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2. Fertility status among long-term childhood acute lymphoblastic leukaemia survivors enrolled between 1971 and 1998 in EORTC CLG studies: results of the 58 late adverse effects study

Author

Rossi, G., primary, Kicinski, M., additional, Suciu, S., additional, Vandecruys, E., additional, Plat, G., additional, Uyttebroeck, A., additional, Paillard, C., additional, Barbati, M., additional, Dresse, M.F., additional, Simon, P., additional, Minckes, O., additional, Pluchart, C., additional, Ferster, A., additional, Freycon, C., additional, Millot, F., additional, van, der Werfften Bosch J., additional, Chantrain, C., additional, Paulus, R., additional, de, Rojas T., additional, de, Schaetzen G., additional, Rohrlich, P., additional, Benoit, Y., additional, and Piette, C., additional

Published
2022
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3. Differential impact of drugs on the outcome of ETV6-RUNX1 positive childhood B-cell precursor acute lymphoblastic leukaemia: results of the EORTC CLG 58881 and 58951 trials

Author

Piette, C, Suciu, S, Clappier, E, Bertrand, Y, Drunat, S, Girard, S, Yakouben, K, Plat, G, Dastugue, N, Mazingue, F, Grardel, N, van Roy, N, Uyttebroeck, A, Costa, V, Minckes, O, Sirvent, N, Simon, P, Lutz, P, Ferster, A, Pluchart, C, Poirée, M, Freycon, C, Dresse, M-F, Millot, F, Chantrain, C, van der Werff tenBosch, J, Norga, K, Gilotay, C, Rohrlich, P-S, Benoit, Y, and Cavé, H

Published
2018
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7. Severe toxicity free survival: physician-derived definitions of unacceptable long-term toxicities following acute lymphocytic leukaemia.

Author

Andrés-Jensen, L, Attarbaschi, A, Bardi, E, Barzilai-Birenboim, S, Bhojwani, D, Hagleitner, MM, Halsey, C, Harila-Saari, A, van Litsenburg, RRL, Hudson, MM, Jeha, S, Kato, M, Kremer, L, Mlynarski, W, Möricke, A, Pieters, R, Piette, C, Raetz, E, Ronceray, L, Toro, C, Grazia Valsecchi, M, Vrooman, LM, Weinreb, S, Winick, N, Schmiegelow, K, Ponte di Legno Severe Toxicity Working Group, Andrés-Jensen, L, Attarbaschi, A, Bardi, E, Barzilai-Birenboim, S, Bhojwani, D, Hagleitner, MM, Halsey, C, Harila-Saari, A, van Litsenburg, RRL, Hudson, MM, Jeha, S, Kato, M, Kremer, L, Mlynarski, W, Möricke, A, Pieters, R, Piette, C, Raetz, E, Ronceray, L, Toro, C, Grazia Valsecchi, M, Vrooman, LM, Weinreb, S, Winick, N, Schmiegelow, K, and Ponte di Legno Severe Toxicity Working Group

Abstract

5-year overall survival rates have surpassed 90% for childhood acute lymphocytic leukaemia, but survivors are at risk for permanent health sequelae. Although event-free survival appropriately represents the outcome for cancers with poor overall survival, this metric is inadequate when cure rates are high but challenged by serious, persistent complications. Accordingly, a group of experts in paediatric haematology-oncology, representative of 17 international acute lymphocytic leukaemia study groups, launched an initiative to construct a measure, designated severe toxicity-free survival (STFS), to quantify the occurrence of physician-prioritised toxicities to be integrated with standard cancer outcome reporting. Five generic inclusion criteria (not present before cancer diagnosis, symptomatic, objectifiable, of unacceptable severity, permanent, or requiring unacceptable treatments) were used to assess 855 health conditions, which resulted in inclusion of 21 severe toxicities. Consensus definitions were reached through a modified Delphi process supplemented by two additional plenary meetings. The 21 severe toxicities include severe adverse health conditions that substantially affect activities of daily living and are refractory to therapy (eg, refractory seizures), are without therapeutic options (eg, blindness), or require substantially invasive treatment (eg, cardiac transplantation). Incorporation of STFS assessment into clinical trials has the potential to improve and diversify treatment strategies, focusing not only on traditional outcome events and overall survival but also the frequencies of the most severe toxicities. The two major aims of this Review were to: prioritise and define unacceptable long-term toxicity for patients with childhood acute lymphocytic leukaemia, and define how these toxicities should be combined into a composite quantity to be integrated with other reported outcomes. Although STFS quantifies the clinically unacceptable health tradeoff fo

Published
2021

8. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study

Author

Tsugu, T, Postolache, A, Dulgheru, R, Sugimoto, T, Tridetti, J, Nguyen Trung, M, Piette, C, Moonen, M, Manganaro, R, Ilardi, F, Chitroceanu, A, Sperlongano, S, Go, Y, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Magne, J, Cosyns, B, Galli, E, Donal, E, Santoro, C, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Tsugu, Toshimitsu, Postolache, Adriana, Dulgheru, Raluca, Sugimoto, Tadafumi, Tridetti, Julien, Nguyen Trung, Mai-Linh, Piette, Caroline, Moonen, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi, Lang, Roberto M, Lancellotti, Patrizio, Tsugu, T, Postolache, A, Dulgheru, R, Sugimoto, T, Tridetti, J, Nguyen Trung, M, Piette, C, Moonen, M, Manganaro, R, Ilardi, F, Chitroceanu, A, Sperlongano, S, Go, Y, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Magne, J, Cosyns, B, Galli, E, Donal, E, Santoro, C, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Tsugu, Toshimitsu, Postolache, Adriana, Dulgheru, Raluca, Sugimoto, Tadafumi, Tridetti, Julien, Nguyen Trung, Mai-Linh, Piette, Caroline, Moonen, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andreas, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Dragos, Zamorano, Jose Luis, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi, Lang, Roberto M, and Lancellotti, Patrizio

Abstract

Aims : To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. Methods and results : A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were -15.0% in men and -15.6% in women for epicardial strain, -16.8% and -17.7% for mid-myocardial strain, and -18.7% and -19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = -0.20, P = 0.007, mid-myocardial; r = -0.21, P = 0.006, endocardial; r = -0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1). Conclusion : The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.

Published
2020

10. PF177 NATION-WIDE PROSPECTIVE, REAL-TIME MONITORING OF PEGYLATED E.COLI AND ERWINIA ASPARAGINASE THERAPY IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA AND NON-HODGKIN LYMPHOMA IN BELGIUM

Author

Mondelaers, V., primary, Lammens, T., additional, Dedeken, L., additional, Uyttebroeck, A., additional, Brichard, B., additional, van der Werff ten Bosch, J., additional, Norga, K., additional, Francotte, N., additional, Piette, C., additional, Benoit, Y., additional, and De Moerloose, B., additional

Published
2019
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13. Differential impact of drugs on the outcome of ETV6-RUNX1 positive childhood B-cell precursor acute lymphoblastic leukaemia: results of the EORTC CLG 58881 and 58951 trials

Author

Piette, C, primary, Suciu, S, additional, Clappier, E, additional, Bertrand, Y, additional, Drunat, S, additional, Girard, S, additional, Yakouben, K, additional, Plat, G, additional, Dastugue, N, additional, Mazingue, F, additional, Grardel, N, additional, van Roy, N, additional, Uyttebroeck, A, additional, Costa, V, additional, Minckes, O, additional, Sirvent, N, additional, Simon, P, additional, Lutz, P, additional, Ferster, A, additional, Pluchart, C, additional, Poirée, M, additional, Freycon, C, additional, Dresse, M-F, additional, Millot, F, additional, Chantrain, C, additional, van der Werff ten Bosch, J, additional, Norga, K, additional, Gilotay, C, additional, Rohrlich, P-S, additional, Benoit, Y, additional, and Cavé, H, additional

Published
2017
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15. Paravertebral Burkitt's Lymphoma in a Child: An Unusual Presentation

Author

Hoyoux, C., Forget, P., Piette, C., Dresse, M. F., Florkin, B., Rausin, L., and Thiry, A.

Subjects
Article Subject
Abstract

Paravertebral malignant tumors constitute 4.8% of cancer cases in pediatric oncology and are mostly composed of neuroblastoma (46.4%) and soft tissue sarcomas (35.7%). We describe the case of a Caucasian 6-year-old boy who was admitted for middle back pain radiated to limbs and progressively increasing weakness of the legs, suggesting a spinal cord disease. The exploration revealed two paravertebral masses extending through the neural foraminae into the epidural space. The association with elevated serum neuron specific enolase suggested at first the diagnosis of neuroblastoma, but the pathological examination revealed a Burkitt's lymphoma. This is a rare location of sporadic Burkitt's lymphoma with neurologic syndrome as first symptoms.

Published
2012
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17. Une nouvelle méthode hybride pour calculer tous les MSS et tous les MUS

Author

Grégoire, E., Mazure, B., Piette, C., Centre de Recherche en Informatique de Lens (CRIL), and Université d'Artois (UA)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[INFO.INFO-PL]Computer Science [cs]/Programming Languages [cs.PL]
Abstract

Dans ce papier, nous présentons une nouvelle technique complète permettant le calcul des sous-formules maximales consistantes (MSS) et des formules minimales inconsistantes (MUS) d'un ensemble de clauses booléennes. Cette approche améliore la meilleure technique complète connue de plusieurs manières. Elle utilise à la fois une recherche locale peu coûteuse en ressources et le nouveau concept de clause critique pour améliorer un algorithme complet proposé par Liffiton et Sakallah. Cette hybridation permet l'obtention de gains exponentiels. Ainsi, des résultats expérimentaux montrent que cette nouvelle approche dépasse la meilleure méthode proposée jusque ici.

Published
2007

20. Second malignant neoplasms after treatment of childhood acute lymphoblastic leukemia

Author

Schmiegelow, K, Levinsen, M, Attarbaschi, A, Baruchel, A, Devidas, M, Escherich, G, Gibson, B, Heydrich, C, Horibe, K, Ishida, Y, Liang, D, Locatelli, F, Michel, G, Pieters, R, Piette, C, Pui, C, Raimondi, S, Silverman, L, Stanulla, M, Stark, B, Winick, N, Valsecchi, M, VALSECCHI, MARIA GRAZIA, Schmiegelow, K, Levinsen, M, Attarbaschi, A, Baruchel, A, Devidas, M, Escherich, G, Gibson, B, Heydrich, C, Horibe, K, Ishida, Y, Liang, D, Locatelli, F, Michel, G, Pieters, R, Piette, C, Pui, C, Raimondi, S, Silverman, L, Stanulla, M, Stark, B, Winick, N, Valsecchi, M, and VALSECCHI, MARIA GRAZIA

Abstract

PURPOSE Second malignant neoplasms (SMNs) after diagnosis of childhood acute lymphoblastic leukemia (ALL) are rare events. PATIENTS AND METHODS We analyzed data on risk factors and outcomes of 642 children with SMNs occurring after treatment for ALL from 18 collaborative study groups between 1980 and 2007. Results Acute myeloid leukemia (AML; n = 186), myelodysplastic syndrome (MDS; n = 69), and nonmeningioma brain tumor (n = 116) were the most common types of SMNs and had the poorest outcome (5-year survival rate, 18.1% ± 2.9%, 31.1% ± 6.2%, and 18.3% ± 3.8%, respectively). Five-year survival estimates for AML were 11.2% ± 2.9% for 125 patients diagnosed before 2000 and 34.1% ± 6.3% for 61 patients diagnosed after 2000 (P < .001); 5-year survival estimates for MDS were 17.1% ± 6.4% (n = 36) and 48.2% ± 10.6% (n = 33; P = .005). Allogeneic stem-cell transplantation failed to improve outcome of secondary myeloid malignancies after adjusting for waiting time to transplantation. Five-year survival rates were above 90% for patients with meningioma, Hodgkin lymphoma, thyroid carcinoma, basal cell carcinoma, and parotid gland tumor, and 68.5% ± 6.4% for those with non-Hodgkin lymphoma. Eighty-nine percent of patients with brain tumors had received cranial irradiation. Solid tumors were associated with cyclophosphamide exposure, and myeloid malignancy was associated with topoisomerase II inhibitors and starting doses of methotrexate of at least 25 mg/m(2) per week and mercaptopurine of at least 75 mg/m(2) per day. Myeloid malignancies with monosomy 7/5q- were associated with high hyperdiploid ALL karyotypes, whereas 11q23/MLL-rearranged AML or MDS was associated with ALL harboring translocations of t(9;22), t(4;11), t(1;19), and t(12;21) (P = .03). CONCLUSION SMNs, except for brain tumors, AML, and MDS, have outcomes similar to their primary counterparts.

Published
2013

24. EPENDYMOMA

Author

Zaghloul, M., primary, Elbeltagy, M., additional, Mousa, A., additional, Eldebawy, E., additional, Amin, A., additional, Pavelka, Z., additional, Vranova, V., additional, Valaskova, I., additional, Tomasikova, L., additional, Oltova, A., additional, Ventruba, J., additional, Mackerle, Z., additional, Kren, L., additional, Skotakova, J., additional, Zitterbart, K., additional, Sterba, J., additional, Milde, T., additional, Kleber, S., additional, Korshunov, A., additional, Witt, H., additional, Hielscher, T., additional, Koch, P., additional, Koch, H.-G., additional, Jugold, M., additional, Deubzer, H. E., additional, Oehme, I., additional, Lodrini, M., additional, Grone, H.-J., additional, Benner, A., additional, Brustle, O., additional, Gilbertson, R. J., additional, von Deimling, A., additional, Kulozik, A. E., additional, Pfister, S. M., additional, Ana, M.-V., additional, Witt, O., additional, Kool, M., additional, Mack, S. C., additional, Taylor, M. D., additional, Fouyssac, F., additional, Schmitt, E., additional, Mansuy, L., additional, Marchal, J.-C., additional, Coffinet, L., additional, Bernier, V., additional, Chastagner, P., additional, Sperl, D., additional, Zacharoulis, S., additional, Massimino, M., additional, Schiavello, E., additional, Pizer, B., additional, Piette, C., additional, Kitanovski, L., additional, von Hoff, K., additional, Quehenberger, F., additional, Rutkowski, S., additional, Benesch, M., additional, Tzaridis, T.-D., additional, Bender, S., additional, Pfaff, E., additional, Barbus, S., additional, Bageritz, J., additional, Jones, D.-T.-W., additional, Kulozik, A., additional, Lichter, P., additional, Pfister, S.-M., additional, Song, S.-H., additional, Kang, C.-W., additional, Kim, S.-H., additional, Bandopadhayay, P., additional, Ullrich, N., additional, Goumnerova, L., additional, Scott, R. M., additional, Silvera, V. M., additional, Ligon, K. L., additional, Marcus, K. J., additional, Robison, N., additional, Manley, P. E., additional, Chi, S., additional, Kieran, M. W., additional, Biassoni, V., additional, Pierani, P., additional, Cesaro, S., additional, Maura, M., additional, Mack, S., additional, Jager, N., additional, Jones, D. T. W., additional, Stutz, A., additional, Northcott, P. A., additional, Fults, D. W., additional, Gupta, N., additional, Karajannis, M., additional, Rutka, J. T., additional, Korbel, J., additional, de Rezende, A. C. P., additional, Chen, M. J., additional, da Silva, N. S., additional, Cappellano, A., additional, Cavalheiro, S., additional, Weltman, E., additional, Currle, S., additional, Thiruvenkatam, R., additional, Murugesan, M., additional, Kranenburg, T., additional, Phoenix, T., additional, Gupta, K., additional, Gilbertson, R., additional, Rogers, H., additional, Kilday, J.-P., additional, Mayne, C., additional, Ward, J., additional, Adamowicz-Brice, M., additional, Schwalbe, E., additional, Clifford, S., additional, Coyle, B., additional, Grundy, R., additional, Mitra, B., additional, Domerg, C., additional, Andreiuolo, F., additional, Osteso-Ibanez, T., additional, Mauguen, A., additional, Varlet, P., additional, Le Deley, M.-C., additional, Lowe, J., additional, Ellison, D. W., additional, Grill, J., additional, Grundy, R. G., additional, Fleischhack, G., additional, Pajtler, K., additional, Zimmermann, M., additional, Warmuth-Metz, M., additional, Kortmann, R.-D., additional, Pietsch, T., additional, Faldum, A., additional, Bode, U., additional, Gandola, L., additional, Pecori, E., additional, Scarzello, G., additional, Barra, S., additional, Mascarin, M., additional, Scoccianti, S., additional, Mussano, A., additional, Garre, M. L., additional, Jacopo, S., additional, Viscardi, E., additional, Balter, R., additional, Bertin, D., additional, Giangaspero, F., additional, Pearlman, M., additional, Khatua, S., additional, Van Meter, T., additional, Koul, D., additional, Yung, A., additional, Paulino, A., additional, Su, J., additional, Dauser, R., additional, Whitehead, W., additional, Teh, B., additional, Chintagumpala, M., additional, Perek, D., additional, Drogosiewicz, M., additional, Filipek, I., additional, Polnik, M. P., additional, Baginska, B. D., additional, Wachowiak, J., additional, Kazmierczak, B., additional, Sobol, G., additional, Musiol, K., additional, Kowalczyk, J., additional, Slusarz, H. W., additional, Peregud-Pogorzelski, J., additional, Grajkowska, W., additional, Roszkowski, M., additional, Teo, W.-Y., additional, Okcu, F., additional, Mahajan, A., additional, Adesina, A., additional, Jea, A., additional, Bollo, R., additional, Paulino, A. C., additional, Velez-Char, N., additional, Doerner, E., additional, Muehlen, A. z., additional, Vladimirova, V., additional, Kortmann, R., additional, Friedrich, C., additional, von Bueren, A. O., additional, Barszczyk, M., additional, Buczkowicz, P., additional, Morrison, A., additional, Tabori, U., additional, Hawkins, C., additional, Krajewski, K., additional, Kammler, G., additional, von Bueren, A., additional, Krauss, J., additional, Ferreira, C., additional, Dieffenbach, G., additional, Barbosa, C., additional, Cuny, P., additional, Piccinin, E., additional, Brenca, M., additional, Lorenzetto, E., additional, Sardi, I., additional, Genitori, L., additional, Pollo, B., additional, Maestro, R., additional, Modena, P., additional, MacDonald, S., additional, Ebb, D., additional, Lavally, B., additional, Yeap, B., additional, Marcus, K., additional, Tarbell, N., additional, Yock, T., additional, Schittone, S., additional, Donson, A., additional, Birks, D., additional, Amani, V., additional, Griesinger, A., additional, Handler, M., additional, Madey, M., additional, Merchant, T., additional, Foreman, N., additional, Hukin, J., additional, Ailon, T., additional, Dunham, C., additional, Carret, A.-S., additional, McNeely, P. D., additional, Zelcer, S., additional, Wilson, B., additional, Lafay-Cousin, L., additional, Johnston, D., additional, Eisenstat, D., additional, Silva, M., additional, Jabado, N., additional, Yip, S., additional, Goddard, K., additional, Fryer, C., additional, Hendson, G., additional, Dunn, S., additional, Singhal, A., additional, Lassen-Ramshad, Y., additional, Vestergaard, A., additional, Seiersen, K., additional, Schultz, H. P., additional, Hoeyer, M., additional, Petersen, J. B., additional, Moreno, L., additional, Popov, S., additional, Jury, A., additional, Al Sarraj, S., additional, Jones, C., additional, Bowers, D., additional, Gargan, L., additional, Horton, C. J., additional, Rakheja, D., additional, Margraf, L., additional, Yeung, J., additional, Hamilton, R., additional, Okada, H., additional, Jakacki, R., additional, Pollack, I., additional, Fleming, A., additional, Saint-Martin, C., additional, Freeman, C., additional, Albrecht, S., additional, and Montes, J.-L., additional

Published
2012
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46. Results of a 12-month quality-circle prescribing improvement programme for GPs.

Author

Riou F, Piette C, Durand G, and Chaperon J

Abstract

BACKGROUND: The impact of a quality-circle GP prescribing improvement programme, implemented in France in 2001-2002, was assessed by a controlled study. The study involved all 27 GPs of three semi-rural areas of Brittany, France. Practice data (overall prescribing cost and markers of prescribing efficiency) were collated in an intention-to-treat analysis, using the Mann-Whitney U test. Twenty-four GPs attended the meetings regularly. The reduction in drug expenditure exceeded the cost of the programme, although variations in size effects were observed among the settings. [ABSTRACT FROM AUTHOR]

Published
2007

47. [Prognosis and prognostic factors of hemorrhage by rupture of varices in cirrhotic patients in the era of endoscopic sclerotherapy]

Author

Heresbach D, Jf, Bretagne, Jl, Raoul, Chaperon J, Piette C, laurent Siproudhis, Gastard J, and Gosselin M

Subjects
Adult, Liver Cirrhosis, Male, Middle Aged, Esophageal and Gastric Varices, Prognosis, Endoscopy, Gastrointestinal, Actuarial Analysis, Recurrence, Sclerotherapy, Humans, Female, Gastrointestinal Hemorrhage, Aged, Retrospective Studies
Abstract

The aim of this study was to evaluate the prognosis and the determinants of survival in cirrhotics presenting with variceal bleeding. One hundred and ninety one consecutive patients with cirrhosis (alcoholic 93 percent) were enrolled between 1983 and 1988. Treatment was principally but not exclusively based on early endoscopic sclerotherapy. At admission all patients were classified according to Child-Pugh's classification (class A = 16 percent; class B = 53 percent; class C = 31 percent). The rebleeding rates at 48 hours and for the entire hospitalisation were 11 and 30 percent respectively. Actuarial survival rates were 45, 40, and 37 percent at 12, 18, and 36 months, respectively. Prognostic factors, as determined by uni- and multivariate analysis (Cox model), corresponded to Child-Pugh's score, to the five components, and the occurrence of early bleeding recurrence. This study also showed that: i) the role of Child-Pugh's classification on long-term prognosis is determined during the 3 months following index bleeding; ii) early rebleeding is a significant prognostic factor, particularly in Child-Pugh's class B patients; iii) there are few indicators of early rebleeding (serum albumin level, presence of gastric varices at initial endoscopy). Prognosis of variceal bleeding is still severe in cirrhosis but efforts made to prevent early bleeding recurrence seem to be fully justified.

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