survival

Cardiac myxomas are the most common primary cardiac neoplasm (30-50%) with clinical incident of 0.5/ million population. Tranthoracic echocardiography remains the investigation of choice. Surgical excision is curative. The present study aims to analyze demographic and clinical characteristics as well as surgical outcomes in terms of mortality and recurrence of cardiac myxoma.

Thirty patients of cardiac myxoma who met the inclusion criteria during study period study period, January-2018 to April-2024 were included. Data was analyzed for demographic characteristics, echocardiographic findings of myxoma and associated valve lesion, associated valve surgery and survival outcome.

Of all subjects, 83.33% presented with dyspnea. Majority of myxoma, 76.67% were attached to interatrial septum. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Myxomas with valvular incompetence are rare entity and there is paucity of data and evidences recommending concomitant valve intervention in such cases. There were no immediate peri-operative deaths, however, in contrast to other studies; surgical site infection was the most common post operative complication. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Recurrence occurred in first- and third-year following surgery.

Study highlights decent outcomes following cardiac myxoma resection. Case specific concomitant valve intervention spiral the success of surgery.

One of the leading causes of endometriosis is the return of menstrual blood flow into the pelvic cavity and the establishment of menstrual blood mesenchymal stem cells (MenSCs) outside the uterus. MenSCs from endometriosis patients (E-MenSCs) and healthy women have been shown to vary in terms of surface markers and gene expression, which may suggest the involvement of these cells in the development and expansion of ectopic lesions. This study aimed to investigate the effects of beta-catenin signaling inhibitor C-82 and naringenin as PI3K signaling pathway inhibitors on E-MenSCs to modulate their gene expression and functional pattern. 

Briefly, E-MenSCs isolated by density-gradient centrifugation were treated with C-82 and naringenin, and the genes and pathways related to inflammation, proliferation, and survival were evaluated. E-MenSCs showed increased early apoptosis and decreased levels of ROS, IL-6 and IL-8, ER, α-SMA, and Ki-67 protein expression. 

Our results shed light on the function of C-82 and naringenin in modulating E-MenSCs. 

However, more research is needed to analyze the precise effects of small molecule C-82 and naringenin on endometriosis.

Several factors can affect the survival of patients with breast cancer (BC). We estimated BC patients' 5-, 10-, and 15-year survival rates and influential factors in a single medical center during the last three decades.

We enrolled patients diagnosed with BC managed in the Cancer Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran from 1991 to 2018. All patients were followed to check the patients' status. The data were analyzed regarding demographic, clinical, pathological, and molecular biology characteristics. Descriptive and survival analyses were performed. Kaplan Meier and Cox proportional hazards regression models were used for survival analysis.

Overall, 4, 429 women were included. The mean age was 49. 11 (±11. 98) yr. Nearly 70% of the patients had high school degrees. Totally, 35% of patients were diagnosed in the advanced stages of BC. Estrogen Receptor (ER), Progesterone Receptor (PR), and human epidermal growth factor receptor 2 (HER2) were positive in 72. 50%, 66. 90%, and 16. 20% of the cases, respectively. About 11. 6% of patients died. The overall 5-, 10-, and 15-year survival rates of BC were 90%, 83%, and 75%, respectively. In the Cox proportional hazard analysis, the survival rate was affected by literacy level, positive lymph nodes, lymphovascular invasion, ER, tumor size, and pathological grade.

This is the first report on the 15-year survival rate of BC and its influential factors, from a medical center in Iran. The results were acceptable and comparable with those of developed countries due to scientific protocols, teamwork, and effective follow-up in a developing country.

 Clear cell renal cell carcinoma (CCRCC) is the most common type of renal cancer. Limited studies have been conducted about factors affecting the survival of patients with CCRCC. In this study, we aimed to evaluate the association between histologic growth patterns (HGPs) and some pathologic features and survival in CCRCC.

This cross-sectional study evaluated the association between HGPs and other pathologic features and the survival of 145 patients with CCRCC after nephrectomy in Emam-Reza Hospital (Mashhad, Iran) from 2012 to 2022. Two expert pathologists assessed HGPs and other pathologic features, like cytopathologic changes. All analyses were performed using IBM SPSS version 26 software. A P value less than 0.05 was considered statistically significant.

In the current study, we assessed the association of the 6 most prevalent growth patterns with the patient’s survival. Some clinicopathologic features like tumor stage and grade, tumor size, and necrosis are negatively linked with survival. Two important cytologic features, including sarcomatoid and rhabdoid, were also associated with survival time in patients with CCRCC (P values < 0.05). Regardless of the nuclear grade of the tumor, some patterns like solid sheet, papillary, and thick trabecular were associated with lower survival.

Some HGPs are significantly associated with the patient’s survival in CCRCC. A greater variety of patterns within each specimen has been associated with a reduced survival rate. The impact of HGPs on patient survival may be as significant as the nuclear grade.

Paraquat poisoning is a common and often fatal herbicide poisoning in society. This study presents a clinical case series of patients who survived after paraquat poisoning.

This study evaluated patients hospitalized between March 2016 and March 2021 with paraquat (PQ) poisoning who survived. Out of 115 patients with PQ poisoning, three cases of severe toxicity with an average age of 24.33 years are presented here. The urinary sodium dithionate test result was positive in all three surviving patients. All patients arrived at the poisoning emergency center within an hour of ingestion and received gastric lavage and charcoal therapy. They were also treated with corticosteroids, N-acetylcysteine (NAC), vitamins C and E, Curcumin, and Livergel. Hemodialysis was performed for the patients, with one undergoing hemodialysis and hemoperfusion after ingesting 250 mL of PQ 20%. After a six-month follow-up, all surviving patients were in good health.

Various factors, such as early admission after exposure, prompt gastrointestinal (GI) decontamination, corticosteroids with Curcumin and Livergel, antioxidants, hemodialysis, and hemoperfusion in one case may have contributed to the survival of patients with PQ poisoning in this study. However, individual vulnerability should also be considered a crucial factor requiring further investigation.

Exploring risk factors for the development of COVID-19 in vital organs of the body is necessary to improve patient survival and reduce disability and morbidity due to disease progression. By identifying these underlying risk factors and controlling them, it is possible to prevent extra-pulmonary involvement and even alleviate pulmonary involvement in patients, resulting in a significant reduction in mortality and morbidity rates. This study aimed to identify the underlying risk factors associated with pulmonary and extrapulmonary organ complications of COVID-19.

This study was a cross-sectional descriptive-analytical study. Patients with a definitive diagnosis of COVID-19 who were admitted to the intensive care unit of Imam Khomeini Hospital in Tehran due to respiratory distress and poor clinical condition were included in the study population and were clinically followed up on. Patients' information was collected by reviewing patients' records and the hospital information system.

A total of 123 patients were included in the study (63.4% were male, mean age = 58.87 ± 12.37). Using ROC curve analysis, the calculated risk score is considered statistically significant for diagnostic accuracy (AUC = 0.862 [0.797–0.927], P value < value<0.001). A risk score cutoff greater than 1.5 (sensitivity 89.9%, specificity 38.9%) favors an increased likelihood of in-hospital mortality. According to multiple linear regression (F (9,93).369, P value=0.001), chronic obstructive pulmonary disease, asthma, diabetes, SOFA score on days 2 & 3, and ventilation support were predictors of ICU length of stay.

A history of chronic heart failure with renal impairment, liver cirrhosis with liver complication, and any underlying disease are associated with pulmonary complications in COVID-19 patients.

Since the first successful hematopoietic stem cell transplantation (HSCT) in 1968 for severe combined immunodeficiency (SCID), clinical studies have commenced. However, there is a high heterogeneity across studies. This is a review of studies evaluating the efficacy of SCT in SCID. There were 25 multi-center studies (MCSs) and 60 single-center studies (SCSs). Overall, MCSs provided a full range of survival rates (30-88.5%), though 80% of MCSs reported a survival rate of ≥60%. All MCSs, except one, that reported an overall survival of <60% were performed before the year 2000. Also, all MCSs that reported an overall survival rate of ≥80% were conducted in American/European centers. Totally, 85%, 60%, 31.67%, and 8.33% of SCSs reported a survival rate of ≥60%, 70%, 80%, and 90%, respectively. Asian studies reported the broadest range (16.6-86.67%) of survival rate compared to American (58.3-88%) and European studies (48.39-100%). Consistent with MCSs, SCSs with survival rates of <40% were conducted across Asian countries. The outcomes of SCT in SCID patients varies widely according to the center where the study is conducted, the sample size, the study period, age at SCT, race, lung or viral infection before SCT, active infection at the time of SCT, the protected environment used at SCT, early development of T-cell reconstitution after SCT, prophylaxis against GvHD, SCID phenotype and molecular diagnosis, conditioning regimen, and donor type. Therefore, future investigations are needed to discover the chief determinants of such a different survival rate in SCID patients who underwent SCT.

There are conflicting results regarding survival in preemptive versus non?preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non?preemptive kidney transplant recipients.

In the present retrospective cohort study, all end?stage renal disease (ESRD) patients who underwent kidney transplantation between 1996 and 2021 in referral kidney transplantation centers in Isfahan province were investigated. In total,499 patients who received dialysis before kidney transplantation (non?preemptive) and 168 patients who received no dialysis before kidney transplantation (preemptive) were included in the final analysis. Data regarding demographic and clinical variables includingsex, age, body mass index (BMI), follow?up duration, immunosuppressive regimen change, kidney donor type, underlying causes of ESRD, and comorbidities before and after kidney transplantation were collected.

The mean age was 55.47 ± 15.53 years in preemptive and 54.87 ± 14.69 years in non?preemptive patients (P = 0.65). Mortality rates were 24.44/1000 person?years of follow?up for preemptive and 18.25/1000 person?years of follow?up for non?preemptive patients (P = 0.013). In the crude model of Cox regression analysis, preemptive kidney transplant recipients had a significantly higher risk of mortality compared to  on?preemptive kidney transplant recipients (hazard ratio [HR] = 1.59; 95% confidence interval [CI]: 1.09–2.33; P = 0.015). However, the association attenuated and became insignificant after adjustment for confounders, including age, BMI, immunosuppressive regimen change, kidney donor type, and comorbidities (HR = 1.35; 95% CI: 0.92–1.99; P = 0.12).

The results of the present study indicated that there is no  ndependent association between preemptive kidney transplantation and increased risk of mortality.

Although many previous studies verified the role of BTX-A in the augmentation of flap survival and decreasing the rate of necrosis in random pattern cutaneous flaps, drug injection at different times has not been investigated in this regard. This study compares the effect of BTX- A injection time at 0, 3, and 7 days before surgery to determine the best and most effective injection time.

In 20 male rats, divided into four equal groups, on different days of pre-operation (0, 3, or 7 days) BTX-A or saline was administered to the whole length of the flap. Random pattern dorsal skin flaps with 4:1 length-to-width ratios were elevated and returned to the original position. Flap survival was evaluated on day 10 and 20 after surgery and a histopathological examination were performed 20 days after flap elevation.

The BTX-A group had a greater survival mean compared with the saline group (87.92±16.30 vs 65.60±30.71 or 1.34 fold increase in survival rate) in flaps with a length-to-width ratio of 4:1 (P = 0.05), and If botulinum toxin is injected 7 days before flap elevation, this increase in survival will be 1.5 times (97.5±4.06 vs 65.60±30.71) compared to the saline group (P= 0.02).

Preoperative injection of botulinum toxin type A in random pattern skin flaps increases skin flap survival in rats, and the best time for injections is 7 days before flap elevation. We found a reduction in the proliferation of cutaneous myofibroblasts in flaps by injecting BTX-A. It could play a role in increasing blood flow and survival by reducing wound contraction, however, more studies should be conducted to determine the possible mechanism.

Breast cancer (BC) is the most prevalent and lethal cancer in women. Prognostic factors are used to guide treatment and predict the prognosis. This study aimedto assess the influence of prognostic factors on the survival of patients with non-metastatic invasive BC.

Data from invasive BC patients admitted to Medical Oncology Department of Süleyman Demirel University between October 2002 and October 2013 were retrospectively reviewed. Clinicopathologic features, treatment information, and follow-up data were noted. The Kaplan-Meier method was used to estimate survival functions. Multivariate Cox regression analysis was performed to identify prognostic factors for disease-free survival (DFS) and overall survival (OS), with P-values <0.05 for univariate results

A total of 717 patients entered the study.The median follow-up time was 41 months. Recurrence was detected in 17.4% of the patients, and 111 (15.5%) patients died. The 5-and 10-year DFS rates were 78% and 61%; OS rates were 86% and 70%, respectively. In multivariate analyses, DFS and OS were associated with axillary lymph node involvement (P<0.001 and P<0.05, respectively), tumor size (P<0.05), and histologic grade (P<0.05),whereas human epidermal growth factor receptor 2 positivity had only a statistically significant effect on poor OS (P=0.004).

Consistent withprevious studies, traditional prognostic factors had an important impact on prognosis in invasive BC patients. In the current era, where more conservative surgical approaches and new, effective systemic neoadjuvant and adjuvant therapies are widely used, the importance of the traditional prognostic factors highlighted in our study needs to be established by further studies.

Acute myeloid leukemia (AML) accounts for 15%-20% of childhood leukemia. A variety of cytogenetic abnormalities have been reported in AML, but it is still debated how these alterations affect patient survival and outcome. We aimed to evaluate the cytogenetic abnormalities of pediatric AML in association with prognosis. In this retrospective cross-sectional study, 46 cases of pediatric AML, diagnosed using French-American-British (FAB) criteria, admitted to a referral center during 2018-2023, who had not yet received chemotherapy, were included. Patients were evaluated for cytogenetic alterations by bone marrow karyotyping and polymerase chain reaction molecular methods. Patients were followed up to evaluate overall survival and recurrence-free survival. Data were analyzed using SPSS software version 23 and chi-square, Mann-Whitney, t-test and Kaplan-Meier tests. P < 0.05 was considered significant. Totally, 19 of 46 (41.3%) patients showed cytogenetic abnormalities. The prevalence of numerical and structural abnormalities was 23.9% and 28.3%, respectively. The most common numerical changes included monosomy 7, loss of chromosome Y, and trisomy 21, as order. The most common structural variants included t(v;11), t(15;17), t(8;21) and del(7q). Those with t(8;21) and t(15;17) or absence of cytogenetic abnormalities had a lower recurrence and death rate as compared with those with unfavorable cytogenetic abnormalities (P = 0.007 and P = 0.002 respectively). White blood cell count was significantly lower in patients with numerical cytogenetic abnormalities than those without. Cytogenetic abnormalities were rather common in pediatric AML. Monosomy 7/del(7q) and chromosome 11 alteration were the most common cytogenetic abnormalities. Presence of abnormalities, other than those known as favorable, were associated with worse survival.

Ovarian granulosa cell tumors (GCT) are rare tumors with a late recurrence and a good prognosis. The current study investigated the fertility and obstetrics situation, survival, and the factors influencing the mortality of patients with these uncommon ovarian neoplasms.

This is a retrospective study on ovarian GCT patients admitted to the Al-Zahra hospital oncology department, the tertiary referral hospital in Tabriz, between 2009 and 2022. Data were collected from medical records. Chi-square/Fisher exact tests and t tests were used to compare categorical and quantitative variables between the alive and dead patients, respectively. The Kaplan-Meier curve was used to present patients’ survival.

The study involved 65 patients with ovarian GCT. The presence of ovarian cysts statistically increased the survival of GCT patients (P=0.028). The advanced tumor stage (P=0.023), fast tumor growth (P=0.001), and tumor relapse (P=0.001) are significantly correlated with mortality in the affected patients. However, age and adjuvant chemotherapy were not associated with survival.

There was no evidence of increased survival with the use of adjuvant chemotherapy. Tumor staging is an important prognostic factor. Advanced stages were associated with inferior survival, and only prospective studies can ascertain their definite role.

Gastric Adenocarcinoma (GAC) is the second most frequent cause of cancer-related deaths worldwide. Determining survival and its associated prognostic factors provides a basis for further interventions to prolong survival among patients with GAC. In this study, we aimed to perform a 5-year survival analysis among GAC patients in Kerman, Iran.

This retrospective multi-centric study was conducted on all patients with GAC who were referred to Afzalipour, Bahonar, and Shafa Hospitals in Kerman, Iran in 2009-2019. The 5-year survival rates were calculated based on prognostic factors, including age, histopathology, stage/grade of the tumor, metastatic status, and surgical procedures using the Kaplan-Meier analysis and log-rank test.

The 5-year survival rate of GAC patients with total gastrectomy was higher than those with subtotal gastrectomy (P = 0.03). Also, the 5-year survival rate was substantially improved after lymph node dissection (P < 0.001). Overall survival has not been significantly different in terms of age, sex, grade, histological type, clinical T stage, lymphovascular invasion, and perineural invasion.

Overall survival was different for the two surgical procedures and lymph node dissection. Therefore, total gastrectomy and lymph node dissection are significant independent prognostic factors for overall survival in patients with GAC.

The analysis methods for breast cancer (BC) data have also advanced alongside medical advancements in the treatment of the disease.

This study tried to investigate the factors affecting the survival rate of BC patients using the cured model based on Kumaraswamy's defective distribution.

A retrospective study collected data on 2 574 BC patients between September 2013 and September 2020, including demographic, clinicopathological, and biological characteristics. The best model for predicting cure was chosen based on AIC.

The selected cure model revealed that age (P = 0.046), tumor histologic grade (P = 0.0.38), tumor size (P = 0.0.41), HER2 status (P = 0.001), KI67 levels (P = 0.027), P53 status (P = 0.029), and hormone therapy (P = 0.039) were significant variables. The estimated cured rate of this data was 0.82.

Considering that the advanced cured model has the highest accuracy in identifying the factors affecting the survival rate of BC patients and more risk factors have become significant in this model, it is recommended to pay special attention to patients aged over 60 with poorly differentiated historical grade, T3 tumor size, HER2 positive status, KI67 levels below 20%, negative P53 status, and no hormone therapy received in the process of disease prognosis.

Esophageal squamous cell carcinoma (ESCC) is one of the most lethal types of cancer. Late diagnosis significantly decreases patient survival rates.

The study aimed to identify survival groups for patients with ESCC and find predictive biomarkers of time-to-death from ESCC using state-of-the-art deep learning (DL) and machine learning algorithms.

Expression profiles of 60 ESCC patients, along with their demographic and clinical variables, were downloaded from the GEO dataset. A DL autoencoder model was employed to extract lncRNA features. The univariate Cox proportional hazard (Cox-PH) model was used to select significant extracted features related to patient survival. Hierarchical clustering (HC) identified risk groups, followed by a decision trees algorithm which was used to identify lncRNA profiles. We used Python.3.7 and R.4.0.1 software.

Inputs of the autoencoder were 8,900 long noncoding RNAs (lncRNAs), of which 1000 features were extracted. Out of the features, 42 lncRNAs were significantly related to time-to-death using the Cox-PH model and used as input for clustering of patients into high and low-risk groups (P-value of log-rank test = 0.022). These groups were then labeled for supervised HC. The C5.0 algorithm achieved an overall accuracy of 0.929 on the test set and identified four hub lncRNAs associated with time-to-death.

Novel discovered lncRNAs lnc - FAM84A-1 , LINC01866 , lnc - KCNE4-2 and lnc - NUDT12-4 implicated in the pathogenesis of death from ESCC. Our findings represent a significant advancement in understanding the role of lncRNAs on ESCC prognosis. Further research is necessary to confirm the potential and clinical application of these lncRNAs.

The prognosis of thyroid cancer treatment is unsatisfactory in the presence of different independent parameters, such as older age, which may worsen the quality of life and mental health of patients. It is necessary to improve the quality of life and mental health of patients with thyroid cancer.

This study evaluated the nurse-led care impact as psycho-oncological support on anxiety and quality of life of patients with a history of thyroid cancer, comparing it to a consultant-led usual care and a non-care.

Patients received half an hour of nurse-led care (NC cohort, n = 105), or consultant-led usual care (UC cohort, n = 125), or did not receive healthcare professional-led care (PO cohort, n = 135) at the institute during treatment and a follow-up period of 12 months. The EORTC QLQ-C30 Chinese version was used to assess the quality of life. Anxiety and depression were evaluated, using the Hospital Anxiety and Depression Scale.

Before the healthcare professional-led care, the quality of life scale score was 35 (36 - 33) and all patients had definitive anxiety and depression (scale score ≥ 11). After 12 months of the healthcare professional-led care, patients in the NC cohort showed improved quality of life and decreased anxiety and depression as compared to them before the healthcare professional-led care conditions and those of patients in the UC and PO cohorts after 12 months of the healthcare professional-led care (P < 0.001 for all). A higher number of patients survived in the NC cohort than in the UC (P = 0.0327) and PO (P = 0.0014) cohorts. Personal satisfaction of patients was higher in the NC cohort than in the UC and PO cohorts (P < 0.001 for both). Patient satisfaction was higher in the UC cohort than in the PO cohort (P < 0.001).

Supportive cancer care after surgery or during follow-up is necessary in patients with thyroid cancer. Nurse-led care had beneficial effects on the quality of life, psychological conditions, survival, and personal satisfaction of patients with thyroid cancer during the follow-up period.

Renal cell carcinoma (RCC) is the 9th most common cancer in men and the 14th most common in women. To date, there remains considerable uncertainty regarding factors that influence the survival of RCC patients.

This study aimed to determine the clinicopathologic characteristics and outcomes of RCC over a 15-year period in northeast Iran.

Data were collected from RCC patient records at Omid and Imam Reza Hospitals and Reza Radiation Oncology Center from 2001 to 2016. Demographic and clinicopathological data were extracted from patient records, and the current status of participants was assessed through telephone follow-ups. Overall and disease-free survival were analyzed using SPSS version 20.

A total of 230 RCC patients were enrolled in this study. The majority of patients were male, with a mean age of 56.78 years. Overweight status was common among patients, and pain was the most frequently reported symptom. The most common histologic subtype was clear cell carcinoma. The median follow-up period was 10.50 months, with overall survival rates at 1, 3, 5, and 10 years being 74.8%, 52.2%, 44.8%, and 39.6%, respectively. The mean overall and disease-free survival rates were approximately 24 and 25 months, respectively. Survival was significantly associated with RCC histologic subtype, disease stage, hemoglobin level, and underweight status. In contrast, sex, type of surgery, and chemotherapy regimen did not significantly impact survival.

Renal cell carcinoma patient survival was influenced by histologic subtype, disease stage, low hemoglobin levels, and underweight status.