Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Wang, Chih-Kai; Ho, Che-Fang; Niu, Kuang-Yu; Wu, Chien-Hung; Chang, Yun-Chen; Hsiao, Chien-Han; Yen, Chieh-Ching

doi:10.1186/s12885-022-09945-y

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…Second, all significant variables from the univariable analyses were inputted into the multivariable logistic regression model to further examine their statistical association. Continuous variables were categorized as a priori using either the standard threshold values established in our laboratory settings or thresholds associated with poor outcomes, as identified in the existing literature [17][18][19][20][21][22][23][24]. In the multivariable model, a p-value of < 0.05 was set as the threshold for the incorporation of variables into the final prediction score.…”

Section: Derivation Stagementioning

confidence: 99%

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Lu,

Niu,

Pai

et al. 2024

Cancers

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Purpose: To develop and internally validate a novel prediction score to predict the occurrence of arterial–esophageal fistula (AEF) in esophageal cancer bleeding. Methods: This retrospective cohort study enrolled patients with esophageal cancer bleeding in the emergency department. The primary outcome was the diagnosis of AEF. The patients were randomly divided into a derivation group and a validation group. In the derivation stage, a predictive model was developed using logistic regression analysis. Subsequently, internal validation of the model was conducted in the validation cohort during the validation stage to assess its discrimination ability. Results: A total of 257 patients were enrolled in this study. All participants were randomized to a derivation cohort (n = 155) and a validation cohort (n = 102). AEF occurred in 22 patients (14.2%) in the derivation group and 14 patients (13.7%) in the validation group. A predictive model (HEARTS-Score) comprising five variables (hematemesis, active bleeding, serum creatinine level >1.2 mg/dL, prothrombin time >13 s, and previous stent implantation) was established. The HEARTS-Score demonstrated a high discriminative ability in both the derivation and validation cohorts, with c-statistics of 0.90 (95% CI 0.82–0.98) and 0.82 (95% CI 0.72–0.92), respectively. Conclusions: By employing this novel prediction score, clinicians can make more objective risk assessments, optimizing diagnostic strategies and tailoring treatment approaches.

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Section: Derivation Stagementioning

confidence: 99%

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Lu,

Niu,

Pai

et al. 2024

Cancers

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“…Poor intake due to dysphagia, odynophagia, and esophageal stenosis can lead to malnutrition and cachexia, which might weaken the immune system and reduce the resistance to infection. Additionally, previous research suggested that patients with nutritional deficiency might have poorer tolerance to the toxicity of chemoradiotherapy and surgical intervention (37)(38)(39).…”

Section: B Amentioning

confidence: 99%

Clinical characteristics and risk factors for 30-day mortality in esophageal cancer patients with upper gastrointestinal bleeding: a multicenter study

Pai

Yang

et al. 2023

Front. Oncol.

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BackgroundEsophageal cancer is a highly malignant neoplasm with poor prognosis. Of its patients, upper gastrointestinal bleeding (UGIB) is one of the most challenging and threatening conditions in the emergency department (ED). However, no previous studies have analyzed the etiologies and clinical outcomes in this specific population. This study aimed to identify the clinical characteristics and risk factors for 30-day mortality in esophageal cancer patients with UGIB.MethodsThis retrospective cohort study enrolled 249 adult patients with esophageal cancer presenting with UGIB in the ED. Patients was divided into the survivor and non-survivor groups, and their demographic information, medical history, comorbidities, laboratory parameters, and clinical findings were recorded. The factors associated with 30-day mortality were identified using Cox’s proportional hazard model.ResultsAmong the 249 patients in this study, 30-day mortality occurred in 47 patients (18.9%). The most common causes of UGIB were tumor ulcer (53.8%), followed by gastric/duodenal ulcer (14.5%), and arterial-esophageal fistula (AEF) (12.0%). Multivariate analyses indicated that underweight (HR = 2.02, p = 0.044), history of chronic kidney disease (HR = 6.39, p < 0.001), active bleeding (HR = 2.24, p = 0.039), AEF (HR = 2.23, p = 0.046), and metastatic lymph nodes (HR = 2.99, p = 0.021) were independent risk factors for 30-day mortality.ConclusionsThe most common cause of UGIB in esophageal cancer patients was tumor ulcer. AEF, accounting for 12% of UGIB in our study, is not an uncommon cause. Underweight, underlying chronic kidney disease, active bleeding, AEF, and tumor N stage > 0 were independent risk factors for 30-day mortality.

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“…Wang et al 85 analyzed 231 patients with head and neck cancer who experienced bleeding. Among these patients, 112 (48.5%) had a recurrent bleeding event.…”

Section: New Risk Factors For Bleeding In Patients With Cancermentioning

confidence: 99%

In Search of the Perfect Thrombosis and Bleeding-Associated Cancer Scale

Wojtukiewicz,

Tesarova,

Karetová

et al. 2023

Semin Thromb Hemost

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Thrombosis and bleeding are commonly observed in cancer patients, and their management is crucial for positive patient outcomes. A comprehensive, prophylactic, and therapeutic management of venous thrombosis should focus on identifying the patients who would benefit most from treatment to reduce mortality and minimize the risk of thrombosis recurrence without significantly increasing the risk of bleeding. Existing cancer scales provide valuable information for assessing the overall burden of cancer and guiding treatment decisions, but their ability to predict thrombotic and bleeding events remains limited. With increasing knowledge of the pathophysiology of cancer and the availability of advanced anticancer therapies, new risk factors for cancer-associated thrombosis and bleeding are being identified. In this report, we analyze the current literature and identify new risk factors for venous thrombosis and bleeding which are not included in routinely used risk scores. While some existing cancer scales partially capture the risk of thrombosis and bleeding, there is a need for more specific and accurate scales tailored to these complications. The development of such scales could improve risk stratification, aid in treatment selection, and enhance patient care. Therefore, further research and development of novel cancer scales focused on thrombosis and bleeding are warranted to optimize patient management and outcomes.

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Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Cited by 4 publications

References 35 publications

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Novel Prediction Score for Arterial–Esophageal Fistula in Patients with Esophageal Cancer Bleeding: A Multicenter Study

Clinical characteristics and risk factors for 30-day mortality in esophageal cancer patients with upper gastrointestinal bleeding: a multicenter study

In Search of the Perfect Thrombosis and Bleeding-Associated Cancer Scale

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