74, 95% CI 0.58-0.94), selleck compound with an estimated
5-year survival of 52% in patients treated with TPF and 42% in those receiving PF. Median survival was 70.6 months (95% CI 49.0-89-0) in the TPF group versus 34.8 months (22.6-48.0) in the PF group (p=0.014). Progression-free survival was also significantly better in patients treated with TPF (median 38.1 months, 95% CI 19.3-66.1, vs 13.2 months, 10.6-20-7; HR 0.75,95% CI 0.60-0.94). We detected no significant difference in dependence on gastric feeding tubes and tracheostomies between treatment groups. In the TPF group, three (3%) of 91 patients remained feeding-tube dependent, compared with eight (11%) of 71 patients in the PF group. Six (7%) of 92 patients had tracheostomies in the TPF group, versus eight (11%) of 71 in the PF group.\n\nInterpretation Induction chemotherapy with TPF provides long-term survival benefit compared with PF in locally advanced head and neck cancer. Patients who are candidates for induction chemotherapy should be treated with TPF.”
“Objective Risk stratification models perform poorly regarding elderly patients.This study aims to evaluate the performance of the Italian Coronary Artery Bypass Graft Outcome Project (ItCABG) model and the logistic European System for Cardiac Operative Risk Evaluation (LogEuroSCORE) model by age group to build a model specifically for elderly patients.\n\nMethods
and results Data from the ItCABG and Mattone Outcome-BYPASS study (MO-BYPASS) have been used.
ItCABG and LogEuroSCORE models were applied to the ItCABG population (n=34,310) stratified BEZ235 mouse by four age classes: <60, 60-69, 70-79, >= 80 years. Each model’s ability to predict 30-day mortality was assessed for accuracy (Brier score and pseudo-R-2), calibration (Hosmer-Lemeshow test, XH-L) and discrimination (area under the receiver operating characteristic curve, AUC) in age classes.To estimate the elderly risk function a logistic regression was performed on 2,255 octogenarian patients from ItCABG and MO-BYPASS. Elderly model’s performance was tested. Model accuracy is fair in all age classes although the explained variance is poor. ItCABG and LogEuroSCORE models revealed AZD1208 manufacturer good discrimination power in patients aged <60, 60-69, and 70-79 years, but not in patients aged 80 years (AUCs: 0.82, 0.77, 0.76, 0.64, and 0.78, 0.75, 0.74, 0.65, respectively). Calibration of both models is poor in patients >= 80 years (ItCABG: XH-L = 18.1, P=0.05; LogEuroSCORE: XH-L = 129.7, P < 0.001). When a new model specific to octogenarian patients was built, discrimination power remained poor (AUC = 0.66), although calibration power improved (XH-L = 3.93, P=0.86).\n\nConclusions ItCABG and LogEuroSCORE models were poor predictors of mortality in octogenarian patients. Elderly-specific risk factors must be assessed to improve risk stratification in patients aged 80 years and older.