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PubMed1996

Bax promotes neuronal survival and antagonises the survival effects of neurotrophic factors.

Bcl-2, Bcl-x and Bax are members fo a family of cytoplasmic proteins that influence cell survival. Whereas increased expression of Bcl-2 or Bcl-x promotes cell survival following withdrawal of survival factors, increased expression of Bax is thought to suppress survival. To investigate the potential roles of these proteins in regulating the survival of developing neurons, we compared the effects of overexpressing these proteins in embryonic neurons deprived of different neurotrophic factors in vitro. Surprisingly, overexpression of Bax rescued populations of sensory neurons deprived of nerve growth factor, as did overexpression of Bcl-2 and two Bcl-x variants, Bcl-XL and Bcl-Xbeta. Bax also enhanced the survival of ciliary neurons deprived of ciliary neurotrophic factor, although this effect was short-lived. Whereas Bcl-2 overexpression did not affect the survival response of neurons to neurotrophic factors, Bax overexpression partially inhibited the action of neurotrophic factors. Co-injection of Bcl-2 and Bax expression vectors promoted the survival of neurotrophic factor-deprived neurons if either was in excess, but failed to rescue neurons if they injected at a 1:1 ratio. Our findings demonstrate that Bax can promote the survival of neurotrophic factor-deprived neurons and that its effect on survival is dominant to that of neurotrophic factors. Our results also argue that the relative amounts of Bcl-2 and Bax are critical in regulating neuronal survival.

Animals↗
PubMed1990

Survival after liver transplantation of patients with primary biliary cirrhosis in the Nordic countries. Comparison with expected survival in another series of transplantations and in an international trial of medical treatment.

Until December 1988, 38 patients with primary biliary cirrhosis (PBC) had been transplanted in the Nordic countries. The observed survival probability in accordance with Kaplan-Meier analysis was around 75% 2-3 months after surgery, with few deaths during the next 3 years. The observed survival curve was compared with the expected survival calculated from the experience of a recent English PBC transplant series; the patterns are very similar. Secondly, the observed survival was compared with the expected survival curve, calculated from the survival experience of an international trial of medical treatment--that is, the expected survival had the patients not been transplanted; after the first 2-3 months the observed survival stayed better than the expected survival. Finally, the merits of transplantation for each particular patient was evaluated by means of the ratio of probability of survival when transplanted to probability of survival when medically treated 3, 6, and 8 months after surgery. The ratio increased with time, indicating a relative increase in the benefit of transplantation with time after surgery.

Denmark↗
PubMed2001

Midterm survival of stented versus stentless valves: does concomitant coronary artery bypass grafting impact survival?

The purpose of this study was to examine the impact of concomitant coronary artery bypass grafting (CABG) and valve design on survival following aortic valve replacement (AVR) with stentless and stented bioprostheses. Survival data for 1798 patients undergoing AVR between 1991 and 1997 with either a stentless (Medtronic Freestyle = 700, Toronto SPV = 447; N = 1147) or stented (Hancock II = 224, Carpentier-Edwards SAV = 427; N = 651) valve were analyzed. Bivariable analyses using Kaplan-Meier survival curves and log-rank test were performed to compare survival probabilities by valve type. Multivariable stepwise Cox's proportional hazard models were used to control for potentially confounding variables. Concomitant CABG was performed in 41% of stentless and 46% of stented patients (P =.04). Survival probability at 5 years was 0.84 (95% CI = 0.81, 0.87) for stentless versus 0.79 (95% CI = 0.75, 0.83) for stented patients (P =.004). In the absence of concomitant CABG, survival was superior in stentless (0.84) over stented (0.80) patients, but these differences were not statistically significant (P =.053). In patients that underwent AVR with concomitant CABG, survival was significantly better in stentless patients (0.82) than in stented individuals (0.77, P =.049). The unadjusted hazard ratio for stented versus stentless was 1.44 (95% CI = 1.12, 1.86, P =.005). In the final Cox's proportional hazard model the variables that effected survival were valve type and age in decades. New York Heart Association class at the time of surgery had a marginal effect on survival. The data demonstrate improved midterm survival with stentless versus stented valves. Subgroup analysis suggests survival benefits of stentless valves may be greater in patients who undergo concomitant CABG surgery.

Aged↗
PubMed2002

[A comparison of patients with hepatocellular carcinoma between a short-term (less than 6 months) survival group and a long-term (over 24 months) survival group after treatment with transcatheter arterial chemoembolization].

BACKGROUND/AIMS: Although hepatocellular carcinoma(HCC) shows poor prognosis, transcatheter hepatic arterial chemoembolization(TACE) can improve survival rate in some patient groups. This study investigated the synergy effect of the different clinical indices on the survival time in patients with HCC underwent TACE. MATERIALS AND METHODS: A retrospective study of 241 patients with HCC who underwent TACE with a mixture of lipiodol, mitomycin-C and adriamycin, alone or followed by gelfoam was conducted. Three different survival groups (A, less than 6 months; B, between between 6 and 23 months; and C, over 24 months) were compared. RESULTS: Alkaline phosphatase was lowest in group C (p=0.0001). The longer the survival, the lower (p=0.027, p=0.007) the AST and AST/ALT ratio were. Albumin was higher (p=0.032), GGT and LDH were lower (p=0.003, p=0.002) in the long-term survival group. The long-term survival group revealed an absence of both ascites(p<0.002) and portal vein thrombosis(p<0.001), and lower TNM stage (P<0.0001). The single nodular type of HCC was more frequent (P<0.0001) and the size of tumor was smaller in the long-term survival group (P<0.0001). Child-Pugh class was lower in the long-term survival group (p=0.017). The higher serum albumin and elder age, the higher albumin and the lower alkaline phosphatase or alpha-fetoprotein, represented synergic effects on a long term survival. The higher albumin and the smaller size or the lower tumor stage, the higher albumin and platelet revealed similar synergy effects. Although the age or platelet is high, low albumin showed poor prognosis. CONCLUSION: Patients with small-sized single, nodular HCC in a low Child-Pugh class without evidence of ascites and portal vein thrombosis, and the higher level of serum albumin but lower levels of alpha-fetoprotein, alkaline phosphatase, GGT, and LDH, can expect a long-term survival over 24 months by the treatment of TACE. There are meaningful synergies of the different clinical variables affecting the survival times in the patients with HCC undergoing TACE.

Adult↗
PubMed2005

Cardiovascular risk factors predictive for survival and morbidity-free survival in the oldest-old Framingham Heart Study participants.

OBJECTIVES: To examine whether midlife cardiovascular risk factors predict survival and survival free of major comorbidities to the age of 85. DESIGN: Prospective community-based cohort study. SETTING: Framingham Heart Study, Massachusetts. PARTICIPANTS: Two thousand five hundred thirty-one individuals (1,422 women) who attended at least two examinations between the ages of 40 and 50. MEASUREMENTS: Risk factors were classified at routine examinations performed between the ages of 40 and 50. Stepwise sex-adjusted logistic regression models predicting the outcomes of survival and survival free of morbidity to age 85 were selected from the following risk factors: systolic and diastolic blood pressure, total serum cholesterol, glucose intolerance, cigarette smoking, education, body mass index, physical activity index, pulse pressure, antihypertensive medication, and electrocardiographic left ventricular hypertrophy. RESULTS: More than one-third of the study sample survived to age 85, and 22% of the original study sample survived free of morbidity. Lower midlife blood pressure and total cholesterol levels, absence of glucose intolerance, nonsmoking status, higher educational attainment, and female sex predicted overall and morbidity-free survival. The predicted probability of survival to age 85 fell in the presence of accumulating risk factors: 37% for men with no risk factors to 2% with all five risk factors and 65% for women with no risk factors to 14% with all five risk factors. CONCLUSION: Lower levels of key cardiovascular risk factors in middle age predicted overall survival and major morbidity-free survival to age 85. Recognizing and modifying these factors may delay, if not prevent, age-related morbidity and mortality.

Academic Medical Centers↗
PubMed2006

Expression of KLF5 is a prognostic factor for disease-free survival and overall survival in patients with breast cancer.

PURPOSE: Kruppel-like factor (KLF5) is a cell growth mediator in various epithelial cells. Higher KLF5 increases cell growth rate and leads to transformed phenotypes. Because tumor cell proliferation is tightly associated with tumor progression, and consequently, with survival of cancer patients, we wanted to examine the prognostic value of KLF5 gene expression for patients with breast cancer. EXPERIMENTAL DESIGN: The gene expression levels of KLF5, ER, PR, HER2, and MKI67 were quantified in the tumor tissues of 90 patients with breast cancer and correlated with disease-free survival and overall survival of the patients. The correlations of gene expression between KLF5 and ER, PR, HER2, and MKI67 were analyzed. In addition, KLF5 expression was also compared with clinical data and age of patients. RESULTS: Statistically significant correlations were found between gene expression of KLF5 and both disease-free survival (univariate analysis) and overall survival (univariate and multivariate analysis). Patients with higher KLF5 expression had shorter disease-free survival and overall survival time, whereas patients with lower KLF5 expression had better survival. Moreover, KLF5 was also found to be positively correlated with HER2 and MKI67, and negatively correlated with age of the patients at diagnosis. CONCLUSION: The gene expression of KLF5 is directly correlated with cell proliferation in vivo and is a prognostic factor for patients with breast cancer. Patients with higher KLF5 expression have shorter disease-free survival and overall survival than patients with lower KLF5 expression. In addition, KLF5 has higher expression in patients ages </=50 years old than in patients >50 years old.

Age Factors↗
PubMed1997

Survival chance in papillary thyroid cancer in Hungary: individual survival probability estimation using the Markov method.

PURPOSE: The typically benign, but occasionally rapidly fatal clinical course of papillary thyroid cancer has raised the need for individual survival probability estimation, to tailor the treatment strategy exclusively to a given patient. MATERIALS AND METHODS: A retrospective study was performed on 400 papillary thyroid cancer patients with a median follow-up time of 7.1 years to establish a clinical database for uni- and multivariate analysis of the prognostic factors related to survival (Kaplan-Meier product limit method and Cox regression). For a more precise prognosis estimation, the effect of the most important clinical events were then investigated on the basis of a Markov renewal model. The basic concept of this approach is that each patient has an individual disease course which (besides the initial clinical categories) is affected by special events, e.g. internal covariates (local/regional/distant relapses). On the supposition that these events and the cause-specific death are influenced by the same biological processes, the parameters of transient survival probability characterizing the speed of the course of the disease for each clinical event and their sequence were determined. The individual survival curves for each patient were calculated by using these parameters and the independent significant clinical variables selected from multivariate studies, summation of which resulted in a mean cause-specific survival function valid for the entire group. On the basis of this Markov model, prediction of the cause-specific survival probability is possible for extrastudy cases, if it is supposed that the clinical events occur within new patients in the same manner and with the similar probability as within the study population. RESULTS: The patient's age, a distant metastasis at presentation, the extent of the surgical intervention, the primary tumor size and extent (pT), the external irradiation dosage and the degree of TSH suppression proved to be statistically significant and independent prognostic factors with regard to cause-specific survival in multivariate studies. During follow-up, 14, 14, 9 and 12% of the patients underwent local/regional/distant relapses or thyroid cancer-related death, respectively. Through use of the above six independent clinical variables and the parameters relating to the four clinical events and their interrelations, mean cause-specific survival probabilities of 88, 83 and 78% were determined at 10, 20 and 30 years, respectively. The survival-predicting software (PATHYPRE) written on the basis of the biostatistical model is available through Internet connections on the home page of the National Institute of Oncology, Budapest (www.oncol.hu). CONCLUSION: Prediction of the individual survival probability for extrastudy cases affords a rationale for individualization of the treatment of papillary thyroid cancer patients.

Adolescent↗
PubMed2002

The long-term survival and causes of death in patients who survive at least 1 year after liver transplantation.

BACKGROUND: The purpose of this study was to examine the long-term survival and causes of death in patients who survive the first year after liver transplantation. METHODS: The focus of the analysis was 433 patients who survived for at least 1 year after liver transplantation between November 1, 1984, and December 31, 2001. A total of 586 liver transplants were performed in 542 patients during this time period. The overall 1-, 5-, and 10-year survivals and the 5- and 10-year survivals for those patients who lived for a year were analyzed on the basis of Kaplan-Meier survival estimates. Factors examined included diagnosis, sex, age, and retransplantation. The causes of death were also analyzed. RESULTS: The overall 1-, 5-, and 10-year survivals were 85%, 73%, and 55%, respectively. The 5- and 10-year survivals for those patients who lived for a year were 86% and 65%, respectively. Fifty-one percent of the causes of late death were graft-related, 71% from recurrent primary disease. Cardiovascular events and de novo malignancies were responsible for 65% of the nongraft-related deaths. CONCLUSIONS: The long-term survival in patients who survive for the first year after liver transplantation is excellent. Recurrent primary disease is responsible for the majority of graft-related deaths. Cardiovascular events and de novo malignancy cause most of the nongraft-related deaths.

Adolescent↗
PubMed1999

Estimation of post-lead-time survival under dependence between lead-time and post-lead-time survival.

Early detection of cancer by screening advances the date of diagnosis, but may or may not alter time to death. Screening programme need to assess the true benefit of screening, that is, the length of time by which survival has been extended, beyond merely the time by which the diagnosis is advanced (lead-time). One method is to estimate the distribution of the time survived post-lead-time using total survival time data for screen-detected cancer cases, under the assumption of independence of the lead-time and the past-lead-time survival. However, it seems biologically reasonable that the lead-time and the post-lead-time survival are positively correlated. This paper investigates the consequences of departures from independence of lead-time and post-lead-time survival on estimation of post-lead-time survival. We introduce a new model that involves dependence between the lead-time and the post-lead-time survival. We show that the new model can be converted to the model discussed by Xu and Prorok. We consider the non-parametric maximum likelihood estimator of the post-lead-time survival under the new model. We apply the method to data from the HIP (Health Insurance Plan of Greater New York) breast cancer screening trial. We make comparisons with the survival of cancer cases not detected by screening, such as interval cases, cases among individuals who refused screening, and randomized control cases.

Breast Neoplasms↗
PubMed1982

Comparison of 5- and 10-year survival rates in operated gastric cancer patients. Assessment of the 5-year survival rate as a valid indicator of postoperative curability.

To evaluate whether it is appropriate to estimate the postoperative curability of gastric cancer based on the 5-year survival rate, we compared 5- and 10-year survival rates in 477 primary gastric cancer patients who had undergone gastrectomy during the 8-year period from 1960-1967. In patients who had died more than 5 years after surgery, the cause of death was investigated. The 10-year survival rate of 315 curatively operated patients was 59.1%, 2.9% lower than the 5-year survival rate. Of 176 patients who survived more than 5 years postoperatively, only 9 (5.1%) died of cancer recurrence, suggesting that the 5-year survival rate adequately reflects the curative success of gastric cancer surgery. The postoperative curability of gastric cancer is usually estimated by the 5-year survival rate. However, even in patients who survived for more than 5 years postoperatively, cancer recurrence has been observed. Therefore, we deemed it useful to assess whether it is appropriate to estimate the postoperative curability of gastric cancer based on the 5-year survival rate. From this point of view, we compared the 5- and 10-year survival rates of operated primary gastric patients and investigated the cause of death in patients who died more than 5 years postoperatively. Furthermore, in patients with cancer recurrence more than 5 years postoperatively, the pathologic findings on the cancer in the originally resected specimen were re-evaluated.

Adult↗
PubMed1998

Expected survival compared with survival of peptic ulcer patients.

In analyses of patient survival it is often desirable to compare observed survival curves with expected survival curves based on information obtained from the general population. However, current methods of calculating expected survival curves are difficult to interpret and are often poorly documented. We discuss an alternative formulation of the so-called direct method which we recommend for general use. By simulation, we show that the expected survival curve obtained from this method represents the expectation of a Kaplan-Meier curve for a set of random population controls. Thus, the term expected survival does not refer to the expectation of patient survival, but rather to the expected survival curve for a random set of controls. The alternative methods are discussed, and we illustrate the methods in an analysis of long time survival of a population-based sample of peptic ulcer patients.

Age Factors↗
PubMed2000

Android obesity at diagnosis and breast carcinoma survival: Evaluation of the effects of anthropometric variables at diagnosis, including body composition and body fat distribution and weight gain during life span,and survival from breast carcinoma.

BACKGROUND: Although a large body of research exists concerning pathologic prognostic indicators of the rate of incidence and survival from breast carcinoma, to the authors' knowledge very few studies have examined the effects of anthropometric variables such as height, obesity, weight gain in adulthood, timing of weight gain, and body composition to survival, although these variables are related to the incidence rate. METHODS: The survival status of 166 patients diagnosed with primary breast carcinoma and followed for at least 10 years was obtained from the Cancer Center's registry, and significant anthropometric and other known prognostic indicators regarding survival after diagnosis were determined by Cox proportional hazards analysis. RESULTS: Eighty-three of 166 breast carcinoma patients (50%) with up to 10 years of follow-up died of disease. Android body fat distribution, as indicated by a higher suprailiac:thigh ratio, was a statistically significant (P < 0.0001) prognostic indicator for survival after controlling for stage of disease, with a hazards ratio of 2.6 (95% confidence interval [95% CI], 1.63-4.17). Adult weight gain, as indicated specifically by weight at age 30 years, was a statistically significant (P < 0.05) prognostic indicator for survival with a hazards ratio of 1.15 (95% CI, 1.0-1.28). In addition, the authors observed the Quatelet Index, a negatively significant (P < 0.01) prognostic indicator for survival with a hazards ratio of 0.92 (95% CI, 0.87-0.98). Other markers of general obesity such as weight at diagnosis, percent body fat, and body surface area were not significant markers influencing survival. Similarly, height; triceps, biceps; subscapular, suprailiac, abdominal, and thigh skinfolds; waist and hip circumferences; family history; and reproductive and hormonal variables at the time of diagnosis showed no apparent significant relation to survival. CONCLUSIONS: The results of the current study provide some evidence that android body fat distribution at diagnosis and increased weight at age 30 years increases a woman's risk of dying of breast carcinoma.

Adult↗
PubMed1982

Efforts to enhance survival of limb allografts by prior administration of whole blood in rats using a new survival end-point.

Injecting whole blood into the recipient before surgery can significantly prolong renal transplant survival in rats. Therefore, experiments were performed in rats to study the effects of prior administration of whole blood on the survival of limb allografts. Tests to quantitate survival of the allografts included monitoring the internal temperature of the leg, assaying serum creatine kinase levels, and testing for alloantibodies. Lewis recipients of (BN x LEW)F1 limb transplants that received 1 ml of BN or (BN x LEW)F1 whole blood before surgery had mean survival times that were longer compared with controls as measured by a 10 F change in temperature. In a test-retest experiment, decline of temperature proved to be a reliable quantitative determination of limb allograft survival since a difference of only 5.6% was observed in the mean number of days of graft survival between two separate groups of control Lewis recipients. Moreover, combined data demonstrated that control Lewis recipients of (BN x LEW)F1 limb allografts averaged 24.0 days of graft survival based on a 10 F decline in temperature with a 95% confidence interval of +/- 6.3 days. It is concluded that prior administration of whole blood can produce significant prolongation of survival in organ transplantation, but it is not as effective in enhancing survival of limb allografts. It is also concluded that internal temperature measurement of limb allografts is an easy, effective, and quantitative method of monitoring rejection.

Animals↗
PubMed2005

Microsuction of blastocoelic fluid before vitrification increased survival and pregnancy of mouse expanded blastocysts, but pretreatment with the cytoskeletal stabilizer did not increase blastocyst survival.

OBJECTIVE: To ascertain effects of thermal change, size of blastocoele, artificial shrinkage, and cytoskeletal stabilizer on survival of blastocysts from vitrification. DESIGN: In vitro and in vivo study. SETTING: University infertility clinic and academic research laboratory. ANIMAL(S): Female mice of outbred ICR strain, aged 6 to 8 weeks. INTERVENTION(S): In experiment 1, various stages of mouse blastocysts were vitrified by using conventional straws or closed pulled straws (CPS). In experiment 2, microsuction was performed of blastocoelic fluid for blastocysts and expanded blastocysts before vitrification. In experiment 3, cytochalasin B (CCB) was used to treat embryos during vitrification. In experiment 4, vitrified expanded blastocysts were transferred to pseudopregnant mice. MAIN OUTCOME MEASURE(S): Survival and pregnancy. RESULT(S): The survival rates of early blastocysts were high and not different between the conventional straws and the CPS. The survival rates decreased for blastocysts and expanded blastocysts in both of the two methods. But the use of CPS achieved higher survival rates for blastocysts (83% vs. 70%) and expanded blastocysts (60% vs. 39%) than did the conventional straws. Microsuction before vitrification increased the survival rates for blastocysts (92% vs. 80%) and expanded blastocysts (89% vs. 59%). Survival of vitrified embryos was not distinct between CCB treatment and non-CCB treatment. The percentage of live young from vitrified expanded blastocysts using microsuction was greater than that from vitrified expanded blastocysts without microsuction (34% vs. 9%). CONCLUSION(S): The size of the blastocoeles influenced survival of blastocysts from vitrification. A rapid thermal change of CPS and effective reduction of blastocoelic fluid by microsuction may facilitate vitrification and reduce ice crystal damage for blastocysts and expanded blastocysts. The microfilament inhibitor of CCB treatment did not increase their survival rates.

Animals↗
PubMed2005

The female gender has a positive effect on survival independent of background life expectancy following surgical resection of primary non-small cell lung cancer: a study of absolute and relative survival over 15 years.

Surgical resection is the treatment of choice for non-advanced lung cancer, but is encumbered with an overall relative poor long time prognosis. The purpose of this study was to examine if long time survival for patients operated for non-small cell lung cancer have changed over a 15 years period. We retrospectively studied hospital records of the 351 patients operated, with the intention to cure, for a primary non-small cell carcinoma (NSCLC) in our department between 1 January 1988 and 31 December 2002. Preoperative clinical variables were noted together with variables allowing staging based on pathological examination. Absolute survival and survival relative to expected was studied for the whole group using uni- and multivariate Cox analyses. Early 30 days mortality was 2.0%. The 5-year absolute and relative survivals for all patients were 46.3% and 52.6%, respectively. After 10 years corresponding values were 32.9% and 44.6%. At the end of the study, the 15-year absolute survival was 27.8% with a relative survival of 46.2%. Univariate analysis revealed that age, gender, nodular stage, tumour size, p-stage, type of resection, time of operation and additional cardiovascular disease at the time of operation significantly influenced survival. Multivariate analysis for all patients revealed that low age, female gender, low nodular stage, and operation late in the study period were significant prognostic factors predicting improved survival. When including a population based age- and gender-adjusted median expected life time for every patient as a predictor for survival, only female gender and low nodular stage were additional significant and independent positive prognostic factors.

Adult↗
PubMed2001

A retrospective analysis of the results of p(65) + Be neutrontherapy for the treatment of prostate adenocarcinoma at the cyclotron of Louvain-la-Neuve. Part I: Survival and progression-free survival.

PURPOSE: To retrospectively evaluate survival, progression-free survival (PFS) and biological response in a series of patients irradiated with mixed neutron/photon beams for locally advanced prostate cancer in our institution. PATIENTS AND METHODS: Three hundred and eight patients were treated between January 1990 and December 1996. Fifty-five of these were recruited for pT3 or pN1 tumors after radical prostatectomy. Neoadjuvant androgen deprivation was given in 106 patients. The treatment protocol consisted of a mixed photon/neutron irradiation in a two-to-three proportion, up to a total equivalent dose of 66 Gy (assuming a clinical RBE value of 2.8). Pre- and post-treatment PSA determinations were available in practically all cases. Study endpoints were overall survival (OAS) and progression-free survival (PFS). The Cox proportional hazard regression model was used to investigate the prognostic value of baseline characteristics on survival and progression-free survival were a progression was defined as local, regional, metastatic or biological progression. Mean age was 69 years (49-86); mean pretreatment PSA was 15 (0.5-330) in all patients and 14 (0.5-160) in those receiving neoadjuvant hormonotherapy; seven patients only had an initial PSA < or = 4 ng/mL; 15% were T1, 46% were T2, 28% were T3 or pT3 and 4% were T4 (7% unspecified); WHO grade of differentiation was I in 38%, II in 38% and III in 14% (5% unspecified). RESULTS: The median follow-up was 2.8 years (0-7.8). Five-year overall survival (OAS) was 79% (95% CI: 71-87%) and 5-year progression-free survival (PFS) was 64% (95% CI: 54-74%) for the entire series. PFS in patients with an initial PSA > or = 20 ng/mL was the same. PFS could be predicted by two optimal Cox regression models, one including histological grade (p = 0.003) and initial PSA (p = 0.0009) as cofactors, the other including histological grade (p = 0.003) and T stage (p = 0.02). The main prognostic factors for overall survival were PSA and age. Biological responses with PSA < 1.5 ng/mL, < 1 ng/mL and < 0.5 ng/mL at any time after treatment were documented in 70%, 61% and 47% of the patients, respectively. CONCLUSION: Five-year OAS was 79%, PFS was 64%, and biological response was 70% for prostate cancer patients treated with mixed photon/neutron beams as applied at Louvain-la-Neuve, which are good results as compared with the literature. The usual prognostic factors were confirmed.

Adenocarcinoma↗
PubMed1989

The effect of donor-specific blood transfusion, cyclosporine, and dietary prostaglandin precursors on rat cardiac allograft survival. II. Effectiveness of a 24-hour induction period with DST and CsA in inducing long-term graft survival.

We investigated the effect of donor-specific transfusion given 24 hours pretransplant, a short course of low-dose cyclosporine, and dietary enrichment with the prostaglandin precursor linoleic acid (LA) to see which of the modalities could act synergistically on cardiac allograft survival in a stringent animal model. ACI male rats (RT1a) were used as blood and heart donors, and Lewis male rats (RT1l) were used as recipients. DST alone (1 ml) given 24 hr pretransplant or LA alone started 24 hr pretransplant and given daily p.o. until rejection prolonged cardiac allograft survival slightly but significantly, from 6 to 8 days. CsA alone started at the time of transplant at a dose of 5 mg/kg/day s.c. and given daily for 14 days prolonged cardiac survival to 11.8 days. However, when CsA was started 24 hr pretransplant and continued for two weeks, there was a significantly prolonged allograft survival to 55 days. CsA given together with DST 24 hr pretransplant and continued for two weeks posttransplant significantly prolonged cardiac allograft survival to 80 days and resulted in permanent tolerance in some animals. The addition of LA to a DST and CSA treatment regimen did not further improve allograft survival. CsA blood levels were determined in a separate group of Lewis rats. Three dosages of CsA were administered s.c. for 2 weeks: 2.5 mg/kg/day, 5 mg/kg/day, and 10 mg/kg/day. One injection of the three CsA doses did not achieve what are considered therapeutic levels in man. After 5 days, all three doses of CsA achieved significant blood levels. Significant blood levels were still present one week, but not 3 weeks after CsA was stopped. We conclude that DST given 24 hr before transplant and a 2-week course of low-dose CsA started one day pretransplant have strong synergism in inducing long-term graft survival in this rat model. Linoleic acid started 24 hr pretransplant, together with DST and CsA, did not contribute significantly to graft survival compared with the group given CsA and DST alone. Prolonged heart allograft survival was not due to persistently high CsA levels after the drug was discontinued.

Animals↗
PubMed2002

Long-term survival of equine surgical colic cases. Part 2: modelling postoperative survival.

Colic surgery is a frequently performed operation with high postoperative mortality. This study was undertaken to identify variables associated with decreased postoperative survival. We used data from 321 horse years of postoperative survival time to model the probability of survival following recovery from colic surgery. Continuous variables were modelled using a 6 variable, penalised Cox regression model. This demonstrated approximately linear relationships between survival and the following variables: increase in packed cell volume (PCV), intestinal resection length, time to surgery (interval between onset of colic and surgery) and duration of surgery. No significant decrease in survival was demonstrated with increasing age of the patient or with heart rate. The only categorical variable to be significantly associated with decreased survival was epiploic foramen entrapment. The final, fixed effects Cox proportional hazards model of postoperative survival included the variables epiploic foramen entrapment, PCV, resection length and duration of surgery, each variable adjusted for the nonlinear relationship with time to surgery. Residual variation in postoperative survival attributable to professional personnel (referring veterinary surgeon, anaesthetist and surgeon) was explored by fitting each as a random effects term in the model. Little of the residual variation could be attributed to any category of personnel. Model diagnostics indicated little influence by individual outliers on model parameters and little evidence of subjects poorly predicted by the final model. The study highlights factors influencing the long-term survival of horses recovering from colic surgery and proposes a model that can be used to inform prognosis.

Animals↗