Background: Recently, peripheral blood inflammatory biomarkers such as neutrophil-lymphocyte ratio (NLR) have been identified for their prognostic role in many types of cancers. Elevated NLR was associated with poor prognosis & increased mortality rates. This study assessed the predictive value of pretreatment NLR in non-metastatic breast cancer.
Objective: To assess the role of pretreatment NLR in non-metastatic breast cancer and their effect on prognosis in terms of 5 years disease-free survival and overall survival.
Methods: This retrospective cross-sectional study was conducted in Suez Canal University Hospitals in Ismailia, Egypt. 105 patients with pathologically proven breast cancer were recruited from January 2015 to December 2016. Patients & tumor characteristics were collected from medical records. Five-year overall survival & disease-free survival were analyzed.
Results: Mean patients’ ages were 47.82 ± 11.65. The age ranges were between 25 & 78 years. There was no statistical significance between patients with low & high pretreatment NLR in terms of patients’ characteristics & tumor variables. With the ROC curve, the cut-off points for NLR were 1.65 & 1.55 for DFS and OS, respectively. In terms of patients’ DFS & OS, no statistically significant difference was found between non-metastatic breast cancer patients with low & high NLR (plog-rank =.357 and.236, respectively). No statistically significant difference was found between patients with low & high pretreatment NLR in the period of five years OS & DFS.
Conclusions: Pretreatment NLR is an inflammatory biomarker that might affect patient prognosis and survival. Further research is required to confirm the prognostic significance.
Background: Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia which remains a major contributor to cardiac morbidity and mortality worldwide. Recently the use of stereotactic radiation has demonstrated efficacy, although standardization of methodology is lacking and variations in technique exist. In this paper, we discuss our outcomes as well as the various options available and the proposed indications for each.
Methods: 12-lead EKGs and device-obtained tracings were used to approximately localize the arrhythmogenic origin and to define the arrhythmic mechanism. When feasible, electrophysiology studies (EPS) with 3-D electroanatomic (EA) mapping during which a 3-D electroanatomic substrate map was created to delineate cardiac structures, identify areas of low voltage scar and confirm arrhythmic circuits. A 4-D cardiac magnetic resonance imaging (cMRI) or cardiac computed tomography (cCT) was performed to delineate cardiac geometry and structures. The Stereotactic arrhythmia radioablation (STAR) treatment plans delivered a total dose of 25 Gy in a single treatment fraction covering the entire arrhythmogenic target.
Results: Six of the nine patients showed a reduction in VT events at 6 weeks post STAR. One patient underwent cardiac transplantation two weeks following STAR. Excluding this patient from the analysis, all but one patient had a dramatic diminution in VT events (to 0) at 6 months post-procedure, including both patients with an LVAD. Six of the nine patients survived at least 4 months post procedure event free and 6 patients survive to date. The lone patient who did not respond died 13 months post procedure, however he had no further defibrillator discharges. Another patient died two months post procedure from uncontrolled multiple myeloma. One patient developed an asymptomatic pleural effusion, but no serious STAR-induced postoperative complications occurred.
Conclusions: STAR appears to be an effective therapy for refractory ventricular tachycardia, although long term data are still developing. Additional clinical trials and techniques are in development and STAR programs should be encouraged for additional well-equipped centers with experienced multidisciplinary clinicians.