16 research outputs found
Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery
Peer reviewe
Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000â14 (CONCORD-3) : analysis of individual data from 258 cancer registries in 61 countries
Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed
data for children (aged 0â14 years) and adults (aged 15â99 years) diagnosed with a haematological malignancy
during 2000â14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and
morphology, in young patients (aged 0â24 years).
Methods We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3
that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0â14 years),
adolescents (15â19 years), and young adults (20â24 years). We categorised leukaemia subtypes according to the
International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases
for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs,
using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by
country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age
survival estimates were standardised to the marginal distribution of young people with leukaemia included in the
analysis.
Findings 164563 young people were included in this analysis: 121328 (73·7%) children, 22963 (14·0%) adolescents, and
20272 (12·3%) young adults. In 2010â14, the most common subtypes were lymphoid leukaemia (28205 [68·2%] patients)
and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and
young adults for all leukaemias combined during 2010â14 varied widely, ranging from 46% in Mexico to more than
85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better
age-standardised survival (from 43% in Ecuador to â„80% in parts of Europe, North America, Oceania, and Asia) than
those with acute myeloid leukaemia (from 32% in Peru to â„70% in most high-income countries in Europe,
North America, and Oceania). Throughout 2000â14, survival from all leukaemias combined remained consistently
higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young
adults in most countries.
Interpretation This study offers the first worldwide picture of population-based survival from leukaemia in children,
adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower
survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators
of the quality of cancer management in this age group.peer-reviewe
Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000â2014 (CONCORD-3)
Background:
Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.
Methods:
We analyzed individual data for adults (15â99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000â2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.
Results:
The study included 556,237 adults. In 2010â2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%â38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000â2004 and 2005â2009. These improvements were more noticeable among adults diagnosed aged 40â70 years than among younger adults.
Conclusions:
To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines
A comparative assessment of two experimental methods for aerodynamic performance evaluation of a car
518-522This paper presents experimental investigation of aerodynamics of a car named ADRENe, representative of small
segment of current popular car spectrum, through wind tunnel tests. Out of two different strategies adopted for experimentation,
one relies on measurement of pressures in effective domain upstream and downstream of car, and other relies on pressure
distribution along centerline, over car profile. A good agreement between performance values obtained by these two methods
independently, suggest their reliability and suitability for further experimentation purposes
Hybrid strategy in neonates with ductal-dependent systemic circulation and multiple risk factors
OBJECTIVE: The study objective was to analyze outcomes of the hybrid strategy for ductal-dependent systemic circulation consisting of bilateral pulmonary artery banding with or without ductal stenting followed by delayed Norwood-type palliation or comprehensive stage II operation in high-risk neonates. METHODS: A retrospective analysis was performed between December 2017 and March 2021. Thirty high-risk neonates underwent palliation with bilateral pulmonary artery banding: 11 with prostaglandin therapy and 19 with ductal stenting. Median (range) age and body weight of patients at hybrid stage I were 3 days (0-43) and 2.9 kg (1.1-4.2), respectively. Operative and interstage mortality, morbidity, and reintervention rates were assessed. RESULTS: Overall survival was 70% (21/30) at a median follow-up time of 9 months (range, 0-37) from hybrid stage I. Operative survival for hybrid stage I was 90% (27/30), of which 2 patients received palliative care, and there was 1 interstage death (4%, 1/27). After hybrid stage I, 37% of patients had a reintervention, and 3% (n = 1) used extracorporeal membrane oxygenation before the next stage of repair. Five patients are awaiting second-stage operation, and 9 patients are awaiting Fontan completion. CONCLUSIONS: High-risk neonates with hypoplastic left heart syndrome or its variants can be successfully palliated using the hybrid strategy and bridged to a delayed Norwood or comprehensive stage II operation with satisfactory survival. This operative approach is a promising alternative pathway for neonates deemed to be high risk due to multiple preoperative risk factors