Prognostic value of CD34 expression status in patients with myxofibrosarcomas and undifferentiated pleomorphic sarcomas

AbstractIt is controversial whether patients with myxofibrosarcomas (MFSs) have better prognoses than those with undifferentiated pleomorphic sarcomas (UPSs). No useful prognostic factors have been established to date. We therefore aimed to evaluate the prognostic value of CD34 expression status in 192 patients with MFSs and UPSs. Using the log-rank test, we showed that patients with MFSs had a significantly better overall survival than did those with UPSs when defining the former as having a > 10% myxoid component (p = 0.03), but not when defining it as having a > 50% myxoid component (p = 0.1). Under the definition of MFSs as > 10% myxoid component, the log-rank test revealed that the diagnosis of the UPS and the CD34 loss (p < 0.001) were significant adverse predictors of overall survival. As per the Cox model, the CD34 loss remained an independent prognostic factor (hazard ratio = 3.327; 95% confidence interval 1.334–8.295), while the diagnosis of the UPS was a nonsignificant confounding factor (hazard ratio = 1.084; 95% confidence interval 0.679–1.727). In conclusion, CD34 expression status is a useful prognostic factor in patients with MFS and UPS, and it should be incorporated into grading systems that are used to predict outcomes.

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Statin Use Significantly Improves Overall Survival in High-Grade Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000819 ◽

2016 ◽

Vol 26 (9) ◽

pp. 1642-1649 ◽

Cited By ~ 11

Author(s):

Christine H. Feng ◽

Charlie M. Miller ◽

Meaghan E. Tenney ◽

Nita K. Lee ◽

S. Diane Yamada ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Endometrial Cancer ◽

High Risk ◽

Confidence Interval ◽

Hazard Ratio ◽

Rank Test ◽

Log Rank Test ◽

Definitive Therapy ◽

Statin Use

ObjectivePreclinical data and recent epidemiological studies suggest that statins have antiproliferative and antimetastatic effects in various cancer cells, and reduce cancer mortality and recurrence. We study the effect of statin use on survival outcomes and recurrence rates in patients with endometrial cancer with high-risk histology.Materials and MethodsAll patients receiving definitive therapy for high-risk endometrial cancer from 1995 to 2014 were retrospectively reviewed. Health characteristics at baseline were collected, and statin use was determined from medical records. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Cox proportional hazards regression models were used for univariate and multivariate analysis to determine independent factors associated with OS and PFS.ResultsA total of 199 patients were included in the study, of which 76 were hyperlipidemic and 50 used statins. The median follow-up time was 31 months from time of diagnosis. Hyperlipidemic patients who used statins had improved OS compared with hyperlipidemic patients not using statins (hazard ratio, 0.42; 95% confidence interval, 0.20–0.87;P= 0.02). Statin use was also associated with improved PFS (hazard ratio, 0.47; 95% confidence interval, 0.23–0.95;P= 0.04) on multivariate analysis. Hyperlipidemic patients who used statins had borderline improved freedom from local failure compared with hyperlipidemic cases not using statins (P= 0.08, log-rank test). Statin use was not found to be associated with improved cancer-specific mortality.ConclusionsStatin use is independently associated with significant improvements in PFS for the overall group and PFS and OS in the hyperlipidemic group.

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CDKN2A or CDKN2B homozygous deletion with high-immune infiltration as a favorable prognostic factor for lung adenocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e20543 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e20543-e20543

Author(s):

Benxu Tan ◽

Yonghong Chen ◽

Lei Xia ◽

Xian Yu ◽

Yusheng Huang ◽

...

Keyword(s):

Prognostic Factor ◽

Lung Adenocarcinoma ◽

Homozygous Deletion ◽

Hazard Ratio ◽

Gene Set Enrichment Analysis ◽

Rank Test ◽

Immune Infiltration ◽

Log Rank Test ◽

Significant Difference ◽

Wild Group

e20543 Background: CDKN2A and CDKN2B both acted as tumor suppressor genes by regulating the cell cycle, which in humans were located at chromosome 9, band p21.3. The frequencies of homozygous deletion (HomDel) in CDKN2A and CDKN2B in lung adenocarcinoma (LUAD) were 12.5% and 12.1%, respectively. However, the genomic, immunogenomic features and impact on the prognosis of LUAD patients with CDKN2A/B HomDel were still unclear. Methods: The cohort of this study was from The Cancer Genome Atlas (TCGA). A total of 508 LUAD patients, including 99 CDKN2A/B HomDel (homdel) and 509 CDKN2A/B wild (wild). This study explored the difference of genomic and immunogenomic landscape between homdel and wild by analysis of whole-exome sequencing (WES) and RNA sequencing data. Results: The most frequently mutated genes were TP53, TTN, MUC16, and CSMD3. Their frequencies in homdel and wild are 46% and 48%, 43% and 46%, 35% and 41%, 33% and 38%, respectively. There was no significant difference of tumor mutational burden (TMB) between homdel and wild (median TMB, 133 in homdel vs 177 in wild; Wilcoxon test, p = 0.11), and clinical characteristics including age, gender, smoking history, and tumor stage were not significantly different between homdel and wild. Homdel had a shorter overall survival (OS) than wild (Log-rank test, p = 0.04, Hazard Ratio: 0.7, 95% CI: 0.49-1.02), but there was no significant difference in progression-free survival (PFS) (Log-rank test, p = 0.05, Hazard Ratio: 0.73, 95% CI: 0.51-1.04). We used single sample gene set enrichment analysis (ssGSEA) to calculate the enrichment score (ES) of 25 immune-related pathways such as antigen presentation and T cell-mediated immunity, and then used the consensus clustering algorithm (ConsensusClusterPlus) to cluster homdel and wild respectively, and both clustered into low and high immune infiltration groups. For the high immune infiltration and low immune infiltration in homdel and wild, high immune infiltration had a longer OS (Log-rank test, p = 0.009, Hazard Ratio: 2.19, 95% CI: 1.22-3.94) and PFS (Log-rank test, p = 0.044, Hazard Ratio: 1.8, 95% CI: 1.01-3.2) than low immune infiltration in homdel. However, there was no significant heterogeneity between high and immune infiltration in terms of PFS (Log-rank test, p = 0.28, Hazard Ratio: 1.21, 95% CI: 0.87-1.68) and OS (Log-rank test, p = 0.96, Hazard Ratio: 1.01, 95% CI: 0.71-1.44) in the wild group, the wild group had longer OS than homdel group with low immune infiltration (Log-rank test, p = 0.003, Hazard Ratio: 0.5, 95% CI: 0.29-0.88), while had the same OS with homdel with high immune infiltration, irrespective of immune infiltration. And so was PFS (Log-rank test, p = 0.005, Hazard Ratio: 0.48, 95% CI: 0.27-0.82). Conclusions: CDKN2A/B homdel was an unfavorable prognostic factor for LUAD, but which with high immune infiltration might improve patient survival time.

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miR-181 Expression is Associated With The Prognosis in Lung Cancer.

10.21203/rs.3.rs-44942/v1 ◽

2020 ◽

Author(s):

Yue Zhao ◽

Xiangjun Kong ◽

Hongbing Wang

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Prognostic Value ◽

Cox Regression ◽

Suppressor Gene ◽

Rank Test ◽

High Morbidity ◽

Cox Regression Analysis ◽

Log Rank Test ◽

Cancer Tissues

Abstract Background: Lung cancer is one of the most common cancers, with high morbidity and mortality. MiRNAs are proved to play important roles in various human cancers. In our study, we aimed to explore the prognostic value of miR-181 in lung cancerMethods: Quantitative real-time polymerase chain reaction (QRT-PCR) was used to detect the expression level of miR-181 in lung cancer tissues and the paired non-cancerous tissues. The relationship between miR-181 expression and clinicopathologic parameters were analyzed by chi-square test. Kaplan-Meier method with log rank test was applied for overall survival analysis. Furthermore, the Cox regression analyses were performed to evaluate the prognostic value of miR-181 in lung cancer.Results: Down-regulated miR-181 expression was observed in lung cancer tissues (P<0.001), moreover, its expression was significantly correlated with TNM stage (P=0.015) and metastasis (P=0.000). In addition, lung cancer patients with lower miR-181 expression level had poorer overall survival than those with higher expression (log rank test, P=0.011). Cox regression analysis suggested that miR-181 was an independent prognostic factor for lung cancer (HR=1.961, 95%CI=1.135-3.388, P=0.016).Conclusion: MiR-181 may be a tumor suppressor gene in lung cancer, which can predict outcomes for the patients.

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P2609H2FPEF score as a prognostic value in HFpEF patients

European Heart Journal ◽

10.1093/eurheartj/ehz748.0933 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

D Sueta ◽

T Nishihara ◽

E Yamamoto ◽

K Tsujita

Keyword(s):

Confidence Interval ◽

Cardiovascular Events ◽

Left Ventricular ◽

Hazard Ratio ◽

Left Ventricular Ejection ◽

Rank Test ◽

Characteristic Analysis ◽

Simple Method ◽

Log Rank Test ◽

Cerebrovascular Events

Abstract Background The H2FPEF score is recognized as a simple method to diagnose heart failure (HF) with preserved left ventricular ejection fraction (HFpEF). Purpose We investigated the value of the H2FPEF score in predicting subsequent cardiovascular events in HFpEF patients. Methods This study was a retrospective, single-center, observational study. We calculated the H2FPEF scores for 404 consecutive HFpEF patients. Subjects were subdivided into low- (0–3), intermediate- (4–6), and high-score (7–9) groups and followed for 50-months. The primary and secondary endpoints were composite cardiovascular/ cerebrovascular events (cardiovascular death, non-fatal myocardial infarction, unstable angina pectoris, hospitalization for HF decompensation and non-fatal stroke) occurrence and HF-related events (hospitalization for HF decompensation) occurrence at 50-months, respectively. Results Kaplan–Meier analyses demonstrated a significantly higher incidence of cardiovascular/cerebrovascular events in proportion to a higher H2FPEF score (log-rank test, P=0.005). The HF-related event rate was higher in proportion to the H2FPEF score (log-rank test, P<0.001). Multivariate Cox hazard analyses identified the H2FPEF score (per 1 point) as an independent predictor of cardiovascular and HF-related events (Table, hazard ratio, 1.179; 95% confidence interval, 1.066–1.305; P=0.001 and hazard ratio, 1.288; 95% confidence interval, 1.134–1.463; P=0.001, respectively). Receiver operating characteristic analysis showed that the H2FPEF significantly predicted cardiovascular events (Figure A, AUC 0.626, 95% CI 0.557–0.693; P<0.001) and HF-related events (Figure B, AUC 0.680, 95% CI 0.600–0.759; P<0.001). The cutoff H2FPEF score was 5.5 for the identification of cardiovascular and HF-related events. Conclusion The H2FPEF score is a potentially useful marker for the prediction of cardiovascular and HF-related events in HFpEF patients.

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Combining Measurements of Plasma Cell Apoptosis and Proliferation in Multiple Myeloma Identifies Patients with Poor Survival.

Blood ◽

10.1182/blood.v106.11.3410.3410 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3410-3410 ◽

Cited By ~ 1

Author(s):

Shaji Kumar ◽

Michael Timm ◽

Martha Q. Lacy ◽

Angela Dispenzieri ◽

Suzanne R. Hayman ◽

...

Keyword(s):

Overall Survival ◽

Plasma Cell ◽

Cell Apoptosis ◽

Prognostic Value ◽

Median Overall Survival ◽

Plasma Cells ◽

Annexin V ◽

Rank Test ◽

Poor Survival ◽

Log Rank Test

Abstract Background: Multiple Myeloma (MM) is characterized by accumulation of malignant plasma cells with relatively low proliferative and apoptotic rates. The proliferative rate of plasma cells, measured in terms of % plasma cells labeled by bromodeoxyuridine (BrdU) using slide based fluorescence microscopy (plasma cell labeling index or PCLI) has been shown to be a powerful prognostic factor in MM. We have previously shown that the % bone marrow plasma cells in apoptosis (PCAP) determined by a flow cytometry method that uses Annexin V staining or 7-amino Actinomycin D (7-AAD) correlates with disease stage in MM. The goal of this study was to examine the prognostic value of the PCAP. Methods: We studied 145 patients with MM including 74 with newly diagnosed MM, 40 with relapsed MM, and 31 with MM on treatment in whom simultaneous measurements of % plasma cell apoptosis and PCLI were available. The PCLI is expressed as the percentage of cytoplasmic immunoglobulin positive plasma cells that have taken up BrdU. The PCLI was characterized as high when >= 1%. Mononuclear cells isolated from bone marrow aspirate, following red cell lysis with ACK solution, are incubated with CD38-PE and either CD138-FITC or CD45-FITC. This is followed by incubation with 7-AAD and the plasma cells are gated using the CD38/CD45 staining pattern. The Annexin method used a similar strategy, with Annexin V in place of 7-AAD. The percentage of plasma cells in apoptosis (PCAP) was categorized as high when >5%, the median value. Results: The median follow up for the entire group was 34 months (range, 0.1 mo to 9 years) and 112 (77%) had died at the time of analysis. Forty seven patients (32%) had a high PCLI (>=1%). The median overall survival for the patients with high PCLI was 14.6 months versus 42.3 months for those with a low PCLI; P = 0.0005 (log rank test). Seventy-five (51.7%) patients had a high PCAP. The median overall survival for those patients was 28.9 months versus 40.2 months for those with a low PCAP; P = 0.078. We next examined if there was any correlation between a high PCAP and high PCLI and found none; P = NS by (Fisher’s exact test). Additionally in a multivariate Cox model using both PCLI and PCAP, both were independently prognostic for overall survival. We then developed an index by adding PCLI to log transformed PCAP (PCLI + log PCAP). Using a cutoff of 1.5 for the new index we were able identify a group of patients with poor survival. The 59 patients with a high value for the new index had a median survival of 19.3 months vs 46.1 months for the rest (P < 0.0001, log rank test). Conclusion: The measurement of plasma cell apoptosis has prognostic value in patients with MM. More importantly, we have shown that by combining measures of two important biological characteristics of the plasma cell, namely proliferation and apoptosis, patients with a poor prognosis can be identified. Such a prognostication strategy can help stratify patients in clinical trials as well as shed light on the disease biology.

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Relationship of common variants in Krüppel-like factor 7 gene with susceptibility and prognosis of oral squamous cell carcinoma

10.21203/rs.3.rs-61631/v1 ◽

2020 ◽

Author(s):

Lili Wang ◽

Hongguang Song ◽

Shiming Yang

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factor ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Multivariate Analyses ◽

Rank Test ◽

Log Rank Test ◽

Kaplan Meier ◽

Tumor Tissues

Abstract Background The aim of this study was to assess the prognostic value of Krüppel-like factor 7 (KLF7) for patients with oral squamous cell carcinoma(OSCC). Methods The expression of KLF7 was detected by quantitative real-time polymerase chain reaction (qRT-PCR) in pairs of tumor tissues and adjacent non-tumor tissues of OSCC. Chi-square (χ2) test was applied to evaluate the association of KLF7 expression with clinicopathological characteristics of OSCC patients. Overall survival was estimated using the Kaplan-Meier method with log rank test. The cox proportional hazards model was used for univariate and multivariate analyses. Results The expression of KLF7 was remarkably increased in OSCC tissues compared with adjacent non-tumor tissues (P < 0.001). KLF7 expression was related to TNM stage (P = 0.006), tumor size (P = 0.010), smoking (P = 0.006) and drinking (P = 0.000). Kaplan-Meier analysis showed that OSCC patients with high KLF7 expression had a poorer overall survival than those with low expression (log rank test, P = 0.018). Moreover, multivariate analyses showed that KLF7 was an independent prognostic factor for OSCC (P = 0.002 HR = 2.645 95%CI: 1.426–4.906). Conclusion Decreased expression of KLF7 may be a potential unfavorable prognostic factor for patients with OSCC.

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Relationship of Common Variants in Krüppel-like Factor 7 Gene With Susceptibility and Prognosis of Oral Squamous Cell Carcinoma

10.21203/rs.3.rs-48539/v1 ◽

2020 ◽

Author(s):

Lili Wang ◽

Hongguang Song ◽

Shiming Yang

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Prognostic Factor ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Multivariate Analyses ◽

Rank Test ◽

Log Rank Test ◽

Kaplan Meier ◽

Tumor Tissues

Abstract Background: The aim of this study was to assess the prognostic value of Krüppel-like factor 7 (KLF7) for patients with oral squamous cell carcinoma(OSCC).Methods: The expression of KLF7 was detected by quantitative real-time polymerase chain reaction (qRT-PCR) in pairs of tumor tissues and adjacent non-tumor tissues of OSCC. Chi-square (χ2) test was applied to evaluate the association of KLF7 expression with clinicopathological characteristics of OSCC patients. Overall survival was estimated using the Kaplan-Meier method with log rank test. The cox proportional hazards model was used for univariate and multivariate analyses.Results: The expression of KLF7 was remarkably increased in OSCC tissues compared with adjacent non-tumor tissues (P<0.001). KLF7 expression was related to TNM stage (P=0.006), tumor size (P=0.010), smoking (P=0.006) and drinking (P=0.000). Kaplan-Meier analysis showed that OSCC patients with high KLF7 expression had a poorer overall survival than those with low expression (log rank test, P=0.018). Moreover, multivariate analyses showed that KLF7 was an independent prognostic factor for OSCC (P=0.002 HR=2.645 95%CI: 1.426-4.906).Conclusion: Decreased expression of KLF7 may be a potential unfavorable prognostic factor for patients with OSCC.

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LMTK3 polymorphism in patients with metastatic colon cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.471 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 471-471 ◽

Cited By ~ 5

Author(s):

Fotios Loupakis ◽

Wu Zhang ◽

Armin Gerger ◽

Dongyun Yang ◽

Pierre Oliver Bohanes ◽

...

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Estrogen Receptor ◽

Prognostic Factor ◽

Cox Model ◽

White Blood Cells ◽

Comprehensive Cancer Center ◽

Rank Test ◽

Cancer Center ◽

Metastatic Colon Cancer

471 Background: LMTKs are a family of serine-threonine-tyrosine kinases. LMTK3 isoform is a potent regulator of estrogen receptor activity LMTK3 gene polymorphisms affect DFS and OS of breast cancer patients. Cumulative evidence implies that estrogen receptor signalling plays a role in colon carcinoma development and progression. We investigated whether the LMTK3 rs9989661 SNP is a prognostic factor in patients with advanced colon cancer. Methods: 318 patients with metastatic colon cancer treated at the USC/Norris Comprehensive Cancer Center or the LA County/USC Medical Center were included in this study. Genomic DNA was extracted from white blood cells of peripheral blood samples using the QiaAmp kit (Qiagen, Valencia, CA). The LMTK3 polymorphism was genotyped by PCR-RFLP. The association between the LMTK3 polymorphism and overall survival was examined using the log-rank test and multivariate Cox-model. Results: There were 141 females and 177 males, with a median age of 58 years (range 25-86). The cohort comprised 234 whites, 43 Asians, 15 Blacks, 24 Hispanics, and 2 Native Americans. The median survival was 13.7 months with a median follow-up of 2.3 years. The median overall survival was 16.6 vs. 12.8 months for patients with C/- vs. patients with T/T (HR=0.78; 95% CI: 0.56-1.08; p=0.055). At a multivariate analysis restricted to subjects with left-sided disease (n=126) the median OS for patients with C/- genotype was 23.8 months compared to 14.9 months of T/T patients (HR=0.51; 95%CI: 0.28-0.91; p=0.014). Conclusions: This study suggests that LMTK3 may be an independent prognostic factor for patients with metastatic colon cancer and raise the issue of possible disparities according to primary tumor location. Our group produced similar results also in the adjuvant setting. Functional correlative preclinical analyses and external clinical validation studies are currently ongoing.

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Preoperative Neutrophil-to-Lymphocyte Ratio Was a Predictor of Overall Survival in Small Renal Cell Carcinoma: An Analysis of 384 Consecutive Patients

BioMed Research International ◽

10.1155/2020/8051210 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Hao Zhao ◽

Wang Li ◽

Xiang Le ◽

Zixiang Li ◽

Peng Ge

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Prognostic Factor ◽

Cell Carcinoma ◽

Renal Cell ◽

Cox Model ◽

Prognostic Significance ◽

Neutrophil To Lymphocyte Ratio ◽

Rank Test ◽

Lymphocyte Ratio

Objective. The aim of this study was to investigate the prognostic significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in small renal cell carcinoma (sRCC, ≤4 cm). Methods. This study was approved by the review board (NO.XYFY2019-KL032-01). Between 2007 and 2016, a total of 384 consecutive patients who underwent curative surgery for sRCC at our institution were evaluated. Patients were divided into high NLR and low NLR groups by plotting the NLR receiver operating characteristic curve. The Kaplan–Meier method was utilized to graphically display survivor functions. Univariate and multivariate Cox proportional hazards regression analysis addressed time to overall survival (OS) and cancer-specific survival (CSS). Results. Of the 384 patients, 264 (68.8%) were males and 120 (31.2%) were females. Median follow-up time after surgical resection was 54 months. One hundred and eighty-seven (48.7%) patients had a high NLR (≥1.97), and the remaining 197 (51.3%) had a low NLR (<1.97). Patients with high NLR were more likely to be aged compared with patients with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR (P=0.002, P=0.065, respectively, the log-rank test). Multivariate Cox model analysis showed that the high NLR was an independent prognostic factor for OS (hazard ratio: 3.145, 95% confidence interval: 1.158–8.545, P=0.025). Conclusions. Elevated preoperative NLR is an independent adverse prognostic factor for OS after surgery with curative intent for sRCC.

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Removal of Endobronchial Malignant Mass by Cryotherapy Improved Performance Status to Receive Chemotherapy

The Scientific World JOURNAL ◽

10.1155/2014/369739 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Yueh-Fu Fang ◽

Meng-Heng Hsieh ◽

Tsai-Yu Wang ◽

Horng-Chyuan Lin ◽

Chih-Teng Yu ◽

...

Keyword(s):

Confidence Interval ◽

Survival Curve ◽

Performance Status ◽

Hazard Ratio ◽

Rank Test ◽

Minor Bleeding ◽

Log Rank Test ◽

Improved Performance ◽

And Performance ◽

To Receive

Although malignant endobronchial mass (MEM) has poor prognosis, cryotherapy is reportedly a palliative treatment. Clinical data on postcryotherapy MEM patients in a university-affiliated hospital between 2007 and 2011 were evaluated. Survival curve with or without postcryotherapy chemotherapy and performance status (PS) improvement of these subjects were analyzed using the Kaplan-Meier method. There were 59 patients (42 males), with median age of 64 years (range, 51–76, and median performance status of 2 (interquartile range [IQR], 2-3). Postcryotherapy complications included minor bleeding (n=12) and need for multiple procedures (n=10), while outcomes were relief of symptoms (n=51), improved PS (n=45), and ability to receive chemotherapy (n=40). The survival of patients with chemotherapy postcryotherapy was longer than that of patients without such chemotherapy (median, 534 versus 106 days; log-rank test,P=0.007; hazard ratio, 0.25; 95% confidence interval, 0.10–0.69). The survival of patients with PS improvement postcryotherapy was longer than that of patients without PS improvement (median, 406 versus 106 days; log-rank test,P=0.02; hazard ratio, 0.28; 95% confidence interval, 0.10–0.81). Cryotherapy is a feasible treatment for MEM. With better PS after cryotherapy, further chemotherapy becomes possible for patients to improve survival when MEM caused dyspnea and poor PS.

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