scholarly journals Reconsidering the prognostic significance of tumour deposit count in the TNM staging system for colorectal cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Song Wang ◽  
Xu Guan ◽  
Mingfei Ma ◽  
Meng Zhuang ◽  
Tianyi Ma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Tnm Staging System ◽  
Baseline Characteristics

AbstractAlthough the occurrence of tumour deposits (TDs) without metastatic lymph nodes (mLNs) is classified as “N1c” in the 8th TNM staging system for colorectal cancer (CRC), the prognostic significance of the TD count is still controversial. A total of 39155 CRC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The potential associations between baseline characteristics and TD status were evaluated using the χ2 test. Cancer-specific survival (CSS) rates were calculated by using the Kaplan-Meier method, and CSS comparisons were performed by using the log-rank test. The results showed that TD count was an important prognostic factor and that the number of TDs was negatively correlated with the prognosis of CRC patients. We found that the prognostic value of one TD is equivalent to that of two mLNs based on the comparison of CSS rates. Accordingly, we proposed a novel N staging system by integrating the TD count into the N category with the ratio of TDs to mLNs being 1:2. There were no prognostic differences in patients with or without TDs in each novel N category. Weighing one TD as two mLNs in this novel TNM staging system is superior to the “N1c” classification in the 8th TNM staging system in evaluating the prognosis of CRC patients.

Prognostic Significance of Visible Lesions on Transrectal Ultrasound in Impalpable Prostate Cancers: Implications for Staging

2003 ◽  
Vol 21 (15) ◽  
pp. 2860-2868 ◽  
Author(s):  
Herbert Augustin ◽  
Markus Graefen ◽  
Jüri Palisaar ◽  
Jakob Blonski ◽  
Andreas Erbersdobler ◽  
...  
Keyword(s):  
Free Probability ◽  
Prognostic Significance ◽  
Transrectal Ultrasound ◽  
Staging System ◽  
Tnm Staging ◽  
Rank Test ◽  
Consecutive Series ◽  
Log Rank Test ◽  
Biochemical Cure ◽  
Prostate Cancers

Purpose: The current tumor-node metastasis (TNM) staging system classifies impalpable prostate cancers identified by needle biopsy and invisible by imaging as T1c and those visible as T2. Palpable cancers are classified as at least T2. However, most urologists consider impalpable prostate cancers T1c tumors, irrespective of findings on transrectal ultrasound (TRUS). The aim of this article is to provide a differentiated view of the significance of TRUS findings for staging purposes in impalpable prostate cancers. Patients and Methods: A consecutive series of 1,670 patients with impalpable tumors and palpable T2 cancers after radical prostatectomy were evaluated. Tumor characteristics and 5-year biochemical cure rates of cancers invisible and visible on TRUS were compared, as well as the rates of impalpable but visible and palpable T2 cancers. Results: Impalpable cancers invisible on TRUS presented significantly more favorable pathologic stages and lower cancer volumes than those visible on TRUS (P = .002, P = .010). In the latter, these clinical features were more favorable compared with T2 cancers (P < .001, P < .001). Progression-free probability of impalpable cancers invisible on TRUS was 86.8%; progression-free probability for impalpable cancers visible on TRUS was 85.4% (log-rank test P = .2060). The corresponding rate for T2 tumors was 73.9%, significantly lower when compared to those of visible and impalpable cancers (log-rank test P = .0001). Conclusion: Impalpable prostate cancers invisible on TRUS present more favorable cancer features than those that are visible on TRUS. However, these differences are not as pronounced as those between impalpable but visible cancers and palpable T2 tumors. Thus, based on our data, it seems inappropriate to classify impalpable prostate cancers visible on TRUS as T2 cancers.

scholarly journals Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study

2019 ◽  
Vol 44 (1) ◽  
pp. 213-222
Author(s):  
Lin-Yong Zhao ◽  
Yong-Liang Zhao ◽  
Jun-Jiang Wang ◽  
Qi-Di Zhao ◽  
Wen-Qi Yi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Staging System ◽  
Tnm Staging ◽  
Plasma Fibrinogen ◽  
Tnm Staging System ◽  
N Stage ◽  
Gastric Cancer Patients

Abstract Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

scholarly journals A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiangxing Kong ◽  
Jun Li ◽  
Yibo Cai ◽  
Yu Tian ◽  
Shengqiang Chi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Seer Database ◽  
Tnm Staging System

Is the Seventh Edition of the UICC/AJCC TNM Staging System Reasonable for Patients With Tumor Deposits in Colorectal Cancer?

2012 ◽  
Vol 255 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Lin-lin Tong ◽  
Peng Gao ◽  
Zhen-ning Wang ◽  
Yong-xi Song ◽  
Ying-ying Xu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Seventh Edition ◽  
Tnm Staging System

scholarly journals A comparison of the prognostic significance of changes in NT-proBNP levels in HFrEF and HFpEF.

2021 ◽  
Author(s):  
Nishant Sahni ◽  
Umesh Sharma ◽  
Rashi Arora
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Regional Health Care ◽  
Comorbidity Scores ◽  
Blood Pressures

Background: Rising NT-proBNP are associated with reduced survival patients with HFrEF. However, it remains to be conclusively and formally demonstrated that the temporal trend in NT-proBNP level carries prognostic significance in HFpEF. Objective: To determine whether there is an association between rising NT-proBNP levels and 6-month survival in patients with HFpEF and HFrEF. Methods: We examined a cohort of 5203 patients to 5 hospitals in a regional health care system — who had at least one admission to the hospital with diagnoses of heart failure over a 3-year period. Kaplan-Meier survival curves were constructed for patients with downtrending (>25% net decrease), stable or uptrending (>25% net increase) NT-proBNP levels in HF, HFpEF and HFrEF patients. The log-rank test was used to test for differences in 6-month survival amongst the groups. Multivariate extended Cox regression models were constructed for 6-month survival with NT-proBNP as a time-varying covariate. Age, albumin, sex, race, serum creatinine, systolic and diastolic blood pressures and Charlson comorbidity scores at baseline were used as covariates in the model. Separate analyses were done for HFpEF and HFrEF patients. Results: HFpEF and HFrEF patients with up-trending levels had significantly lower 6-month survival rates than patients with downtrending or stable NT-proBNP levels. A doubling of the NT-proBNP level in patients was significantly associated with reduced 6-month survival in patients with in both subgroups of HF, HFpEF and HFrEF (HFpEF-HR: 1.53(1.49-2.57), HFrEF HR: 1.45(1.43-1.48) after adjusting for covariates.

scholarly journals Prognostic nomogram to predict the overall survival of patients with early-onset colorectal cancer: a population-based analysis

2021 ◽  
Author(s):  
Junxian Wu ◽  
Linbin Lu ◽  
Hong Chen ◽  
Yihong Lin ◽  
Huanlin Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Early Onset ◽  
Clinical Decision Making ◽  
Staging System ◽  
Tnm Staging ◽  
Discriminative Ability ◽  
Tnm Staging System ◽  
Early Onset Colorectal Cancer

Abstract Purpose The present study aimed to identify independent clinicopathological and socio-economic prognostic factors associated with overall survival of early-onset colorectal cancer (EO-CRC) patients and then establish and validate a prognostic nomogram for patients with EO-CRC. Methods Eligible patients with EO-CRC diagnosed from 2010 to 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly divided into a training cohort and a testing cohort. Independent prognostic factors were obtained using univariate and multivariate Cox analyses and were used to establish a nomogram for predicting 3- and 5-year overall survival (OS). The discriminative ability and calibration of the nomogram were assessed using C-index values, AUC values, and calibration plots. Results In total, 5585 patients with EO-CRC were involved in the study. Based on the univariate and multivariate analyses, 15 independent prognostic factors were assembled into the nomogram to predict 3- and 5-year OS. The nomogram showed favorable discriminatory ability as indicated by the C-index (0.840, 95% CI 0.827–0.850), and the 3- and 5-year AUC values (0.868 and 0.84869 respectively). Calibration plots indicated optimal agreement between the nomogram-predicted survival and the actual observed survival. The results remained reproducible in the testing cohort. The C-index of the nomogram was higher than that of the TNM staging system (0.840 vs 0.804, P < 0.001). Conclusion A novel prognostic nomogram for EO-CRC patients based on independent clinicopathological and socio-economic factors was developed, which was superior to the TNM staging system. The nomogram could facilitate postoperative individual prognosis prediction and clinical decision-making.

scholarly journals A nomogram to predict prognosis after surgery for young patients with hepatocellular carcinoma

2020 ◽  
Author(s):  
Xingchen Li ◽  
Xinyu Bi ◽  
Jianjun Zhao ◽  
Zhiyu Li ◽  
Jianguo Zhou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Young Patients ◽  
Risk Groups ◽  
Curve Analysis ◽  
Rank Test ◽  
Cancer Center ◽  
Cancer Specific Survival ◽  
Decision Curve Analysis ◽  
Log Rank Test ◽  
Kaplan Meier

Abstract Background Only few studies have been evaluated the clinical characteristics and prognosis of hepatocellular carcinoma in young patients. The purpose of this study is to identify prognostic factors and develop an efficient and practical nomogram to predict cancer-specific survival in young patients with hepatocellular carcinoma.Methods Four-hundred-and-forty-one young patients with hepatocellular carcinoma who had undergone surgery from 2004-2015 were selected from the Surveillance, Epidemiology, and End Results database. The competing risk model, Lasso and Cox regression were used to screen prognostic factors for cancer-specific survival, and a prognostic nomogram was established using these factors. Thirty-nine young patients with hepatocellular carcinoma from the National Cancer Center, Cancer Hospital, Chinese Academy of Medical Science were used to validate our model. To further evaluate the predictive performance of our model, the concordance index was calculated and the calibration curves were drawn. The clinical usefulness was evaluated by decision curve analysis(DCA). Finally, all patients were grouped by our nomogram. The survival of different risk groups was analyzed using the Kaplan-Meier method, and the differences among survival curves were compared by the log-rank test.Results The median survival times of the Surveillance, Epidemiology, and End Results training group and the external National Cancer Center validation group were 41 and 52 months, respectively. Histological grade, tumor size, Alpha-fetoprotein, T stage, and M stage were selected as independent factors for cancer-specific survival, and a prognostic nomogram was established. The concordance indices of the training and external validation groups were 0.76 (95% CI, 0.72 to 0.80) and 0.92 (se=0.085), respectively. The calibration plots showed good agreement. Decision curve analysis revealed that our nomogram resulted in a better clinical net benefit than the AJCC 7th edition and Barcelona Clinic Liver Cancer staging systems. Patients were divided into two risk groups according to the cut-off value of 125 of the total points from our nomogram. Kaplan-Meier plots for cancer-specific survival were performed using the log-rank test, the p-value of which was <0.001.Conclusions The practical nomogram resulted in a more-accurate prognostic prediction for young hepatocellular carcinoma patients after curative liver resection.

Disease-Free Survival for Patients with Thin Melanomas according to the American Joint Committee on Cancer 8th Edition

Dermatology ◽  
2019 ◽  
Vol 235 (4) ◽  
pp. 334-339
Author(s):  
◽  
Luisa Elena Gambra Michel ◽  
Jon Uña Gorospe ◽  
Antonio Luis López Figueroa ◽  
Raquel Mullor Nogales ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Staging System ◽  
Tnm Staging ◽  
Wilcoxon Test ◽  
Rank Test ◽  
Free Survival ◽  
7Th Edition ◽  
Kaplan Meier ◽  
Disease Free ◽  
8Th Edition

Background: The recently implemented AJCC 8th edition TNM staging system for malignant melanoma (MM) changed the definition for T1a and T1b tumours. Objectives: To analyse differences in disease-free survival (DFS) among patients with thin MM staged according to both AJCC 7th and 8th editions. Methods: An observational study including 285 patients with cutaneous thin MM (thickness ≤1 mm). Cases were staged as T1a and T1b using both 7th and 8th editions. Neither regional nor visceral diseases were present at diagnosis. DFS curves were generated according to the Kaplan-Meier method. Results: An 8% shift of patients from a T1a towards a T1b stage group was observed after applying the AJCC 8th edition. According to this 8th edition, DFS for T1a patients was significantly longer than for T1b patients (log-rank test; p = 0.005); 5-year DFS for T1a and T1b was 100 and 95%, respectively (Wilcoxon test; p = 0.002). According to the AJCC 7th edition, DFS did not significantly differ for T1a and T1b patients; 5-year DFS for T1a and T1b was 99 and 97%, respectively (p > 0.05). Conclusions: The AJCC 8th edition seems to be a better tool for staging thin melanomas.

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