJECTIVES

This study aims to describe the demographic factors, clinical and laboratory features and outcomes of adult cryptococcal meningitis and possibly to identify demographic as well as CSF parameters affecting mortality in adult Filipinos with cryptococcal meningitis.

STUDY DESIGN

Retrospective case review

RESULTS

A total of 61 patients were admitted with a diagnosis of cryptococcal meningitis from 1993 to 2005, 60% of which were males (male to female ratio 1.5:1). Ages ranged from 18 to 73 years, with 11 (18%) patients having underlying co-morbidities. The most common presenting complaint was headache (76%) followed by nausea and vomiting (72%) and fever (52%). All patients had lumbar puncture. Of the 18 patients with available complete CSF profiles, all had an elevated opening pressure on initial lumbar tap (mean: 396mmH₂0), 83% had elevated total protein (mean: 120mg/dl), 61% showed hypoglycorrhachia, 83% had CSF WBC count greater than 20 cells/mm³, 70% had a positive India ink test, and 89% had a CSF CALAS titer of at least 1 :8. The mortality rate was 49% and the most common cause of death was found to be brain herniation. Forty nine percent of the patients received treatment, 40% of whom died. The relationship between age, sex, CSF findings and mortality were analyzed using Chi square test or Fisher's exact test. Only the CSF CALAS titer was found to be predictive of subsequent outcome (p=0.0019).

CONCLUSION

Most Filipinos admitted at UP-PGH with cryptococcal meningitis were males, with a mean age of 54 years old. Only 11 patients were found to be immu11ocompromised. The most common presenting complaint was headache, whereas the most common sign was nuchal rigidity. All patients have elevated opening pressure, abnormal CSF profiles, positive India ink and elevated CALAS titers. The mortality rate was found to be 49%. Only a CALAS titer greater than 1 :32 was found to be predictive of outcome.

Human ; Adult: 25-44 Yrs Old ; Meningitis ; Prognostic Factors ; Prognosis