Research Article
Pretreatment Platelet Indices and Red Cell Distribution Width as a Predictor of Endometrial Carcinoma Among Patients with Abnormal Uterine Bleeding
Issue:
Volume 13, Issue 1, March 2025
Pages:
1-9
Received:
19 December 2024
Accepted:
3 January 2025
Published:
21 January 2025
DOI:
10.11648/j.jctr.20251301.11
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Abstract: Introduction: Endometrial carcinoma is the sixth most common cancer for females in the world and the seventh most common gynecological cancer in developing countries. The values of platelet indices (MPV, PDW) and red cell distribution width (RDW) are associated with different stages of endometrial and cervical carcinoma. Thus, this study aimed to determine the relation of MPV, PDW, and RDW with endometrial carcinoma. Methods: This cross-sectional study was conducted in the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2022 to July 2023. This study included 61 women with histopathologically confirmed endometrial carcinoma (FIGO stage I to IV) as cases and 122 women with histopathologically confirmed benign endometrial disease as the control group. Result: This study found that the case group had a higher mean age (55.62 years vs. 43.75 years). Blood parameter findings showed higher mean MPV (10.46 vs. 9.96) and RDW (46.64 vs. 43.05) in cases. PDW mean was lower in cases (11.33 vs. 14.39). MPV correlated positively with the FIGO stage and histological type, while PDW had a negative correlation. ROC analysis of MPV yielded an AUC of 0.645, with a cut-off of 10.50 showing sensitivity 58%, specificity 72%, and accuracy 57%. ROC analysis of PDW yielded an AUC of 0.789, with a cut-off of 13.50 showing sensitivity 44%, specificity 97%, and accuracy 61%. Multivariant regression revealed MPV to be the strongest factor of endometrial carcinoma (OR-6.20, p=0.039). Conclusion: This study showed that the mean platelet volume (MPV) and red cell distribution width (RDW) are potential markers for detecting endometrial carcinoma.
Abstract: Introduction: Endometrial carcinoma is the sixth most common cancer for females in the world and the seventh most common gynecological cancer in developing countries. The values of platelet indices (MPV, PDW) and red cell distribution width (RDW) are associated with different stages of endometrial and cervical carcinoma. Thus, this study aimed to d...
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Research Article
Comparing the Outcomes of Neoadjuvant Versus Adjuvant Chemotherapy for Osteosarcoma Patients
Issue:
Volume 13, Issue 1, March 2025
Pages:
10-22
Received:
15 April 2025
Accepted:
27 April 2025
Published:
29 May 2025
DOI:
10.11648/j.jctr.20251301.12
Downloads:
Views:
Abstract: Background: Neoadjuvant chemotherapy followed by surgery and subsequent adjuvant chemotherapy has been a mainstay of many osteosarcoma treatment protocols. However, the overall survival (OS) benefit over surgery and adjuvant chemotherapy is unclear. Aims: This study therefore directly compares the outcomes among these treatment groups using a large population in the National Cancer Database (NCDB). Methods: In a retrospective cross-sectional study, osteosarcoma patients in the NCDB (2004-2019) were stratified based on chemotherapy and surgery timing (neoadjuvant and adjuvant vs adjuvant-only chemotherapy). We used Kaplan-Meier curves to compare OS in the unmatched population and in a propensity score matched cohort that controlled for demographics, treatment, and tumor characteristic differences. Univariate and multivariate analyses were also used to predict the likelihood of positive margins among the population. Chi-square tests were used to compare 30- and 90-day mortality among treatment groups. P-values <0.05 were considered significant. Results: The study population included 4,659 patients: 3,733 neoadjuvant and 926 adjuvant-only chemotherapy regimens. Patients who underwent neoadjuvant therapy had significantly longer survival in the unmatched analysis (p<0.001), but this difference narrowed when controlling for covariates in the matched cohort (p=0.67). Mortality at 30 and 90 days was insignificant between treatment groups in both the full and matched cohorts (p=0.3 and p=0.9 respectively). Neoadjuvant chemotherapy regimens predominated with over 75% utilization, but this rate remained constant during the 15-year study period. Three- and five-year survival rates were relatively unchanged during this period at 75% and 62.5% respectively. Factors significantly associated with positive margins in the multivariate analysis included adjuvant-only chemotherapy (OR=1.6, p<0.001), older age (OR=1.01, p<0.001), female sex (OR=1.27, p=0.04), adjuvant radiation (OR=4.96, p<0.001), and stage IVB tumors (OR=2.11, p<0.001). Conclusions: These results indicate that neoadjuvant chemotherapy did not increase overall or short-term survival compared to adjuvant chemotherapy alone in our study. However, neoadjuvant therapy was associated with fewer positive margins at the time of surgery. These insights offer information to help clinicians evaluate osteosarcoma treatment regimens to maximize outcomes and limit treatment morbidity.
Abstract: Background: Neoadjuvant chemotherapy followed by surgery and subsequent adjuvant chemotherapy has been a mainstay of many osteosarcoma treatment protocols. However, the overall survival (OS) benefit over surgery and adjuvant chemotherapy is unclear. Aims: This study therefore directly compares the outcomes among these treatment groups using a large...
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,
Shirin Akter Begum
