An evaluation of the prognostic factors in metastatic gestational trophoblastic disease

A retrospective evaluation of prognostic factors in 55 patients suffering from metastatic gestational trophoblastic disease (MGTD) treated by modified Bagshawe's CHAMOCA regimen was done. The prognostic significance of the eight prognostic factors in the WHO scoring system, number of sites of metastasis and FIGO staging were evaluated by univariate analysis using Chi-square test with Yates' correction and odds ratio and by multivariate analysis using Cox proportional hazard analysis and logistic regression analysis. In the univariate analysis, the intervals between antecedent pregnancy and the diagnosis of GTD, (P= 0.004) the level of hCG (P= 0.02) and the number of metastatic sites (P= 0.046) were significantly associated with death. In the multivariate analysis, only the interval between the antecedent pregnancy and the diagnosis and the level of hCG were significantly associated with death. Thus, it seems that the interval between antecedant pregnancy and the diagnosis and the level of hCG were the two most significant factors in predicting mortality in high risk MGTD. The WHO staging was more predictive of poor outcome than that of the FIGO staging in this group of patients.

Download Full-text

PROGNOSTIC FACTORS OF RENAL TUMOR RECURRENCE AFTER RADICAL NEPHRECTOMY

British Journal of Surgery ◽

10.1093/bjs/znab160.044 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

G Martínez Izquierdo ◽

A R Arnaiz Pérez ◽

E Escolano Fernández ◽

M Merayo Álvarez ◽

B Carrasco Aguilera ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Radical Nephrectomy ◽

Univariate Analysis ◽

Malignant Neoplasms ◽

Histopathological Analysis ◽

Chi Square ◽

Renal Sinus ◽

Chi Square Test

Abstract INTRODUCTION Renal cell carcinoma (RCC) represents 3% of overall malignant neoplasms in adults. However, its aetiology has not been clearly established. Although surgery represents the cornerstone in treatment, recurrence postoperative rates are around 20-30%, what implies prognostic factors search must be mandatory in order to help to plan de follow-up and the different adjuvant therapy possibilities available in case they were necessary. MATERIAL AND METHODS A retrospective observational study was carried out in 110 patients who underwent radical nephrectomy between 2004 and 2018, with the aim of identifying possible prognostic factors of recurrence of RCC after these surgeries. Preoperative data (epidemiological, comorbidities and laboratory tests), surgical, pathological and variables related to follow-up were taken into account. A univariate and multivariate analysis were performed, using chi-square test and logistic regression, respectively. RESULTS The median follow-up time was 53.5 months (SD = 35.8), time in which 19 patients had a recurrence of RCC after radical nephrectomy (17.2%). Histopathological items such as the surgical piece size, the nodal and microvascular invasion, the renal sinus invasion and the presence of necrosis in the surgical piece were associated with RCC recurrence in the univariate analysis, while only the presence of necrosis in the surgical piece showed a significant result in the multivariate analysis (p = 0.004). CONCLUSIONS Histopathological analysis, highlighting the presence of necrosis in the histological sample, was proved to be the main risk factor of RCC recurrence.

Download Full-text

Clinicopathological Characteristics and Prognostic Factors in Axial Chondroblastomas: A Retrospective Analysis of 61 Cases and Comparison with Extra-Axial Chondroblastomas

10.21203/rs.3.rs-1242480/v1 ◽

2022 ◽

Author(s):

Bo-Wen Zheng ◽

Bo-Yv Zheng ◽

Hua-Qing Niu ◽

Xiao-Bin Wang ◽

Guo-Hua Lv ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Univariate Analysis ◽

Prognostic Significance ◽

Clinicopathological Characteristics ◽

Motor Dysfunction ◽

Surrounding Tissue ◽

Wide Resection ◽

Tissue Specimens

Abstract Background The clinical characteristics and prognostic factors of axial chondroblastoma (ACB) are still poorly understood. Purpose To characterize clinicopathological characteristics in a large ACB cohort and investigate their correlation with survival. We also sought to compare these results with extra-axial CB (EACB). Methods Our institution's local database was retrospectively reviewed and included a total of 132 CB patients, including 61 ACB patients and 71 EACB patients. Immunohistochemistry was used to assess the expression levels of Vimentin (Vim), S100, and cytokeratin (CK) on tumor cells in 132 tissue specimens. Results Overall, ACB and EACB had similar characteristics, except for older age and tumor size, as well as higher Vim expression, incidence of surrounding tissue invasion and postoperative sensory or motor dysfunction. Whereas wide resection and absence of invasion of surrounding tissues were consistently associated with favorable survival in the ACB and EACB cohorts in univariate analysis, most parameters showed differential prognostic significance between the 2 groups. Significant prognostic factors for local recurrence-free survival in multivariate analysis included the type of resection and chicken-wire calcification in the ACB cohort. Multivariate analysis of overall survival demonstrated that the type of resection was a significant predictor in the ACB cohort, whereas the type of resection and postoperative sensory or motor dysfunction were predictive of overall survival in the EACB group. Conclusion These data suggest that there may be distinct biological behaviors between ACB and EACB and may provide useful information to better understand the prognostic characteristics of patients with ACB and to improve outcome prediction in patients with ACB.

Download Full-text

The significance of blood cell biomarkers in the prognosis of gastric cancer

10.21203/rs.3.rs-33702/v1 ◽

2020 ◽

Author(s):

Pu Huang ◽

Yiran Zhang ◽

Anqiang Wang ◽

Zhao-de Bu

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Blood Cell ◽

Cox Regression ◽

Univariate Analysis ◽

Prognostic Significance ◽

Vascular Tumor ◽

Tumor Differentiation ◽

Chi Square ◽

Preoperative Serum

Abstract Background Studies have shown that inflammation-associated blood cell markers are associated with prognoses in a variety of tumors. However, the prognostic significance of these markers for gastric cancer (GC) is still not very clear. This article aims to explore its value of GC prognostic assessment.Methods From July 2011 to July 2016, 353 GC patients with surgical treatment were enrolled in this retrospective study. Patients’ demographics were analyzed along with clinical and pathologic data. The chi-square test was used to evaluate relationships between the markers and other clinicopathological variables; The Kaplan–Meier method and Cox regression proportional hazard model were performed to evaluate prognostic factors.Results Univariate analysis indicated T stage, N stage, vascular tumor thrombus, tumor long diameter, Bormann Classification, preoperative MWR (monocyte/leukocyte ratio), preoperative serum CEA levels are prognostic factors for GC. Multivariate analysis showed that preoperative MWR, tumor differentiation, and tumor length were independent prognostic factors in patients with GC. The boundary value of MWR is 0.8.Conclusion Preoperative MWR was convenient, simple marker of gastric cancer, might be useful for the evaluation of prognosis of patients with GC. Comparing with TNM stage, tumor differentiation was a more reliable pathological factor evaluating recurrence.

Download Full-text

Prognostic factors for intrathyroidal papillary carcinomas – a multivariate analysis

Problems of Endocrinology ◽

10.14341/probl201662556-57 ◽

2016 ◽

Vol 62 (5) ◽

pp. 56-57

Author(s):

Nada Miroslav Santrac ◽

Ivan Zoran Markovic ◽

Merima Ramiz Goran ◽

Marko Nikola Buta ◽

Igor Dusan Djurisic ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Total Thyroidectomy ◽

Univariate Analysis ◽

Prognostic Significance ◽

Disease Free Survival ◽

Adequate Treatment ◽

Ptnm Classification ◽

Quality Life ◽

Poorly Differentiated

Aim: to examine prognostic significance of patient-related, tumor-related and treatment-related factors for intrathyroidal papillary thyroid carcinomas (PTC), via multivariate analysis.Material and methods. This study included 153 patients with intrathyroidal PTCs (pT1/pT2/pT3) surgically treated in our Institution during two-decade period. Patients with locally invasive tumors (pT4) and initial distant metastases (M1) were excluded. Parameters of interest were: gender (male; female), age (<=45; >45 years), tumor size (pTNM classification WHO 1984), multifocality (no; yes), histological type of PTC (pure; microcarcinoma; follicular; poorly differentiated), presence of lymphonodal metastases (pN1a; ipsilateral-pN1b; contralateral-pN1b; total), surgery extent (total thyroidectomy; total thyroidectomy with lymphonodal dissections). Univariate and multivariate analysis of all parameters was performed in order to distinguish factors of significance for disease-free survival (DFS) and cancer-specific overall survival (cs-OS).Results. In the follow-up, 10% of patients had locoregional or distant relapse, while 5.2% died due to PTC. Univariate analysis distinguished older age, male gender, tumors over 4cm in diameter, multifocality and poorly differentiated PTC-types as unfavorable prognostic factors for cs-OS. DFS was significantly shorter in males vs. females, as well as in patients with multifocal vs. solitary PTC. Tumor multifocality was unfavorable prognostic factor for both DFS and cs-OS. Independent prognostic factors for intrathyroidal PTCs, based on Cox multivariate analysis, were multifocality and gender for DFS, and multifocality and age at diagnosis for cs-OS.Conclusions. Prognostic factors define risk groups within population of differentiated PTCs providing timely, adequate treatment and opportunity for longer quality life of patients with PTCs.

Download Full-text

Prognostic factors in duodenal adenocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15797 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15797-e15797

Author(s):

Brandon M Huffman ◽

Zhaohui Jin ◽

Cristobal T. Sanhueza ◽

Mindy L. Hartgers ◽

Benny Johnson ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Lymph Node ◽

Tumor Invasion ◽

Univariate Analysis ◽

Prognostic Significance ◽

Clinical Staging ◽

Lymph Node Status ◽

Duodenal Adenocarcinoma

e15797 Background: Duodenal adenocarcinoma is a rare tumor representing approximately 0.3% of all gastrointestinal tract cancers. Prognostic factors in relation to survival outcomes for these patients are sporadically reported in the medical literature. We aimed to evaluate outcomes of patients with duodenal adenocarcinoma who underwent pancreaticojejunostomy treated at Mayo Clinic Rochester from January 1, 2006 to December 31, 2016. Methods: Clinicopathological data of 52 duodenal cancer patients were collected. JMP software was used for statistical analysis. Kaplan-Meier method and log-rank tests were used for survival analysis, and multivariate cox proportional hazards model was used to evaluate the prognostic effect of pertinent clinical variables. All tests were two sided and a P value of < 0.05 was considered significant. Results: The median age at diagnosis was 65.9 years (range 39-81). The median overall survival was 51 months (95% CI 31.3-105.4) and the median progression free survival was 30.4 months with median follow up of 73.4 months. There were 3, 9, 21, and 19 patients with stage I, II, III, and IV disease, respectively. Depth of tumor invasion (p = 0.0156) and lymph node metastasis (p = 0.0441) were associated with overall survival on multivariate analysis. Advanced clinical staging influenced overall survival in univariate analysis, but lost prognostic significance in multivariate analysis. Age, gender, surgical technique, presence of metastases, tumor size, number of lymph nodes removed, location of duodenal segment involvement, and adjuvant treatment had no significant impact on overall survival. Laparoscopic approach did not influence survival but was associated with less hospital days (p = 0.0437). Conclusions: Depth of tumor invasion and lymph node status were associated with improved overall survival in patients with duodenal adenocarcinoma. Laparoscopic procedure decreased the hospital stay without affecting outcomes.

Download Full-text

Multivariate analysis of prognostic factors in CLL: clinical stage, IGVH gene mutational status, and loss or mutation of the p53 gene are independent prognostic factors

Blood ◽

10.1182/blood.v100.4.1177.h81602001177_1177_1184 ◽

2002 ◽

Vol 100 (4) ◽

pp. 1177-1184 ◽

Cited By ~ 375

Author(s):

David G. Oscier ◽

Anne C. Gardiner ◽

Sarah J. Mould ◽

Sharron Glide ◽

Zadie A. Davis ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Clinical Stage ◽

Univariate Analysis ◽

Prognostic Significance ◽

P53 Gene ◽

Early Stage Disease ◽

Cd38 Expression ◽

Mutational Status ◽

Chromosome 11Q23

This study evaluates the prognostic significance of genetic abnormalities (detected at or shortly after presentation), clinical stage, lymphocyte morphology, CD38 expression, and IGVHgene status in 205 patients with chronic lymphocytic leukemia (B-CLL). Deletion of chromosome 11q23, absence of a deletion of chromosome 13q14, atypical lymphocyte morphology, and more than 30% CD38 expression are significantly associated with the presence of unmutatedIGVH genes. Advanced stage, male sex, atypical morphology, more than 30% CD38 expression, trisomy 12, deletion of chromosome 11q23, loss or mutation of the p53 gene, and unmutatedIGVH genes are all poor prognostic factors in a univariate analysis. However, only 98% or more homology of IGVH genes to the germline sequence, loss or mutation of the p53 gene, and clinical stage retain prognostic significance in a multivariate analysis. The median survival of patients with mutated IGVHgenes, unmutated IGVH genes, and loss or mutation of thep53 gene regardless of IGVH gene status is 310, 119, and 47 months, respectively. These data should facilitate the design of new trials for the management of patients presenting with advanced disease or poor prognosis early stage disease.

Download Full-text

Do pathological parameters of primary tumor correlate with overall survival (OS) of metastatic clear-cell renal cell carcinoma (ccRCC)?

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.549 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 549-549

Author(s):

Umberto Basso ◽

Marco Maruzzo ◽

Anna Paola Fraccon ◽

Teodoro Sava ◽

Francesco Massari ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Primary Tumor ◽

Clinical Laboratory ◽

Univariate Analysis ◽

Prognostic Significance ◽

Fuhrman Grade ◽

Metastatic Setting ◽

N Stage ◽

Grade 3

549 Background: T and N stage, Fuhrman grade, necrosis and sarcomatoid features in the primary tumor are key prognostic factors for relapse of ccRCC, but they are not part of Heng's algorithm applied to predict OS in the metastatic setting, which instead is based on 6 clinical/laboratory items. Methods: Retrospective analysis on correlation between pathological parameters and OS (from start of first-line targeted therapy) and Heng's prognostic factors in a multicenter cohort of pts with advanced ccRCC, all of whom had undergone surgery on the kidney. Results: From 2006 to 2012, data of 903 eligible metastatic pts were collected from 33 Italian Oncology Institutions, median age 66 years, 72.6% males, 36.4 metastatic at diagnosis. After a median observation of 42 mo, 70,5% of pts died, estimated OS is 28.5 mo. Heng good prognosis pts were 14.45%, intermediate 69.1% and poor 16.45%. Univariate analysis showed that all pathological parameters significantly correlated with OS: T stage 3-4 vs 1-2 (HR 1.3), N1 vs N0 (1.3), Fuhrman grade 3-4 vs 1-2 (1.7) presence of necrosis (1.5) and sarcomatoid features (1,6). All pathological parameters had a strong correlation with a time to metastases < 1 year, while only weak correlations were found with the other clinical prognostic items of Heng's model. At multivariate analysis only N stage showed an independent impact on OS (table). Conclusions: T3-4 stage, N1, Fuhrman grade 3-4, presence of necrosis and sarcomatoid features negatively affect OS of metastatic ccRCC, but clinical items of Heng's model confirm to have a more robust prognostic significance at multivariate analysis. [Table: see text]

Download Full-text

Prognostic Significance of Metabolic Parameters by 18F-FDG PET/CT in Thymic Epithelial Tumors

Cancers ◽

10.3390/cancers13040712 ◽

2021 ◽

Vol 13 (4) ◽

pp. 712

Author(s):

Joohee Lee ◽

Young Seok Cho ◽

Jhingook Kim ◽

Young Mog Shim ◽

Kyung-Han Lee ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Fdg Pet ◽

Univariate Analysis ◽

Thymic Epithelial Tumors ◽

Epithelial Tumors ◽

Masaoka Stage ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Background: Imaging tumor FDG avidity could complement prognostic implication in thymic epithelial tumors. We thus investigated the prognostic value of volume-based 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT parameters in thymic epithelial tumors with other clinical prognostic factors. Methods: This is a retrospective study that included 83 patients who were diagnosed with thymic epithelial tumors and underwent pretreatment 18F-FDG PET/CT. PET parameters, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured with a threshold of SUV 2.5. Univariate and multivariate analysis of PET parameters and clinicopathologic variables for time-to-progression was performed by using a Cox proportional hazard regression model. Results: There were 21 low-risk thymomas (25.3%), 27 high-risk thymomas (32.5%), and 35 thymic carcinomas (42.2%). Recurrence or disease progression occurred in 24 patients (28.9%). On univariate analysis, Masaoka stage (p < 0.001); histologic types (p = 0.009); treatment modality (p = 0.001); and SUVmax, SUVavg, MTV, and TLG (all p < 0.001) were significant prognostic factors. SUVavg (p < 0.001) and Masaoka stage (p = 0.001) were independent prognostic factors on multivariate analysis. Conclusion: SUVavg and Masaoka stage are independent prognostic factors in thymic epithelial tumors.

Download Full-text

The Clinical and Prognostic Significance of Protein Arginine Deiminases 2 and 4 in Colorectal Cancer

Pathobiology ◽

10.1159/000518414 ◽

2021 ◽

pp. 1-11

Author(s):

Mohamed Gijon ◽

Rachael L. Metheringham ◽

Michael S. Toss ◽

Samantha J. Paston ◽

Lindy G. Durrant

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Survival Time ◽

Patient Survival ◽

Prognostic Significance ◽

High Expression ◽

Related Protein ◽

Post Translational Modification

Introduction: Protein arginine deiminases (PADIs) are a family of enzymes that catalyse the post-translational modification of proteins. Association between PADI expression and clinicopathology, protein expression, and outcome was determined. Methods: PADI2 and PADI4 expression was assessed immunohistochemically in a cohort of colorectal cancer (CRC) patients. Results: CRC tissues expressed variable levels of PADI2 which was mainly localised in the cytoplasm and correlated with patient survival (p = 0.005); high expression increased survival time from 43.5 to 67.6 months. Expression of cytoplasmic PADI2 correlated with the expression of nuclear β catenin, PADI4, and alpha-enolase. In contrast, expression of nuclear PADI2 correlated with a decrease in survival (p = 0.010), with high expression decreasing survival from 76.4 to 42.9 months. CRC tissues expressed variable levels of PADI4 in both the nucleus and cytoplasm. Expression of cytoplasmic PADI4 correlated with survival (p = 0.001) with high expression increasing survival time from 48.1 to 71.8 months. Expression of cytoplasmic PADI4 correlated with expression of nuclear β catenin, alpha-enolase (p ≤ 0.0001, p = 0.002), and the apoptotic related protein, Bcl-2. Expression of nuclear PADI4 also correlated with survival (p = 0.011), with high expression of nuclear PADI4 increasing survival time from 55.4 to 74 months. Expression of nuclear PADI4 correlated with p53, alpha-enolase, and Bcl-2. Multivariate analysis showed that TNM stage, cytoplasmic PADI2, and PADI4 remained independent prognostic factors in CRC. Both PADI2 and PADI4 are good prognostic factors in CRC. Conclusion: High expression of cytoplasmic PADI2, PADI4, and nuclear PADI4 were associated with an increase in overall survival.

Download Full-text

Low-Grade Stage III-IV Follicular Lymphoma: Multivariate Analysis of Prognostic Factors in 484 Patients—A Study of the Groupe d'Etude des Lymphomes de l'Adulte

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.8.2499 ◽

1999 ◽

Vol 17 (8) ◽

pp. 2499-2499 ◽

Cited By ~ 56

Author(s):

Didier Decaudin ◽

Eric Lepage ◽

Nicole Brousse ◽

Pauline Brice ◽

Jean-Luc Harousseau ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Risk Ratio ◽

Univariate Analysis ◽

International Prognostic Index ◽

Phase Iii ◽

Stage Iii ◽

Low Grade ◽

Number Of Patients ◽

Follicular Lymphomas

PURPOSE: To identify the prognostic factors that influence overall survival (OS) in patients with stage III-IV follicular lymphomas and evaluate the clinical usefulness and the prognostic value of the International Prognostic Index (IPI). PATIENTS AND METHODS: Four hundred eighty-four patients with Ann Arbor stage III-IV follicular lymphomas treated in two phase III trials from 1986 to 1995 were screened for this study. All histologic slides were reviewed by two hematopathologists. The influence of the initial parameters on survival was defined by univariate (log-rank test) and multivariate (Cox model) analyses. RESULTS: The poor prognostic factors for OS (age > 60 years, “B” symptom(s), ≥ two extranodal sites, stage IV disease, tumor bulk > 7 cm, at least three nodal sites > 3 cm, liver involvement, serous effusion-compression or orbital/epidural involvement, and erythrocyte sedimentation rate > 30 mm/h) that were significant in univariate analysis were subjected to multivariate analysis. Three factors remained significant: B symptom(s) (risk ratio = 1.80), age greater than 60 years (risk ratio = 1.60), and at least three nodal sites greater than 3 cm (risk ratio = 1.71). When the IPI was applied to these patients, the score was 1, 2, 3, and 4-5 in 49%, 39%, 11%, and 2%, respectively, and it was significant for progression-free survival (P = .002) and OS (P = .0001). CONCLUSION: Three prognostic factors for poor OS were identified: B symptoms, age greater than 60 years, and at least three nodal sites greater than 3 cm. The IPI was prognostic for OS, but in this population, a very low number of patients belonged to the high-risk groups.

Download Full-text