scholarly journals Endoscopic management versus radical nephroureterectomy for localized upper tract urothelial carcinoma in a high endemic region

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yung-Tai Chen ◽  
Chih-Chin Yu ◽  
Hsin-Chih Yeh ◽  
Hsiang-Ying Lee ◽  
Yuan-Hong Jiang ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Treatment Modalities ◽  
Endoscopic Management ◽  
Radical Nephroureterectomy ◽  
Endemic Region ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Free Survival ◽  
Endoscopic Ablation ◽  
Endoscopic Group

AbstractOur aim was to analyze the clinical and survival differences among patients who underwent the two main treatment modalities, endoscopic ablation and radical nephroureterectomy. This study examined all patients who had undergone endoscopic management and RNU between Jul. 1988 and Mar. 2019 from the Taiwan UTUC registry. The inclusion criteria were low stage UTUC in RNU and all cases in endoscopic managed UTUC with a curative intent. The demographic and clinical characteristics were included for analysis. In total, 84 cases in the endoscopic group and 272 cases in the RNU group were enrolled for final analysis. The median follow-up period were 33.5 and 42.0 months in endoscopic and RNU group, respectively (p = 0.082). Comparison of Kaplan–Meier estimated survival curves between groups, the endoscopic group was associated with similar overall survival (OS), cancer specific survival (CSS), and intravesical recurrence free survival (IVRS) but demonstrated inferior disease free survival (DFS) (p = 0.188 for OS, p = 0.493 for CSS and p < 0.001 for DFS). Endoscopic management of UTUC was as safe as RNU in UTUC endemic region.

A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna
Keyword(s):  
Colorectal Cancer ◽  
Comparative Study ◽  
Disease Free Survival ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinicopathologic Features ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.

scholarly journals Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuzhou Zhu ◽  
Zechuan Jin ◽  
Yuran Qian ◽  
Yu Shen ◽  
Ziqiang Wang
Keyword(s):  
Rectal Cancer ◽  
Web Of Science ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Tumor Stroma ◽  
Pathologic Feature ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Risk Predictor ◽  
Disease Free

BackgroundTumor-stroma ratio (TSR) is a promising new prognostic predictor for patients with rectal cancer (RC). Although several studies focused on this pathologic feature, results from those studies were still inconsistent.MethodsThis research aimed to estimate the prognostic values of TSR for RC. A search of PubMed, EMBASE, and Web of Science was carried out. A meta-analysis was performed on disease-free survival, cancer-specific survival, and overall survival in patients with RC.ResultsThe literature search generated 1,072 possible studies, of which a total of 15 studies, involving a total of 5,408 patients, were eventually included in the meta-analysis. Thirteen of the 15 articles set the cutoff for the ratio of stroma at 50%, dividing patients into low-stroma and high-stroma groups. Low TSR (rich-stroma) was significantly associated with poorer survival outcome. (DFS: HR 1.54, 95% CI 1.32–1.79; OS: HR 1.52 95% CI 1.34–1.73; CSS: HR 2.05 95% CI 1.52–2.77).ConclusionPresent data support TSR to be a risk predictor for poor prognosis in RC patients.

The prognostic relevance of 14-3-3 expression in cancers: a meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
Caihong Li ◽  
Honglan Zhu ◽  
Changlu Liu ◽  
Ya Liu ◽  
Ting Huang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Size Analysis ◽  
Tumor Type ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Hazard Ratios ◽  
Prognostic Importance ◽  
Patient Prognosis

AbstractObjective: A number of recent clinical studies have identified a relationship between elevated expressions of 14-3-3 and poorer patient prognosis in the context of several cancers. The present meta-analysis was therefore conducted to gain an enhanced understanding of the prognostic importance of 14-3-3 levels in cancer patients. Methods: Two reviewers independently systematically reviewed the Web of Science, Embase, and PubMed databases to identify published, suitable studies through October 2019. The correlation between the level of 14-3-3 and cancer patient survival were assessed based upon pooled HR (hazard ratios) and 95% CI (confidence intervals) derived from chosen studies. Results: In total we were able to identify 22 eligible studies that had enrolled 2676 patients in the present meta-analysis. Assessment of these studies revealed that elevated 14-3-3 level correlated significantly with poorer OS (overall survival) (HR : 1.93, 95% CI : 1.42-2.61) in cancer patients. This was true even when studies were analyzed in subgroups according to tumor type, sample size, analysis type, and method of HR determination. With respect to disease-free survival (DFS), the pooled HR for cancer patients expressing high levels of 14-3-3 was 1.89 (95% CI: 1.56-2.30). Patients with elevated 14-3-3 expression also exhibited reduced CSS (cancer-specific survival) (HR: 3.47, 95% CI: 2.12-5.69).Conclusions: The outcomes indicate that higher level of 14-3-3 correlates with poorer patient prognosis in a range of cancer types.Keywords: Meta-analysis, Prognosis, 14-3-3 Proteins C Continuous...

scholarly journals Prognostic Value of Preoperative Hydronephrosis in Patients Undergoing Radical Nephroureterectomy for Upper Tract Urinary Carcinoma: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 10 ◽  
Author(s):  
Tao Ye ◽  
Xiaoqi Yang ◽  
Peng Lv ◽  
Haoran Liu ◽  
Zhangqun Ye
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Current Evidence ◽  
Cochrane Library ◽  
Radical Nephroureterectomy ◽  
Eligibility Criteria ◽  
Free Survival ◽  
Upper Tract ◽  
Worse Prognosis

BackgroundSeveral recent publications have evaluated the prognostic value of preoperative hydronephrosis (HN) in patients with upper tract urinary carcinoma (UTUC). The aim of this meta-analysis was to explore the pooled effect of preoperative HN on the prognosis of UTUC patients treated with radical nephroureterectomy (RNU) based on current evidence.MethodsWe performed a systematic search of Pubmed, Cochrane library, and Web of Science databases from inception to June 2020. The outcomes of interest included overall survival (OS), cancer-special survival (CSS), disease-free survival (DFS), and intravesical recurrence-free survival (IVRFS).ResultsTwenty-two studies with a total of 7,542 patients satisfied the eligibility criteria and were finally included in this meta-analysis. The percent of patients with preoperative HN varied in the eligible studies, ranging from 18 to 81%. The pooled results showed that preoperative HN was significantly associated with worse OS (P = 0.004), CSS (P &lt; 0.001), and DFS (P = 0.005), but not IVRFS (P = 0.12). No obvious publication bias was detected by Begg’s test in all the analyses.ConclusionsThe results drawn in our meta-analysis suggest that the presence of preoperative HN is associated with worse prognosis in patients treated with RNU for UTUC. Therefore, closer surveillance and more aggressive therapy may be needed for UTUC patients present with preoperative HN. Well-designed prospective studies are necessary to substantiate the prognostic value of HN in UTUC.

scholarly journals The prognostic value of hypoxia-inducible factor-1α in advanced cancer survivors: a meta-analysis with trial sequential analysis

2019 ◽  
Vol 11 ◽  
pp. 175883591987585 ◽  
Author(s):  
Susu Han ◽  
Tao Huang ◽  
Fenggang Hou ◽  
Liting Yao ◽  
Xiyu Wang ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Trial Sequential Analysis ◽  
Advanced Cancer Patients ◽  
Cancer Specific Survival ◽  
Study Region ◽  
Free Survival

Background: Expression of hypoxia-inducible factors (HIFs) has been observed, but their prognostic role in advanced cancers remains uncertain. We conducted a meta-analysis to establish the prognostic effect of HIFs and to better guide treatment planning for advanced cancers. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Trial sequential analysis (TSA) was also performed. The clinical outcomes included overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), cancer-specific survival (CSS), relapse/recurrence-free survival (RFS), and metastasis-free survival (MFS) in patients with advanced tumors according to multivariate analysis. Results: A total of 31 studies including 3453 cases who received chemotherapy, radiotherapy, or chemoradiotherapy were identified. Pooled analyses revealed that HIF-1α expression was correlated with worse OS (HR = 1.61, p < 0.001), DFS (HR = 1.61, p < 0.001), PFS (HR = 1.49, p = 0.01), CSS (HR = 1.65, p = 0.056), RFS (HR = 2.10, p = 0.015), or MFS (HR = 2.36, p = 0.002) in advanced cancers. HIF-1α expression was linked to shorter OS in the digestive tract, epithelial ovarian, breast, non-small cell lung, and clear cell renal cell carcinomas. Subgroup analysis by study region showed that HIF-1α expression was correlated with poor OS in Europeans and Asians, while an analysis by histologic subtypes found that HIF-1α expression was not associated with OS in squamous cell carcinoma. No relationship was found between HIF-2α expression and OS, DFS, PFS, or CSS. Conclusions: Targeting HIF-1α may be a useful therapeutic approach to improve survival for advanced cancer patients. Based on TSA, more randomized controlled trials are strongly suggested.

Surgery of colorectal metastasis in the Optimox 1 study. A GERCOR Study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3522-3522 ◽  
Author(s):  
N. Perez-Staub ◽  
G. Lledo ◽  
F. Paye ◽  
B. Gayet ◽  
M. Flesch ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Response Rate ◽  
Disease Free Survival ◽  
Complete Response ◽  
Additional Benefit ◽  
Curative Intent ◽  
Free Survival ◽  
Before And After ◽  
Unresectable Metastasis ◽  
Disease Free

3522 Background: Surgery of metastasis can cure arround 20% of metastatic colorectal cancer (MCRC) patients. The Optimox 1 study achieved a response rate over 50% with FOLFOX therapy in patients (pts) with initially unresectable metastasis which allowed to perform surgery in a significant number of pts (JCO 2006). We report here the results in pts who underwent surgery of metastasis (met). Methods: From jan 2000 to june 2002, 620 previously untreated patients with unresectable metastasis were randomized between FOLFOX4 every two weeks until progression (arm A), or FOLFOX7 for 6 cycles, maintenance without oxaliplatin for 12 cycles and reintroduction of FOLFOX7 (arm B). 101 pts were resected with a curative intent, 57 in arm A and 45 in arm B. Results: Patients characteristics were (arm A/B %): metachronous metastasis 77/51, liver met 82/91, lung met 16/11, other met 7/4, PAL < 3 ULN: 98/97, normal LDH: 52/51. 8% of pts achieved a complete response, 72% a partial response, 16% a stable disease. 89 pts had a single resection, 12 had a two-stage surgery. One patient died in arm B. Eleven pts who relapsed had a second surgery. Resection was radical (R0) for 71 pts (43 in arm A and 28 in arm B), 15 were R1 (margin invasion) and 15 were R2. R0/R1 patients had a median overall survival (OS) of 51 mo in arm A and 38 mo in arm B. Median disease-free survival (DFS) since surgery was 12 mo in arm A and 9 mo in arm B, with no statistical difference. 32% of R0/R1 pts were alive with no progression at 3 years in arm A and 20% in arm B. Median time from randomization to surgery was 8 mo. No difference was found between patients resected before 8 mo (n = 50) and after (n = 37) in OS (39 vs 45 mo, p = .67) nor in DFS (11.6 vs 9.5 mo, p = .24). Neither in pts resected before and after 6 mo in OS (p = .77) and DFS (p = .44). Conclusions: FOLFOX treatment allowed 14 % of unresectable patients to be rescued by surgery. There was no additional benefit to perform surgery after 6 months of therapy compared to early surgery. [Table: see text]

Additional variables other than AJCC staging show clinical utility for predicting survival in colon cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14584-14584
Author(s):  
S. M. Wiseman ◽  
S. Leung ◽  
O. Griffith ◽  
S. Jones ◽  
H. Masoudi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Disease Free Survival ◽  
Lymphatic Invasion ◽  
Disease Stage ◽  
Clinicopathologic Characteristics ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
The Mean ◽  
Disease Free

14584 Background: The most important predictor of colon cancer patient outcome is disease stage at the time of surgery. However, staging does not accurately predict survival for all patients undergoing a resection with curative intent. The aim of this study was to analyze clinical and pathological characteristics of patients undergoing curative colon cancer, in order to identify characteristics, in addition to stage, predictive of disease outcome. Methods: Between 1997 and 2005 data for 114 patients undergoing curative resection for colon cancer at a tertiary care institution were collected. Clinical and pathological characteristics evaluated were: age, gender, tumor location, tumor size, scheduled vs emergent surgery, pathologic margin status, TNM stage, pathologic grade, number of positive lymph nodes, total number of lymph nodes resected, vascular and lymphatic invasion. Characteristics found to be significant in a Kaplan-Meier univariate survival analysis were included in a multivariate stepwise logistic regression analysis. Patient outcomes studied were overall survival, cancer specific survival, and disease free survival. Results: From the 114 patients examined in this cohort the mean age was 67 years, the male to female ratio was 0.8:1, and the mean follow up time was 2.61 years. Overall survival, cancer specific survival, and disease free survival were calculated to be 83.3%, 91.2% and 84.2%, respectively. Statistically significant variables by univariate analysis were: AJCC stage, number of positive lymph nodes, pathologic N stage, lymphatic and vascular invasion by the primary tumor. Further multivariate analysis revealed that lymphatic invasion was the only significant independent influence for predicting disease recurrence. Conclusions: Clinicopathologic characteristics, in addition to AJCC disease stage, may be of clinical utility in predicting outcome for patients who have undergone curative resection for colon cancer. Further evaluation of these clinicopathologic characteristics should be carried out in a larger colon cancer patient cohort. No significant financial relationships to disclose.

Impact of the third and subsequent lines of chemotherapy in the cure rate of patients with high-risk gestational trophoblastic neoplasia (HR-GTN).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15521-e15521
Author(s):  
Gustavo Jankilevich ◽  
Maria Ines Bianconi ◽  
Silvina Otero ◽  
Lucia Alvarez ◽  
Claudio Storino
Keyword(s):  
Medical Records ◽  
Disease Free Survival ◽  
Gestational Trophoblastic Disease ◽  
Cure Rate ◽  
Curative Intent ◽  
Free Survival ◽  
The Third ◽  
Trophoblastic Disease ◽  
Disease Free ◽  
Line Chemotherapy

e15521 Background: Successful chemotherapy is the backbone of the treatment of patients with HR-GTN. However a percentage of this patients will recur to first treatment attempt. It is not defined how many lines of chemotherapy are required to achieve complete reponse and wether to continue with different chemotherapy regimens is beneficial for achieving the cure. Methods: We performed a review of medical records of consecutive patients with diagnosis of gestational trophoblastic disease (GTD) and HR-GTN by FIGO-OMS criteria between 1990-2011. All were treated in our hospital. Results: 365 patients were registrated with GTD diagnosis. Thirty-four patients had HRNTG, 23 patients (67.6%) had complete reponse with first and second line chemotherapy (EMA PE and EMA CO). Eight of eleven patients had complete reponse with additional regimens. Three patients died, one due toxicity. The reponse rate of third and more lines was 72%. Overall disease free survival was 91%. Conclusions: In patients with HRNTG three or more lines of treatment achieves the cure in a high percentage of patients. In this setting the therapy should always be with curative intent, regardless of the number of lines required to achieve this objective.

scholarly journals The Prognostic Roles and Clinical Features of CD44v9 in Human Solid Cancers—A Meta-Analysis

2020 ◽  
Author(s):  
Yuanxiu Deng ◽  
Jie Wang ◽  
Shenhui Ji ◽  
Lu Huang ◽  
Meijiang Feng
Keyword(s):  
Clinical Features ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
High Expression ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Diagnosis And Prognosis

Abstract Background: CD44 is the primary receptor for hyaluronic acid and serves as a marker for cancer stem cells. CD44v9 is one of CD44’s variants and takes part in cancer’s growth and metastasis. However, the prognostic roles and clinical features of CD44v9 in cancers remain unclear. Therefore, we conducted this meta-analysis to summarize the prognostic significance and clinical features of CD44v9 in human solid cancers.Methods: we systematically searched all of related studies in PubMed, the Web of Science, Embase and Cochrane library up to June 2020. We analyzed the pooled hazard ratios (HRs) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) to assess the prognostic functions and clinical features of CD44v9 in various human solid cancers.Results: In this meta-analysis, we included 1705 cancer patients among 12 studies. Results indicated that high expression of CD44v9 was significantly related to poorer overall survival (OS) (HR=1.60, 95%CI 1.28-1.99, P<0.0001), recurrence-free survival/progression-free survival/disease-free survival (RFS/PFS/DFS).( HR=1.81, 95%CI 1.16-2.84, P=0.009) and disease-specific survival/cancer-specific survival (DSS/CSS) (HR=2.93, 95%CI 1.69-5.10, P<0.001). At the same time, we also found that high expression of CD44v9 increased the possibility of lymphoid infiltrates (OR=1.59, 95%CI 1.16-2.20, P=0.005), vascular invasion (OR=1.57, 95%CI 1.11-2.22, P=0.010) and higher TNM stage (OR=1.63, 95%CI 1.19-2.23, P=0.002).Conclusion: Our results demonstrate that CD44v9 overexpression is associated with worse OS, RFS/PFS/CFS and DSS/CSS in patients with solid cancers, which might be a biomarker in the diagnosis and prognosis of cancers in the future.

Sign in / Sign up

Export Citation Format

Share Document