Preoperative Thrombocytosis is Not Associated with Overall Survival in 309 Glioblastoma Patients

2021 ◽  
Author(s):  
Sascha Marx ◽  
Robert Altmann ◽  
Marcel Baschin ◽  
Heiko Paland ◽  
Bernhard Rauch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Extent Of Resection ◽  
Kaplan Meier ◽  
Potential Risk Factors ◽  
Patient Documentation ◽  
Worse Prognosis

Abstract Background In recent years, a correlation of thrombocytosis and a worse prognosis was shown for many solid cancers, including glioblastoma multiforme (GBM). Methods A retrospective review was performed for all patients with a histologically proven and first-diagnosed GBM between 2005 and 2015 in our department. Clinical and paraclinical parameters were acquired from patient documentation and structured for subsequent data analysis. The association of potential risk factors with overall survival was assessed using the Kaplan–Meier survival analysis and Cox regression. Results The present study includes 309 patients first diagnosed with primary GBM. Our analyses validate well-known risk factors of a decreased overall survival such as higher patient age, a larger preoperative tumor volume, Karnofsky performance status, extent of resection, tumor localization, and adjuvant treatment. However, no correlation was observed between a preoperative thrombocytosis, the mean platelet volume, leucocyte count, activated partial thromboplastin time (apTT), fibrinogen level, and acetylsalicylic acid 100 co-medication. Patients with preoperative hemoglobin below 7.5 mmol/L had decreased overall survival. Conclusion The present study, enrolling the largest numbers of patients assessing this topic to date, did not find any association between a preoperative thrombocytosis and overall survival in 309 patients with GBM.

VTE among pancreatic cancer and its possible risk factors among metastatic pancreatic cancer (mPC): Experience at Fox Chase Cancer Center.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 232-232 ◽  
Author(s):  
Ramesh Kumar Pandey ◽  
Kristen Sorice ◽  
Jiangtao Gou ◽  
Shannon M. Lynch ◽  
Aryeh Blumenreich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Smoking Status ◽  
Performance Status ◽  
Stage Iv ◽  
Cancer Center ◽  
Academic Center ◽  
Impact On Survival ◽  
Potential Risk Factors

232 Background: The incidence of VTE is relatively high among mPC pts, upto 57%. It is associated with higher health care burden and mortality. We evaluated the mPC pts treated at a single academic center from 2010-16 for prevalence of VTE, its impact on survival and possible risk factors. Methods: Medical charts of mPC pts treated at a single academic center were analyzed retrospectively for VTE diagnosis, overall survival and potential risk factors for VTE development. The factors considered were: age, sex, stage, body mass index, smoking status, surgery, performance status (PS), Charlson comorbidity index (CCI) and treatment. Logistic regression was used to identify the factors correlating with VTE and Cox Proportional Hazard model was used to evaluate overall survival (OS) differences between those with VTE (Gp A) and those without VTE (Gp B). Results: Out of the 439 mPC pts (52% males, 86% with PS0-1, 63% with stage IV at diagnosis), 127 (29%) were in Gp A and 312 (71%) in Gp B. The groups were well balanced with respect to all factors except age (median age 67 Gp A; 65 in Gp B, p = 0.04). 2.3 % of pts in Gp A and 4.8 % pts in Gp B were on anticoagulation for reason other than VTE treatment. Within Gp A, 55% developed VTE after diagnosis of metastasis. A clear separation of the survival curves noted beyond the median OS (9 m, P = 0.02), favoring GpB. Statistically significant factors associated with risk of VTE included advanced stage at diagnosis (P = 0.004) and worse PS (P = 0.005). Treatment regimen used and CCI didn’t correlate with the risk of development of VTE. Conclusions: The incidence rate of VTE in our patients is lower than published literature, yet the diagnosis of VTE was associated with worse OS. Most cases occurred after the diagnosis of metastatic disease. The higher use of anticoagulants for other medical causes may be contributing to a lower incidence of VTE in mPC. These findings need prospective Validation.

scholarly journals Oligodendroglioma resection: a Surveillance, Epidemiology, and End Results (SEER) analysis

2018 ◽  
Vol 128 (4) ◽  
pp. 1076-1083 ◽  
Author(s):  
Ali A. Alattar ◽  
Michael G. Brandel ◽  
Brian R. Hirshman ◽  
Xuezhi Dong ◽  
Kate T. Carroll ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cox Regression ◽  
Primary Cns Lymphoma ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Cns Lymphoma ◽  
Who Grade ◽  
Kaplan Meier ◽  
Clinical Benefits ◽  
End Results

OBJECTIVEThe available evidence suggests that the clinical benefits of extended resection are limited for chemosensitive tumors, such as primary CNS lymphoma. Oligodendroglioma is generally believed to be more sensitive to chemotherapy than astrocytoma of comparable grades. In this study the authors compare the survival benefit of gross-total resection (GTR) in patients with oligodendroglioma relative to patients with astrocytoma.METHODSUsing the Surveillance, Epidemiology, and End Results (SEER) Program (1999–2010) database, the authors identified 2378 patients with WHO Grade II oligodendroglioma (O2 group) and 1028 patients with WHO Grade III oligodendroglioma (O3 group). Resection was defined as GTR, subtotal resection, biopsy only, or no resection. Kaplan-Meier and multivariate Cox regression survival analyses were used to assess survival with respect to extent of resection.RESULTSCox multivariate analysis revealed that the hazard of dying from O2 and O3 was comparable between patients who underwent biopsy only and GTR (O2: hazard ratio [HR] 1.06, 95% confidence interval [CI] 0.73–1.53; O3: HR 1.18, 95% CI 0.80–1.72). A comprehensive search of the published literature identified 8 articles without compelling evidence that GTR is associated with improved overall survival in patients with oligodendroglioma.CONCLUSIONSThis SEER-based analysis and review of the literature suggest that GTR is not associated with improved survival in patients with oligodendroglioma. This finding contrasts with the documented association between GTR and overall survival in anaplastic astrocytoma and glioblastoma. The authors suggest that this difference may reflect the sensitivity of oligodendroglioma to chemotherapy as compared with astrocytomas.

Gamma Knife Stereotactic Radiosurgery for Patients with Glioblastoma Multiforme

Neurosurgery ◽  
2002 ◽  
Vol 50 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Emmanuel C. Nwokedi ◽  
Steven J. DiBiase ◽  
Salma Jabbour ◽  
Joseph Herman ◽  
Pradip Amin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Glioblastoma Multiforme ◽  
Stereotactic Radiosurgery ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Cox Regression Analysis ◽  
Group 2 ◽  
Group 1

ABSTRACT OBJECTIVE Stereotactic radiosurgery (SRS) has become an effective therapeutic modality for the treatment of patients with glioblastoma multiforme (GBM). This retrospective review evaluates the impact of SRS delivered on a gamma knife (GK) unit as an adjuvant therapy in the management of patients with GBM. METHODS Between August 1993 and December 1998, 82 patients with pathologically confirmed GBM received external beam radiotherapy (EBRT) at the University of Maryland Medical Center. Of these 82 patients, 64 with a minimum follow-up duration of at least 1 month are the focus of this analysis. Of the 64 assessable patients, 33 patients were treated with EBRT alone (Group 1), and 31 patients received both EBRT plus a GK-SRS boost (Group 2). GK-SRS was administered to most patients within 6 weeks of the completion of EBRT. The median EBRT dose was 59.7 Gy (range, 28–70.2 Gy), and the median GK-SRS dose to the prescription volume was 17.1 Gy (range, 10–28 Gy). The median age of the study population was 50.4 years, and the median pretreatment Karnofsky performance status was 80. Patient-, tumor-, and treatment-related variables were analyzed by Cox regression analysis, and survival curves were generated by the Kaplan-Meier product limit. RESULTS Median overall survival for the entire cohort was 16 months, and the actuarial survival rate at 1, 2, and 3 years were 67, 40, and 26%, respectively. When comparing age, Karnofsky performance status, extent of resection, and tumor volume, no statistical differences where discovered between Group 1 versus Group 2. When comparing the overall survival of Group 1 versus Group 2, the median survival was 13 months versus 25 months, respectively (P = 0.034). Age, Karnofsky performance status, and the addition of GK-SRS were all found to be significant predictors of overall survival via Cox regression analysis. No acute Grade 3 or Grade 4 toxicity was encountered. CONCLUSION The addition of a GK-SRS boost in conjunction with surgery and EBRT significantly improved the overall survival time in this retrospective series of patients with GBM. A prospective, randomized validation of the benefit of SRS awaits the results of the recently completed Radiation Therapy Oncology Group's trial RTOG 93-05.

scholarly journals Reoperation for recurrent glioblastomas: What to expect?

2021 ◽  
Vol 12 ◽  
pp. 42
Author(s):  
Iuri Santana Neville ◽  
Alexandra Gomes dos Santos ◽  
Cesar Cimonari Almeida ◽  
Leonardo Bilich Abaurre ◽  
Samia Yasin Wayhs ◽  
...  
Keyword(s):  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Survival Rates ◽  
Weibull Model ◽  
University Hospital ◽  
Current Standard ◽  
Weibull Regression ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Background: The current standard treatment for glioblastoma (GBM) is maximal safe surgical resection followed by radiation and chemotherapy. Unfortunately, the disease will invariably recur even with the best treatment. Although the literature suggests some advantages in reoperating patients harboring GBM, controversy remains. Here, we asked whether reoperation is an efficacious treatment strategy for GBM, and under which circumstances, it confers a better prognosis. Methods: We retrospectively reviewed 286 consecutive cases of newly diagnosed GBM in a single university hospital from 2008 to 2015. We evaluated clinical and epidemiological parameters possibly influencing overall survival (OS) by multivariate Cox regression analysis. OS was calculated using the Kaplan–Meier method in patients submitted to one or two surgical procedures. Finally, the survival curves were fitted with the Weibull model, and survival rates at 6, 12, and 24 months were estimated. Results: The reoperated group survived significantly longer (n = 63, OS = 20.0 ± 2.3 vs. 11.4 ± 1.0 months, P < 0.0001). Second, the multivariate analysis revealed an association between survival and number of surgeries, initial Karnofsky Performance Status, and age (all P < 0.001). Survival estimates according to the Weibull regression model revealed higher survival probabilities for reoperation compared with one operation at 6 months (83.74 ± 3.42 vs. 63.56 ± 3.59, respectively), 12 months (64.00 ± 4.85 vs. 37.53 ± 3.52), and 24 months (32.53 ± 4.78 vs. 12.02 ± 2.36). Conclusion: Our data support the indication of reoperation for GBM, especially for younger patients with good functional status. Under these circumstances, survival can be doubled at 12 and 24 months.

Safety analysis of bevacizumab plus NovoTTF-100A in patients with recurrent malignant gliomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2082-2082 ◽  
Author(s):  
Grace Elzinga ◽  
Amy T Chung ◽  
Eric Wong
Keyword(s):  
Overall Survival ◽  
Side Effects ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Malignant Gliomas ◽  
Treatment Interruption ◽  
Recurrent Glioblastoma ◽  
Combined Modality Treatment ◽  
Kaplan Meier ◽  
Bevacizumab Treatment

2082 Background: Both bevacizumab and the NovoTTF-100A device are treatments approved by the FDA for recurrent glioblastoma. We examined our single-institution experience in using this combination for patients with recurrent malignant gliomas. Methods: We identified retrospectively the side effects experienced by patients while on both bevacizumab and NovoTTF-100A. Overall survival was also tabulated from initiation of this combined modality treatment. Results: There were 14 men and 6 women. Their median age was 54 (range 29-76). All had Karnofsky Performance Status of 60 or above. Fourteen patients received NovoTTF-100A after failure of bevacizumab treatment while the other 6 received both treatments concurrently. The median duration of bevacizumab plus NovoTTF-100A treatments was 2.3 (95% CI 1.8-4.7) months. There were 2 patients who experienced electric shock sensation on the scalp from a poorly-applied transducer array that resulted in minor scalp burns, 3 patients developed scalp rashes (2 moderate and 1 severe), 4 patients experienced liquefied hydrogel from the arrays as a result of high ambient temperature during summer months, 2 experienced vivid dreams of applying the arrays and 3 removed the arrays while periods of sleep or confusion. Only one patient required NovoTTF-100A treatment interruption because of severe scalp rash. No hemorrhage into the malignant glioma or thromboembolism was seen in this cohort. From the time of initiation of bevacizumab plus NovoTTF-100A treatments, the Kaplan-Meier median overall survival was 5.6 (95% CI 4.2-N/A) months. Conclusions: No additive or synergistic side effects were observed when patients were treated with both bevacizumab and NovoTTF-100A. Further evaluation in a prospective manner would be needed to evaluate both side effects and efficacy of this treatment combination.

Three or More Courses of Stereotactic Radiosurgery for Patients with Multiply Recurrent Brain Metastases

Neurosurgery ◽  
2017 ◽  
Vol 80 (6) ◽  
pp. 871-879 ◽  
Author(s):  
Rupesh Kotecha ◽  
Nicholas Damico ◽  
Jacob A. Miller ◽  
John H. Suh ◽  
Erin S. Murphy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Confidence Interval ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Intracranial Recurrence

Abstract BACKGROUND: Although patients with brain metastasis are treated with primary stereotactic radiosurgery (SRS), the use of salvage therapies and their consequence remains understudied. OBJECTIVE: To study the intracranial recurrence patterns and salvage therapies for patients who underwent multiple SRS courses. METHODS: A retrospective review was performed of 59 patients with brain metastases who underwent ≥3 SRS courses for new lesions. Cox regression analyzed factors predictive for overall survival. RESULTS: The median age at diagnosis was 52 years. Over time, patients underwent a median of 3 courses of SRS (range: 3-8) to a total of 765 different brain metastases. The 6-month risk of distant intracranial recurrence after the first SRS treatment was 64% (95% confidence interval: 52%-77%). Overall survival was 40% (95% confidence interval: 28%-53%) at 24 months. Only 24 patients (41%) had a decline in their Karnofsky Performance Status ≤70 at last office visit. Quality of life was preserved among 77% of patients at 12 months, with 45% experiencing clinically significant improvement during clinical follow-up. Radiation necrosis developed in 10 patients (17%). On multivariate analysis, gender (males, Hazard Ratio [HR]: 2.0, P &lt; .05), Karnofsky Performance Status ≤80 (HR 3.2, P &lt; .001), extracranial metastases (HR: 3.6, P &lt; .001), and a distant intracranial recurrence ≤3 months from initial to repeat SRS (HR: 3.8, P &lt; .001) were associated with a poorer survival. CONCLUSION: In selected patients, performing ≥3 SRS courses controls intracranial disease. Patients may need salvage SRS for distant intracranial relapse, but focal retreatments are associated with modest toxicity, do not appear to negatively affect a patient's performance status, and help preserve quality of life.

Quantitative volumetric assessment of baseline enhancing tumor volume as an imaging biomarker predicts overall survival in patients with glioblastoma

2020 ◽  
pp. 028418512095379
Author(s):  
Timo A Auer ◽  
Marta Della Seta ◽  
Federico Collettini ◽  
Julius Chapiro ◽  
Sebastian Zschaeck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Methyltransferase ◽  
Tumor Volume ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Imaging Biomarker ◽  
Entire Cohort ◽  
Volumetric Assessment

Background Glioblastoma multiforme (GBM) is the commonest malignant primary brain tumor and still has one of the worst prognoses among cancers in general. There is a need for non-invasive methods to predict individual prognosis in patients with GBM. Purpose To evaluate quantitative volumetric tissue assessment of enhancing tumor volume on cranial magnetic resonance imaging (MRI) as an imaging biomarker for predicting overall survival (OS) in patients with GBM. Material and Methods MRI scans of 49 patients with histopathologically confirmed GBM were analyzed retrospectively. Baseline contrast-enhanced (CE) MRI sequences were transferred to a segmentation-based three-dimensional quantification tool, and the enhancing tumor component was analyzed. Based on a cut-off percentage of the enhancing tumor volume (PoETV) of >84.78%, samples were dichotomized, and the OS and intracranial progression-free survival (PFS) were evaluated. Univariable and multivariable analyses, including variables such as sex, Karnofsky Performance Status score, O6-methylguanine-DNA-methyltransferase status, age, and resection status, were performed using the Cox regression model. Results The median OS and PFS were 16.9 and 7 months in the entire cohort, respectively. Patients with a CE tumor volume of >84.78% showed a significantly shortened OS (12.9 months) compared to those with a CE tumor volume of ≤84.78% (17.7 months) (hazard ratio [HR] 2.72; 95% confidence interval [CI] 1.22–6.03; P = 0.01). Multivariable analysis confirmed that PoETV had a significant prognostic role (HR 2.47; 95% CI 1.08–5.65; P = 0.03). Conclusion We observed a correlation between PoETV and OS. This imaging biomarker may help predict the OS of patients with GBM.

scholarly journals Impact on Awake Mapping on Overall Survival and Extent of Resection in Patients With Adult Diffuse Gliomas Within or Near Eloquent Areas: A Retrospective Propensity Score-matched Analysis of Awake Craniotomy Vs. General Anesthesia

2021 ◽  
Author(s):  
Atsushi Fukui ◽  
Yoshihiro Muragaki ◽  
Taiichi Saito ◽  
Masayuki Nitta ◽  
Shunsuke Tsuzuki ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
General Anesthesia ◽  
Propensity Score Matching ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Extent Of Resection ◽  
Awake Craniotomy ◽  
World Health ◽  
Eloquent Areas

Abstract Introduction: Awake craniotomy (AC) with intraoperative mapping is the best approach to preserve neurological function for glioma surgery in eloquent or near eloquent areas, but whether AC improves the extent of resection (EOR) is controversial. Furthermore, there is less evidence of improved overall survival (OS) in glioma patients. This study aimed to compare the long-term clinical outcomes of glioma resection under AC with those under general anesthesia (GA).Methods: Data of 335 patients who underwent surgery with intraoperative magnetic resonance imaging for newly diagnosed gliomas of World Health Organization (WHO) grades II-IV between 2000 and 2013 were reviewed. EOR and OS were quantitatively compared between the AC and GA groups after 1:1 propensity score matching. The two groups were matched for age, preoperative Karnofsky performance status, tumor location, and pathology based on the WHO 2007 classification.Results: After propensity score matching, 91 pairs were obtained. The median EOR were 96.1% (interquartile range [IQR] 7.3) and 97.4% (IQR 14.4) in the AC and GA groups, respectively (p=0.31). The median survival times were 163.3 months (95% confidence interval [CI] 77.9-248.7) and 143.5 months (95% CI 94.4-192.7) in the AC and GA groups, respectively (p=0.585).Conclusions: Even if the glioma was within or close to the eloquent area, AC was comparable with GA in terms of EOR and OS. In case of difficulties in randomizing patients with eloquent or near eloquent glioma, our propensity score-matched analysis provides retrospective evidence that AC can obtain EOR and OS equivalent to removing glioma under GA.

Evaluation of imatinib mesylate (IM) in patients with large volume gastrointestinal stromal tumors (GISTs)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10054-10054 ◽  
Author(s):  
D. M. Byrd ◽  
G. D. Demetri ◽  
H. Joensuu ◽  
M. von Mehren ◽  
M. Heinrich ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Volume ◽  
Cox Regression ◽  
Performance Status ◽  
Tumor Burden ◽  
Overall Response ◽  
Kaplan Meier ◽  
Dose Levels ◽  
The Relationship ◽  
Baseline Hemoglobin

10054 Background: GIST size is one of the most important prognostic markers for recurrence and poor survival. However, little information exists regarding the relationship between tumor volume and clinical outcome after treatment with IM. A phase II randomized clinical trial of two dose levels of IM (400 vs. 600 mg daily) in pts with incurable GIST was previously presented (Proc ASCO 2001; Combined GI Symp 2004 and 2007). With median follow-up of 64 months, we report additional analyses of the relationship between tumor volume and IM efficacy. Methods: Data on initial tumor bulk were prospectively collected, and 146 pts were separated into quartiles according to total tumor volume: < 39.1 cm2 (n=36), 39.1 = 102.16 cm2 (n=37), 102.16 = 262.6 cm2 (n=36), = 262.6 cm2 (n=37). Tumor bulk was correlated with standard efficacy outcomes. Results: The overall response rate (CR + PR) for all pts was 68.1% (95% CI 59.8% - 75.5%). Median time-to-progression (TTP) was 24 months, and overall survival (OS) was 57 months. The overall response rates for the four quartiles according to tumor burden (lowest to highest) were: 64%, 70%, 75%, and 65% respectively. Median TTP by quartile was: 57, 25, 18, and 17 months. Median OS for these same groups: not reached, 57, 47, and 35 months. The Kaplan-Meier estimates of patients alive at 64 months based on tumor bulk were 62%, 40%, 44%, and 31% respectively. Disease bulk was an independent prognostic factor for overall survival using a Cox regression model including sex, performance status, IM dose, gender, age, prior chemotherapy, and tumor volume, but not when baseline hemoglobin was included. Conclusions: Pts with bulky GISTs progress sooner and die more quickly than those with lesser tumor volumes, though other factors may contribute as well. Even pts with the bulkiest tumors frequently respond to treatment with IM, however. TTP for this population approaches 1.5 yrs, and median survival for these pts approximates 3 yrs. One-third of pts with extraordinarily bulky GISTs are long-term survivors. The potential relationship between baseline hemoglobin and tumor bulk requires further investigation. [Table: see text]

scholarly journals Serum ANCA and Overall Mortality: A 10-Year Retrospective Cohort Study on 1,024 Italian Subjects

2021 ◽  
Vol 12 ◽  
Author(s):  
Enrico Brunetta ◽  
Giacomo Ramponi ◽  
Marco Folci ◽  
Maria De Santis ◽  
Emanuela Morenghi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Perinuclear Anca ◽  
Worse Prognosis

BackgroundAntineutrophil cytoplasmic antibodies (ANCA) are primarily involved in the pathogenesis of ANCA-associated vasculitides (AAV). However, ANCA may also be present in healthy subjects and in patients with autoimmune disorders different from AAV. We hypothesized that serum ANCA are associated with a worse prognosis in disorders other than AAV.ObjectiveWe investigated the association between the overall survival and the presence of serum ANCA in 1,024 Italian subjects with various testing indications in a 10-year interval.MethodsIn this retrospective cohort study, a population of 6,285 patients (many of whom were subsequently excluded due to our criteria) who tested for ANCA at a single center in 10 years was considered, and life status and comorbidities of subjects were collected. We compared the overall survival of ANCA-positive and ANCA-negative patients by means of Kaplan-Meier curves, while a multivariable adjusted Cox regression was used to evaluate the association between the ANCA status and the outcome (death) in terms of hazard ratios (HR) with 95% confidence intervals (CI).ResultsThe positivity of perinuclear ANCA (pANCA) increased significantly mortality (HR, 1.60; 95% CI, 1.10–2.32), while cytoplasmic ANCA (cANCA) positivity failed to show a significant association (HR, 1.43; 95% CI, 0.77–2.68). The increased mortality rate was observed for both pANCA and cANCA in patients suffering from rheumatic disorders. No association was found between mortality and anti-MPO (HR, 0.63; 95% CI, 0.20–2.00) or anti-PR3 (HR, 0.98; 95% CI, 0.24–3.96) after adjusting for confounders.ConclusionsSerum pANCA and cANCA are independent negative prognostic factors in patients with concurrent autoimmune diseases.

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