Term Outcome Of Patients Research Articles

Long term outcomes in patients with anti-DPPX autoimmunity

DDPX antibody-associated encephalitis is characterized by cognitive dysfunction, neuropsychiatric symptoms, and CNS hyperexcitability, preceded by prodromal weight loss and diarrhea. Data regarding long-term outcomes is scarce. We retrospectively identified six anti-DPPX encephalitis patients across all three Mayo Clinic sites with inclusion criteria: 1) positive DPPX cell-based assay and mouse tissue-based immunofluorescence samples in both serum and CSF; 2) duration of follow up of at least 36 months from symptom onset to last follow up. Only one patient had a paraneoplastic process in the setting of chronic lymphocytic leukemia. At last follow up, all patients had resolution of GI symptoms. Residual cognitive impairment was seen in 4/6 (67%). Clinical stability was reached in 3/6 (50%) while on immunotherapy. Immunotherapy was discontinued in 2/6 (33%) and they remained stable without relapse at last follow up. One patient died of unclear etiology. Overall long-term outcomes are good in anti-DPPX encephalitis. Symptoms can improve on immunotherapy, but full resolution and return to premorbid baseline is unlikely.

Long term outcome of patients with hepatocellular carcinoma treated with transarterial radioembolization

Long term outcome of patients with hepatocellular carcinoma treated with transarterial radioembolization

1023 The Changing Indication and Outcomes of Patients Undergoing Pancreatectomy for Malignancy

Abstract Aim Pancreatic surgery has evolved significantly in terms of indications and peri-operative management to improve long term outcomes for patients. The aim of this study is to assess the change in indication and long-term outcome for patients undergoing pancreatectomy for malignancy. Method Patients who underwent pancreatectomy at the West of Scotland Pancreatic Unit, Glasgow Royal Infirmary between 2000 – 2020 for malignancy were included. Clinicopathological variables, survival and recurrence data were collected from patient notes and electronic patient records. Results 594 patients were identified. The majority were for pancreatic ductal adenocarcinoma (PDAC) n = 325 (54.7%). There was a significant increase in overall survival for all indications (28.6 months vs 41.8 months, P = 0.001), completion of adjuvant therapy and the use of neoadjuvant therapy (P<0.001) over the first and second decades in the study period. After adopting a neoadjuvant strategy for PDAC in the unit from 2013, the overall median survival increased from 24.6 months to 34.5 months (P<0.001). The overall survival for PDACs was higher for those receiving neoadjuvant chemotherapy compared to upfront resection (41.9 months vs 38.9 months, P = 0.151). For patients with PDAC who received upfront surgery, median survival increased from 24.2 to 40.3 months (P = 0.004) once a neoadjuvant strategy was adopted. Conclusions There has been significant changes to the indications and long-term outcomes for patients undergoing pancreatectomy. A neoadjuvant strategy improved survival even in those patients who received upfront surgery.

Paper 59: No Difference in Post-Operative Outcomes for High-Grade Acromioclavicular Joint Surgery Performed Acutely vs Chronically

Objectives: There have been no large studies that directly compare long term outcomes in patients with Rockwood grade III-V acromioclavicular (AC) joint separations treated with acute vs. chronic repair. Therefore, the purpose of this study was to compare post-operative outcomes between patients who undergo high-grade AC joint surgery acutely (<6 weeks) vs chronically (>6 weeks). Methods: A list of all AC joint surgery patients from 2010-2019 was obtained from the medical records. Chart review was conducted to determine patient demographics, time from injury to surgery, injury grade, and surgical technique, as well as outcomes and complications of AC joint surgery. Post-operative American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores were also collected via RedCap. Patient radiographic outcomes were retrospectively reviewed by reviewing preoperative, immediate postoperative, and follow-up AP views of the operative shoulder and measuring the coracoclavicular (CC) interval distance. Loss of reduction was defined as a follow-up change of greater than 5 mm from the immediate post-operative radiographs measurement. Several multivariate analyses were conducted with post-operative ASES, SANE, and CC distance as the outcomes of interest in order to account for demographic differences between groups. Results: Overall, 225 patients (113 acute, 112 chronic) were included in this study with an average follow-up of 3.5±2.8 years, average age of 40±15 years, and 86% being male. Patients in the acute group underwent surgery 2 ± 1 weeks after initial injury while patients in the chronic group underwent surgery 42 ± 35 weeks after injury. Significant differences in patient age, BMI, injury grade, surgical technique utilized, and pre-operative CC distance were observed between groups (all p<0.05) (Table 1). Rates of revision, loss of reduction, infection, fracture, and total complication rate, as well as post-operative ASES scores did not differ between groups. Patients treated acutely had a lower rate of loss of reduction (1.8mm v. 3.2mm, p=.044), a larger decrease in CC distance at latest follow-up compared to pre- operatively (11.8mm v. 9.0mm, p =.002), and better SANE scores (85.5 v. 75.5, p=.032). All other post- operative outcomes did not differ between groups. After controlling for confounding variables such as age, sex, BMI, injury grade, surgical technique, and time from injury to surgery, multivariate analysis found that female patients had lower ASES scores than male patients, while all other variables did not significantly relate to ASES score, SANE score, or post-operative CC distance (Table 2). Conclusions: Patients who underwent AC joint surgery acutely (<6 weeks) had similar post-operative outcomes to patients who underwent surgery chronically (>6 weeks) after initial injury. Multivariate analysis found that time from injury to surgery did not affect post-operative ASES scores, SANE scores, or post-operative CC distance. [Table: see text][Table: see text]

Long term outcome in patients who refused radiofrequency ablation for atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Rhythm control is a therapeutic approach to restore sinus rhythm from atrial fibrillation (AF). Current studies have demonstrated efficacy of rhythm control with radiofrequency catheter ablation (RFCA) for survival, however there is lack of data regarding the long term outcome of patients who refused RFCA. Purpose This study was aimed to compare outcomes, consist of death and stroke, in patients who refused RFCA. Method Patients with AF who had been proposed for RFCA but refused and also any rhythm control strategy were enrolled. The primary outcome was all cause death and incidence of stroke, compared with patients with AF who had been treated with RFCA. Results A total 174 patients who refused AF, 175 patients treated with RFCA were enrolled. Median follow up duration was 1125.1 ± 799.0 days. Of refused AF group, 39 (22.3%) were paroxysmal AF at the time of diagnosis. During follow-up, 9 patients in refused RFCA and 11 patients treated with RFCA group had died (4.1% vs 6.1%, p=0.3 by log rank test). Incidence of stroke was significantly higher in patients who refused RFCA, compared with RFCA group (12.0% vs 1.1% , p =0.001 by log-rank test). Cox Regression model showed refusing RFCA was an independent risk factor for the incidence of stroke (Hazard ratio 6.7, 95% Confidence Interval 1.48 – 30.3, p=0.013). Conclusion In AF patient who had refused rhythm control, incidence of stroke was significantly higher in patients who refused RFCA and rhythm control, compared with who had been treated with RFCA. There was no difference in all-cause mortality between two groups.

P38 SINGLE VERSUS DOUBLE STENTING IN NSTEMI PATIENTS WITH COMPLEX LEFT MAIN BIFURCATION DISEASE

Abstract Background Among patients with non–ST–segment elevation myocardial infarction (NSTEMI) the presence of a bifurcation left main (LM) disease represents a particular subset graved by both clinical and technical challenges. We sought to assess the long–term outcomes of patients with NSTEMI treated either by single or double stent strategy, having an LM bifurcation culprit lesion. Methods We retrospectively analyzed the procedural and medical data of consecutive patients referred to our center for NSTEMI due to complex LM bifurcation disease as the culprit lesion, treated using either single or dual stenting (provisional stenting, T or T–and–Protrusion (TAP), Culotte, and Nano–inverted–T (NIT)) techniques between January 2008 and May 2018. Target lesion failure (TLF) was defined as the composite of cardiovascular death, target–vessel myocardial infarction (MI), and clinically driven target lesion revascularization (TLR). Results Four hundred and forty–five patients (54.1% males, mean age 70.3 ± 12.8 years, mean Syntax score 31.6 ± 6.3) were evaluated. Of these, 155 patients (34.8%) were treated using a single stent while the remaining were treated with a double stent strategy. After a mean follow–up of 37.1 months (IQR 22.1–39.3), TLF rate was 8.7% (n = 39): 5/155 (3.2%) in the crossover group; 10/53 (18.8%) in T/TAP group, 14/89 (15.7%) in the culotte group, and 10/148 (6.7%) in the NIT group of patients. Cardiovascular mortality rate was 2.9% (n = 13) while stent thrombosis was 0.89% (n = 4). On multivariate analysis dyslipidemia, Syntax score > 25, triple vessel disease, additional LM ostial, or LM body lesions and the use of Rotablator, were independent predictors of TLF. Conclusions Either a single or double stent strategy resulted in low rates of TLF, cardiovascular death, and stent thrombosis in the long–term period in NSTEMI LM patients with contraindications or refusal of surgery. A single stent strategy appeared to have a slightly better outcome compared to a 2–stent strategy.

Long Term Follow Up of Dacron Versus Bovine Pericardium For Carotid Endarterectomy With Patch Angioplasty: a Retrospective Cohort Study

Objective: Patch angioplasty during carotid endarterectomy (CEA) is commonly used to treat carotid artery stenosis. Various patch materials are available, including venous, Dacron, bovine pericardium, and polytetrafluoroethylene. However, the choice of which patch to use is still a matter of debate. Autologous venous material has disadvantages such as wound related problems and a prolonged intervention time. This is due to the harvesting of the vein. These limitations can be bypassed when synthetic or biological patches are used, which are immediately available. Therefore, the aim of this study was to compare the long term outcomes in patients who received a CEA with either a bovine pericardial patch (BPP) or a Dacron patch.

Long Term Outcomes in Patients with Anti-DPPX Autoimmunity (S22.009)

<h3>Objective:</h3> To describe long term outcomes in anti-DPPX encephalitis. <h3>Background:</h3> Dipeptidyl-peptidase-like protein 6 (DDPX) antibody-associated encephalitis is a rare type of immune-mediated encephalitis characterized by cognitive disorder, neuropsychiatric symptoms, and CNS hyperexcitability, preceded by prodromal weight loss and diarrhea. Although anti-DPPX encephalitis has been described to be immunotherapy responsive, data regarding long-term outcomes is lacking. <h3>Design/Methods:</h3> We retrospectively identified anti-DPPX encephalitis patients across all three Mayo Clinic sites using the neuroimmunology lab database with the following inclusion criteria: 1) DPPX cell-based assay positive samples in serum and CSF; 2) duration of follow up of at least 36 months from symptom onset to last follow up. <h3>Results:</h3> Six anti-DDPX patients were included (median age, 56.5 years; range, 28–70 years) with a median follow up of 70.5 months (range 42–144 months). Of these 67% (4/6) were males. Median time from symptom onset to initiation of treatment was 15.5 months (range 4–48 months). Only 16% (1/6) had a malignancy identified (CLL). All patients had prodromal weight loss and gastrointestinal (GI) symptoms. All patients had cognitive impairment ranging from mild symptoms to dementia. One had neuropsychiatric symptoms including agitation, paranoia, and delusions. Seizures were documented in 33% (2/6), none were drug resistant. All patients had resolution of GI symptoms at last follow up, but all had persistence of sleep disturbances. 100% (6/6) had relapses. One patient died who had severe dysautonomia, but cause of death is unknown. The rest had stability or improvement in symptoms determined objectively with Kokmen mental status exam, ambulatory status (5/6) and ability to return to work (1/6). 33% (2/6) were able to discontinue immunotherapy and remained stable. <h3>Conclusions:</h3> Overall long-term outcomes are good in anti-DPPX encephalitis. Relapses are common, particularly in the setting of weaning off immunotherapy. Patients can improve symptoms on treatment, but full resolution and return to premorbid baseline is unlikely. <b>Disclosure:</b> Dr. Dominguez has nothing to disclose. The institution of Dr. McKeon has received research support from Euroimmun AG. The institution of Dr. McKeon has received research support from National Institutes of Health. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received publishing royalties from a publication relating to health care. Dr. Lopez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Lopez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech .

MP46-12 TWENTY YEAR TEMPORAL TRENDS IN SHORT AND LONG-TERM OUTCOMES AFTER RADICAL CYSTECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP46-12 TWENTY YEAR TEMPORAL TRENDS IN SHORT AND LONG-TERM OUTCOMES AFTER RADICAL CYSTECTOMY Majed Alrumayyan, Alexandre Zlotta, Neil Fleshner, Katherine Lajkosz, and Girish Kulkarni Majed AlrumayyanMajed Alrumayyan More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Neil FleshnerNeil Fleshner More articles by this author , Katherine LajkoszKatherine Lajkosz More articles by this author , and Girish KulkarniGirish Kulkarni More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003292.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy is a standard of care to treat muscle invasive urothelial bladder cancer. To improve outcomes, innovations in patient care, such as improved selection and preparation for surgery, Enhanced Recovery After Surgery protocols and implementation of extended Venous thromboembolism (VTE) prophylaxis have been introduced. The purpose of this study is to assess whether these changes have led to improvements in short and longer term outcomes in patients treated with Radical cystectomy for bladder cancer over the last 20 years. METHODS: This is a retrospective study of patients whom underwent Radical cystectomy from 2000 to 2020 in University Health Network Toronto, Canada.This time period was divided into 5 groups: 2000-2003, 2004-2007, 2008-2011, 2012-2015 and 2016-2020. Outcomes assessed included overall survival and metastasis free survival. The study also assessed the number of lymph nodes dissected, the rate of Venous thromboembolism (VTE), and use of neoadjuvant and adjuvant chemotherapy and their association with the outcomes. Univariable and multivariable analysis, adjusted for age, Charlson comorbidity index, and TNM stage, were compared between the temporal time groups. RESULTS: A total of 728 patients were included. There was no variance in age among all groups, with mean age of 68 years. 76% of patients were males. The Charlson comorbidity index mean was 3 in the last few years (p<0.001). Regarding the staging; PT0 after cystectomy was 14.3% and 14.7% from (2012-2020) (p<0.001). In the first few years, PT4 stage was found to be higher with 21%. As time evolved, Non muscle invasive bladder cancer increased to 45% (p<0.001). The mean number of lymph nodes dissected was 15 with no difference between the groups (p 0.39). In the most recent years, neoadjuvant chemotherapy was given more 34.3% and 46.6% (p<0.001). While Adjuvant Chemotherapy was given more to patients from (2000 to 2007) 27.5% and 25.2% (p<0.001). In the early years (2000-2003) VTE after surgery was 14.3% (p<0.001). VTE after neoadjuvant chemotharepy was 6.8% (p<0.001). Overall survival showed no difference in the 5 groups followed for 1 year with mortality mean between 19% and 27% and and also in the first 4 groups followed for 5 years after the surgery (p 0.67 and 0.29). Metastasis free survival as well showed no difference between the groups followed for 1 and 5 years with mean of 22.5% and 49% (p 0.23 and 0.27). CONCLUSIONS: We noted improved use of neoadjuvant chemothrepy, increase in non muscle invasive bladder cancer, decrease in VTE post surgery and stable survival rate across time. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e635 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Majed Alrumayyan More articles by this author Alexandre Zlotta More articles by this author Neil Fleshner More articles by this author Katherine Lajkosz More articles by this author Girish Kulkarni More articles by this author Expand All Advertisement PDF downloadLoading ...

Prognostic Value of CT Pulmonary Angiography Parameters Prediction Short Term Outcome in Patients with Acute Pulmonary Embolism

Prognostic Value of CT Pulmonary Angiography Parameters Prediction Short Term Outcome in Patients with Acute Pulmonary Embolism

MP59-04 HOLMIUM LASER ENUCLEATION OF THE PROSTATE FOR VERY LARGE BENIGN PROSTATIC HYPERPLASIA (&gt;200 ML): LONG TERM OUTCOME OF A LARGE SERIES.

You have accessJournal of UrologyCME1 Apr 2023MP59-04 HOLMIUM LASER ENUCLEATION OF THE PROSTATE FOR VERY LARGE BENIGN PROSTATIC HYPERPLASIA (>200 ML): LONG TERM OUTCOME OF A LARGE SERIES. Matteo Tallè, Francesco Mengoni, Roberto Orciani, Donato Dente, and Angelo Cafarelli Matteo TallèMatteo Tallè More articles by this author , Francesco MengoniFrancesco Mengoni More articles by this author , Roberto OrcianiRoberto Orciani More articles by this author , Donato DenteDonato Dente More articles by this author , and Angelo CafarelliAngelo Cafarelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients presenting with very large prostates (>200 ml of total volume) are a challenge to both patients and surgeons. Nowadays, although the efficacy and the less invasiveness of HoLEP compared to open techniques has been proven, still high level evidences for the best treatment of large prostates are limited. Aim of the study is to evaluate the short and long term outcomes of patients with very large prostates (>200 cc) in the largest series available so far. METHODS: Clinical data were collected in a prospective maintained database, we performed 183 HoLEP procedures on prostates greater than 200 gr in 86 months. We reported patient preoperative, intraoperative, postoperative outcomes and complications. Surgical technique: we used a Gilling modified technique with a three-lobe enucleation with a high power 120 W Holmium laser (Lumenis Pulse). Morcellation is conducted with a 7 gr/min morcellator (Lumenis VersaCut) together with basket for removal of the small prostate chips, in order to reduce operating time. Patients results were collected in a proper database Patients with limited follow-up and with data unavailable were excluded. RESULTS: We collected retrospectivally data of consecutive male patients who underwent HoLEP from July 2015 to September 2022 (86 months). There were 183 patients with a mean preoperative gland size of 218.9 cc (200-366 cc). Mean operative (145 min) and enucleation time (83 min) .Enucleation efficiency was greater for glands ≥300 cc (4.5 cc/min). Mean length of stay was 2.2±days and catheter duration was 2.8±days. Mean haemoglobin loss was (3,6 gr/dl, SD 0,1 - 6 gr/dl). 7 cases required blood transfusion (3.8%). 52 patients (28.4%) had indwelling catheter before surgery for urinary retention; this population experienced higher incidence of post-operative UTI and fever (42% vs 13%; p=0.001) Mean variation of Qmax was+14 ml/s (p<0,05) and IPSS score -16 points (p<0.05) at long term follow-up, these results stayed stable for during time with a mean follow 24 months (range 2-86) 3 (7.1%) patient required retreatment of BPH at last follow-up. CONCLUSIONS: HoLEP for giant prostate is a minimally invasive option with low morbidity and good post-operative outcomes. These data support the feasibility of HoLEP regardless the size of the prostate and suggest that HoLEP could become the “gold standard” approach for prostate >200 cc. Source of Funding: 1) World Journal of Urology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e807 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matteo Tallè More articles by this author Francesco Mengoni More articles by this author Roberto Orciani More articles by this author Donato Dente More articles by this author Angelo Cafarelli More articles by this author Expand All Advertisement PDF downloadLoading ...

Clinical characteristics, etiological profile, treatment and long term outcomes in patients with non ischemic systolic heart failure; Himachal Pradesh heart failure registry (HP–HF registry)

BackgroundThe data on clinical characteristics, treatment practices and out comes in patients with Non- ischemic Systolic Heart Failure (NISHF) is limited. We report clinical characteristics, treatment and outcomes in patients with NISHF. Methods1004 patients with NISHF were prospectively enrolled and their demographics, clinical characteristics, and treatment were recorded systematically. Patients were followed annually for a median of 3 years (1 year to 8 years) for allcause death, major adverse cardiovascular events (MACE); composite of all-cause death, hospitalization of heart failure, and or for stroke. ResultsPatients of NISHF were middle-aged (58.8±16.2 years) population with severely depressed left ventricular ejection fraction (29.3±7.02%) and 31.1% had symptoms of advanced Heart failure. Hypertension (43.6%), obesity and or overweight (28.0%), Diabetes (15.0%), and valvular heart disease (11.8%) were the common risk factors. The guideline directed medical treatment was prescribed in more than 80% of the study cohort. Incidence of all cause death and MACE was 7 (6.8, 8.8) per 100 person years and 11(10, 13) per 100 person years respectively. The cumulative incidence of deaths and MACE was 35% (30%, 40%) and 49% (44%, 53%) at 8 years of follow-up. ConclusionsPatients of NISHF were middle-aged population with severely depressed LV systolic function with significant incident morbidity and mortality. Early detection of risk factors and their risk management and enhancing the use of guideline directed treatment may improve the outcomes. Keywords: Non-ischemic systolic heart failure, risk factors, outcomes, guideline directed treatment.

Abstract PD15-02: PD15-02 Long Term Outcome in Patients with Nodal-Positive Breast Cancer Treated with Sentinel Lymph Node Biopsy Alone After Neoadjuvant Chemotherapy

Abstract Importance: The use of neoadjuvant chemotherapy (NAC) in the clinical care of breast cancer patients has increased considerably over recent years especially in node positive cases. For patients who have axillary nodal metastases prior to NAC, the prevailing standard of care is to undergo an axillary lymph node dissection (ALND), regardless of response to therapy. Sentinel lymph node biopsy (SLNB) has yet to be accepted as the standard staging procedure in patients who had clinical complete response in the axilla following NAC. This is due to the presumed high false negative rate associated with SLNB in such scenario. But there are limited data on the long term outcome of these patients who are only treated with SLNB alone. Aim: A retrospective cohort study comparing the long term outcome of breast cancer patients with clinically node positive disease (N1) but turned clinically node negative (N0) following NAC, receiving SLNB alone versus ALND. Methods: Patients who had pathologic proven N1 breast cancer (before NAC) treated with NAC and turned clinically N0 from January 2009 to December 2014 were identified from Asan Medical Center breast cancer database in South Korea. Primary endpoint was axillary recurrence rate (ARR) and secondary endpoints were disease-free survival (DFS) and overall survival (OS). These outcomes were reported for patients who had SLNB alone versus ALND. Results: 561 patients with clinically stage N1 (cN1) cancer treated with NAC and turned clinically stage N0 (cN0) were identified. 253 (45.1%) patients received SLNB only while 308 (54.9%) patients had ALND. The clinicopathological features of these patients were illustrated in Table 1. Majority of these patients received adjuvant radiotherapy, 81.2% in the SLNB group and 76.5% in the ALND group. In the pathologically stage N0 (ypN0) group, at a median follow up of 69 months, ARR was 3.0% in the SLNB only group and 1.7% in the ALND group (p=0.704). DFS and OS were not significantly different between patients with SLNB alone versus ALND (p= 0.561 and 0.810 respectively). Median number of SLN harvested in the SLNB only group is 5 (range 1 -17). In the pathologically stage N1 (ypN1) group with only 1-2 lymph node positive for metastasis, at a median follow up of 66 months, ARR was 5.8% in the SLNB group and 4.7% in the ALND group (p=0.768). There was no significant difference in DFS and OS between the SLNB and ALND group (p=0.537 and 0.645). In the SLNB only group, the median number of positive lymph node was 1 (range 1-2), the median number of sentinel lymph node was 6 (range 2-18). Conclusion: In cN1 breast cancer patients who were converted to cN0 following NAC, axillary recurrences were rare. No statistically significant differences were noted in DFS and OS between patients with SLNB or ALND. Our findings suggest that these patients may be safely treated with SLNB only, even when there are up to 2 positive SLNs. Table 1 Clinicopathological features of breast cancer patients with nodal disease and NAC Citation Format: Sue Zann Lim, Tae-Kyung Yoo, Sae Byul Lee, Jisun Kim, Il-Yong Chung, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Sei Hyun Ahn, Hee Jeong Kim. PD15-02 Long Term Outcome in Patients with Nodal-Positive Breast Cancer Treated with Sentinel Lymph Node Biopsy Alone After Neoadjuvant Chemotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD15-02.

WCN23-0578 LONG TERM OUTCOMES OF PATIENTS WITH LUPUS NEPHRITIS

WCN23-0578 LONG TERM OUTCOMES OF PATIENTS WITH LUPUS NEPHRITIS

Uretero-pelvic junction obstruction in children: Is vascular hitch an effective and safe solutions in very long term outcome? Report of 25 years follow-up

Vascular (VH) according to Hellstrom-Chapman technique is considered a safe and effective alternative approach to pure extrinsic Ureteropelvic Junction Obstruction (UPJO) with good results in short and medium term, but few data are available on long and verylong term outcomes. Our aim is to evaluate VH long and very-long term outcomes in patients treated in pediatric age focusing on relapse, development of hypertension and/or inferior polar kidney hypotrophy during puberty and adulthood. From 1990 to 2015 in our Department 76 children were treated by open or laparoscopic VH for pure extrinsic-UPJO. We were able to contact 54 of 76. 41 patients (25 males, 16 females) accepted to be studied. Mean follow- up time was 12.7 years (range 6-27 years); mean age at the assessment was 22.2 years. We excluded patients who were younger than 13 (if females) or 14 (if males) at the assessment (upper limits of physiological puberty onset). Patients were followed with US, MAG-3-scan and arterial blood pressure measurement. Collected data were compared with the preoperative ones by Student t-test. 95% of US images and MAG-3-scan reports were compatible with complete resolution of obstruction with good renal functionality. 87% of patients were completely healthy. We recorded 3 cases of hypertension (7%) not secondary to renovascular origin; 2 cases with recurrent flank pain (5%) with slightly dilated pelvis at the US and sub-obstructive pattern at MAG-3-scan with preserved renal function. Our experience confirms that VH, (open/laparoscopic) is a safe and effective procedure with good outcomes at very longterm follow-up. No patients at puberty and in adulthood required reoperation or presented polar hypotrophy and related vascular hypertension. VH is an alternative approach to pure extrinsic-UPJO. There were few data about long and very-long term outcomes in patients after this kind of surgery. We followed-up 41 patients confirming that VH (open/laparoscopic) is safe and effective with good long-term outcomes.

Association of left atrial size and function by cardiac magnetic resonance imaging with long term outcomes in patients with hypertrophic cardiomyopathy.

Left atrial (LA) function and strain are being investigated as markers of disease progression in hypertrophic cardiomyopathy (HCM). To assess LA function and strain by cardiac magnetic resonance imaging (MRI) in patients with HCM and evaluate the association of these parameters with long-term clinical outcomes. We retrospectively evaluated 50 HCM patients and 50 patients with no significant cardiovascular disease (control) who underwent clinically indicated cardiac MRI. We calculated LA volumes using the Simpson area-length method to derive LA ejection fraction and expansion index. MRI-derived left atrial reservoir (ƐR), conduit (ƐCD), and contractile strain (ƐCT) were measured using dedicated software. A multivariate regression analysis with endpoints of ventricular tachyarrhythmias (VTA) and heart failure hospitalization (HFH) was performed. HCM patients had significantly higher LV mass, higher LA volumes and lower LA strain compared to controls. During the median follow up of 15.6months (interquartile range 8.4-35.4months), 11 patients (22%) experienced a HFH, while 10 patients (20%) had VTA. Multivariate analysis demonstrated that ƐCT (odds ratio (OR) 0.96, confidence interval (CI) 0.83-1.00) and LA ejection fraction (OR 0.89, CI 0.79-1.00) were significantly associated with VTA and HFH respectively.

Abstract WP9: Number Needed To Treat With Intravenous Tenecteplase To Reduce The Need For Mechanical Thrombectomy In Large Vessel Occlusion Acute Ischemic Stroke Patients: Real-world Experience Data.

Objective: We sought to describe short term outcomes in patients with large vessel occlusion acute ischemic stroke (LVOAIS) who were treated with intravenous tenecteplase (TNK) as compared to alteplase, focusing on reduction in the need for mechanical thrombectomy (MT). Background: In LVOAIS, TNK has shown improved reperfusion and outcomes with a similar safety profile to alteplase. Ultra-early reperfusion has been described with TNK which would prevent the need for MT. We analyze the magnitude of this effect in a “real-world” setting. Design/Methods: In this retrospective study, demographic, clinical, and imaging information from patients with LVOAIS treated with intravenous thrombolysis was collected. Data was compared between the group treated with TNK and alteplase. Results: One hundred eighty-six patients met the criteria for the study (LVOAIS and candidates for IV thrombolysis and MT). Of these, 144 patients received tPA and 42 received TNK. Nine had clinical improvement prior to groin puncture and did not require angiography. This phenomenon occurred in 2.1% who received IV tPA and 14.3% who received TNK (p=0.005). For 8.2 patients treated with TNK rather than tPA, one catheter angiography would be prevented. When combining the number of patients who had recanalization on angiography before MT, and those who had clinical improvement prior to angiography, there were a total of 23 patients. This was noted in 9.7% of patients who received tPA, and 21.4% of those who received TNK (p=0.043). For 8.5 patients treated with TNK rather than tPA, one patient will have spontaneous recanalization either angiographically or with clinical improvement, preventing the need for MT. Conclusions: Intravenous TNK in patients with LVOAIS reduces the need for catheter angiography and mechanical thrombectomy.

146 - Long Term Outcomes of Patients with Chronic Myeloid Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation in the Era of Oral Tyrosine Kinase Inhibitors

146 - Long Term Outcomes of Patients with Chronic Myeloid Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation in the Era of Oral Tyrosine Kinase Inhibitors

Comparison of postoperative outcomes of milrinone versus dobutamine in tetralogy of Fallot with transannular patch

Background: Since the original description of TOF, its management modalities are continuously evolving. Present modality includes complete correction of the pathology by intra-cardiac repair with or without using transannular patch. Various finer aspects of intraoperative and postoperative management of the TOF repair are still evolving. Aims and Objectives: In this single centre study we are aiming to compare short term outcomes in patients of tof operated with transannular patch repair treated postoperatively with dobutamine vs milrinone. Materials and Methods: Total 100 patients undergoing TOF repair with transannular patch were grouped with respect to the inotropes used. One group who received milrinone and other who received dobutamine. Postoperative outcomes depending upon the need of other inotropic support, duration of ventilatory support, icu stay, inotropic support, hospital stay, morbidity and mortality are compared between the groups. Observations: No significant difference was seen in both groups for mean ventilation time, duration of icu and hospital stay. Only parameter which was significant was increase in usage of adjuvant inotropic support in milrinone group which were depicted in terms of increased VIS (Vasoactive inotrope score). Almost equal incidence of adverse events were noted in both the groups. Conclusion: Milrinone and dobutamine are fairly comparable to each other in cases of TOF repair with transannular patch. Dobutamine being a cheaper alternative have a better scope in developing countries like India.

In Hospital and Long Term Outcomes of Patients Who Underwent Endo or Open Repair of Axillosubclavian Arterial Injuries

In Hospital and Long Term Outcomes of Patients Who Underwent Endo or Open Repair of Axillosubclavian Arterial Injuries