Long-term results of intrathoracic chemohyperthermia (ITCH) for the treatment of pleural malignancies.
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ABSTRACT:
SUBMITTER: Monneuse O
PROVIDER: S-EPMC2741113 | biostudies-other | 2003 Jun
REPOSITORIES: biostudies-other
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Project description:ObjectiveTreatment of patients with thymic malignancies metastatic to the pleura or pericardium is challenging, and benefits of aggressive treatment are unclear. We sought to characterize the long-term outcomes in this population.MethodsWe retrospectively identified patients who underwent resection for de novo thymic malignancies metastatic to the pleura between May 1997 and December 2017. Patients with pleural recurrence after prior thymectomy were excluded. Patient demographics, perioperative treatments, pathologic findings, and postoperative outcomes were collected. Descriptive statistics and Kaplan-Meier analyses were performed.ResultsSeventy-two patients were included (median age, 51 years [range 25-80]; 36/72 women [50%]). Pathologic diagnosis was thymoma in 57 patients (79%) and thymic carcinoma in 15 patients (21%). Most patients (67/72; 93%) received chemotherapy, radiation, or both. Forty-eight patients underwent thymectomy with pleurectomy, 7 patients underwent extrapleural pneumonectomy, 10 patients underwent thymectomy alone, and 7 patients were unresectable. Macroscopic complete resection was achieved in 52 patients (73%). Five-, 10-, and 15-year overall survivals were 73%, 51%, and 18%, respectively, and median overall survival was 11 years (median follow-up, 5.9 years). Forty-six patients (64%) had disease progression (median time to progression, 2.2 years). Repeat episodes of progression and treatment were common (median, 3 episodes/patient). The longest disease-free interval was 12.4 years. Thirteen patients (18%) remain disease-free; 7 patients (10%) were disease-free for more than 5 years. The longest ongoing survival without progression or reintervention is 9.9 years.ConclusionsProlonged survival and, in some cases, cure can be achieved in patients with thymic malignancies metastatic to the pleura or pericardium. Aggressive multimodality therapy may be appropriate for select patients.
| S-EPMC7067622 | biostudies-literature
Project description:Antibiotic treatment of acute appendicitis has gained interest and inquiries. Reports have demonstrated both safety and high resolution of symptoms and inflammation following antibiotic treatment of appendicitis, but information on long-term results is required. Our present aim was therefore to evaluate long-term recurrence rate of initial antibiotics-alone treatment for suspected acute appendicitis.Patients with favourable response to antibiotics in earlier randomized (RCT, n = 97) and population-based (PBT, n = 342) studies as well as subsequently treated non-randomized (Non-R, n = 271) patients are evaluated for long-term risk to relapse demanding surgical appendectomy; altogether 710 patients.Clinical characteristics among randomized and non-randomized patients were similar without any statistical difference according to abdominal symptoms and degree of systemic inflammation (CRP, WCC) when antibiotic treatment started. Females and males showed the same results. The median follow-up time was 2162 days (5.92 years), and the range across highest and lowest follow-up was 3495 days (range 2-3497) for the entire group, without significant differences among subgroups (RCT, PBT, Non-R). The cumulative probability for relapse of appendicitis demanding appendectomy was: 0.09, 0.12, 0.12 and 0.13 at 1-, 2-, 3- and 5-year follow-up, with a probability of 0.86 ± 0.013 without appendectomy after 8 years. This may imply an overall benefit of 60-70% by antibiotics during expected 10-year follow-up accounting for initial treatment failures at 10-23% in our published reports.Antibiotic treatment is safe and effective as a first-line therapy in unselected adults with acute appendicitis with a risk around 15% for long-term relapse following favourable initial treatment response.
| S-EPMC5544800 | biostudies-other
Project description:We used a custom-designed microarray and qPCR to characterize the persistent transcriptional response to long-term habituation training in the marine mollusk Aplysia californica. Aplysia were exposed to either 3 days of spaced long-term habituation training (10 rounds of stimulation/day; each round = 15 min brushing at a 10s ISI; 15 min rest between rounds); a matched set of controls was not exposed to any brushing (n = 8/group). While reflex responsiveness remained stable in controls, trained animals exhibited a large reduction in siphon-withdrawal duration that was evident at stimulation sites across the entire dorsal surface of the body (head, tail, and siphon). This habituation was retained for at least 24 hours after the end of training. Immediately after 24 hour retention tests, pleural ganglia were harvested from each trained animal and its matched control. The pleural ganglia contain the VC nociceptors, which we confirmed are activated by the brush stimulus used to produce habituation. Microarray analysis from 8 biological replicates suggests that long-term habituation training persistently regulates 21 transcripts. We used qPCR to test a subset of these transcripts and found persistent regulation of an putative Aplysia cornichon homolog. Between-subjects comparison of a trained animal to a matched control (matching based on duration of pre-test responsiveness). Conducted with 8 biological replicates, meaning 8 arrays, each comparing 1 trained and 1 matched control.
2014-07-16 | E-GEOD-59448 | biostudies-arrayexpress
Project description:We used a custom-designed microarray and qPCR to characterize the rapid transcriptional response to long-term sensitization training in the marine mollusk Aplysia californica. Aplysia were exposed to repeated noxious shocks to one side of the body (4 ten-second shocks at 90mA, 30 min ISI), a procedure known to induce a transcription-dependent and long-lasting increase in reflex responsiveness that is restricted to the side of training. One hour after training, pleural ganglia from the trained and untrained sides of the body were harvested; these ganglia contain the sensory nociceptors which help mediate the expression of long-term sensitization memory. Â Microarray analysis from 8 biological replicates suggests that long-term sensitization training rapidly regulates at least 102 transcripts. We used qPCR to test a subset of these transcripts and found that 86% were confirmed in the same samples, and 83% of these were again confirmed in an independent sample (n = 9 animals). Thus, our new microarray design shows very strong convergent and predictive validity for analyzing the transcriptional correlates of memory in Aplysia. Fully validated transcripts include some previously identified as regulated in this paradigm (ApC/EBP and ApEgr) but also include novel findings. Specifically, we show that long-term sensitization training rapidly up-regulates the expression of transcripts which encode a C/EBP gamma, a glycine transporter, and a vacuolar-protein-sorting-associated protein. Within-subjects comparison of trained (Cy5) to untrained (Cy3) pleural ganglia with 8 biological replicates. Each replicate is a trained sample from two animals (right and left trained) and each untrained sample is from the same two aniamls (right and left untrained)
2014-05-08 | E-GEOD-57458 | biostudies-arrayexpress
Project description:Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.
| S-EPMC7549477 | biostudies-literature
Project description:We used a custom-designed microarray and qPCR to characterize the persistent transcriptional response to long-term sensitization training in the marine mollusk Aplysia californica. Aplysia were exposed to a 1-day unilateral LTS training protocol (4 rounds of noxious shock at 30 min intervals, each shock 10s of 1/2s off 1/2on 90mA 60-hz biphasic square-wave shock). Training produced robust sensitization in all animals (measured as an increase in T-SWR response from baseline to 24h after training). Immediately after 24h post-tests, pleural ganglia was harvested. Samples from a left-trained and right-trained animal were combined to smooth out lateralized gene expression. The pleural ganglia contains the VC nociceptors, which are thought to play a primary role in expressing LTS memory.
2017-03-03 | GSE95596 | GEO
Project description:We used a custom-designed microarray and qPCR to characterize the transcriptional response that persists 7 days after long-term sensitization training in the marine mollusk Aplysia californica, a time-point at which recall has decayed but savings memory is still possible to induce. Aplysia were exposed to a 1-day unilateral LTS training protocol (4 rounds of noxious shock at 30 min intervals, each shock 10s of 1/2s off 1/2on 90mA 60-hz biphasic square-wave shock). Training produced robust sensitization in all animals (measured as an increase in T-SWR response from baseline to 24h after training). One week (7 days) after training, animals were again post-tested, and showed little-to-no evidence of recall (average change from baseline = -4% on the trained side, -4% on the untrained side). Pleural ganglia were then harvested. Samples from a left-trained and right-trained animal were combined to smooth out lateralized gene expression. The pleural ganglia contains the VC nociceptors, which are thought to play a primary role in expressing LTS memory.
2017-06-08 | GSE99792 | GEO
Project description:We used a custom-designed microarray and qPCR to characterize the persistent transcriptional response to long-term habituation training in the marine mollusk Aplysia californica. Aplysia were exposed to either 3 days of spaced long-term habituation training (10 rounds of stimulation/day; each round = 15 min brushing at a 10s ISI; 15 min rest between rounds); a matched set of controls was not exposed to any brushing (n = 8/group). While reflex responsiveness remained stable in controls, trained animals exhibited a large reduction in siphon-withdrawal duration that was evident at stimulation sites across the entire dorsal surface of the body (head, tail, and siphon). This habituation was retained for at least 24 hours after the end of training. Immediately after 24 hour retention tests, pleural ganglia were harvested from each trained animal and its matched control. The pleural ganglia contain the VC nociceptors, which we confirmed are activated by the brush stimulus used to produce habituation. Microarray analysis from 8 biological replicates suggests that long-term habituation training persistently regulates 21 transcripts. We used qPCR to test a subset of these transcripts and found persistent regulation of an putative Aplysia cornichon homolog.
2014-07-16 | GSE59448 | GEO
Project description:We used a custom-designed microarray and qPCR to characterize the rapid transcriptional response to long-term sensitization training in the marine mollusk Aplysia californica. Aplysia were exposed to repeated noxious shocks to one side of the body (4 ten-second shocks at 90mA, 30 min ISI), a procedure known to induce a transcription-dependent and long-lasting increase in reflex responsiveness that is restricted to the side of training. One hour after training, pleural ganglia from the trained and untrained sides of the body were harvested; these ganglia contain the sensory nociceptors which help mediate the expression of long-term sensitization memory. Microarray analysis from 8 biological replicates suggests that long-term sensitization training rapidly regulates at least 102 transcripts. We used qPCR to test a subset of these transcripts and found that 86% were confirmed in the same samples, and 83% of these were again confirmed in an independent sample (n = 9 animals). Thus, our new microarray design shows very strong convergent and predictive validity for analyzing the transcriptional correlates of memory in Aplysia. Fully validated transcripts include some previously identified as regulated in this paradigm (ApC/EBP and ApEgr) but also include novel findings. Specifically, we show that long-term sensitization training rapidly up-regulates the expression of transcripts which encode a C/EBP gamma, a glycine transporter, and a vacuolar-protein-sorting-associated protein.
2014-05-08 | GSE57458 | GEO
Project description:Osteochondritis dissecans (OD) mostly appears at the knee joint on the weight-bearing part of the medial femoral condyle. A multi-factorial event is most likely responsible for the triggering of OD. The aim of this retrospective study was to carry out long-term assessment of the results of operative treatment. Between 1959 and 1976, 148 patients were treated for OD by an open technique. For this purpose, a total number of 38 patients were analysed after approximately 30 years. Twenty-six patients were evaluated clinically by means of standardised questionnaires and also radiologically; 12 patients were analysed only by questionnaire. In order to verify the clinical findings and the subjective assessment, radiographs were done and analysed according the Kannus score. The Brückl score was used to evaluate the results of the OD. Twenty-four knee joints were analysed by radiographs. Sixty percent of the operated joints showed poor results in the analysis according to Kannus. Only four patients showed an excellent result by using the clinical scoring system. Nevertheless, we were able to prove a markedly higher rate of osteoarthrosis. The causal explanation for this lies in the patient selection. Most of the patients were above average age, and the OD was discovered quite late, and thus the disease had already progressed to a higher degree. In 74% of all cases, an extirpation of the osteochondral fragment was performed, whereas today there are several operative options. In our view, therefore, the need arises to conduct further follow-up examinations with comparative time spans, as well as to conduct a parallel analysis of corresponding control groups in order to evaluate the aetiology of the increased rate of osteoarthrosis.
| S-EPMC2269012 | biostudies-other