Background: Primary cardiac sarcomas (PCS) are extremely rare malignant tumors involving the heart. Only isolated case reports have been described in the literature over different periods of time. This pathology has been associated with a dismal prognosis and given its rarity; treatment options are very limited. Furthermore, there are contrasting data about the effectiveness of current treatment modalities in improving the survival of patients with PCS, including surgical resection which is the mainstay of therapy. There is a paucity of data on the epidemiological characteristics of PCS. This study has the objective of investigating the epidemiologic characteristics, survival outcomes, and independent prognostic factors of PCS. Methods: A total of 362 patients were ultimately registered in our study from the Surveillance, Epidemiology, and End Results (SEER) database. The study period was from 2000 to 2017. Demographics such as clinical characteristics, overall mortality (OM), and PCS-specific mortality (CSM) were taken into account. A p value of <0.1 in the univariate analysis leads to the incorporation of the variable into multivariate analysis adjusting for covariates. Adverse prognostic factors were represented by a Hazard Ratio (HR) greater than one. The five-year survival analysis was carried out using the Kaplan–Meier method and the log-rank test was used to compare survival curves. Results: Crude analysis revealed a high OM in age 80+ (HR = 5.958, 95% CI 3.357–10.575, p < 0.001), followed by age 60–79 (HR = 1.429, 95% CI 1.028–1.986, p = 0.033); and PCS with distant metastases (HR = 1.888, 95% CI 1.389–2.566, p < 0.001). Patients that underwent surgical resection of the primary tumor and patients with malignant fibrous histiocytomas (HR = 0.657, 95% CI 0.455–0.95, p = 0.025) had a better OM (HR = 0.606, 95% CI 0.465–0.791, p < 0.001). The highest cancer-specific mortality was observed in age 80+ (HR = 5.037, 95% CI 2.606–9.736, p < 0.001) and patients with distant metastases (HR = 1.953, 95% CI 1.396–2.733, p < 0.001). Patients with malignant fibrous histiocytomas (HR = 0.572, 95% CI 0.378–0.865, p = 0.008) and those who underwent surgery (HR = 0.581, 95% CI 0.436–0.774, p < 0.001) had a lower CSM. Patients in the age range 80+ (HR = 13.261, 95% CI 5.839–30.119, p < 0.001) and advanced disease with distant metastases (HR = 2.013, 95% CI 1.355–2.99, p = 0.001) were found to have a higher OM in the multivariate analyses adjusting for covariates). Lower OM was found in patients with rhabdomyosarcoma (HR = 0.364, 95% CI 0.154–0.86, p = 0.021) and widowed patients (HR = 0.506, 95% CI 0.263–0.977, p = 0.042). Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups, and lower mortality in patients with Rhabdomyosarcoma. Conclusion: In this United States population-based retrospective cohort study using the SEER database, we found that cardiac rhabdomyosarcoma was associated with the lowest CSM and OM. Furthermore, as expected, age and advanced disease at diagnosis were independent factors predicting poor prognosis. Surgical resection of the primary tumor showed lower CSM and OM in the crude analysis but when adjusted for covariates in the multivariate analysis, it did not significantly impact the overall mortality or the cancer-specific mortality. These findings allow for treating clinicians to recognize patients that should be referred to palliative/hospice care at the time of diagnosis and avoid any surgical interventions as they did not show any differences in mortality. Surgical resection, adjuvant chemotherapy, and/or radiation in patients with poor prognoses should be reserved as palliative measures rather than an attempt to cure the disease.
Background: Carcinoma of prostate is one of the common tumors of old age in men. Although there is great apprehension in these patients when they are associated with even mild increase in the prostate specific antigen level (PSA) which can be seen in various benign lesions of prostate. With digital rectal examination (DRE), prostate specific antigen (PSA) remains a major screening tool for early detection of prostate cancer. Materials and method: The study includes 150 cases who presented clinically as prostatic lesions and in whom the PSA levels and tissue biopsy was available and was further correlated among spectrum of prostatic disease. Results: All cases with abnormal DRE were turn out to be malignant lesion on biopsy and was found that the cut off of PSA level for malignancy was 19.5ng/ml. The median PSA levels for benign prostatic hyperplasia (BPH), prostatitis, prostate intraepithelial neoplasia (PIN) and adenocarcinoma is 5ng/ml, 10 ng/ml, 14 ng/ml and 81ng/ml respectively. Statistically there was no significant difference of the PSA levels between low grade prostate intraepithelial neoplasm and high grade. Conclusion: In Benign prostatic lesion, PSA level ranges between 0 to 4.0ng/ml. The cut off value of 19.5ng/ml of PSA is most sensitive and specific for the detection of malignant lesion in the prostate. In addition to elevated level of more than 4.0ng/ml and abnormal DRE with TURP biopsy is most useful and accurate diagnostic method for prostatic lesions. All raised PSA levels cases were not malignant thus it is required to use this biochemical marker judiciously to minimize the apprehension among these patients.
No abstract
Information systems are integral parts of an organization that plays a vital role in the management of its activities. They help the organization to meet its goals and objectives by delivering output efficiently. Raw material information is collected in a database to be used for processing and storage. The Database Management system is software designed to manage the data effectively and efficiently. End-users can use a DBMS to create, protect, read, update, and delete data in a database. It provides a centralized view of data that can be accessed in a controlled manner by multiple users from multiple locations. We present a new and simple method for integrating different databases on browser-based support that is easier to manage. The proposed Database Management System (DBMS) will also include backup capabilities to help in database recovery in the event of a failure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.