RESUMEN
Malignant mesothelioma is a rare but highly lethal form of cancer that affects the serosal membranes. Malignant peritoneal mesothelioma (MPM) is the second most common form of malignant mesothelioma (pleural mesothelioma is the most common). The aim of this study was to evaluate prognostic factors influencing the survival of patients with MPM. A retrospective analysis was performed on 35 patients who were admitted to our hospital between March 2005 and July 2013. The patients' demographic and clinical data, laboratory results, radiological signs, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and treatment outcomes were evaluated. The mean age of the 35 patients was 59.0±14.4 years, the mean survival time was 16.2±12.9 months, and the majority of the histopathological types of MPM were epithelial (68.6%). 82.9% of the patients had been exposed to asbestos, and the mean duration of exposure was 28.3±14.5 years. The most frequent symptoms were abdominal distention/pain, weight loss, dyspnea, and chest pain. The mean interval between the onset of symptoms and the diagnosis was 4.6±3.3 months. Platinum-based combination chemotherapy in combination with supportive care was used in the treatment of 68.6% of the patients, while supportive treatment alone was used in the others. Our results revealed that patients who were >60 years old (p=0.019), who were exposed to asbestos >20 years (p=0.033), who had an ECOG PS of 3 (p=0.000) were more likely to have a poor MPM prognosis.In conclusion, increased age, duration of environmental asbestos exposure and ECOG PS are important factors that influence the prognosis of MPM patients.
Asunto(s)
Neoplasias Pulmonares/mortalidad , Mesotelioma/mortalidad , Neoplasias Peritoneales/mortalidad , Neoplasias Pleurales/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Amianto/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/patología , Masculino , Mesotelioma/etiología , Mesotelioma/patología , Mesotelioma Maligno , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Peritoneales/etiología , Neoplasias Peritoneales/patología , Neoplasias Pleurales/etiología , Neoplasias Pleurales/patología , Pronóstico , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
BACKGROUND AND OBJECTIVES: Malignant pleural mesothelioma (MPM) is a fatal malignancy. Radiological imaging is necessary for the diagnosis, staging, and clinical management of patients with MPM. The 18 fluorodeoxyglucose positron emission tomography (18 FDG-PET) scan has proven useful in preoperative staging and as a prognostic tool in MPM. We aimed to investigate the relationship between the pre-treatment 18 FDG PET/CT results, together with other known clinical parameters, and the survival of patients with MPM in our region. PATIENTS AND METHODS: A retrospective analysis was performed on the data of 177 patients with MPM between April 2007 and April 2011. Pre-treatment 18 FDG PET/CT scans were done on all patients. Survival time was calculated by the Kaplan-Meier method. RESULTS: The mean age was 55.40 years. There were 56% male patients and 44% female patients. The mean survival time was 11 months from time of diagnosis. According to multivariate analysis results, being of male gender increased the poor prognosis 5.30 times, a Karnofsky performance score (KPS) < 60 increased a poor prognosis 2.18 times, being on "best supportive care" increased a poor prognosis 25.40 times, the stage III-IV increased a poor prognosis 11.13 times, and a level of maximum standardized uptake value (SUVmax) > 5 increased a poor prognosis 4.34 times. CONCLUSIONS: MPM remains a fatal prognosis. Significant predictors of survival include KPS, stage of disease, gender, treatment regimen and level of SUVmax. An understanding of the importance of these markers for MPM prognosis should allow targeted treatments to be developed.
Asunto(s)
Fluorodesoxiglucosa F18 , Mesotelioma/diagnóstico por imagen , Neoplasias Pleurales/diagnóstico por imagen , Radiofármacos , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Mesotelioma/mortalidad , Persona de Mediana Edad , Análisis Multivariante , Neoplasias Pleurales/mortalidad , Tomografía de Emisión de Positrones , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores Socioeconómicos , SobrevidaRESUMEN
BACKGROUND AND OBJECTIVES: Dental laboratory technicians (DLTs) have much exposure to mineralogical dust that may have adverse effects on their lung health. The aim of our study was to investigate occupational dust exposure, and to determine the frequency of respiratory function disorders and radiologic abnormalities among DLTs. MATERIALS AND METHODS: The study enrolled 94 DLTs who were exposed to dust in dental laboratories and 94 control subjects. Dust concentrations in the workplaces were measured. RESULTS: The mean age of DLTs was 30.70 ± 9.84 years. No significant difference was found between the DLTs and the control groups for age or smoking status (p > 0.05). Spirometric values for the DLTs were found to be lower than the control group (p < 0.05). The mean working period for DLTs was 9.19±5.9 years. The pulmonary function test results for the DLTs showed that 65.9% had a normal pattern, 22.4% were restrictive, and 11.7% showed obstructive type pulmonary function disorder. Negative correlations were found between the working period time and Forced Expiratory Volume in 1 second in the DLTs (R = -0.675 p = 0.000). Negative correlations were also found between working period time and Forced Vital Capacity in the DLTs (R = -0.720 p = 0.000). All DLTs had chest X-rays and 16 (17%) of them showed radiological pneumoconiosis. CONCLUSIONS: This study showed a negative association between level of respiratory function and working period in DLTs.
Asunto(s)
Técnicos Dentales , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Trastornos Respiratorios/etiología , Adulto , Polvo , Femenino , Humanos , Laboratorios , Personal de Laboratorio , MasculinoRESUMEN
BACKGROUND AND OBJECTIVE: In this study, we aimed to investigate the factors affecting the survival of patients with malignant pleural mesothelioma (MPM) according to their treatment regimens, including best supportive care (BSC), chemotherapy, surgical group and multimodality (MM) therapy. PATIENTS: A retrospective analysis was performed on clinical data and treatment outcomes of 400 patients registered in our hospital with MPM between January 1989 and April 2010. RESULTS: Mean age (p < 0.001), presence of asbestos exposure (p = 0.0014), presence of smoking history (p < 0.001), Karnofsky performance status (p < 0.001), histological subtype (p = 0.034) and stage (p < 0.001) variables were found to be significantly different among the four treatment regimens. Mean survival time of all patients was 12.32 months. Mean survival time 10.5 months for the BSC group, 15.7 for the surgical group, 16.02 for the chemotherapy group, and 26.55 for the MM group. There were significant differences in mean survival time among the four treatment regimens. In addition, a significant difference was found in survival time between the two chemotherapy groups (p = 0.032). Mean survival time for cisplatin + gemcitabine was found to be 14.49 months and for cisplatin + pemetrexed, 18.34 months. CONCLUSIONS: The MM group had better survival rates than the other groups. The new chemotherapy combination, cisplatin + pemetrexed, can be helpful in improving survival time.
Asunto(s)
Mesotelioma/terapia , Neoplasias Pleurales/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Estimación de Kaplan-Meier , Modelos Logísticos , Masculino , Mesotelioma/mortalidad , Persona de Mediana Edad , Neoplasias Pleurales/mortalidad , Estudios RetrospectivosRESUMEN
BACKGROUND: In Turkey, there are insufficient data regarding the relation between altitude and the incidence of tuberculosis (TB). OBJECTIVES: This study aimed to investigate the effect of high altitude and socio-economic conditions on the incidence of TB in Turkey. METHODS: The mean incidence of TB in 56 Turkish cities was measured as n/100,000 population between 1999 and 2005. The mean altitude of each city was recorded in metres. RESULTS: The incidence of TB was lower in cities located at high altitude (P=0.000) and higher in cities with a high population density (P=0.000). Multivariate analysis showed that the incidence of TB in low altitude cities was 3.28-fold higher than in high altitude cities (P=0.000). In cities with a population density >80 people/km(2), the incidence of TB was 4.18-fold higher than in cities with a lower population density (P=0.000) Other factors found to affect the incidence of TB were having a social insurance card and a low annual income. CONCLUSIONS: There was a strong negative correlation between altitude and the incidence of TB, and population density was significantly associated with the incidence of TB. Possession of a social insurance card and fertility rate were also risk factors for TB. The authors believe that altitude has a stronger influence on the incidence of TB than the other factors. The effect of altitude on TB may reveal new data, but further studies need to be undertaken to assess the effects of potential factors on the incidence of TB.