P211 COMPARISON OF PROGNOSTIC VALUE FOR G8 SCREENING TOOLS WITH FTRST IN OLDER PATIENTS OF ESOPHAGEAL CANCER

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Terayama Masayoshi ◽  
Yamada Kazuhiko ◽  
Saito Noriyuki ◽  
Wake Hitomi ◽  
Kataoka Atsuko ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Older Patients ◽  
Prognostic Value ◽  
Postoperative Outcome ◽  
The Elderly ◽  
Screening Tools ◽  
Ecog Ps

Abstract Aim We investigated two prognostic value of geriatric screening tools, G8 and Flemish version of the Triage Risk Screening Tool (fTRST), for overall survival and postoperative outcome in older patients undergoing esophagectomy for esophageal cancer (EC). Backgrounds&Method The elderly cancer population is a very heterogeneous group due to differences in comorbidities and functional status. G8 and fTRST are short and easy tools to administer in clinical settings and reported to be useful for identifying patients with geriatric risks. However, the prognostic value of G8 and fTRST has not been compared in EC patients after surgery. Patients aged ≥ 70 years old with EC were retrospectively included who received an operation at National Center for Global Health and Medicine from April 2014 to December 2017. G8 and fTRST were administered to all patients. The impaired were defined as a G8 ≤ 14 and fTRST ≥ 2. We evaluated overall survival (OS) and 30-day postoperative complications classified into Clavien-Dindo (CD) severity grade. Results 63 patients were included. Median age was 76 years (range, 70 to 89 years), and 84% of patients were men. 44 patients (69%) were G8 impaired, 22 patients (34%) were fTRST impaired, 23 patients (36%) were impaired on both screening tools. G8 was an independent predictor of overall survival (hazard ratio 9.9; 95% confidence interval 1.24-79.4, p=0.02), while fTRST was not. The CD≥3 postoperative complications occurred in 33 patients (52%). In univariable logistic regressions, ECOG-PS, G8 and fTRST were associated with CD≥3 complications. G8 alone was not independently predictive for CD≥3 complications, however combined with fTRST, the predictive value of G8 was increased (p=0.001). Conclusions G8 is useful for prognostic value of OS and prior to fTRST in EC. G8 combined with Ftrst has the strongest predictive value for postoperative CD≥3 complications. Further studies are needed to design interventions to improve outcomes for those frail patients.

Prognostic value of the G8 and modified-G8 screening tools for multidimensional health problems in older patients with cancer

2017 ◽  
Vol 83 ◽  
pp. 211-219 ◽  
Author(s):  
Claudia Martinez-Tapia ◽  
Elena Paillaud ◽  
Evelyne Liuu ◽  
Christophe Tournigand ◽  
Rima Ibrahim ◽  
...  
Keyword(s):  
Older Patients ◽  
Prognostic Value ◽  
Health Problems ◽  
Screening Tools ◽  
Patients With Cancer ◽  
Multidimensional Health

Neoadjuvant chemoradiation is associated with improved overall survival in older patients with esophageal cancer

2018 ◽  
Vol 9 (1) ◽  
pp. 40-46 ◽  
Author(s):  
David M. Guttmann ◽  
Nandita Mitra ◽  
James M. Metz ◽  
John Plastaras ◽  
Weiwei Feng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Older Patients ◽  
Neoadjuvant Chemoradiation

Evaluation of lesion-based response at 12 weeks (LBR12) of treatment (Rx) in metastatic colorectal cancer (mCRC): Findings from 9,092 patients (pts) in the ARCAD database.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 612-612
Author(s):  
Fang-Shu Ou ◽  
Yiyue Lou ◽  
Eric Van Cutsem ◽  
Leonard Saltz ◽  
Hans-Joachim Schmoll ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Value ◽  
Progressive Disease ◽  
Egfr Inhibitor ◽  
Cox Models ◽  
Treatment Regimens ◽  
Vegf Inhibitor ◽  
Predicting Outcome ◽  
Ecog Ps

612 Background: mCRC is a heterogeneous disease leading to possible disparate responses among lesions in a single pt. This study assesses the heterogeneity of lesion responses and evaluates the prognostic value of LBR12 and its mortality risk discrimination beyond RECIST responses. Methods: Pts with ≥ 2 lesions and no new lesions at 12 weeks (wks) were eligible. For each pt, after 12 wks of Rx, each lesion was categorized as progressive disease (L-PD: ≥20% increase in the longest diameter [LD]), partial response (L-PR: ≥30% decrease in LD), or stable disease (L-SD: neither L-PD nor L-PR). LBR12 was defined, per patient, by the combination of lesion responses: homogeneous LBR12 (L-PD, L-SD, L-PR only) and heterogeneous LBR12 (mixture of L-PD/L-SD, L-PD/L-PR, L-SD/L-PR). LBR12 and overall survival (OS) were correlated using stratified multivariate Cox models after adjusting for age, gender, and ECOG PS. Results: Among 9,092 mCRCs (Rx: chemo alone 44%; chemo + VEGF inhibitor [VEGFi] 42%; chemo + EGFR inhibitor [EGFRi] 10%) from 16 1st-line studies. Median OS: 2.2 years. Per RECIST at 12 wks, CR 0%; PR 36.1%; SD 60.9%; PD 3.0%. Responses in 52% were heterogeneous (Table). VEGFi and EGFRi treated pts had the highest rate of L-SD/L-PR (45%) and L-PR only (22%) status, respectively. Median OS increased monotonically across pts with more L-PRs and fewer L-PDs (Table). Pts with L-SD/L-PR status, among which 51% had SD per RECIST, had longer OS than those with L-SD only status (HRadj.= .81, padj.< .0001), but shorter OS than those with L-PR only status (HRadj.= 1.46, padj.< .0001). Pts with L-PD/L-SD status, among which 71% were SD per RECIST, had shorter OS than those with L-SD only status (HRadj.= 2.22, padj.< .0001). These associations were consistent across treatment regimens. Conclusions: The lesion-based response captures the heterogeneity of within pt lesion responses and provides refinement in predicting outcome beyond RECIST response at 12 wks. [Table: see text]

scholarly journals Frailty-independent Undertreatment Negative Impact on Survival in Older Patients With Breast Cancer

2021 ◽  
Author(s):  
Fernando Osório ◽  
António Barros ◽  
Bárbara Peleteiro ◽  
Ana Rita Barradas ◽  
Joana Urbano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Older Patients ◽  
Negative Impact ◽  
Treatment Options ◽  
Daily Practice ◽  
Screening Tools ◽  
Impact On Survival ◽  
Causes Of Mortality ◽  
Ecog Ps ◽  
Self Examination

Abstract Introduction: The management of older patients with breast cancer remains controversial. The difficult assessment of ageing idiosyncrasies and the insufficient evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival.Materials and methods: Consecutive patients with breast cancer aged 70 years or older were prospectively enrolled in 2014. Three frailty screening tools (G8, fTRST, GFI) and two functional status scales (KPS, ECOG-PS) were applied. Disease characteristics, treatment options and causes of mortality were recorded in a 5-year follow-up. We defined undertreatment and correlated its survival impact with frailty. Results: A total of 92 patients were included. Median age was 77 (range 70-94) years. The prevalence of frailty was discordant (G8: 41,9%, fTRST: 74.2%, GFI: 32.3%). A low-risk disease was not found (51.2% were N+) probably due to a late diagnosis (76.1% based on self-examination). Thirty-three patients (35.6%) died 15 of them from breast cancer. We found a considerable high proportion (53.3%) of undertreatment, which had a frailty-independent negative impact on 5-year survival (HR=5.1 [95% CI: 2.1-12.5]). Additionally, omission of surgery had a frailty-independent negative impact on overall survival (HR=3.9 [95% CI: 1.9-7.9]). Conclusion: Breast cancer treatment in older adults ought to be individualized. More important than assessing frailty (not to treat) is essential to be aware of the risk-benefit profile and the patient's well-informed willingness to be treated. The undertreatment in daily practice is frequent and might have, as we report, a negative impact on survival.

Prognostic and predictive value of immunoscore signature in gastric cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15594-e15594 ◽  
Author(s):  
Xiaolong Qi ◽  
Yuming Jiang ◽  
Qi Zhang ◽  
Yanfeng Hu ◽  
Tuanjie Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Predictive Value ◽  
Prognostic Value ◽  
Cox Regression ◽  
External Validation ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Predictive Tool

e15594 Background: TNM staging system is not adequate to define the prognosis of patients with gastric cancer (GC). This system is also unable to predict whether the GC patients are likely to benefit from adjuvant chemotherapy. We postulated that ImmunoScore of GC (ISGC) could markedly improve the prediction of postsurgical survival and adjuvant chemotherapeutic benefits. Methods: 125 GC patients were enrolled as a training cohort to detect the expression of 27 immune features using immunohistochemistry and then constructed a five-feature-based ISGC using the LASSO Cox regression model. Internal validation cohort (126 specimens) and two external validation cohorts (628 specimens) were utilized to validate the prognostic and predictive value of ISGC. Results: We established the ISGC classifier based on the five features: CD3invasive margin (IM), CD3center of tumor (CT), CD8IM, CD45ROCT, and CD66bIM. The ISGC classifier could distinguish GC patients with high-ISGC from those with low-ISGC with significant differences in 5-year disease-free survival (45.0% v.s. 4.4%, p < 0.001) and 5-year overall survival (48.8% v.s. 6.7%, p < 0.001). According to the multivariate analysis, the ISGC classifier was proved to be an independent prognostic factor. A combination of ISGC and TNM had better prognostic value than TNM stage alone. In a further analysis, stage II and III GC patients with high-ISGC exhibited a favorable response to adjuvant chemotherapy. To provide a quantitative method to predict stage II and III GC patients’ probability of 3- and 5-year overall survival, we constructed two nomograms that integrated the ISGC and clinicopathological risk factors. Calibration plots showed that the nomograms performed well compared with an ideal model. The predictive accuracy and clinical usefulness of the nomograms were also demonstrated. Conclusions: The ISGC classifier could effectively predict recurrence and survival of GC, and complemented the prognostic value to TNM system. Moreover, the classifier might be a useful predictive tool to identify candidates with stage II and III GC who would benefit from adjuvant chemotherapy. Therefore, the ISGC might facilitate the counseling and personalize the postoperative management of GC patients.

Prognostic value of routine biomarkers in older patients with cancer: Pooled analysis of three prospective cohorts.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11551-11551
Author(s):  
Elena Paillaud ◽  
Pierre Soubeyran ◽  
Nadia Oubaya ◽  
Etienne Brain ◽  
Marianne Fonck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Older Patients ◽  
Prognostic Value ◽  
Prognostic Score ◽  
Performance Status ◽  
Glasgow Prognostic Score ◽  
Pooled Analysis ◽  
Clinical Model ◽  
Patients With Cancer ◽  
Net Reclassification Improvement

11551 Background: To assess prognostic value of routine biomarkers in older patients with cancer. Methods: A pooled analysis of three prospective multicentre cohorts, ELCAPA, PHRC Aquitaine and ONCODAGE was conducted. Patients aged 70 years or older, with cancer were included. Biomarkers collected were plasmatic C-reactive protein, albumin and a combined score: Glasgow Prognostic Score (GPS). The GPS comprised three categories (0: CRP≤10 mg/L, albumin≥35 g/L; 1: CRP≤10 mg/L and albumin < 35 g/L, or CRP > 10 mg/L and albumin≥35 g/L; 2: CRP > 10 mg/L and albumin < 35 g/L).The primary endpoint was overall survival at 12 months. Multivariable Cox models were used, adjusting for age, sex, localisation, metastatic status, performance status, frailty screening index, the G8. Discriminative properties were assessed using Harrell C index and NRI (Net Reclassification Improvement). Results: Overall 1800 patients were analyzed (ELCAPA: N = 543, PHRC Aquitaine: N = 253, ONCODAGE: N = 1004; mean age: 78.5±5.5 years; 61.7% of men; 37% metastatic; most frequent localisations: breast (34.9%) and colon-rectum (17.7%); 70.7% of patients screened at risk of frailty with G8). Overall survival was 71.1%. GPS was independently associated with death (among normal G8: GPS 1: Hazard Ratio (HR) = 4.48; 95% Confidence Interval (95% CI) = [2.03; 9.89], GPS 2: 11.64 [4.54; 29.81], among abnormal G8: GPS 1: 2.45 [1.79; 3.34], GPS 2: 3.97 [2.93; 5.37]. The addition of GPS to the clinical model (Harell C: 0.82 [0.80; 0.83]) improved discrimination (Harell C: 0.84 [0.82; 0.85], NRI: 11% [5; 19]). Conclusions: GPS could be used in older patients with cancer to help decision-making and prognosis assessment.

KLRK1 as a Prognostic Biomarker for Lung Adenocarcinoma Cancer

2021 ◽  
Author(s):  
Yanan Zhang ◽  
Zeyang Chen ◽  
Guanqi Gao
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Lung Adenocarcinoma ◽  
Older Patients ◽  
Prognostic Value ◽  
Prognostic Biomarker ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Lung Adenocarcinoma Cancer

Abstract Background. Lung cancer is one of the most common malignancy worldwide and causes estimated 1.6 million deaths each year. Cancer immunosurveillance has been found to play an important role in lung cancer and may be related with its prognosis. KLRK1, encoding NKG2D, is a homodimeric lectin-like receptor. However, there has not been one research of KLRK1 as a biomarker in lung cancer.Methods. Data including patients` clinical characteristics and RNAseq information of KLRK1 from TCGA were downloaded. A total of 1019 patients with lung cancer were included in this study, among which 407 patients were female and 611 patients were male. Evaluations of mRNA expression, diagnostic value by ROC (Receiver operating characteristic) curves and prognostic value by survival curve, Cox model and subgroup analysis were performed. The CCK-8 assay investigated the proliferation rate and the wound healing assay assessed the migratory ability in vitro.Results. The expression of KLRK1 in tumor was lower than that in normal tissue. KLRK1 expression was associated with gender, histologic grade, stage, T classification and vital status. Patients with high KLRK1 expression presented an improved overall survival (P=0.0036) and relapse free survival (P=0.0031). KLRK1 was found to have significant prognostic value in lung adenocarcinoma (P=0.015), stage I/II (P=0.03), older patients (P=0.0052), and male (P=0.0047) by subgroup overall survival analysis, and in lung adenocarcinoma (P=0.0094), stage I/II (P=0.0076), older patients (P=0.0072) , and male (P=0.0033) by subgroup relapse free survival analysis. Lung adenocarcinoma cancer patients with high KLRK1 expression presented an improved overall survival (P=0.015) and relapse free survival (P=0.0094). In vitro studies indicated that KLRK1 inhibited tumor cell proliferation and migration.Conclusions. KLRK1 was an independent prognostic factor and high KLRK1 expression indicated a better overall and relapse free survival. KLRK1 may be a prognostic biomarker for lung adenocarcinoma cancer.

Prognostic Value of Lymph Node Yield on Overall Survival in Esophageal Cancer Patients

2019 ◽  
Vol 269 (2) ◽  
pp. 261-268 ◽  
Author(s):  
Els Visser ◽  
Sheraz R. Markar ◽  
Jelle P. Ruurda ◽  
George B. Hanna ◽  
Richard van Hillegersberg
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Lymph Node Yield ◽  
Node Yield

Symptomatic Waldenstrom’s Macroglobulinemia (WM) in Young Patients: Disease Characteristics and Outcome.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4730-4730
Author(s):  
Efstathios Kastritis ◽  
Evangelos Eleftherakis-Papaiakovou ◽  
Magdalini Migkou ◽  
Dimitra Gika ◽  
Evangelos Terpos ◽  
...  
Keyword(s):  
Overall Survival ◽  
Older Patients ◽  
Young Patients ◽  
Nucleoside Analogs ◽  
The Elderly ◽  
Response To Treatment ◽  
International Prognostic Scoring System ◽  
Survival Times ◽  
Equal Distribution ◽  
Laboratory Features

Abstract Introduction: WM is a disease of the elderly with a median age of 70 years in most series. Advanced age is recognized as an adverse prognostic feature and age > 65 years has been included among the 5 adverse covariates in the recently reported International prognostic Scoring System for WM (Morel et al, ASH 2006). There is little information regarding the incidence of disease features and outcomes after treatment of young patients (≤ 50 years of age) with symptomatic WM. Patients and methods: Our database includes 220 patients with previously untreated, symptomatic WM. These patients were separated in two groups according to age ≤ 50 years and >50 years at the time of initiation of treatment. Clinical and laboratory characteristics, response to treatment, overall survival (OS) and disease-specific survival (DSS) were compared among the two groups. Results: Twenty-two patients (10%) were ≤ 50 years of age at the time of initiation of treatment. The incidence of clinical and laboratory features was similar among young and older patients: gender (p=0.3), B-symptoms (p=0.3), splenomegaly (p=0.9), lymphadenopathy (p=0.1), anemia (p=0.3), median serum IgM level (p=0.6), hyperviscosity syndrome (p=0.7), elevated β2-microglobulin (p=0.3) and IgM related disorders (p=0.6). primary treatment consisted of chlorambucil, nucleoside analogs or rituximab-based regimens with equal distribution among young and older patients. At least partial response was observed in 73% of young patients and in 57% of older patients (p=0.16). The median OS was not reached in young patients and it was 106 months in older patients (p=0.07). The median DSS was not reached in young patients and it was 116 months in older patients (p=0.2). Conclusion: 10% of patients with WM are ≤50 years at the time of treatment initiation. Their clinical and laboratory features and response to treatment are similar to those of older patients. Overall survival tend to be longer in young patients, but when deaths unrelated to WM or complications of treatment are excluded, survival times among young and older patients are similar.

Sign in / Sign up

Export Citation Format

Share Document