Preoperative tracheotomy as reflection of tumor size impacting oncologic outcomes of patients with advanced stage glottic carcinoma

Abstract Background: Lung adenocarcinoma (LUAD) is the leading cause of cancer-related death. This study aimed to develop and validate reliable prognostic biomarkers and signature.Methods: Differentially expressed genes were identified based on three Gene Expression Omnibus (GEO) datasets. Based on three LUAD cohorts’ data included 1052 samples and extracted from our cohort, GEO, The Cancer Genome Atlas, we explored clinicopathological features and the expression of NEIL3 to determine its clinical effect in LUAD. Western blotting, Real-time quantitative PCR; (22 pairs of tumor and normal tissues), and immunohistochemical analyses (406-tumor tissues subjected to microarray) were conducted. TIMER and ImmuCellAI analyzed relationship between NEIL3 expression and the abundance of tumor-infiltrating immune cells in LUAD. The co-expressed-gene prognostic signature was established based on the Cox regression analysis.Results: This study identified 502 common differentially expressed genes and confirmed that NEIL3 was significantly overexpressed in LUAD samples(P<0.001). Increased NEIL3 expression was related to advanced stage, larger tumor size and poor overall survival (p < 0.001) in three LUAD cohorts. The proportions of natural T regulatory cells and induced T regulatory cells increased in the high NEIL3 group, whereas those of B cells, Th17 cells and dendritic cells decreased. Gene set enrichment analysis indicated that NEIL3 may activate cell cycle progression and P53 signaling pathway, leading to poor outcomes. We identified nine prognosis-associated hub genes among 370 genes co-expressed with NEIL3. A 10-gene prognostic signature including NEIL3 and nine key co-expressed genes was constructed. Higher risk-score was correlated with more advanced stage, larger tumor size and worse outcome (p<0.05). Finally, the signature was verified in test cohort (GSE50081) with superior diagnostic accuracy. Conclusions: This study suggested that NEIL3 has the potential to be an immune-related therapeutic target and an independent predictor for LUAD. We also developed a prognostic signature for LUAD with a precise diagnostic accuracy.

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Functional and oncologic outcomes of nephron-sparing surgery (NSS) for patients with renal cell carcinoma (RCC) greater than 4 cm in diameter.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.347 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 347-347

Author(s):

C. Piper ◽

S. Richter ◽

B. Brehmer ◽

D. J. Pfister ◽

R. Epplen ◽

...

Keyword(s):

Tumor Size ◽

Perioperative Complications ◽

Tnm Classification ◽

Surgical Margins ◽

Oncologic Outcomes ◽

Renal Tumors ◽

Cancer Specific Survival ◽

Survival Difference ◽

Group 2 ◽

Group 1

347 Background: Organ preserving surgery represents the guideline recommended surgical treatment of choice for patients with small renal tumors ≤ 4cm in diameter. There are only few data in the literature with regard to the oncological and functional outcome of elective NSS in RCC larger than 4cm. Methods: We retrospectively reviewed the charts of all patients who underwent elective NSS for RCC at our institution during 2004-2009. We identified 288 patients of whom 196 (68.1%) patients and 92(31.9%) patients underwent NSS for a tumor < 4cm (group 1) and a tumour ≥ 4cm (group 2), respectively. We analyzed tumor size, TNM-classification, OR time, surgical margins, complications, mortality, recurrences and metastases in both groups. Results: We identified significant differences between group 1 and 2 for the following variables: mean tumor size (2.9 vs. 8.6cm, p = 0.03), necessity for warm ischemia (15.1% vs. 51%, p = 0.001), mean ischemia time (3.5 vs. 10.2 min, p = 0.002), need for endoluminal stenting due to involvement of the renal pelvis (0.5% vs. 24.2%, p = 0.001). Significantly less pT2 (12.7% vs. 29.7%, p = 0.03) and pT3 tumors (8.7% vs. 12%, p = 0.05) were identified in group 1 when compared to group 2. There were no significant differences with regard to mean OR time (61 vs. 74 min), positive surgical margins (1/192 vs. 1/92), hospital stay, and perioperative complications. There were no significant differences with regard to stage specific overall survival, cancer-specific survival and progression-free survival. There was no significant survival difference between NSS and radical nephrectomy. Conclusions: NSS can be safely performed in RCC > 4 cm without increasing the frequency of treatment-associated complications or decreasing cancer-specific survival. NSS should represent the treatment of choice in all patients with RCC of 4-7cm in diameter if technically feasible. No significant financial relationships to disclose.

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Early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival

Cancer ◽

10.1002/cncr.24060 ◽

2009 ◽

Vol 115 (3) ◽

pp. 581-586 ◽

Cited By ~ 44

Author(s):

Katherine R. Birchard ◽

Jenny K. Hoang ◽

James E. Herndon ◽

Edward F. Patz

Keyword(s):

Lung Cancer ◽

Cell Lung Cancer ◽

Tumor Size ◽

Nonsmall Cell Lung Cancer ◽

Advanced Stage

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Early changes in tumor size in patients treated for advanced stage nonsmall cell lung cancer do not correlate with survival

Cancer ◽

10.1002/cncr.24803 ◽

2010 ◽

Vol 116 (6) ◽

pp. 1615-1615 ◽

Cited By ~ 1

Author(s):

Geoffrey R. Oxnard ◽

Lawrence H. Schwartz

Keyword(s):

Lung Cancer ◽

Cell Lung Cancer ◽

Tumor Size ◽

Nonsmall Cell Lung Cancer ◽

Advanced Stage

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Role of Pelvic Exenteration in the Treatment of Persistent or Recurrent Gynecological Cancers

Austin Journal of Obstetrics and Gynecology ◽

10.26420/austiniobstetgynecol.2021.1163 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Matteo Maruccio ◽

◽

Alessia Aloisi ◽

Carlo Personeni ◽

Michela Palumbo ◽

...

Keyword(s):

Lymph Nodes ◽

Tumor Size ◽

Pelvic Exenteration ◽

Multivariable Analysis ◽

Final Analysis ◽

Primary Treatment ◽

Oncologic Outcomes ◽

Secondary Outcome ◽

Multivariable Logistic Regression Analysis ◽

Positive Lymph Nodes

Objective: To assess the oncological outcomes of Persistent/Recurrent Gynaecological Cancers who underwent Pelvic Exenteration (PE) in terms of DFS and OS in a 23 years-single center experience. Secondary outcome was to identify factors associated with recurrence. Methods: From June 1996 to March 2019, data of all patients who underwent PE were retrospectively collected. The Kaplan-Meier method was used to estimate DFS and OS. Univariable and multivariable logistic regression analysis was performed to identify potential independently associated predictors of recurrence. Results: 192 patients were considered for final analysis. After surgery 77 women (40.1%) received a post-operative oncologic treatment. Overall 106 patients (55.2%) experienced a relapse with a median follow-up of 58 months (range, 2 to 236 months). Presence of LVI (adjusted HR 2.2, 95% CI 1-4.9, P=0.05) was the only factor that retained an independent association with relapse at multivariable analysis. Positive lymph nodes were associated with death at univariable analysis (HR 3.9, 95% CI 1.7-9.4, P=0.002). When stratifying patients by cervical cancer, among 115 women, 67 (58.3%) relapsed. Presence of LVI (HR 2.7, 95% CI 1.1-6.6, P=0.02) and patients with pathologic risk factors such as tumor size, positive lymph nodes and LVI (HR 3.1, 95% CI 1.4-6.8, P=0.005) were associated with recurrence both at univariable and multivariable analysis. Conclusion: Pelvic exenteration may have a therapeutic role in cervical and endometrial tumors that recur at least 6 months after primary treatment. Patients affected by vulvar cancer or either with tumor size >5 cm, positive lymph nodes, LVI have worse oncologic outcomes.

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Comparison of clinicopathologic parameters and oncologic outcomes between type 1 and type 2 papillary renal cell carcinoma

BMC Urology ◽

10.1186/s12894-020-00716-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xiang Le ◽

Xiang-Bo Wang ◽

Hao Zhao ◽

Ren-Fu Chen ◽

Peng Ge

Keyword(s):

Renal Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Papillary Renal Cell Carcinoma ◽

Oncologic Outcomes ◽

Angiolymphatic Invasion ◽

Clinicopathologic Parameters ◽

Foamy Macrophages

Abstract Background To compare the clinicopathologic parameters and oncologic outcomes between type 1 and type 2 papillary renal cell carcinoma (PRCC). Methods This study was approved by the review board (NO.XYFY2019-KL032–01). Between 2007 and 2018, 52 consecutive patients who underwent surgery at a single tertiary referral hospital were included. Clinicopathologic and survival data were collected and entered into a database. The Kaplan-Meier method, and univariate and multivariate Cox proportional hazard regression analyses were performed to estimate progression-free survival (PFS) and cancer-specific survival (CSS). Results Of the 52 patients, 24 (46.2%) were diagnosed with type 1 PRCC, and 28 (53.8%) had type 2 PRCC. The mean tumor size was 4.8 ± 2.5 cm. The two subtypes displayed different morphological features: foamy macrophages were more common in type 1 PRCC, while eosinophils and microvascular angiolymphatic invasion were more frequent in type 2 PRCC. Type 2 cases showed higher tumor stage and World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade than type 1 cases (T3-T4: 43% vs 17%, P = 0.041; G3-G4: 43% vs 8%, P = 0.005). In univariate analysis, type 2 PRCC had a lower probability for PFS and CSS than patients with type 1 PRCC (P = 0.016, P = 0.049, log-rank test, respectively). In multivariate analysis, only WHO/ISUP grade (HR 11.289, 95% CI 2.303–55.329, P = 0.003) and tumor size (HR 1.244, 95% CI 1.034–1.496, P = 0.021) were significantly associated with PFS. Conclusions PRCC subtype displayed different morphological features: foamy macrophages, eosinophils and microvascular angiolymphatic invasion are pathologic features that may aid in the distinction of the two subtypes. Histologic subtype of PRCC is not an independent prognostic factor and only WHO/ISUP grade and tumor size were independent predictors for PFS.

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Long-Term Oncologic Outcomes of Uterine-Preserving Surgery in Young Women With Stage Ib1 Cervical Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001319 ◽

2018 ◽

Vol 28 (7) ◽

pp. 1350-1359 ◽

Cited By ~ 6

Author(s):

Jill H. Tseng ◽

Alessia Aloisi ◽

Yukio Sonoda ◽

Ginger J. Gardner ◽

Oliver Zivanovic ◽

...

Keyword(s):

Cervical Cancer ◽

Young Women ◽

Tumor Size ◽

Tumor Grade ◽

Oncologic Outcomes ◽

Adjuvant Radiation ◽

Risk Of Death ◽

Select Group

ObjectiveThis study aimed to evaluate oncologic outcomes of women with stage IB1 cervical cancer treated with uterine-preserving surgery (UPS) (defined as conization or trachelectomy) versus non-UPS (defined as hysterectomy of any type).MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was used to identify women younger than 45 years diagnosed with stage IB1 cervical cancer from 1998 to 2012. Only those who underwent lymph node (LN) assessment were included. Outcomes of UPS versus non-UPS were analyzed.ResultsAmong 2717 patients, 125 were treated with UPS and 2592 were treated with non-UPS. Those in the UPS group were younger (median age 33 vs 37 years,P< 0.001), less commonly had tumor size greater than 2 cm (27% vs 45%,P< 0.001), and less commonly received adjuvant radiation therapy (18% vs 29%,P= 0.006). There was no difference in distribution of tumor grade, histology, or rate of LN positivity. Median follow-up was 79 months (range, 0–179). There was no difference in 5-year disease-specific survival (DSS) between the UPS versus non-UPS groups (93% vs 94%, respectively,P= 0.755). When stratified by tumor size, DSS for UPS versus non-UPS was as follows: tumors 2 cm or less, 96.8% versus 96.3% (P= 0.683); tumors greater than 2 cm, 82.4% versus 90.4% (P= 0.112). Factors independently associated with worsened survival included adenosquamous histology (hazard ratio [HR] 2.29, 95% confidence interval [CI]1.51–3.47), G3 disease (HR 2.44, 95% CI 1.01–5.89), tumor size greater than 2 cm (HR 1.93, 95% CI 1.36–2.75) and LN positivity (HR 2.29, 95% CI 1.64–3.22). The UPS was not associated with a higher risk of death.ConclusionsThe UPS does not seem to compromise oncologic outcomes in a select group of young women with stage IB1 cervical cancer, especially in the setting of tumors 2 cm or less. Further studies are needed to clarify the role of UPS in tumors greater than 2 cm.

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Factors impacting oncologic outcomes after sublobar pulmonary resection: Results from ACOSOG Z4032 (Alliance), a randomized trial for high-risk operable non-small cell lung cancer (NSCLC).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.7524 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 7524-7524

Author(s):

Michael S Kent ◽

Rodney Jerome Landreneau ◽

Sumithra J. Mandrekar ◽

Francis C Nichols ◽

Thomas A. DiPetrillo ◽

...

Keyword(s):

High Risk ◽

Tumor Size ◽

Pulmonary Resection ◽

Staple Line ◽

Statistical Significance ◽

Oncologic Outcomes ◽

Progression Rate ◽

Sublobar Resection ◽

Local Progression ◽

Clinical Trial Information

7524 Background: A multicenter study (Z4032) compared sublobar resection (SR) to sublobar resection with brachytherapy (SRB) for stage I NSCLC. Local recurrence (LR) and overall survival (OS) rates at 3-years (3-yr) were similar between arms (see abstract 113613). This analysis combines arms, and evaluates the effect of factors previously reported to impact oncological outcomes after SR. Methods: 213 patients (pts) were evaluable for analysis. LR was defined as recurrence at the staple line (local progression), same lobe away from the staple line, or within hilar nodes. Factors assessed for impact on 3-yr outcomes were: resection type (wedge/segmentectomy), margin size (<1cm /≥1cm), margin:tumor ratio (<1/ ≥1), tumor size (≤2cm/>2cm) and staple line cytology (+/-). Results: LR occurred in 27/213 (12.6%) pts and included local progression in 12/213 (5.6%). OS rate at 3-yr was 152/213 (71.4%). Trends favored the use of segmentectomy, margin:tumor ratio≥1, tumor size ≤2cm and negative staple line cytology; no factor reached statistical significance at 3-yr. The only factor significantly (p=0.02) associated with decreased 3-yr LR was margin size ≥1cm (8.3%) compared to margin<1cm (19.3%). Conclusions: SR is a good option for high-risk pts with NSCLC. The 3-yr OS rate of 71.4% and local progression rate of 5.6% are useful benchmarks to compare to other therapies. A resection margin of at least 1 cm is desirable. Clinical trial information: NCT00107172. [Table: see text]

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