A new prognostic score for predicting survival in patients treated with robotic stereotactic radiotherapy for brain metastases

AbstractThe study aimed to analyze potential prognostic factors in patients treated with robotic radiosurgery for brain metastases irrespective of primary tumor location and create a simple prognostic score that can be used without a full diagnostic workup. A retrospective analysis of 142 patients with 1–9 brain metastases treated with stereotactic radiosurgery (1–4 fractions) was performed. Volumes of all lesions were calculated using linear dimensions of the tumors (CC, LR, AP) and 4/3*π*(CC/2)*(LR/2)*(AP/2) formula. Kaplan–Meier method and log-rank test were used to analyze survival. Variables significantly associated with overall survival in univariate analysis were included in Cox multivariate analysis. The validity of the model was tested with the bootstrap method. Variables from the final model were used to construct a new prognostic index by assigning points according to the impact of a specific variable on overall survival. In the multivariate analysis, four factors: Karnofsky Performance Status (p = 0.000068), number of brain metastases (p = 0.019), volume of the largest lesion (p = 0.0037), and presence of extracerebral metastases (p = 0.0017), were independent predictors of survival. Total scores ranged from 0 to 12 points, and patients were divided into four groups based on median survival of each subgroup: 0–1 points—18.8 months, 2–3 points—16.9 months, 4–5 points—5.6 months, and ≥ 6 points—4.9 months (p < 0.001). The new prognostic index is simple to calculate. It has a strong prognostic value in a heterogeneous population of patients with a various number of brain metastases, but its value requires confirmation in another cohort.

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A novel scoring system to predict survival in patients with advanced pancreatic adenocarcinoma: The Memorial Prognostic Score (MPS).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.26_suppl.36 ◽

2016 ◽

Vol 34 (26_suppl) ◽

pp. 36-36

Author(s):

Andrew Chung Yang ◽

Alison Wiesenthal ◽

Andrew S. Epstein ◽

Junting Zheng ◽

Jessica Goldberg ◽

...

Keyword(s):

Overall Survival ◽

Serum Albumin ◽

Pancreatic Adenocarcinoma ◽

Prognostic Score ◽

Univariate Analysis ◽

Eastern Cooperative Oncology Group ◽

Glasgow Prognostic Score ◽

The United States ◽

Rank Test ◽

Advanced Pancreatic Adenocarcinoma

36 Background: A major limitation of prognostic tools such as the Eastern Cooperative Oncology Group (ECOG), Karnofsky, and Palliative Performance Scale is a reliance on subjective clinical assessment. An objective tool, the Glasgow Prognostic Score (GPS) is derived from C-reactive Protein (CRP) and albumin and has been validated in patients with operable and inoperable malignancies. One disadvantage of this tool is that CRP is not routinely measured in the United States. We examined if the Neutrophil-Lymphocyte Ratios (NLR) (Ahn, H.K., et al., Neutrophil-Lymphocyte Ratio Predicts Survival in Terminal Cancer Patients. J Palliat Med, 2016) could be substituted for CRP in the GPS to predict survival in patients with advanced pancreatic adenocarcinoma. Methods: A retrospective chart review identified patients at MSKCC with pathology-confirmed stage IV pancreatic adenocarcinoma diagnosed between 2011 to 2014. Pre-treatment absolute neutrophil count, absolute lymphocyte count, and albumin were extracted. The NLR for each patient was calculated and assigned: NLR ≤ 4 g/dl = 0, NLR > 4 g/dl = 1; serum albumin > 4 g/dl = 0, and serum albumin < 4 g/dl = 1. Combining NLR and albumin scores resulted in a composite MPS score of 0-2, similar to GPS. We evaluated the association of the MPS with overall survival. Results: N = 833 patients were identified with median survivals summarized in the table below. A log-rank test showed statistically significant differences in survival between MPS groups (p<0.00005). The MPS on univariate analysis had a HR of 1.36 (95% CI 1.23 – 1.50, p<0.0005) associated with overall survival. Conclusions: The MPS, a novel composite of NLR and albumin, is an objective prognostic tool that divided this sample of patients into three clinically distinct subgroups. Further interrogation will control for performance status, disease characteristics and anti-cancer therapy. [Table: see text]

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Single nucleotide polymorphisms (SNPs) as predictors of efficacy of cabazitaxel in patients with metastatic castration-resistant prostate cancer (mCRPC).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e17582 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e17582-e17582

Author(s):

Daniel Herrero Rivera ◽

Ignacio Duran ◽

Laura Marcos Kovandzic ◽

Javier Puente ◽

Begona Mellado ◽

...

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Gleason Score ◽

Univariate Analysis ◽

Progression Free Survival ◽

Rank Test ◽

Genetic Constitution ◽

Castration Resistant Prostate Cancer ◽

Free Survival ◽

The Impact

e17582 Background: Cabazitaxel is a semi-synthetic derivative of a natural taxoid approved for the treatment of mCRPC patients (pts) after failure to docetaxel. Despite its proven efficacy, there is variability in the response, progression-free survival (PFS) and overall survival (OS) of pts. Changes in the genetic constitution of the individual such as the SNPs could explain this variability. The aim of this study was to evaluate the impact of certain SNPs in cabazitaxel activity. Methods: Clinical data from 67 mCRPC pts treated with cabazitaxel between March 2011 and October 2016 were collected. DNA was isolated from formalin fixed paraffin-embedded tumor samples. 56 SNPs in 5 genes related with metabolism and/or mechanism of action of cabazitaxel (CYP3A4, CYP3A5, ABCB1, TUBB1, CYP2C8) were chosen based on their Minor Allele Frequency, linkage disequilibrium and information from dbSNP and analyzed by TaqMan OpenArray (Lifetech). The presence/absence of mutant alleles of the selected SNPs was correlated with clinical features, progression free survival (PFS) and overall survival (OS) of prostate cancer. Chi-square test and Kaplan-Meier with log-rank test were used for statistical analyses. Results: The median age was 61 years (range 44-82). 56.7% (n = 38) had a Gleason score ≥8 and 94% had received docetaxel in first line. Type of response to cabazitaxel was associated with median OS (Partial response = 24.35 months, Stable disease = 11.16 months, Progression disease = 5.8 months; p= 0.045). Univariate analysis, showed worsed OS at 1 year for wild type status of SNP rs151352 (OR = 4, 95%CI 1.27-12.58, p= 0.029). In addition, two SNPs (rs11773597, rs1202186) were associated with radiological response to cabazitaxel ( p= 0.031 and p= 0.030 respectively). Other 7 SNPs (rs11773597, rs2235040, rs1045642, rs1419745, rs1202170, rs6949448, rs11572093) were associated ( p<0.05) with Gleason score, pain, PSA doubling time, febrile neutropenia and asthenia. Conclusions: A particular SNP profile could be predictive of efficacy and related with toxicity in mCRPC population treated with cabazitaxel after progression to docetaxel. These outcomes become particularly relevant in patient selection given the recent results of the CARD trial.

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Prognostic Factors for Children With Hodgkin’s Disease Treated With Combined-Modality Therapy

Journal of Clinical Oncology ◽

10.1200/jco.2003.07.124 ◽

2003 ◽

Vol 21 (10) ◽

pp. 2026-2033 ◽

Cited By ~ 79

Author(s):

Ron S. Smith ◽

Qing Chen ◽

Melissa M. Hudson ◽

Michael P. Link ◽

Larry Kun ◽

...

Keyword(s):

Multivariate Analysis ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Combined Modality Therapy ◽

Prognostic Score ◽

Univariate Analysis ◽

Prognostic Index ◽

Combined Modality ◽

Mediastinal Disease ◽

Significant Difference

Purpose: Evaluation of pretreatment factors to identify children at high risk for relapse after combined-modality therapy for Hodgkin’s disease. Patients and Methods: From 1990 to 2000, 328 pediatric patients with clinical stage I to IV Hodgkin’s disease were treated with chemotherapy and low-dose involved-field radiotherapy on prospective, collaborative, risk-adapted protocols at three institutions. Pretreatment factors were analyzed by univariate and multivariate analysis for prognostic significance for 5-year disease-free survival (DFS) and overall survival (OS). Results: With a median follow-up of 59 months (range, 8 to 125 months), the 5-year DFS and OS for all patients were 83% and 93%, respectively. Several factors were associated with inferior DFS and OS by univariate analysis. By multivariate analysis, male sex; stage IIB, IIIB, or IV disease; bulky mediastinal disease; WBC more than 13.5 × 103/mm3; and hemoglobin less than 11.0 g/dL were significant for inferior DFS. A prognostic index was developed incorporating the five significant factors from the multivariate analysis, assigning each a score of 1. The 5-year DFS and OS for children with a prognostic score of 0 to 1 were 94% and 99%; score 2, 85% and 96%; score 3, 71% and 92%; and score 4 or 5, 49% and 72%, respectively. There was a significant difference in DFS among each of these groups, with significantly worse OS in those with a score of 4 to 5. Conclusion: A prognostic index that was based on five pretreatment factors correlated with inferior DFS by multivariate analysis stratified patients by outcome; this may be useful in assigning children with Hodgkin’s disease to risk-adapted therapy.

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Towards a Comprehensive Prognostic Score in CLL Based On a Combination of Genetic Parameters.

Blood ◽

10.1182/blood.v114.22.1234.1234 ◽

2009 ◽

Vol 114 (22) ◽

pp. 1234-1234

Author(s):

Claudia Haferlach ◽

Frank Dicker ◽

Tamara Weiss ◽

Susanne Schnittger ◽

Christian Beck ◽

...

Keyword(s):

Overall Survival ◽

Chromosome Aberrations ◽

Prognostic Score ◽

Prognostic Significance ◽

Rank Test ◽

Prognostic Impact ◽

Time To Treatment ◽

Log Rank Test ◽

Equity Ownership ◽

The Impact

Abstract Abstract 1234 Poster Board I-256 CLL is a heterogeneous disease with a variable clinical course. In this study the prognostic power of chromosome banding analysis (CBA), interphase FISH and IgVH status was evaluated. In total 399 untreated cases were analyzed. First, we could confirm the prognostic significance of established parameters such as age (≥65 yrs), white blood cell count (≥20.000/μl), IgVH status, TP53 deletion and 11q deletion in our cohort. In addition, a negative prognostic impact of translocations involving the IgH locus, especially t(14;18)(q32;q21) and of the complexity of the karyotype measured by the number of clonal chromosome aberrations in CBA was observed. Furthermore it became obvious that some parameters discriminated better for overall survival and other for time to treatment. While the impact of the IgVH status on overall survival was low within the first 5 years after diagnosis (mutated 88.5% surviving vs unmutated 82.0% surviving, log rank test p=0.022), an unmutated IgVH status was strongly correlated with a shorter median time to treatment (18.3 months unmutated vs 110.7 months mutated, log rank test p<0.0001). On the other hand the impact of TP53 deletion was more pronounced on overall survival as compared to time to treatment. Age was associated with a shorter overall survival but was not significantly associated with time to treatment. Based on these results we propose a score for overall survival (OS) based on: age ≥65 yrs, WBC ≥20.000/μl, unmutated IgVH status, TP53 deletion, t(IgH), and the number of chromosome aberrations observed in CBA. Three respective risk groups showed considerable differences in OS (94.5% vs 64.3% vs 41.1% surviving at 5 yrs, p<0.0001). In contrast, time to treatment (TTT) was predicted best by unmutated IgVH status, ATM deletion, t(IgH) and number of chromosome aberrations. Four subgroups could be separated with median TTT of 110.7 months, 39.8 months, 19.5 months, and 3.8 months, respectively (p<0.0001). In conclusion, our data show that in combination with established prognostic markers such as an unmutated IgVH status, TP53/17p deletions or 11q deletions also the newly defined complexity of the karyotype measured by the number of chromosome aberrations has an important impact both on overall survival and also on time to treatment in CLL. These newly combined parameters translate into a more distinct separation of prognostic subgroups within the first years after diagnosis as compared to other prognostic systems using FISH data only or based on FISH data in combination with IgVH status. Prospective studies should evaluate the power for early stage CLL patients. Disclosures Haferlach: MLL Munich Leukemia Laboratory: Equity Ownership. Dicker:MLL Munich Leukemia Laboratory: Employment. Weiss:MLL Munich Leukemia Laboratory: Employment. Schnittger:MLL Munich Leukemia Laboratory: Equity Ownership. Kern:MLL Munich Leukemia Laboratory: Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Equity Ownership.

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Platelet microparticles (PMP): A predictive factor of overall survival in hormone-refractory prostate cancer (HRPC) patients treated by chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4639 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4639-4639

Author(s):

A. Banu ◽

D. Helley ◽

E. Banu ◽

A. M. Fischer ◽

F. Scotte ◽

...

Keyword(s):

Overall Survival ◽

Growth Factor ◽

Predictive Factor ◽

Cancer Metastasis ◽

Cox Regression ◽

Univariate Analysis ◽

Specific Antigen ◽

Rank Test ◽

Interaction Term ◽

The Impact

4639 Background: Several studies suggest a causal relationship between platelets activation and cancer metastasis. Activated platelets release PMP, VEGF (vascular endothelial growth factor) and bFGF (basic fibroblast growth factor) which could play a role in patient outcome. Methods: Eligible chemonaive HRPC patients (pts) were required to have: ECOG performance status (PS) ≤2, progressive disease after antiandrogen withdrawal. Before chemotherapy, we quantified PMP in whole blood by flow cytometry using an anti-CD41 monoclonal antibody and plasmatic VEGF and bFGF by ELISA. As primary endpoint, we prospectively evaluated the impact of PMP on overall survival (OS) by Cox regression and log-rank test. Secondary, we studied the correlation between PMP and platelets, and their relationship with OS, incorporating an interaction term in the modelling (PMP and platelets). Results: Between July 2001 and April 2004, thirty-eight HRPC pts were treated by chemotherapy [docetaxel (92%), mitoxantrone (8%)] in our center. Median age was 69 years, with median values of hemoglobin 125 g/L, baseline prostate-specific antigen (PSA) 37.7 ng/mL, PMP 6 867 per μL, VEGF 18.1 pg/mL and bFGF 2.8 pg/mL. Significant correlations were observed between PMP and ECOG PS, hormone-sensitivity duration, Gleason and platelets. Median OS was significantly lower in pts with high PMP values (>6 788 per μL), compared to low PMP pts: 16.7 months (95% CI, 5.1–28.2) vs 25.2 months (95% CI, 20.2–30.3), P = 0.025, log-rank. Univariate analysis by Cox regression showed a significant relationship between OS and PMP level [HR = 0.41 (95% CI, 0.19–0.92), P = 0.04]. PMP kept their significance after adjusting by multivariate analysis for baseline hemoglobin, number of metastatic sites, and PSA doubling-time [HR = 0.37 (95% CI, 0.16–0.87), P = 0.02)]. An interaction term (PMP and platelets) was also predictive on OS (P = 0.01). Conclusions: PMP and their interaction with platelets were a predictive factor of OS in HRPC pts. Our analysis showed that the dynamic interaction between PMP and platelets has a major impact on outcome of HRPC pts. No significant financial relationships to disclose.

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CHFR methylation as an epigenetic marker for recurrence of colon cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.4043 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 4043-4043

Author(s):

M. Tanaka ◽

S. Sethi ◽

D. Li ◽

G. Bland ◽

S. R. Hamilton ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Overall Survival ◽

Multivariate Analysis ◽

Cancer Patients ◽

Univariate Analysis ◽

Stage Ii ◽

Rank Test ◽

Tissue Samples ◽

Epigenetic Marker

4043 Background: Currently, no definitive epigenetic markers exist to predict recurrence and overall survival (OS) of colorectal cancer patients after surgical resection. Promoter hypermethylation of the ID4 (inhibitor of DNA binding), RECK (reversion-inducing cysteine rich protein with Kazal motifs), and CHFR (checkpoint with forkhead-associated and RING finger domains) genes have been associated with reduced mRNA and protein expression in colorectal cancer. The purpose of this study was to determine the association of methylation of these genes and also MINT1 (methylated in tumor loci) with recurrence-free survival (RFS) and OS in colon cancer patients. Methods: DNA methylation was quantitatively evaluated using pyrosequencing in tissue samples from 64 patients with AJCC stage II and III colon cancer without HNPCC seen at M.D. Anderson during 1999–2007. Survival outcomes were determined by retrospective chart review and evaluated by Kaplan-Meier plot and log-rank test for univariate analysis and Cox's proportional hazard model for multivariate analysis. Mean methylation rate of multiple CpG sites in the promoter region was used. For this analysis, we defined <15%, 15%-30%, and >30% as methylation-negative, -low, and -high, respectively. Results: There were 19 stage II (30%) and 45 stage III (70%) patients. The median age was 62.1 years (range: 31–86). Adjuvant chemotherapy was completed in 49 patients (77%). After a median follow-up of 54.9 months, 12 (19%) patients developed recurrence and 7 (11%) have died. Methylation of MINT1, ID4, and RECK did not correlate with RFS and OS. The CHFR methylation-high (42%) group had low RFS (P=.04) and OS (P=.03) when compared with the CHFR methylation- negative (38%) and -low (20%) group. CHFR methylation-high was associated with N2 disease (P=.04) and right-sided tumors (P=.002). Multivariate analysis indicated T4 disease [P=.004, HR=8.42 (95% CI: 1.98–35.8)] and CHFR methylation-high [P=.04, HR = 3.79 (95% CI: 1.04–13.8)], were poor prognostic factors for recurrence. Conclusions: The presence of high CHFR promoter methylation correlates with advanced lymph node metastasis and shortened RFS and OS. Methylation of the CHFR promoter is a potential epigenetic marker for colon cancer recurrence and overall survival. No significant financial relationships to disclose.

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Analysis of Kohne's prognostic index in KRAS wild-type patients with metastatic colorectal cancer (mCRC) treated with salvage-line cetuximab-based regimen: HGCSG0901.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.634 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 634-634

Author(s):

Ayako Doi ◽

Satoshi Yuki ◽

Yasushi Tsuji ◽

Takahide Sasaki ◽

Hiraku Fukushima ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Index ◽

Progression Free Survival ◽

Cox Proportional Hazards Model ◽

Rank Test ◽

Prognostic Impact ◽

Wild Type ◽

Free Survival ◽

Significant Difference

634 Background: In the treatment for mCRC, it is essential for understanding the prognosis of each individual patient. Köhne’s index (KI) based on performance status, white blood cell count, alkaline phosphatase and number of metastatic sites has been previously proposed. However, in the salvage setting, the validity of KI has not been reported in patients treated by cetuximab-based chemotherapy. Methods: 269 patients with mCRC treated by cetuximab contained chemotherapy were retrospectively registered from 27 centers in Japan. This analysis was included in the KRAS wild-type patients who were refractory to or intolerant for 5-FU/irinotecan/oxaliplatin and were never administered anti-EGFR-antibody. Univariate and multivariate analysis for overall survival were performed using patient characteristics. Survival analyses were performed with Kaplan-Meier method, log-rank test and Cox proportional hazards model. The analysis was also designed to determine whether the Köhne’s classification could be extended to other endpoints such as progression-free survival. Results: All data were available for prognostic categorization in 127 patients. Median overall and progression-free survival was 9.8 and 4.2 months. The distribution and median survival / progression-free survival for KI were as follows: low risk (L) (n = 40; 13.1/5.1 months), intermediate risk (I) (n = 17; 9.6/3.5 months), and high risk (H) (n = 70; 7.6/4.1 months). For overall survival, there was significant difference between L and H (p = 0.004), but not between L and I (p = 0.213), and between I and H (p = 0.321). For progression-free survival, there was tended to difference between L and H (p = 0.083), but not between L and I (p = 0.392), and between I and H (p = 0.630). In Cox multivariate analysis, KI showed an independent prognostic impact (HR 1.370, p = 0.010), but not predictive impact (HR 1.147, p = 0.212). Conclusions: In this analysis, KI might be a prognostic factor in salvage treatment with cetuximab-based regimen, but no effect predicted impact. Moreover, the prospective evaluation is needed for the further validation.

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A large multicenter study evaluating prognosis and chemosensitivity of metastatic colorectal cancers with microsatellite instability.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.3536 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 3536-3536 ◽

Cited By ~ 4

Author(s):

David Tougeron ◽

Benjamin Sueur ◽

David Sefrioui ◽

Lucie Gentilhomme ◽

Thierry Lecomte ◽

...

Keyword(s):

Multivariate Analysis ◽

Cox Regression ◽

Univariate Analysis ◽

Objective Response ◽

Prospective Trial ◽

Prognostic Index ◽

Rank Test ◽

Colorectal Cancers ◽

First Line ◽

Peritoneal Carcinosis

3536 Background: Deficient Mismatch Repair (dMMR) in colorectal cancers (CRC) represent 12% of all tumors. In non-metastatic CRC setting, dMMR are associated with good prognosis but also with resistance to adjuvant 5-FU chemotherapy. In metastatic CRC (mCRC) setting, dMMR is found in less than 5% and its influence on prognosis and treatment response is little known. Methods: This multicenter retrospective study included all consecutive patients with dMMR mCRC treated between 2005 and 2015 in 17 centers. The Kaplan-Meier method was used to calculate overall survival (OS) and progression-free survival (PFS). Prognostic variables were evaluated in univariate analysis using the Log rank test and in multivariate analysis using the Cox regression model. Results: A total of 198 patients with dMMR mCRC were included (median age 64.6 years). dMMR mCRC were mostly diagnosed with synchronous metastases (59%) and frequent peritoneal carcinosis (43%). Lynch syndrome was found in 34% of cases and 36% of tumors had a BRAFV600E mutation. Median OS was 20.6 months. A low risk Kohne's prognostic index (HR = 0.40 [0.22-0.72], p = 0.02) and absence of peritoneal carcinosis (HR = 0.51 [0.29-0.90], p = 0.02) were associated with better OS in multivariate analysis. Main first-line regimens were 5FU-based (n = 20), oxaliplatin-based (n = 75) or irinotecan-based (n = 46) chemotherapy. Median PFS on first-line treatment was 5.9 months. The objective response rate (ORR) was 0%, 19% and 36% for 5FU-based, oxaliplatin-based and irinotecan-based chemotherapies, respectively (p = 0.02). A trend for a longer PFS (3.3, 5.5 and 10.2 months, respectively, p = 0.06) and OS (17.7, 21.1 and 34.2 months, respectively, p = 0.05) was also observed for irinotecan-based chemotherapy. The addition of bevacizumab to chemotherapy was associated with a significant increase of ORR (p = 0.01) and PFS (p = 0.04) as compared to the addition of an anti-EGFR therapy. Conclusions: This study suggests that dMMR mCRC are associated with poor prognosis and chemoresistance, especially to 5FU-based chemotherapy. Efficacy of irinotecan and bevacizumab should be evaluated in a prospective trial in combination with immune checkpoint inhibitors.

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The Significance of Inflammatory Markers in the Prognosis of Newly Diagnosed Multiple Myeloma Patients

Blood ◽

10.1182/blood-2020-136326 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 15-15

Author(s):

Lin Gui ◽

Fei Wang ◽

Jinning Shi ◽

Baoan Chen

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Overall Survival ◽

Multivariate Analysis ◽

Survival Time ◽

Cox Regression ◽

Conflicts Of Interest ◽

Univariate Analysis ◽

Rank Test ◽

Newly Diagnosed

Objective: To explore the significance of the ratio of neutrophils to lymphocytes (NLR), monocytes to lymphocytes (MLR), and platelets to lymphocytes (PLR) in the prognosis of patients with newly diagnosed multiple myeloma. Methods: We retrospectively reviewed the data for 60 multiple myeloma patients who were diagnosed in Jiangning Hospital Affiliated to Nanjing Medical University from August 2011 to March 2020. According to NLR、MLR、PLR, the patients were divided into the low NLR group (NLR<3.61) or high NLR group (NLR≥3.61), low MLR group (MLR<0.33) or high MLR group (MLR ≥0.33), low PLR group (PLR< 129.78) and high PLR group (PLR ≥129.78). Overall survival time (OS) was used as the prognostic evaluation criteria, and Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to carry out univariate and multivariate analysis on clinical and laboratory parameters. Results: Among the 60 patients, 33 were male and 27 were female, the median age of onset was 65 years old, 19 were in the high NLR group, 41 were in the low NLR group, 24 were in the high MLR group, 36 were in the low MLR group, 26 were in the high PLR group, and 34 were in the low PLR group. The univariate analysis showed the prognosis was influenced by factors including NLR, PLR, age, ISS stages, hemoglobin (HGB), albumin (ALT). MLR, type of immunoglobulin, white globulin ratio (A/G), gender, β2-microglobulin, lactate dehydrogenase (LDH) and creatinine were not correlated with the total survival time of patients. The multivariate analysis showed that ISS III stages, PLR≥129.78、HGB<100g/L were independent risk factors influencing the prognosis of MM patients. Conclusion: ISS III stages, PLR≥129.78、HGB<100g/L are independent prognostic risk factors in newly diagnosed multiple myeloma patients, which can be used as an economical and effective method for early evaluation of patient prognosis. Key Wordsmultiple myeloma; overall survival; NLR; PLR; MLR Disclosures No relevant conflicts of interest to declare.

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SURG-12. A COMPARISON BETWEEN PROGNOSTIC SCORES OF BREAST CANCER BRAIN METASTASES APPLIED TO A NEUROSURGICAL POPULATION

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.147 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i33-i33

Author(s):

Dhiego Bastos ◽

Sujit Prabhu ◽

Raymond Sawaya ◽

Andrei Joaquim ◽

Diane Liu ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Brain Metastasis ◽

Brain Metastases ◽

Predictive Accuracy ◽

Prognostic Score ◽

Univariate Analysis ◽

Prognostic Scores ◽

Cox Models ◽

Biological Subtype

Abstract INTRODUCTION: Prognostic scores have been developed to predict overall survival (OS) in patients with brain metastasis from breast cancer, comprising different combinations of prognostic factors. A new prognostic score including the number of brain metastases has been proposed. We aimed to evaluate the use of these prognostic scores on a neurosurgical population. METHODS: Retrospective study with consecutive patients with brain metastasis from breast cancer treated in the neurosurgery department. Clinical end point is overall survival estimated by the Kaplan Meier method. Univariate and multicovariate Cox proportional hazard models are applied to estimate the effect of covariates of interest on OS. We employ Bootstrap validation method to estimate the bias-corrected or over fitting-corrected predictive accuracy of Cox models, which is presented by concordance index(C-index). RESULTS: 315 consecutive patients with brain metastasis from breast cancer. Median OS was 14 months(95% CI 11–16.9), KPS, number of brain metastases, biological subtypes, age and presence of extracranial metastases were significantly associated with improved OS on the univariate analysis. Multivariate analysis showed that KPS, biological subtype, age and number of brain metastases were statistically significant for OS. The recursive partitioning analysis(RPA) classes, the graded prognostic assessment(GPA) score, the diagnostic specific GPA(DS-GPA) and the modified DS-GPA identified individual subgroups with different OS. RPA and DS-GPA had OS statistical significant between all groups with a C-index of 0.561 and 0.586 respectively. DS-GPA had a c-index of 0.639 and modified DS-GPA had an c-index of 0.637. DS-GPA and modified DS-GPA had a better performance in terms of discrimination when compared to RPA(p< 0.001) and GPA(p=0.01). CONCLUSIONS: DS-GPA and modified DS-GPA were able to better discriminate subgroups OS, which most likely reflects the use of biological subtype in the score calculation. The incorporation of number of BM by the modified DS-GPA improved the distinction between the higher score and the lower score group.

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