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PubMed1995

[Factors related to survival rate, and life satisfaction in stroke patients in Yamagata Prefecture, Japan].

This study was designed to identify survival rate, and life satisfaction of stroke patients living in Yamagata Prefecture. Subjects for the survival rate analysis were composed of 2214 patients who were registered after suffering their first stroke in 1989. Observation was continued over 2-years survival rate by the Cutler-Ederer method. In 1991, survivors were interviewed in their home by public health nurses or public health physicians. Locomotion and Activities of daily living (ADL) were investigated in 1015 survivors, and global life satisfaction was investigated in the 623 who were capable of answering questions by themselves. The results obtained were as follows: 1) One month survival rate was 74.0%, one year survival rate was 57.2%, and two-year survival rate was 50.6% in the total patients. The survival rate according to type of stroke was compared between two age groups (< 65 and > or = 65 years). Type of stroke was associated with survival rate in the patients < 65 years old, but not in those > or = 65 years old, especially for long-term outcome. 2) Of the survivors, 10.8% were bedridden over the two years post stroke, whereas 75.4% were competent in locomotion. Dependence of bathing was most common in terms of all activities of daily living, which were considered burdensome to family members. 3) Global life satisfaction as measured by visual analogue scale (VAS) in survivors two years after stroke was maintained well. The strongest determinant of global life satisfaction was contact with friends after stroke for those < 65 years old, while it was competence in eating for those > or = 65 years old.

Activities of Daily Living↗
PubMed2006

Implant survival rates for oral and maxillofacial surgery residents: a retrospective clinical review with analysis of resident level of training on implant survival.

PURPOSE: This study evaluates dental implant survival rates in cases where surgery was performed by oral and maxillofacial residents and determines whether the level of resident training influenced the outcome of dental implant treatment. PATIENTS AND METHODS: Retrospective review of all 2-stage implants placed between July 1, 2002 and June 30, 2004 by oral and maxillofacial surgery residents-in-training at the Washington Hospital Center was carried out. Patients were seen for follow-up at 1-week, 1-month, and 6-month intervals after implant surgery. The criteria for implant success in this study were based on clinical and radiographic evidence of implant osseointegration during the follow-up period. We evaluated implant survival rates and used Cox proportional hazards modeling to analyze whether level of resident training or location of implant placement influenced implant survival. RESULTS: This study included 175 implants placed in 54 patients. The overall survival rate of implants placed by oral and maxillofacial surgery residents at all levels of training was 91%. No statistically significant difference in implant survival rates was observed as a function of the level of training of the resident surgeon (P = .89) or location of implant placement (P = .93). CONCLUSION: Survival rates for implants placed by surgeons in training are comparable to rates reported in the literature. There was no statistically significant difference in survival rates when a comparison of level of training was taken into consideration. To our knowledge, this study is the first to examine implant survival rates as a function of surgeon experience in the setting of an oral and maxillofacial residency program and suggests that predictable outcomes in implant treatment are attainable by surgeons in training.

Clinical Competence↗
PubMedDate not supplied

Local recurrence and survival rates after extended systematic lymph-node dissection for surgical treatment of rectal cancer.

BACKGROUND/AIMS: Extended systematic lymph-node dissection (ESLND) is a surgical procedure aimed at decreasing the local recurrence rate of rectal cancer and increasing the survival rate. However, it is criticized because it has not shown the expected effects on survival, and it has been shown to increase the proportion of complications in rectal cancer surgery. This study was designed to determine incidence and patterns of recurrence after curative resection with or without ESLND for rectal cancer. METHODOLOGY: A total of 184 patients with rectal cancer were reviewed with respect to surgical procedures, local recurrence and survival rates. RESULTS: 170 of 184 patients with rectal cancer were administered curative surgical resection. ESLND was added to the surgical procedure of 24 of these 170 patients. The local recurrence rate of the patients who did not receive lymph-node dissection was 15%, and the survival rate over 5 years was 58.9%. The local recurrence rate of the patients receiving ESLND was 12.5%, and the survival rate over 5 years was found to be 55.7% (p>0.05). CONCLUSIONS: Because ESLND is a procedure added on to curative resection in the surgical treatment of rectal cancer, it increases the general anesthesia and length of surgery, and it is possible that some complications due to the operation itself may arise. In the current study and in a large amount of research in the literature, a statistically significant effect on the survival rate has not been found. In conclusion, the opinion has been reached that ESLND does not have an important benefit in the curative surgical treatment of rectal cancer.

Aged↗
PubMedDate not supplied

Implant-retained prostheses for facial defects: an up to 14-year follow-up report on the survival rates of implants at UCLA.

PURPOSE: An analysis of retrospective data was conducted to establish the survival rates of osseointegrated implants used to retain orbital, nasal, and auricular prostheses over a 14-year period and to recommend guidelines in the restorative treatment of such facial defects. MATERIALS AND METHODS: Included in this study were all patients who received implant-retained prostheses for auricular, nasal, or orbital defects from 1987 to 2001 in the Maxillofacial Clinics at the UCLA and City of Hope Medical Centers. Data were obtained from patient charts. Two methods were used to determine survival rates: (1) the percentage of the total exposed implants that survived was determined, and (2) life table analysis was used to calculate cumulative survival rates at different time intervals. RESULTS: A total of 207 implants were placed in 72 patients, and 182 implants had been uncovered. During the study period, 35 implants failed to integrate, and the survival rate for all exposed implants was 80%. Auricular implants showed the highest survival rate (95%), and orbital implants showed the lowest survival rate (53%). The life table analysis demonstrated a cumulative 6-year survival rate of 92% for auricular implants and 87% for piriform/nasal implants. In contrast, the survival rate for orbital implants showed a steady downward trend and reached 59% at 66 months. CONCLUSION: It is possible to achieve high survival rates of implants in the auricular and piriform/nasal sites through careful presurgical and radiographic planning. The less favorable long-term survival of implants in the orbital rim, especially at irradiated sites, requires further study.

Adolescent↗
PubMedDate not supplied

Survival rates of invasive breast cancer among ethnic Chinese women born in East Asia and the United States.

BACKGROUND: Few studies have compared the breast cancer survival rates of US born ethnic Chinese women and the survival rates of Chinese immigrants. The main purpose of this study is to explore the difference of breast cancer survival rates between the two populations and compare the survival rates to those of Caucasians born in the US. METHODS: Between 1973 and 2002, 365,215 women who had been diagnosed with primary invasive breast cancer (ICD-O-2 C500:C509) were recorded in the Surveillance, Epidemiology, and End Results (SEER) registries. Of the 316,881 breast cancer patients who were white, 180,835 (57%) were born in the United States, 20,983 (7%) were born elsewhere, and 115,063 (36%) had unknown birthplaces. Among the 3,634 breast cancer patients who were ethnically Chinese, 952 (26%) patients were born in the US, 1,356 (37%) were born in East Asia, 146 (4%) were born elsewhere, and 1,180 (33%) had unknown birthplaces. We compared the survival rates and estimated the risk ratios (RRs) by the Kaplan-Meier estimates and the Cox proportional hazards models. RESULTS: A lower 5-year overall survival rate of breast cancer was observed among Chinese women born in East Asia (0.74, 95% CI=0.72-0.77) than those born in the U.S. (0.79, 95% CI=0.76-0.81), with an adjusted hazards ratio of 1.22 (95% CI=1.06-1.40). The 5-year survival rates for SEER stage were higher among Chinese women born in the U.S. (localized: 0.90, 95% CI=0.87-0.93; regional: 0.71, 95% CI=66-0.77; distant: 0.16, 95% CI=0.06-0.25) than that among Chinese women born in East Asia (localized: 0.86, 95% CI=0.83-0.89; regional: 0.68, 95% CI=0.63-0.73; distant: 0.16, 95% CI=0.07-0.25). Higher 5-year survival rates among Chinese women born in the U.S. in comparison to Chinese women born in East Asia were also observed in different calendar years (1973-1980, 1981-1990, 1991-2002), in surgery and radiation therapy. CONCLUSIONS: Our analysis showed that among the Chinese breast cancer patients, women born in East Asia had lower 5-year survival rates than women born in the United States. SEER stage, grade, and tumor size appear to be important prognostic factors. The poor 5-year survival rates among Chinese women born in East Asia indicate potential problems of accessing medical facilities for early detection, diagnosis and treatment because of potential language and culture barriers, lower education level, as well as stress of the first generation of migrant Chinese women in the United States.

Adult↗
PubMed1997

[Study of the effects of treatment with interferon for the advanced renal cell carcinoma based upon the survival rate].

BACKGROUND: There is no consistent acknowledgment with the effects of the prolongation of survival for the advanced renal cell carcinoma (RCC) treated with interferon (IFN). Therefore, we tried to study on the effects of such prolongation of survival for the advanced RCC through the comparative analysis between the patients treated with IFN and the patients treated with other treatment modalities in the past years. PATIENTS AND METHODS: We differentiated the patients treated with IFN (recurrent patients after nephrectomy as Group I, and patients with stage 4B as Group II) from the patients treated with other modalities (recurrent patients after nephrectomy as Group III, and patients with stage 4B and Group IV). We compared the survival rate between the two groups (Groups I vs III, and Groups II vs IV). RESULTS: Regarding the various factors affecting prognosis of RCC, no significant difference was observed among these groups. 1) There observed a significantly favorable survival rate in the Group I compared with the Group III, and the same result was observed in the Group II compared with the Group IV. 2) In the patients with performance status (P.S.) 0 and low grade, there observed a significantly favourable survival rate in the Group I compared with the Group III, and the same result was observed in the Group II compared with the Group IV. Furthermore, in the patients with low stage, the Group I showed a significantly favourable survival rate compared with the Group III. 3) In the study on the number of metastatic organs (1, 2 and 3 organs or more), there observed a significantly favourable survival rate in the Group I compared with the Group III for all numbers of the metastatic organs. The same result was observed in the group II compared with the Group IV, except for the patient with 3 organs or more. Regarding the operative procedures for the metastatic side, the patients who did not receive the operative procedures showed a significantly favourable survival rate in the Group I compared with the Group III. The same result was observed in the Group II compared with the Group IV. 4) As to the survival rate based upon the response rate, only the patients with no change (N.C.) showed a significantly favourable survival rate in the Group I compared with the Group III. The same result was observed in the Group II compared with the Group IV. CONCLUSION: We conclude that the treatment with IFN for the advanced RCC would much contribute to the prolongation of the survival in comparison with the previous patients who received other treatments.

Adolescent↗
PubMed2003

Combining cohort and period methods for retrospective time trend analyses of long-term cancer patient survival rates.

Assessing trends in long-term cancer patient survival is an essential component of monitoring progress against cancer by cancer registries. Traditional assessment of long-term survival ('cohort analysis') is very useful to disclose trends in long-term survival rates of patients diagnosed many years ago, but it does not allow the disclosure of recent trends in long-term survival rates. The latter can be achieved by an alternative method of survival analysis ('period analysis'), which has been proposed a few years ago. On the other hand, unlike cohort analysis, period analysis does not provide estimates of long-term survival rates for patients diagnosed in the early years after initiation of cancer registration. In this paper, a method of retrospective analysis of time trends in long-term survival rates is introduced, which combines the advantages of both cohort and period analysis ('mixed analysis'). This method thereby allows for a comprehensive monitoring of trends in long-term survival over an extended time span from the earliest to the most recent years of cancer registration. The use of the method is illustrated for retrospective time trend analyses of long-term survival of cancer patients in the United States with the 1973-1999 database of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.

Cohort Studies↗
PubMed1999

Influence of histologic type and age on survival rates for invasive cervical carcinoma in Taiwan.

OBJECTIVE: The aim of this study was to assess survival rates and to evaluate histologic type and age as prognostic factors for cervical carcinoma in an ethnically homogenous population in Taiwan. METHODS: A retrospective analysis was conducted of 3678 cases of squamous cell carcinoma and adenocarcinoma that were diagnosed and treated for invasive cervical carcinoma between 1977 and 1994. Observed survival rates were estimated using the Kaplan-Meier method, and prognostic factors were assessed using Cox's proportional hazards regression analysis. RESULTS: Correlating both FIGO stage and age with histologic type revealed a higher proportion of cases with adenocarcinoma in the lower FIGO stages (P = 0.0417). Further, we found that the younger the age group the higher the proportion of cases of cervical adenocarcinoma (P = 0.0006). The 5-year survival rate was lower for patients with adenocarcinoma than for patients with squamous cell carcinoma (66.5 vs 74.0%, P = 0.0009). The 5-year survival rates for FIGO stages I, II, III, and IV squamous cell carcinoma were 81.3, 75.2, 42.7, and 26.1%, respectively, while for adenocarcinoma they were 75.9, 62.9, 29.2, and 0%, respectively. The difference in survival rates between squamous cell carcinoma and adenocarcinoma was found mainly in stage I (P = 0.0039) and stage II (P = 0.0103), where radiotherapy was used as the primary treatment. Age also affected the overall Kaplan-Meier estimate of survival. The younger the age group, the better the survival rate (P < 0.0001). Multivariate analysis confirmed a highly significant association between survival rate and both histologic type (P < 0.0001) and age (P = 0.0037). CONCLUSIONS: Early stage cervical cancer (stages I and II) with a glandular component had a lower 5-year survival rate than squamous cell carcinoma in cases where radiotherapy was the primary treatment. We speculate that this difference in survival rates between cervical adenocarcinoma and squamous cell carcinoma was due to the relative ineffectiveness of radiotherapy as a primary treatment in cases of adenocarcinoma.

Adenocarcinoma↗
PubMed1980

Fetal survival rate after the surgical transfer of two bovine embryos.

Single embryos were bilaterally transferred on Day 7 to the tip of the uterine horn ipsilateral to the corpus luteum and to the tip of the opposite horn, to the tip and contralateral base, base and tip and base and base (20 recipients/group). Ten of the recipients in each group were treated with 1000 i.u. hCG daily from Days 13 to 35 after oestrus. At 42 days, pregnancy rate (N.S.) and fetal survival rate (P < 0.05) were greater when an embryo had been transferred to the tip rather than to the base of the ipsilateral horn, but the twin pregnancy rate was not improved. Treatment with hCG had no effect on these rates but the corpora lutea of treated animals were heavier (P < 0.02). Unilateral transfers of 2 embryos were made both to the tip of the ipsilateral uterine horn or one to the tip and one to the base (20 recipients/group). The pregnancy rate, fetal survival and twin pregnancy rate in each group were the same, but in the latter one of the embryos had migrated to the other horn in 5/9 animals with twin fetuses. The location of fetuses did not influence their rate of development as determined by fetal measurements. It is concluded that the tip of the ipsilateral uterine horn is the optimal site for fetal survival and that to ensure a high twin fetal survival one embryo must be in this site.

Animals↗
PubMed1982

[The influence of L-dopa and of thymus fraction on the survival rate of whole-body-irradiated mice].

The survival rate of mice with exposure of the whole body (700 cGy) was hardly changed by one dose as well as several doses of the phosphodiesterase inhibitor Amantadine and the interferon inductor measles vaccine. However, the survival rates were increased by one administration of L-dopa or by the long-term therapy using L-dopa at 700 and 900 cGy. The survival rates were also increased at 700 and 900 cGy if, after the exposure, thymus factor isolated from calf thymus was three times applied to the animals. The increased survival rates gained by using L-dopa and thymus factor are correlated with the determined leukocyte values.

Amantadine↗
PubMed2003

Three-year survival rates for all consecutive heart-only and lung-only transplants performed in Eurotransplant, 1997-1999.

The definition of proper patient selection criteria remains a prominent item in constant need of attention. While the concept of gathering evidence in order to determine practice continues to be hopelessly ambiguous, it can never be emphasized too much that these univariate results are just a first foray into analysing predictors of survival; all following results should be regarded and interpreted in this perspective. HEART TRANSPLANT SURVIVAL: The 3-year survival rate for heart transplant recipients under age 16 was 83% versus 72% for adult recipients. Acutely retransplanted adult heart recipients had a 3-year survival rate of 36% compared with 72% for recipients of a first heart allograft. Patients suffering from DCM had the best survival rates at 3 years (74%) compared with patients suffering from CAD (70%) or from another end-stage heart disease (67%). With advancing age of the adult recipient, the mortality risk increased. Patients aged 16-40 had a 3-year survival rate of 77%, compared with 74%, 70% and 61% for transplant recipients aged 41-55, 56-65 and over age 65, respectively. The 3-year survival rates for adult recipients transplanted with an heart allograft from a donor aged under 16 or between 16-44 were 78% and 74%, compared with 66% and 63% for donors aged 45-55 and over 55, respectively. The 3-year survival rates for recipients of hearts with cold ischemic times under 2 hours, 2-3, 3-4, 4-5, 5-6 and more than 6 hours were 74%, 75%, 70%, 65%, 54% and 40%, respectively. Transplanting a female donor heart into a male recipient was associated with the worst prognosis: the 3-year survival rates were 73%, 71%, 66% and 76%, respectively, for the donor/recipient groups male/male, male/female, female/male and female/female, respectively. When the donor-to-recipient body weight ratio was below 0.8, the 3-year survival rate was 64%, compared to 72% for weight-matched pairs and 74% for patients who received a heart from an oversized donor (p=0.004). Better survival rates were obtained for better HLA-matched transplants. The 3-year survival rates were 75%, 89%, 78%, 78%, 69%, 72%, and 71% for HLA-A,-B,-DR zero, 1, 2, 3, 4, 5 and 6 mismatched groups, respectively (p=0.04). Survival was significantly associated with the CMV serologic status of the donor and recipient; the 3-year survival rates were: D+/R+, 71%; D+/R-, 69%; D- R-, 76%; and D-/R+, 76% (p=0.04). Patients in an ICU had a 3-year survival rate of 62%, compared to 72% for patients in a general ward and 74% for outpatients (p<0.0001). Patients that were on a VAD and there-upon transplanted had a 3-year survival rate of 65%, compared to 73% for patients without a VAD (p=0.004). Being on a ventilator was a major risk factor for death after transplantation; patients on ventilator support at the time of the transplant had a 3-year survival rate of 52% compared to 73% for the other patients (p<0.0001). LUNG TRANSPLANT SURVIVAL: The 3-year survival rate for children (73%) appeared to be better than the adult rate (61%; p=0.8). Adult lung transplant survival was significantly worse in the case of a repeat lung transplant; a 3-year retransplant survival rate of 42% was obtained compared with 61% for first transplants (p=0.049). With respect to the underlying end-stage lung disease, no statistically significant difference in long-term survival could be detected in this cohort. The 3-year survival rates were: 62% for COPD/Emphysema, 70% for CF, 58% for IPF, 64% for Alpha-1 ATD and 56% for PPH (p=0.2). Our data demonstrated no effect of the recipient's age on long-term lung transplant survival, except for 2 senior patients in this cohort. At 3-years the survival rates for recipients aged 16-40, 41-55 and 56-65 were 65%, 60% and 62%, respectively (p=0.05). The 3-year survival rates for transplants performed with lungs from donors aged under 16, 16-44, 45-55 and over 55 was 57%, 64%, 55% and 62%, respectively (p=0.1) No association between the duration of cold ischemic time and 3-year survival was observed; under 3 hours, 3-4, 4-5, 5-6 and over 6 hours of ischemia resulted in 3-year survival rates of 53%, 59%, 64%, 68% and 57%, respectively (p=0.2). Early posttransplant outcome tended to be better for gender-matched transplants, while transplanting a female donor lung into a male recipient was associated with the worst prognosis. The 3-year survival rates were 65% for male/male, 63% for male/female, 48% for female/male and 61% for female/female (p=0.009). No effect of donor-to-recipient weight match was observed in this Eurotransplant cohort; when the donor-to-recipient weight ratio was below 0.8, the 3-year survival rate was 57%, compared with 59% for weight-matched pairs and 64% for patients who received a lung from an oversized donor (p=0.5). Long-term survival after lung transplantation was influenced by HLA matching. The 3-year survival rates were 100%, 68%, 70%, 65%, 54% and 55% for the HLA-A,-B,-DR 1, 2, 3, 4, 5 and 6 mismatched groups, respectively (p=0.06). A donor CMV+ and recipient CMV- match was a risk factor for long-term mortality, with 3-year survival rates of 56% for D+/R+, 55% for D+/R-, 71% for D-/R- and 62% for D-/R+ transplants (p=0.046). En-bloc transplantation of both lungs yielded worse early results, but the 3-year survival rates for patients who underwent single (60%), bilateral sequential double lung (63%) and en-bloc double lung transplantation (56%) were not different (p=0.2). Ventilator dependency was associated with a significantly reduced survival at 3 years. Patients on a ventilator support at the time of the transplant had a 3-year survival rate of 48% compared with 63% for other patients (p=0.006).

Adolescent↗
PubMed1988

[End results of gastric cancer detected by mass survey: analysis using the relative survival rate curve].

In the 15-year period 1970 to 1984, the Detection Center of Hokkaido Cancer Society discovered 2,508 gastric cancer cases (1,681 male, 827 female) including 999 cases of early gastric cancers. The survey included 2.01 million people in Hokkaido. Among the cases, 2,508 were diagnosed as stomach cancer, which amounted to 0.12% of the total screened during the period. The proportion of early gastric cancers has been increased over this period. Of those suffering from gastric cancer, 2,287 cases were operable. Mucosal carcinoma accounted for 479 cases, carcinoma with invasion to submucosa accounted for 520 cases. Early gastric cancer numbered 999 cases, or 43.6% of the operable cases. Advanced cancer or cancer with invasion beyond the muscularis propria totalled 1,288 cases, or 56.4% of the operable cases. The relative survival rate was calculated which shows the survival ratio of detected cancer cases to the general population: 67.8% 5-year, 64.0% 10-year and 63.5% 15-year survival rate. These results show that cancer detection leads to a good relative survival rate. The relative survival rate flattens after five years, because the curve of the survival rate of cancer patients decreases gradually, while the expected survival rate of the general population remains constant. If lead time is not considered, the 5-year relative survival rate is satisfactory: if it is considered, however, the 10- or even 15-year survival rate may well be estimated. The 15-year relative survival rate of surgically treated early gastric cancer, advanced gastric cancer and total cancer are 94.0%, 51.0% and 70.7% respectively. These data clearly show that early gastric cancer treated surgically carries an excellent chance for 15-year survival when compared to advanced cancer. One may also note the relatively high survival rate of 63.5% in all gastric cancer patients discovered by this program; this figure reflects a high proportion of early gastric cancer among all cancers. As presented, the mass screening program does have positive effects in reducing gastric cancer deaths by detecting more early gastric cancer cases than among usual clinic patients.

Female↗
PubMed1998

Survival rates among Canadian children and teenagers with cancer diagnosed between 1985 and 1988.

PURPOSE: To describe the survival rates among Canadian children and teenagers with cancer diagnosed between 1985 and 1988 using population-based data, specifically for the more common forms of childhood cancer, and to assess the effect of age at diagnosis and sex as prognostic factors for selected childhood cancers. DESIGN: Retrospective survival study based on incident cases of cancer identified by the National Cancer Incidence Reporting System and follow-up ascertained by computer record linkage to the Canadian Mortality Database. SUBJECTS: A total of 4409 patients with cancer first diagnosed at 19 years of age or younger between 1985 and 1988, and followed up to Dec. 31, 1991. MAIN OUTCOME MEASURES: Survival rates calculated at 1, 3 and 5 years according to the actuarial life table and the proportional hazards models. RESULTS: The 5-year survival rate for all cancers combined was 71%. Females with acute lymphoblastic leukemia and astrocytoma had markedly higher survival rates than their male counterparts (p < 0.05). Age at diagnosis was a significant predictor of survival among children with acute lymphoblastic leukemia or acute nonlymphoblastic leukemia (p < 0.01), infants having a substantially poorer prognosis than older children. Conversely, the survival rate among infants with neuroblastoma was higher than that among older children, 87% surviving for 5 years after diagnosis. CONCLUSIONS: The survival rate among Canadian children and teenagers with cancer is favourable in relation to the rate among adults with cancer. Nonetheless, the 5-year survival rates for several childhood cancers remain poor (i.e., less than 65%). The survival rates among Canadian children with cancer are similar to those among children with cancer in other developed countries.

Adolescent↗
PubMed1999

Massive blood transfusion exceeding 50 units of plasma poor red cells or whole blood: the survival rate and the occurrence of leukopenia and acidosis.

The survival rate after bleeding requiring massive blood transfusions exceeding 50 units has been reported to be low or zero. There seems to be no reports of leukopenia in connection with massive blood transfusion. This retrospective study was carried out to investigate the survival rate and the occurrence of leukopenia and acidosis in patients who were transfused with more than 50 units of plasma poor red cells or whole blood. The survival rate was 16 of 23. Three of the five patients with a blood transfusion of over 100 units survived. Pure component therapy was used on 18 occasions. All patients had a leukopenia, which lasted up to five days. All patients had an acidosis. The range of the lowest pH values in patients who did not survive was from 6.77 to 7.27 and in survivors from 6.87 to 7.28. The survival rate was considerably higher than reported in previous studies. Pure component therapy appeared to be particularly suited to massive transfusion. Leukopenia was a regular phenomenon. Severe acidosis did not predict a poor outcome.

Acidosis↗
PubMed2003

Analysis of an improved survival rate for congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is a condition associated with significant mortality. This study examines the survival rate of neonates with CDH treated by a multidisciplinary team in a single pediatric hospital. Actual survival rate is compared with predicted outcome based on severity of illness. METHODS: A consecutive series of neonates with CDH was evaluated beginning January 1, 2000. There were no excluded patients. A treatment protocol emphasizing minimal barotrauma and control of pulmonary hypertension was used. Predicted survival rate was estimated using birth weight and Apgar score at 5 minutes per the logistic regression equation published by the CDH Study Group. Actual survival rates were calculated and compared with predicted values using a one sample binomial test with significance deemed to be present at P less than.05. RESULTS: Thirty-six of 39 (93%) neonates with CDH survived, whereas the predicted survival rate for this cohort was 68% (P <.001). Twelve of 14 (86%) neonates requiring extracorporeal membrane oxygenation (ECMO) survived, despite a predicted survival rate of 52% for this subset (P <.01). Twenty-five percent of survivors required supplemental oxygen at home. CONCLUSIONS: Using a simple analysis, centers may now objectively compare their CDH survival rates with predicted outcomes adjusted for disease severity. This technique confirmed that a consecutive series of neonates with CDH, treated in one hospital, had a significantly higher than predicted survival rate. Thus, it may be possible to identify other centers with higher than expected survival rates and to define common therapeutic strategies associated with decreased mortality.

Actuarial Analysis↗
PubMed1989

[An analysis of factors influential in improving the survival rate of patients with ovarian cancer].

[OBJECTIVES OF STUDY] This presentation deals with an analysis of factors to improve the survival of patients with ovarian cancer. Some 1051 patients with malignant ovarian tumors who were treated in this group, were divided into two groups for their period of treatment. Of these, 460 patients were treated 1974-1979 (retrospective group) and 591 patients treated 1979-1984, (prospective group) because chemo-immunotherapy was determined by a certain protocol in the group. [RESULTS] The survival rate of the two groups were compared, and the 5-year survival rate of prospective group was 20% higher than in the retrospective group. However, there were no significant differences of any clinical stages between retrospective group and prospective group, and the difference in 5-year survival rate was about 20% in any stages. The survival rate was also compared in accordance with histological types. The most dominant progression was seen in serous adenocarcinoma and when the cases were divided into two groups by their clinical stage; one was the early stage (Stage I) cases. The 5-year survival rate of serous ca, mucinous ca and embryonal ca (Higuchi, Kato) made remarkable progress in recent several years, but, mesonephroid ca made little progress. The other was the late stage (stage II, III, IV) cases, patients with mucinous ca when she had had surgery recurrently on relapse, resulting in prolonged survival period. As to the comparison of age groups, younger patients less than 40 years old showed a progression in their survival period, whereas patients in their sixties had no such progression. In order to evaluate the effect of treatment with due comparable counterpart of ovarian carcinoma, cases were quantified with 3 years survival prediction score which was calculated retrospectively by multivariate statistical analysis. The first evaluation was done with an MFC combination chemotherapy and a CAP combination. The results indicated that a CAP combination had improved the survival rate of ovarian cancer, and statistically significant differences were proved. Z value was 2.24 and P value was less than 5%. The second evaluation was done on the significance of second look operation. The prediction score of patients who underwent second look operation and matched pair control of prediction score without reoperation, were compared. The results indicated that second look operation improved the survival rate of ovarian cancer with statistically significant differences. Z value was 2.37 and P value was less than 5%. [CONCLUSION] According to the present study, the treatment of malignant ovarian tumors showed an improved survival rate of about 20%, regardless of the cl

Adolescent↗
PubMed1998

Evaluation of the death certificate follow-up method for the analysis of survival rate: data from Aichi Prefecture, Japan.

To evaluate the use, for studies on survival, of death certificates from population-based cancer registries in Japan, we compared 5-year survival rates by two different methods: passive, derived from death certificates, and active, using family register systems. Registered cancer cases from Aichi Prefectural Cancer Registry were used as a model. The study subjects comprised 9244 cancer patients (3830 males and 5414 females) newly diagnosed at the Aichi Cancer Center Hospital and recorded in the Aichi Prefectural Cancer Registry between 1983 and 1991. The passive follow-up method, using death certificates, identified 87-89% of deaths among the study subjects. The proportion of deaths which were not identified by the passive follow-up method did not vary greatly with age or gender, but was higher among patients in the earlier rather than the later stages of cancer. Overall, the absolute and relative effects of unregistered deaths on apparent survival rate vary with the absolute survival rate. The absolute and relative differences between the survival rates calculated by the two methods are explained more clearly when data are analyzed by cancer site. The results of the present study provide useful information for interpreting the survival rate following diagnosis of cancer estimated by the passive follow-up method, i.e. using death certificates from a population-based cancer registry.

Aged↗
PubMed2004

Survival rate in congenital diaphragmatic hernia: the experience of the Canadian Neonatal Network.

BACKGROUND/PURPOSE: The Canadian Neonatal Network prospectively collects data from 17 pediatric hospitals accounting for 75% of all neonatal intensive care unit beds nationwide. The purpose of this study was to (1) analyze the database to compare actual survival rates of neonates with congenital diaphragmatic hernia (CDH) to predicted outcomes and (2) assess whether institutional CDH volume was associated with improved survival rate. METHODS: Actual survival rates for CDH patients born during a 22-month period were determined from the registry. Predicted survival rates were calculated using the CDH Study Group logistical regression equation. Actual survival rate was compared with predicted using chi2 analysis. Survival rates were stratified by institutional CDH volume and compared using binomial analysis. P value of less than.05 was deemed statistically significant. RESULTS: Of approximately 20,500 neonatal admissions, 88 cases of CDH were recorded. Seventy-three of 88 (83%) neonates with CDH survived to discharge, whereas the predicted survival rate was 62% (P <.001). Three centers were considered "high-volume" centers with at least 12 CDH diagnoses, and 11 were considered "low-volume" centers. Actual CDH survival was significantly greater at high-versus low-volume centers (90% v 77%; P <.01). CONCLUSIONS: From these prospective data, survival rates of Canadian neonates with CDH are significantly better than predicted by the CDH Study Group equation. Further, high-volume centers in Canada have a significantly higher CDH survival rate than low-volume centers.

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