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Eva-Maria Fick,Alexander Katalinic,Annika Waldmann 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4
Purpose The aim of this cross-sectional health care study (use of bisphosphonates in primary tumorsof the mammae, EBisMa) is to determine how often bisphosphonate medication is used inpatients with non-metastatic primary breast cancer treatment, but who do not suffer fromosteoporosis. Furthermore, we describe patients’ characteristics and the most frequentlyused type of bisphosphonate in adjuvant therapy. Materials and MethodsThe study population included primary breast cancer patients of four breast centers in northernGermany. Data on bisphosphonate therapy were collected by use of patient questionnaires;clinical data were extracted from the registers. Patients with and without prescribedbisphosphonate adjuvant treatment were tested for statistically significant differencesregarding their characteristics. ResultsFour hundred seventy-four of 663 contacted patients participated in the study. Thirty-nineout of 474 patients (9.6%) were on adjuvant bisphosphonate therapy. Zoledronic acid wasthe most frequently reported bisphosphonate used for prevention of bone metastases. Comparedto patients who did not report bisphosphonate medication, women who did reportbisphosphonate therapy had a significantly higher advanced tumor stage (p < 0.001). Boththe T2-T4 stage and N+ stage remained significant predictors in multivariate-adjustedregression models. ConclusionBisphosphonates are rarely used in the adjuvant treatment of primary breast cancer. Patients with advanced tumor stage were more likely to use bisphosphonates in the adjuvanttreatment of primary breast cancer. Further research is needed to identify patientswho may benefit most from adjuvant bisphosphonate treatment.
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Brian J. Linder,John B. Gebhart,Amy L. Weaver,Felecia R. Fick,Randina R. Harvey-Springer,Emanuel C. Trabuco,Christopher J. Klingele,John A. Occhino 대한비뇨의학회 2022 Investigative and Clinical Urology Vol.63 No.2
Purpose: We compared the degree of pelvic floor symptom improvement between pessary use and prolapse surgery. Materials and Methods: Pessary-naïve women who elected prolapse surgery were enrolled and used a pessary preoperatively (for ≥7 days and ≤30 days). Pelvic floor symptoms were assessed at baseline, after pessary use, and at 3 months postoperatively. The primary outcome was concordance in the degree of symptoms improvement between pessary use and surgery, as assessed by Patient Global Impression of Improvement (PGI-I). Secondary outcomes were related to prolapse specific symptoms on validated questionnaires (POPDI-6, PFIQ-7). The McNemar test was used for comparisons of discordant pairs for comparisons of the PGI-I ratings after pessary use and surgery. Results: Sixty-one participants were enrolled (March 2016 through April 2019) and 58 patients used a pessary. Mean±standard deviation age was 60.7±10.7 years; 24.1% had prior hysterectomy, and 13.8% had prior prolapse surgery. While both treatments demonstrated symptomatic improvement, concordance in the degree of overall improvement on the PGI-I score was poor (n=40); responses significantly favored more improvement postoperatively (p<0.001). Pessary use and surgery were associated with significant improvements in prolapse symptoms from baseline on POPDI-6 (both p<0.001) and POPIQ-7 (pessary, p=0.002; surgery, p<0.001). The degree of improvement was larger postoperatively compared to post-pessary use on POPDI-6 (p<0.001) and PFIQ-7 (p=0.004). Conclusions: Both pessary use and surgery significantly improved pelvic floor symptoms from baseline. However, concordance in degrees of improvement between these treatments was poor, with more favorable outcomes after surgery for prolapse symptoms.
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