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- Osterlund, Pia, et al.
(författare)
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Repeated centralized multidisciplinary team assessment of resectability, clinical behavior, and outcomes in 1086 Finnish metastatic colorectal cancer patients (RAXO) : A nationwide prospective intervention study
- 2021
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Resection of colorectal cancer (CRC) metastases provides good survival but is probably underused in real-world practice. Methods: A prospective Finnish nationwide study enrolled treatable metastatic CRC patients. The intervention was the assessment of resectability upfront and twice during first-line therapy by the multidisciplinary team (MDT) at Helsinki tertiary referral centre. The primary outcome was resection rates and survival. Findings: In 2012-2018, 1086 patients were included. Median follow-up was 58 months. Multiple metastatic sites were present in 500 (46%) patients at baseline and in 820 (76%) during disease trajectory. In MDT assessments, 447 (41%) were classified as resectable, 310 (29%) upfront and 137 (18%) after conversion therapy. Sixhundred and ninety curative intent resections or local ablative therapies (LAT) were performed in 399 patients (89% of 447 resectable). Multiple metastasectomies for multisite or later developing metastases were performed in 148 (37%) patients. Overall, 414 liver, 112 lung, 57 peritoneal, and 107 other metastasectomies were performed. Median OS was 80.4 months in R0/1-resected (HR 0.15; CI95% 0.12-0.19), 39.1 months in R2-resected/LAT (0.39; 0.29-0.53) patients, and 20.8 months in patients treated with "systemic therapy alone" (reference), with 5-year OS rates of 66%, 40%, and 6%, respectively. Interpretation: Repeated centralized MDT assessment in real-world metastatic CRC patients generates high resectability (41%) and resection rates (37%) with impressive survival, even when multisite metastases are present or develop later.
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| 2. |
- Potapov, Ilya, et al.
(författare)
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Nonlinear effects of winter swimming and sauna recreational activities on the heart rate variability
- 2017
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Ingår i: Computing in Cardiology. - 2325-8861. ; 44, s. 1-4
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Tidskriftsartikel (refereegranskat)abstract
- Sauna sessions and winter swimming are traditional and popular recreational activities in certain countries. Their positive effects on health and relaxation, both as separate and combined activities, are commonly reported. However, systematic studies of these effects are relatively scarce, especially regarding the nonlinear analysis of the physiological measurements of the heart activity. We performed Multi-Scale Entropy (MSE) and Detrended Fluctuation (DFA) analyses on the inter-beat time series (about 72 h long) of 21 healthy volunteers studied in three distinct contexts: winter swimming combined with sauna bathing (W), sauna bathing alone (S), and control (C) with no related activities. We confirmed that the scaling exponents (DFA) and complexity indices (determined from MSE) stay within the variation observed for healthy individuals as compared to public data sets. Next, we showed that S and W interventions have uncorrelated effects on the whole time series complexity in each individual. Additionally, the long-range scaling properties of S and W groups are not correlated as determined by DFA. Thus, we speculate that winter swimming combined with sauna bathing and sauna bathing alone might have different physiological responses.
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