METHOD: We collected data on demographics, retention and completion and abstinence between January 2021-August 2023 in MSM using Beyond-66. Using 10-point Likert scales, we compared motivation to remain abstinent and mental wellbeing at the beginning and end of Beyond-66.
RESULTS: 25 MSM have either completed or dropped out/referred out of Beyond-66, 12/25(48%) were living with HIV and the median duration of chemsex use was 5 years (IQR = 4-6). 19 (76%) completed programme; 3 were referred out for a psychiatry assessment and 3 dropped out of the programme. 14 (74%) remain abstinent and 5 relapsed. The median motivation for abstinence scores for the 19 completers increased significantly between the pre-programme and post-programme period (7/10 (IQR = 4-8) to 9/10 (IQR = 5-10), p = .04) and the median mental health score (Likert score out of 10 where 10 is poor mental health) reduced significantly (5/10 (IQR = 4-7) to 2/10 (IQR 1-6), p = .008).
CONCLUSION: This pilot evaluation suggests that MSM using Beyond-66 experience high completion (76%) and abstinence (74%) rates and increased motivation for abstinence and mental wellbeing scores. Further research is needed to design, develop, and deliver peer led interventions for MSM who are chemsex dependant.
METHODS: Medical records of dogs with a histopathologic diagnosis of HGMCTs were reviewed from a single institution. Clinical factors, treatment-related variables, and adjuvant therapies were documented to evaluate their association with clinical outcomes. Comparative and survival analyses were conducted using Kaplan-Meier survival analysis, log-rank, and Fisher's exact tests.
RESULTS: The overall median survival time for the 77 dogs was 317 days (range 20-3,041 days) with 6-month, 1-year, and 2-year survival rates of 69, 50, and 30%, respectively. Surgically treated dogs had significantly prolonged survival and were 6.88 times more likely to survive beyond 5.5 months. The presence of metastasis at initial staging was strongly associated with poorer outcomes, as dogs without metastasis at initial staging had 6.94 times higher odds of surviving beyond 2 years. Surgical sites with incomplete margins had a higher local recurrence rate (58%) compared to those with clean margins (26%). Despite aggressive treatment, 75% of the dogs that received concurrent surgical and adjuvant therapy experienced disease progression. Lymph node extirpation, tumor localization, number of tumors, and local recurrence were not associated with the overall outcome.
CLINICAL RELEVANCE: The combination of aggressive local therapy and adjuvant systemic chemotherapy provides a notable survival benefit in dogs with HGMCTs. The limited therapeutic benefit of locoregional lymph node extirpation, combined with a persistently high metastatic rate despite systemic chemotherapy, highlights the critical need for more effective regional and systemic treatment approaches for HGMCT patients.