MO179ACUTE KIDNEY INJURY IN ELDERLY- PROGNOSTIC VALUES OF COMORBIDITY AND THE AGE FOR THE SHORT AND THE LONG TERM OUTCOME

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Zvezdana Petronijevikj ◽  
Gjulsen Selim ◽  
Biljana Gerasimovska ◽  
Lada Trajceska
Keyword(s):  
Regression Analysis ◽  
Risk Factor ◽  
Heart Disease ◽  
High Risk ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Cox Regression ◽  
Kidney Injury ◽  
Comorbid Conditions ◽  
Cox Regression Analysis

Abstract Background and Aims Acute kidney injury (AKI) is defined by a rapid decline in glomerular filtration rate (GFR), resulting in disturbance of renal physiological functions including impairment of nitrogenous waste product excretion, loss of water and electrolyte regulation and loss of acid-base regulation. Coexisting disease and the structural and functional changes that occur during the aging process are disposing factors that increase the risk of AKI in elderly population. Method 101 elderly patients (≥ 65) who filling out one of the criteria of definition of AKI according to Kidney Disease Improving Global Outcome (KDIGO), were included in the study. Patients were divided into 2 groups by age, group <75 and group> 75 years old. In terms of outcome they were divided in group with short and 90-day survival. The burden of the simultaneous presence of comorbid conditions was estimated through the Charles Comorbid Index. (CHI) Results The mortality rate for the 90-day follow-up period after the AKI event was 45.5%. The intra-hospital mortality rate in adult patients with AKI was 22.8%.In our study the age was not confirmed as a risk factor for intra-hospital and 3-month outcome in elderly patients with AKI. The presence of comorbid conditions estimated through the Charles Comorbid Index (CHI), differed un-significantly between survivors and deceased patients with AKI (p = 0.39, p = 0.28 consecutive). Cox regression analysis confirmed the CCI score as a significant factor in survival in patients with ABO. (p = 0.036).The risk of letal outcome increases by 16.3% with each increase in this unit score. Cox regression analysis confirmed heart diseases as a significant prognostic factor for survival, increasing the risk of fatal outcome by about 2 times higher than patients without heart disease. Statistical analysis showed a significant difference in survival time, depending on the presence of heart disease as a comorbidity (p =0.037). Conducted Cox regression analysis showed that HR - for heart disease, as a comorbidity, is 1.837 95% CI (1.020 - 3.306) and p = 0.043. The death rate for patients with heart disease is about 2 times higher than patients without heart disease. Cumulative survival was higher in the group of patients without cardiomyopathy - 64.2% (0.07) compared to the group of patients with cardiomyopathy- 43.8% (0.07). Multivariate Cox regression analysis as significant independent predictors of survival in patients with ABO confirmed the diuresis (p = 0.029) and albumin (p = 0.006). Conclusion AKI survivors with high burden of comorbidities are at high risk for postdischarge death. Cardiomyopathy, as a risk factor, for two times increases the risk of death. CCI score is significant independent high-risk prognostic factors for poor outcome in elderly patients with AKI. Remain the recommendation for individual clinical approach, assessment and selection for the application of treatment taking into account the overall condition in adult patients with acute renal injury.

scholarly journals Kidney function on admission predicts in-hospital mortality in COVID-19

2020 ◽  
Author(s):  
Sinan Trabulus ◽  
Cebrail Karaca ◽  
İlker İnanç Balkan ◽  
Mevlüt Tamer Dincer ◽  
Ahmet Murt ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Kidney Function ◽  
Cox Regression ◽  
Kidney Injury ◽  
Reciprocal Relationship ◽  
Cox Regression Analysis

AbstractBackgroundRecent data have reinforced the concept of a reciprocal relationship between COVID-19 and kidney function. However, most studies have focused on the effect of COVID-19 on kidney function, whereas data regarding kidney function on the COVID-19 prognosis is scarce. Therefore, in this study, we aimed to investigate the association between eGFR on admission and the mortality rate of COVID-19.MethodsWe recruited 336 adult consecutive patients (male 57.1%, mean age 55.0±15.9) that were hospitalized with the diagnosis of COVID-19 in the tertiary care university hospital. Data were collected from the electronic health records of the hospital. On admission, eGFR was calculated using the CKD-EPI formula. Acute kidney injury was defined according to the KDIGO criteria. Binary logistic regression and Cox regression analyses were used to assess the relationship between eGFR on admission and in-hospital mortality of COVID-19.ResultsBaseline eGFR was under 60 mL/min/1.73m2 in 61 patients (18.2%). Acute kidney injury occurred in 29.1% of the patients. In-hospital mortality was calculated as 12.8%. Age-adjusted and multivariate logistic regression analysis (p:0.005, odds ratio:0.974, CI:0.956-0.992) showed that baseline eGFR was independently associated with mortality. Additionally, age-adjusted Cox regression analysis revealed a higher mortality rate in patients with an eGFR under 60 mL/min/1.73m2.ConclusionsOn admission eGFR seems to be a prognostic marker for mortality in patients with COVID-19; We recommend to determine eGFR in all patients on admission and use it as an additional tool for risk stratification. Close follow-up should be warranted in patients with reduced eGFR.

scholarly journals Development of prognosis model for colon cancer based on autophagy-related genes

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Xu Wang ◽  
Yuanmin Xu ◽  
Ting Li ◽  
Bo Chen ◽  
Wenqi Yang
Keyword(s):  
Colon Cancer ◽  
Regression Analysis ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Score ◽  
Cox Regression ◽  
Patient Survival ◽  
Expression Profiles ◽  
Cox Regression Analysis ◽  
Risk Patients

Abstract Background Autophagy is an orderly catabolic process for degrading and removing unnecessary or dysfunctional cellular components such as proteins and organelles. Although autophagy is known to play an important role in various types of cancer, the effects of autophagy-related genes (ARGs) on colon cancer have not been well studied. Methods Expression profiles from ARGs in 457 colon cancer patients were retrieved from the TCGA database (https://portal.gdc.cancer.gov). Differentially expressed ARGs and ARGs related to overall patient survival were identified. Cox proportional-hazard models were used to investigate the association between ARG expression profiles and patient prognosis. Results Twenty ARGs were significantly associated with the overall survival of colon cancer patients. Five of these ARGs had a mutation rate ≥ 3%. Patients were divided into high-risk and low-risk groups based on Cox regression analysis of 8 ARGs. Low-risk patients had a significantly longer survival time than high-risk patients (p < 0.001). Univariate and multivariate Cox regression analysis showed that the resulting risk score, which was associated with infiltration depth and metastasis, could be an independent predictor of patient survival. A nomogram was established to predict 1-, 3-, and 5-year survival of colon cancer patients based on 5 independent prognosis factors, including the risk score. The prognostic nomogram with online webserver was more effective and convenient to provide information for researchers and clinicians. Conclusion The 8 ARGs can be used to predict the prognosis of patients and provide information for their individualized treatment.

scholarly journals A Risk Signature of Nine Autophagy-Related Genes Associated With Immune Microenvironment and Clinical Prognosis in Wilms Tumor

2021 ◽  
Author(s):  
Shaopei Ye ◽  
Wenbin Tang ◽  
Ke Huang
Keyword(s):  
Regression Analysis ◽  
High Risk ◽  
Risk Score ◽  
Cox Regression ◽  
Wilms Tumor ◽  
Risk Group ◽  
High Risk Group ◽  
Differentially Expressed ◽  
Clinical Prognosis ◽  
Cox Regression Analysis

Abstract Background: Autophagy is a biological process to eliminate dysfunctional organelles, aggregates or even long-lived proteins. . Nevertheless, the potential function and prognostic values of autophagy in Wilms Tumor (WT) are complex and remain to be clarifed. Therefore, we proposed to systematically examine the roles of autophagy-associated genes (ARGs) in WT.Methods: Here, we obtained differentially expressed autophagy-related genes (ARGs) between healthy and Wilms tumor from Therapeutically Applicable Research To Generate Effective Treatments(TARGET) and The Cancer Genome Atlas (TCGA) database. The functionalities of the differentially expressed ARGs were analyzed using Gene Ontology. Then univariate COX regression analysis and multivariate COX regression analysis were performed to acquire nine autophagy genes related to WT patients’ survival. According to the risk score, the patients were divided into high-risk and low-risk groups. The Kaplan-Meier curve demonstrated that patients with a high-risk score tend to have a poor prognosis.Results: Eighteen DEARGs were identifed, and nine ARGs were fnally utilized to establish the FAGs based signature in the TCGA cohort. we found that patients in the high-risk group were associated with mutations in TP53. We further conducted CIBERSORT analysis, and found that the infiltration of Macrophage M1 was increased in the high-risk group. Finally, the expression levels of crucial ARGs were verifed by the experiment, which were consistent with our bioinformatics analysis.Conclusions: we emphasized the clinical significance of autophagy in WT, established a prediction system based on autophagy, and identified a promising therapeutic target of autophagy for WT.

Natural History, Risk Factors and Prognostic Impact of Graft-Versus-Host Disease Classified According to the National Institute of Health Criteria in Patients Receiving Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 899-899 ◽  
Author(s):  
Theis H Terwey ◽  
Arturo Vega-Ruiz ◽  
Philipp G. Hemmati ◽  
Peter Martus ◽  
Ekkehart Dietz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Risk Factor ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Prognostic Impact ◽  
Cox Regression Analysis ◽  
Graft Versus Host ◽  
Organ Manifestations ◽  
Grade Iii

Abstract Abstract 899 Introduction: The classic definition of acute (aGVHD) and chronic graft-versus-host disease (cGVHD) was based on a cut-off day 100 after transplantation, but this did not reflect that aGVHD can occur later and that symptoms of aGVHD and cGVHD can occur simultaneously. In 2005 a NIH consensus classification was proposed which included 1) classic aGVHD, occurring before day 100, 2) persistent, recurrent or late aGVHD occurring thereafter, 3) classic cGVHD and 4) an overlap syndrome with simultaneous features of aGVHD and cGVHD. Only few studies have evaluated this classification and no studies have determined the differential impact of reduced intensity (RIC) and myeloablative conditioning (MAC). Method: We retrospectively analyzed 202 AML patients who were transplanted between 1999 and 2008. 102 patients received RIC (generally 6×30 mg/m2 FLU, 4×4 mg/kg BU, 4×10 mg/kg ATG) and immunosuppression with CSA/MMF and 100 patients received MAC (generally 6×2 Gy TBI and 2×60 mg/kg CY) and CSA/MTX. Donors were HLA-matched related (n=82), -matched unrelated (n=88) or -mismatched (n=32). Result: Leukocyte recovery was faster after RIC than after MAC (14 vs. 19 days, P<0.001) but time to reach full donor chimerism was similar (60 vs. 56 days, P=0.12). The cumulative incidence of classic aGVHD was lower after RIC than after MAC (40 vs. 67%, P<0.001) and it occurred later (31 vs. 23 days, P=0.041). No difference was seen in organ manifestations and in the overall aGVHD grade. The cumulative incidence of late aGVHD was low and did not differ between RIC and MAC (9 vs. 7%, P=NS). 13/16 patients with late aGVHD had persistent or recurrent classic aGVHD and 3/16 had de novo late aGVHD. Late aGVHD was less severe after RIC (grade III/IV 22 vs. 86%, P=0.041). The first signs of cGVHD were observed on days 86 after RIC and 97 after MAC with median onset on days 167 and 237, respectively (P=NS). The cumulative incidence of cGVHD tended to be lower after RIC (36 vs. 51%, P=0.088) and it tended to be less severe. Organ manifestations were similar except for cGVHD of the joints and fascia which affected 11% of MAC but no RIC patients (P=0.0021). More than half of cGVHD cases were subclassified as overlap cGVHD with no significant differences between RIC and MAC (51 vs. 65%, P=0.26). In multivariate Cox regression analysis of the whole cohort the only significant risk factor for aGVHD was MAC (HR 2.33, 95%CI 1.51–3.59, p<0.001). In RIC patients the administration of bone marrow lead to less aGVHD (HR 0.13, 95%CI 0.016–0.98, P=0.047). The only relevant risk factor for late aGVHD was prior aGVHD (HR 3.65, 95%CI 1.040–12.81, P=0.043). The most important risk factors for cGVHD were prior aGVHD (HR 2.77, 95%CI 1.64–5.67, P<0.001), female-to-male transplantation (HR 1.94, 95%CI 1.12–3.35, P=0.017) and advanced disease (HR 1.95, 95%CI 1.2–3.1, P=0.018). In multivariate Cox regression analysis with GVHD as time-dependant covariate aGVHD grade III/IV (HR 2.41, 95%CI: 1.51–3.87, P=0.001) and late aGVHD grade III/IV (HR 3.037, 95%CI 1.29–7.18, P=0.011) were associated with inferior overall survival (OS) while moderate cGVHD had a positive effect (HR 0.42, 95%CI 0.18–0.97, P=0.043). Classic and overlap cGVHD had no differential prognostic impact. Conclusion: This study in AML patients shows that previously established GVHD risk factors remain valid for the new NIH classification. It also confirms the major impact of conditioning intensity on GVHD incidence, the negative prognostic impact of severe aGVHD and the benefit of moderate cGVHD. The new category late aGVHD may only include few patients but will allow more adequate allocation to therapies or clinical trials. Whether the subgroups classic and overlap cGVHD are clinically relevant remains to be determined. Disclosures: No relevant conflicts of interest to declare.

Ten-year overall and prostate cancer (PCa)-specific mortality in high-risk patients after high-dose-rate brachytherapy combined with external beam radiation therapy (HDR-BT/EBRT) compared with EBRT alone.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5059-5059
Author(s):  
Trude Baastad Wedde ◽  
Sophie Fosså ◽  
Sigmund Brabrand ◽  
Stein Kaasa ◽  
Kjell Magne Russnes ◽  
...  
Keyword(s):  
Regression Analysis ◽  
High Risk ◽  
Gleason Score ◽  
Dose Escalation ◽  
Cox Regression ◽  
Seminal Vesicles ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Cox Regression Analysis ◽  
Specific Mortality

5059 Background: The effect of dose-escalation with HDR-BT boost for high-risk PCa is not known. The objective is to compare 10-year PCa-specific mortality (PCSM) and overall mortality (OM) in non-metastatic patients treated with HDR-BT/EBRT (2004-2010) to EBRT alone (historical RCT, SPCG-7, 1996-2003). Methods: HDR-BT boosts (10 Gy x 2) were given 2 weeks apart followed by 50 Gy conformal EBRT (2 Gy x 25) to the prostate and seminal vesicles (assuming alpha/beta ratio of 3, EQD2 = 102 Gy). The HDR-BT/EBRT group (N:325) received Androgen Deprivation Therapy (ADT) for a total of 2 years. Patients in the control group (N:296) received 70 Gy (2Gy x 35) to the prostate and seminal vesicles with lifelong Anti-Androgen Treatment (AA). cT1-cT2 vs cT3 tumours and Gleason score 6-7 vs 8-10 were analysed. For each treatment group PCSM and OM were established by Kaplan-Meier (KM) analyses, and inter-treatment differences were tested by the logrank tests. Cox regression analysis evaluated the significance of available pre-treatment variables. Significance level p < 0.05. Results: In both groups the median age was 66 years. Median follow-up was 104 (range 13-120) and 120 (range 3-120) months for the HDR-BT/EBRT and EBRT groups respectively. KM plots revealed an 1.8% risk of PCSM in the HDR-BT/EBRT patient group and an 8.4% risk in the EBRT cohort (p = 0.001). For OM, the figures were 12.3% in the HDR-BT/EBRT group compared to 23.3% in the EBRT group (p = 0.014). In the Cox regression analysis, treatment (HR = 3.9, CI95% 1.8-8.3) and Gleason score (HR = 3.2, CI95% 1.8-5.9) were significantly associated with PCSM whilst T-stage, age and PSA levels were not. Treatment (HR = 1.7, CI95% = 1.1-2.6) was the only factor significantly associated with OM. Conclusions: In men with high-risk PCa dose-escalation with HDR-BT/EBRT compared to EBRT alone resulted in a significantly decreased risk of 10-year PCSM and OM despite shorter length of hormonal therapy. PCSM was significantly influenced by both Gleason score and type of treatment, whereas treatment remained the only significant covariate for OM.

scholarly journals Influence of Old Age on Risk of Lymph Node Metastasis and Survival in Patients With T1 Colorectal Cancer: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua Ye ◽  
Bin Zheng ◽  
Qi Zheng ◽  
Ping Chen
Keyword(s):  
Colorectal Cancer ◽  
Regression Analysis ◽  
Lymph Node ◽  
Elderly Patients ◽  
Old Age ◽  
Tumor Size ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
T1 Colorectal Cancer ◽  
Well Differentiated

BackgroundWe aimed at determining the influence of old age on lymph node metastasis (LNM) and prognosis in T1 colorectal cancer (CRC).MethodsWe collected data from eligible patients in Surveillance, Epidemiology, and End Results database between 2004 and 2015. Independent predictors of LNM were identified by logistic regression analysis. Cox regression analysis, propensity score-matched analysis, and competing risks analysis were used to analyze the associations between old age and lymph node (LN) status and to validate the prognostic value of old age on cancer-specific survival (CSS).ResultsIn total, 10,092 patients were identified. Among them, 6,423 patients (63.6%) had greater than or equal to 12 examined lymph nodes (LNE ≥12), and 5,777 patients (57.7%) were 65 years or older. The observed rate of LNM was 4.6% (15 out of 325) in T1 CRC elderly patients, with tumor size &lt;3 cm, well differentiated, with negative carcinoembryonic antigen (CEA) level, and adenocarcinoma. Logistic regression models demonstrated that tumor size ≥3 cm (odds ratio, OR = 1.316, P = 0.038), poorly differentiated (OR = 3.716, P &lt; 0.001), older age (OR = 0.633 for ages 65–79 years, OR = 0.477 for age over 80 years, both P &lt;0.001), and negative CEA level (OR = 0.71, P = 0.007) were independent prognostic factors. Cox regression analysis demonstrated that CSS was not significantly different between elderly patients undergoing radical resection with LNE ≥12 and those with LNE &lt;12 (hazard ratio = 0.865, P = 0.153), which was firmly validated after a propensity score-matched analysis by a competing risks model.ConclusionsThe predictive value of tumor size, grading, primary site, histology, CEA level, and age for LNM should be considered in medical decision making about local resection. We found that tumor size was &lt;3 cm, well differentiated, negative CEA level, and adenocarcinoma in elderly patients with T1 colorectal cancer which was suitable for local excision.

scholarly journals Risk Factors for Leukemic Transformation Among 1,306 Patients with Primary Myelofibrosis: Mutations Predict Early Events

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3044-3044
Author(s):  
Rangit Reddy Vallapureddy ◽  
Mythri Mudireddy ◽  
Natasha Szuber ◽  
Domenico Penna ◽  
Maura Nicolosi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
High Risk ◽  
Cox Regression ◽  
Primary Myelofibrosis ◽  
Idh1 Mutation ◽  
Severe Anemia ◽  
Cox Regression Analysis ◽  
Version 2.0

Abstract Background: Current prognostic models in primary myelofibrosis (PMF) target overall survival (OS) and utilize MIPSS70 (mutation-enhanced international prognostic scoring system for transplant-age patients), MIPSS70+ version 2.0 (karyotype-enhanced MIPSS70) and GIPSS (genetically-inspired prognostic scoring system, which is based on mutations and karyotype) (JCO 2018;36:310; JCO doi: 10.1200/JCO.2018.78.9867; Leukemia. 2018;doi:10.1038/s41375-018-0107). In the current study, we used logistic regression statistics to identify risk factors for leukemic transformation (LT) within 5 years of diagnosis/referral (i.e. early events) and also performed Cox regression analysis of overall leukemia-free survival (LFS). Methods : Study patients were recruited from the Mayo Clinic, Rochester, MN, USA. Diagnoses of LT and chronic phase PMF were confirmed by both clinical and bone marrow examinations, in line with the 2016 World Health Organization criteria (Blood. 2016;127:2391); specifically, LT required presence of ≥20% blasts in the peripheral blood (PB) or bone marrow (BM) (Blood 2016;127:2391). Statistical analyses considered clinical and laboratory data collected at the time of initial PMF diagnosis or Mayo Clinic referral point. Logistic regression statistics was used to identify predictors of LT at 5 years from initial diagnosis/referral; in the particular method, patients with documented LT within 5 years were "uncensored" while those followed up for at least 5 years, without developing LT, were "censored"; the analysis excluded patients without LT and not followed for at least 5 years. In addition, Cox regression analysis was performed to identify risk factors for overall LFS. The JMP® Pro 13.0.0 software from SAS Institute, Cary, NC, USA, was used for all calculations. Results: 1,306 patients with PMF (median age 65 years; 63% males) were included in the current study; MIPSS70+ version 2.0 risk distribution was 20% very high risk, 41% high risk, 19% intermediate risk, 16% low risk and 4% very low risk. 149 (11%) patients were documented to experience LT, and compared to the remaining patients (n=1157), they were more likely to be males (p=0.02) and mutated for ASXL1 (p=0.01), SRSF2 (0.001) and IDH1 (0.02) and present with higher risk MIPSS70+ version 2.0 (p=0.02). Multivariable logistic regression identified the following as predictors of LT in the first 5 years of disease: IDH1 mutation (odds ratio; OR 78.4), very high risk (VHR) karyotype (OR 57.6), ASXL1 mutation (OR 15.1), age >70 years (OR 13.3), SRSF2 mutation (OR 8.5), male sex (OR 6.9), PB blasts ≥3% (OR 5.4), presence of moderate or severe anemia, adjusted for sex (OR 3.6) and constitutional symptoms (OR 3.1). On Cox regression analysis, the following were associated with inferior LFS: IDH1 mutation (HR 4.3), PB blasts ≥3% (HR 3.3), SRSF2 mutation (HR 3.0), age >70 years (HR 2.1), ASXL1 mutation (HR 2.0) and presence of moderate or severe anemia, adjusted for sex (HR 1.9). Subsequently, HR-based risk point allocation resulted in highly discriminating LT predictive model with HR (95% CI) of 39.4 (10.8-114) for high risk and 4.1 (2.4-7.3) for intermediate risk (Figure 1). Conclusions: The current study identifies IDH1 mutation as a main predictor of LT in PMF. Our study also implicates SRSF2 and ASXL1 mutations and VHR karyotype as other genetic markers of early LT. Other independent contributors of early LT and inferior LFS, overall, included PB blasts ≥3%, moderate to severe anemia and older age. We provide LT prediction model, based on these variables, with leukemia risk ranging from 8% to 57%. Disclosures No relevant conflicts of interest to declare.

scholarly journals Clinicopathological Features, Clinical Efficacy on 101 Cases of Rectal Gastrointestinal Stromal Tumors, and the Significance of Neoadjuvant Therapy

2021 ◽  
Author(s):  
Hongxin Yang ◽  
Chaoyong Shen ◽  
Xiaonan Yin ◽  
Zhaolun Cai ◽  
Qian Wang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
High Risk ◽  
Neoadjuvant Therapy ◽  
Cox Regression ◽  
Clinicopathological Features ◽  
Cox Regression Analysis ◽  
Stromal Tumors ◽  
Risk Patients ◽  
Anal Preservation ◽  
Rectal Gists

Abstract Objective: To investigate the clinicopathological features, clinical efficacy on 101 cases of rectal gastrointestinal stromal tumors (GISTs), and the significance of Imatinib Mesylate (IM) neoadjuvant therapy.Methods: The clinicopathological features, treatment methods, peri-operative data, and prognosis of the patients were summarized and analyzed on 101 patients with rectal GISTs, who received treatment in the Gastrointestinal Department of West China Hospital of SichuanUniversity and the Affiliated Hospital of Guizhou Medical University from August 2002 toNovember 2020 in China. Results: A total of 101 patients, including 64 males and 37 females, were aged from 22 to 79 years (55.4±12.2 years). Among 70 patients with direct surgery, which included 8 very low risk cases, 10 low risk cases, 7 intermediate risk cases, and 45 high risk cases. Cox regression analysis showed that post-operative IM adjuvant treatment improved disease-free survival (DFS) and overall survival (OS) of 52 intermediate and high risk patients. Among the 31 patients who received neoadjuvant therapy, the objective response rate (ORR) was 83.9% (26/31), and the disease control rate (DCR) reached 96.8% (30/31). Diameter subgroup analysis: (1) Among the 36 patients with a diameter ≤ 5 cm, two patients received IM neoadjuvant therapy, while 34 patients received direct surgery. Both univariate and Cox regression analysis did not find that neoadjuvant therapy affects DFS and OS. (2) Among the 65 patients of diameter >5 cm, 29 received IM neoadjuvant therapy and 36 received direct surgery. Patients who underwent neoadjuvant therapy had less blood loss (P=0.022) , shorter post-operative hospital stay (P=0.001), increased anal preservation proportion (93.1% VS72.2% , P=0.031), decreased enterostomy proportion (10.3% VS 33.3%, P=0.037) than those who underwent direct surgery. Cox regression analysis suggested that neoadjuvant therapy and post-operative IM adjuvant therapy improved DFS. Conclusion: Rectal GISTs is relatively rare and is a highly malignant tumor, post-operative oral IM therapy can improve DFS and OS of intermediate and high risk patients. In patients with rectal GISTs with diameter > 5 cm, IM neoadjuvant therapy can improve the anal preservation proportion , preserve the structure and function of the organs, reduce enterostomy proportion, and improve prognosis.

scholarly journals Influence of Waist-to-Hip Ratio on the Prognosis of Heart Failure Patients With Revascularized Coronary Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yingyue Zhang ◽  
Yan Zhang ◽  
Yajun Shi ◽  
Wei Dong ◽  
Yang Mu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Regression Analysis ◽  
Heart Disease ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Waist To Hip Ratio

Background: Heart failure (HF) is considered one of the most common complications of coronary heart disease (CHD), with a higher incidence of readmission and mortality. Thus, exploring the risk factors related to the prognosis is necessary. Moreover, the effect of the waist-to-hip ratio (WHR) on HF patients with revascularized CHD is still unclear. Thus, we aimed to assess the influence of WHR on the prognosis of HF patients with revascularized CHD.Methods: We collected data of HF patients with revascularized CHD who were referred to the Cardiac Rehabilitation Clinic of PLA Hospital from June 30, 2015, to June 30, 2019. Cox proportional hazard regression analysis was used to determine the relationship between WHR and prognosis of HF patients with revascularized CHD. Patients were divided into higher and lower WHR groups based on the cutoff WHR value calculated by the X-tile software. Cox regression analysis was used to analysis the two groups. We drew the receiver operating characteristic curve (ROC) of WHR and analyzed the differences between the two groups. Endpoints were defined as major adverse cardiac events (MACE) (including all-cause mortality, non-fatal myocardial infarction, unscheduled revascularization, and stroke).Results: During the median follow-up of 39 months and maximum follow-up of 54 months, 109 patients were enrolled, of which 91.7% were males, and the mean age was 56.0 ± 10.4 years. WHR was associated with the incidence of MACE in the Cox regression analysis (p = 0.001); an increase in WHR of 0.01 unit had a hazard ratio (HR) of 1.134 (95%CI: 1.057–1.216). The WHR cutoff value was 0.93. Patients in the higher WHR group had a significantly higher risk of MACE than those in the lower WHR group (HR = 7.037, 95%CI: 1.758–28.168). The ROC area under the curve was 0.733 at 4 years. Patients in the higher WHR group had a higher body mass index (BMI; 26.7 ± 3.5 vs. 25.4 ± 2.4, P = 0.033) than patients in the lower WHR group.Conclusions: WHR is an independent risk factor of the long-term prognosis of Chinese HF patients with revascularized CHD. Patients with WHR ≥ 0.93 require intensified treatment. Higher WHR is related to higher BMI and ΔVO2/ΔWR.

scholarly journals A Signature of Autophagy-Related Long Non-coding RNA to Predict the Prognosis of Breast Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoping Li ◽  
Jishang Chen ◽  
Qihe Yu ◽  
Hui Huang ◽  
Zhuangsheng Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
High Risk ◽  
Cox Regression ◽  
Enrichment Analysis ◽  
Low Risk ◽  
Gene Set Enrichment Analysis ◽  
Lasso Regression ◽  
Cox Regression Analysis ◽  
Risk Scoring

Background: A surge in newly diagnosed breast cancer has overwhelmed the public health system worldwide. Joint effort had beed made to discover the genetic mechanism of these disease globally. Accumulated research has revealed autophagy may act as a vital part in the pathogenesis of breast cancer.Objective: Aim to construct a prognostic model based on autophagy-related lncRNAs and investigate their potential mechanisms in breast cancer.Methods: The transcriptome data and clinical information of patients with breast cancer were obtained from The Cancer Genome Atlas (TCGA) database. Autophagy-related genes were obtained from the Human Autophagy Database (HADb). Long non-coding RNAs (lncRNAs) related to autophagy were acquired through the Pearson correlation analysis. Univariate Cox regression analysis as well as the least absolute shrinkage and selection operator (LASSO) regression analysis were used to identify autophagy-related lncRNAs with prognostic value. We constructed a risk scoring model to assess the prognostic significance of the autophagy-related lncRNAs signatures. The nomogram was then established based on the risk score and clinical indicators. Through the calibration curve, the concordance index (C-index) and receiver operating characteristic (ROC) curve analysis were evaluated to obtain the model's predictive performance. Subgroup analysis was performed to evaluate the differential ability of the model. Subsequently, gene set enrichment analysis was conducted to investigate the potential functions of these lncRNAs.Results: We attained 1,164 breast cancer samples from the TCGA database and 231 autophagy-related genes from the HAD database. Through correlation analysis, 179 autophagy-related lncRNAs were finally identified. Univariate Cox regression analysis and LASSO regression analysis further screened 18 prognosis-associated lncRNAs. The risk scoring model was constructed to divide patients into high-risk and low-risk groups. It was found that the low-risk group had better overall survival (OS) than those of the high-risk group. Then, the nomogram model including age, tumor stage, TNM stage and risk score was established. The evaluation index (C-index: 0.78, 3-year OS AUC: 0.813 and 5-year OS AUC: 0.785) showed that the nomogram had excellent predictive power. Subgroup analysis showed there were difference in OS between high-risk and low-risk patients in different subgroups (stage I-II, ER positive, Her-2 negative and non-TNBC subgroups; all P &lt; 0.05). According to the results of gene set enrichment analysis, these lncRNAs were involved in the regulation of multicellular organismal macromolecule metabolic process in multicellular organisms, nucleotide excision repair, oxidative phosphorylation, and TGF-β signaling pathway.Conclusions: We identified 18 autophagy-related lncRNAs with prognostic value in breast cancer, which may regulate tumor growth and progression in multiple ways.

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