The prognostic value of early radiographic response in children and adolescents with embryonal rhabdomyosarcoma stage IV, metastases confined to the lungs: A report from the Cooperative Weichteilsarkom Studiengruppe (CWS)

ObjectiveThe revised version of the International Federation of Gynaecology and Obstetrics (FIGO) staging system (2014) for epithelial ovarian cancer includes a number of changes. One of these is the division of stage IV into 2 subgroups. Data on the prognostic and predictive significance of this classification are scarce. The effect of neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) in relation to the subclassification of FIGO stage IV is also unknown.MethodsWe used data of the EORTC 55971 trial, in which 670 patients with previous stage IIIC or IV epithelial ovarian cancer were randomly assigned to PDS or NACT; 160 patients had previous stage IV. Information on previous FIGO staging and presence of pleural effusion with positive cytology were used to classify tumors as either stage IVA or IVB. We tested the association between stage IVA/IVB and survival to evaluate the prognostic value and interactions between stage, treatment, and survival to evaluate the predictive performance.ResultsAmong the 160 participants with previous stage IV disease, 103 (64%) were categorized as stage IVA and 57 (36%) as stage IVB tumors. Median overall survival was 24 months in FIGO stage IVA and 31 months in stage IVB patients (P = 0.044). Stage IVB patients treated with NACT had 9 months longer median overall survival compared with IVB patients undergoing PDS (P = 0.025), whereas in IVA patients, no significant difference was observed (24 vs 26 months, P = 0.48).ConclusionsThe reclassification of FIGO stage IV into stage IVA or IVB was not prognostic as expected. Compared with stage IVA patients, stage IVB patients have a better overall survival and may benefit more from NACT.

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Circulating tumor cells: a valuable marker of poor prognosis for advanced nasopharyngeal carcinoma

Molecular Medicine ◽

10.1186/s10020-019-0112-3 ◽

2019 ◽

Vol 25 (1) ◽

Cited By ~ 1

Author(s):

Guoping Ou ◽

Shan Xing ◽

Jianpei Li ◽

Lin Zhang ◽

Shulin Chen

Keyword(s):

Nasopharyngeal Carcinoma ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Roc Curve ◽

Poor Prognosis ◽

Regression Models ◽

Prognostic Value ◽

Stage Iv ◽

Stage Iii ◽

Ebv Dna

Abstract Purpose To evaluate the prognostic value of circulating tumor cells (CTCs) in nasopharyngeal carcinoma (NPC). Methods Cox’s proportional hazards regression models were used to identify whether CTCs was a poor prognostic factor for NPC. Chi-square tests were used to analyze and compare the distribution characteristics of CTCs in NPC. ROC curve was used to estimate the cut-off point of CTCs. Kaplan-Meier survival analyses were used to observe the prognostic value of CTCs alone and in combined with Epstein-Barr Virus DNA (EBV-DNA). Results CTCs was confirmed to be an independent risk factor for poor prognosis of NPC by Cox’s regression models that enrolled 370 NPC cases and took age, gender, EBV-DNA and CTCs as variables. The proportion of CTCs in stage IV NPC was statistically different from that in stage III; the cut-off point of CTCs between stage IV (288 cases) and stage III (70 cases) NPC estimated by ROC curve was 0.5. The prognosis of advanced NPC patients became worse with the increase of CTCs count. The combined detection of CTCs and EBV-DNA could better predict the prognosis of NPC compared with the single detection of EBV-DNA.

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Prognostic Value of the Quantitative Metabolic Volumetric Measurement on 18F-FDG PET/CT in Stage IV Nonsurgical Small-cell Lung Cancer

Academic Radiology ◽

10.1016/j.acra.2011.08.020 ◽

2012 ◽

Vol 19 (1) ◽

pp. 69-77 ◽

Cited By ~ 71

Author(s):

Shengri Liao ◽

Bill C. Penney ◽

Hao Zhang ◽

Kenji Suzuki ◽

Yonglin Pu

Keyword(s):

Lung Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Stage Iv ◽

Small Cell ◽

Volumetric Measurement ◽

Small Cell Lung ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Prognostic Value of Volumetric Parameters on Staging and Posttreatment FDG PET/CT in Patients With Stage IV Non–Small Cell Lung Cancer

Clinical Nuclear Medicine ◽

10.1097/rlu.0000000000001126 ◽

2016 ◽

Vol 41 (5) ◽

pp. 347-353 ◽

Cited By ~ 13

Author(s):

Jeong Won Lee ◽

Sun Min Lee ◽

Mijin Yun ◽

Arthur Cho

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Stage Iv ◽

Small Cell ◽

Small Cell Lung ◽

Pet Ct ◽

Fdg Pet Ct

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Exploring the prognostic value of the neutrophil-to-lymphocyte ratio in cancer

Scientific Reports ◽

10.1038/s41598-019-56218-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 8

Author(s):

Rachel Howard ◽

Peter A. Kanetsky ◽

Kathleen M. Egan

Keyword(s):

Prognostic Value ◽

Clinical Characteristics ◽

Proportional Hazards ◽

Area Under The Curve ◽

Stage Iv ◽

Cox Proportional Hazards ◽

Neutrophil To Lymphocyte Ratio ◽

Cancer Center ◽

Lymphocyte Ratio ◽

Patient Subgroups

AbstractIn cancer patients, a high pre-treatment neutrophil-to-lymphocyte ratio (NLR) is associated with poorer survival outcomes. Significant variation in the magnitude of this association has been observed between studies, but sources of this variation are poorly understood. Here, we explore differences in the prognostic potential of NLR between patient subgroups stratified by demographic and clinical characteristics using a retrospective cohort of 5,363 patients treated at Moffitt Cancer Center (Tampa, FL). We identify patients for whom NLR has maximum prognostic potential via adjusted hazard ratios (HRs) calculated using multivariable Cox proportional hazards models and area under the curve analysis. NLR demonstrates stronger associations (HRs > 2) with survival among African-American patients, patients receiving radiation therapy, stage IV patients, and melanoma patients when compared with the overall study population (HR = 1.58). Sensitivity and specificity of NLR as a prognostic marker are also higher in these patient subgroups, and increase further with combinations of multiple “high-risk” demographic or clinical characteristics. In summary, NLR may have greater prognostic value in patients with certain demographic and clinical features. Future prospective studies could validate this hypothesis, after further characterization of populations in which NLR has maximum prognostic potential and the identification of meaningful thresholds for risk stratification.

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