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Eine unizentrische, retrospektive Analyse lokalisierter Myxofibrosarkomen hinsichtlich primärer Therapie und prognostischer Faktoren
Get PDFIntroduction:
Myxofibrosarcoma is a subcategory of soft tissue sarcoma, whose primary therapy is still unclear and subject to further investigation. Despite multimodal primary treatment it is characterized by a high rate of local relapse, which often could lead to a higher risk of metastasis. Our analysis was therefore focused on the hypothesis that MFS may be a chemotherapy-resistant entity and tries to explain its biological behavior from a clinical point of view.
Methods:
Our analysis included 134 Patients treated in the “Sarkomzentrum Helios Klinikum Berlin Buch”, between 1998 and December 2020. We retrospectively investigated the aspects of primary treatment (surgery, radiation, chemotherapy, isolated limb perfusion and hyperthermia) along with other risk factors and tumor characteristics, performing a survival analysis regarding overall survival, local recurrence, and distant metastasis.
Results:
The 5-year overall survival (OS) was 74.9%. The 5-year local-recurrence-free-survival (LRFS) and distant-metastasis-free-survival (DMFS) were 66.1% and 80.8% respectively. Out of 134 Patients: 74 (55.2%) stayed disease-free; 48 (35.8%) had a local recurrence (LR); 23 (17.2%) developed a distant metastasis (DM). Adverse prognostic factors for OS were older age (p<0.001), tumor size cT≥2 (p=0.001), non-extremity localization (p=0.056) and distant metastasis (p<0.001). Positive prognostic factors for LR were performing an incision biopsy (p=0.032), surgery in a specialized-center (p=0.001), wide local excision or compartment-oriented excision (p<0.001), negative margins (p=0.002) and radiotherapy (p<0.001). The only adverse prognostic factor for DM in the univariate analysis war tumor size cT≥3 (p<0.001). In the multivariable analysis grading ≥2 appeared to be an adverse prognostic factor both for LR (HR: 6.264, p=0.020) and for DM (HR: 3.375, p=0.013).
In the subgroup analysis of small tumors (cT1), radiation had a positive impact on LRFS (n=34, p<0.001). In the subgroup of big tumors (cT≥3), chemotherapy had no impact on DMFS (n=34, p=0.617).
Conclusion:
Even small tumors had a benefit from radiation, regarding LRFS. Chemotherapy on the other hand did not have a significant impact regarding DMFS, not even in bigger, high-grade tumors. Our findings support our hypothesis that myxofibrosarcoma may be a chemotherapy resistant entity. We believe that this evidence should be taken into consideration during multimodal treatment of MFS, to prevent the failure of neoadjuvant chemotherapy. This matter should be a subject of more prospective, multicentered studies.Myxofibrosarkome (MFS) sind eine Subkategorie der Weichteilsarkome, welche die WHO seit 2002 separat klassifiziert hat. Üblicherweise entspricht ihre primäre Therapie der multimodalen Therapie der Weichteilsarkome. Trotzdem weisen sie eine hohe Rate an Lokalrezidive auf, welche zu einer hohen Rate an Metastasierung führen kann. Wir fokussierten unsere Analyse auf die Hypothese, dass Myxofibrosarkome eine chemotherapieresistente Entität sein können.
Analysiert wurden Daten von 134 Patienten, die zwischen 1998 und Dezember 2020 im „Sarkomzentrum Helios Klinikum Berlin Buch“ behandelt wurden. Wir analysierten retrospektiv allgemeine prognostische Faktoren (Alter, Tumorgröße, Grading) sowie Aspekte der Diagnostik (Art der Biopsie) und der primären Therapie (Operation, Bestrahlung, Chemotherapie, isolierte Extremitätenperfusion und Hyperthermie). Wir führten eine Überlebensanalyse bezüglich des Gesamtüberlebens, des lokalrezidivfreien Überlebens (LRFS) und des fernmetastasierungfreien Überlebens (DMFS) durch.
Die 5-Jahres Gesamtüberlebens-, Lokalrezidiv- und Fernmetastasierungsraten lagen bei 74,9%, 33,9% und 19,2% entsprechend. Hohes Alter, Tumorgröße größer als 10 cm Durchmesser, Lokalisation außerhalb der Extremitäten und Fernmetastasierung waren negative prognostische Faktoren für das Gesamtüberleben.
Malignitätsgrad 1, die diagnostische Durchführung einer Inzisionsbiopsie, Operation in einem Sarkomzentrum, die weite lokale Resektion, die kompartmentorientierte Resektion, der R0 Status und die adjuvante Bestrahlung waren positive Faktoren für das LRFS.
Eine Tumorgröße von mehr als 10 cm Durchmesser und ein Malignitätsgrad 3 waren negative prognostische Faktoren für das DMFS. Die Chemotherapie zeigte keinen statistisch signifikanten Effekt bezüglich des DMFS.
Zusätzlich führten wir ein Subgruppenanalyse durch, einerseits bezüglich der Bestrahlung kleiner (T1) Tumoren und andererseits bezüglich der Chemotherapie größerer (T≥3) und hochmaligner (G3) Tumore. Nachbestrahlte kleine Tumore ≤ 5cm hatten einen signifikanten Vorteil bezüglich des LRFS. Größere und hochmaligne Tumore profitierten nicht von der Chemotherapie bezüglich des DMFS.
Unsere Daten weisen darauf hin, dass weite lokale Resektionen oder kompartmentorientierte Resektionen die primären operativen Optionen für MFS sein sollten und dass die operative Therapie in einem spezialisierten Sarkomzentrum erfolgen soll. Des Weiteren empfehlen wir, dass Experten die adjuvante Bestrahlung auch kleinerer Tumoren in Betracht ziehen. Schließlich weist unsere Analyse darauf hin, das MFS eine Chemotherapie resistente Entität sein könnte. Soll die Chemotherapie als Teil der primären Therapie benutzt werden, empfehlen wir, dass die Patienten engmaschig kontrolliert werden, um ein Versagen, insbesondere der neoadjuvanten Chemotherapie, rechtzeitig zu erkennen. Die Frage der Chemotherapieresistenz der MFS sollte in mehreren prospektiven, multizentrischen Studien untersucht werden
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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