Obesity Is Associated With Worse Overall Survival in Women With Low-Grade Papillary Serous Epithelial Ovarian Cancer

ObjectiveThe objective of this study was to evaluate prognostic risk factors for survival in women with low-grade serous epithelial ovarian cancer (LGSC).MethodsA multicenter retrospective analysis of patients with LGSC was conducted. Potential epidemiologic risk factors evaluated included obesity, age, parity, race, smoking, oral contraceptive pill and/or hormonal replacement therapy use, and previous hysterectomy or surgery on fallopian tubes and/or ovaries. Additional factors included stage, extent of debulking, residual disease, and disease status.ResultsEighty-one patients were identified, and pathologic diagnosis was independently confirmed. Median age at diagnosis was 56 years (range, 21–86 years). Thirty-four percent were obese, and 80% had optimally debulked disease. Forty-six percent were alive, 14% with disease, whereas 25% were dead of disease, 2% died of intercurrent disease, and 27% had an unknown status. In a univariate analysis, optimal surgical debulking was associated with improved progression-free survival (P= 0.01), disease-specific survival (P= 0.03), and overall survival (OS) (P< 0.001) and body mass index with worse OS (P= 0.05). On multivariate analysis, obesity (hazard ratio, 2.8; 95% confidence interval, 1.05–7.3;P= 0.04) and optimal tumor debulking (hazard ratio, 0.05; 95% confidence interval, 0.008–0.29;P= 0.001) were a significant predictor of OS.ConclusionsIn a multivariate analysis, obesity and optimal tumor cytoreduction were significant predictors of OS. However, obesity was not associated with worse disease-specific survival, suggesting that mortality of obese patients with LGSC may result from other comorbidities. Interventions addressing obesity may improve survival for women diagnosed with LGSC, and further study is warranted to address the role of obesity in LGSC.

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Prognostic Factors Influencing Survival in Solitary Plasmacytoma: A SEER Database Analysis.

Blood ◽

10.1182/blood.v112.11.1670.1670 ◽

2008 ◽

Vol 112 (11) ◽

pp. 1670-1670

Author(s):

Paul Mehan ◽

Giridharan Ramsingh ◽

Jingqin Luo ◽

Daniel Morgansztern ◽

Ravi Vij

Keyword(s):

Multiple Myeloma ◽

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Solitary Plasmacytoma ◽

Seer Database ◽

Disease Specific Survival ◽

Factors Influencing ◽

Younger Age ◽

Disease Specific

Abstract Solitary plasmacytoma (PCM) is a focal, neoplastic, plasma cell disorder without evidence of systemic disease. While PCM is a clinically distinct entity, survival can be limited by progression to multiple myeloma. Prior studies have attempted to identify factors influencing survival in PCM but have been limited by small patient cohorts. This study identified 1472 patients with PCM using the SEER database between 1988 and 2004. The median age of the patients was 64 years (range 12–97), 65.4% male, 34.6% female, 83% Caucasians, 10.7% African Americans and 6.3% other races. 63.8% had medullary PCM and 36.2% extramedullary PCM. 84% of medullary PCM occurred in axial skeleton and the rest in appendicular skeleton. Extramedullary PCM most frequently occurred in the head and neck region (51.4%) followed by skin/subcutaneous tissue (16.2%), GI tract 6% and other sites (26.4%). 55.2% were treated with radiation therapy alone, 29.5% with radiation therapy and surgery and 15.3% with surgery alone. 558 died during this period and the mean overall survival was 6.83 years (range, 0–16.9). The cause of death was multiple myeloma in 49.6%, other cancers 20.9% and cardiovascular diseases 12.9%. In all patients, survival probability at one year was 87.6% (95% CI, 85–89%), at five years was 58.9% (95% CI, 56–62%), and at 10 years was 40.0% (95% CI, 36–44%). The five year overall survival in the ≤40yo cohort was 83.5% as compared to 76.7% and 44.8% in the 40–60yo and >60yo groups, respectively (p<0.0001). The five year disease specific survival probability in the ≤40yo cohort was 94.5% as compared to 86.0% and 66.2% in the 40–60yo group and >60yo group, respectively (p<0.0001) (figure 1)). Overall survival in the extramedullary PCM was 65.9% at five years as compared to 54.6% in the medullary PCM (p<0.0001) and the disease specific survival in the extramedullary PCM was 86.2% compared to 70.1% in the medullary PCM (p<0.0001) (figure 1). Multivariate analysis of disease specific survival revealed that younger age, male gender, extramedullary type, and race other than African American or Caucasian were favorable prognostic factors (Table 1). Younger age, extramedullary site, treatment with XRT + surgery, and race other than African Americans were associated with improved overall survival by multivariate analysis (Table 1). To our knowledge, this is the largest published review of survival in PCM. This study identifies several prognostic risk factors influencing survival in PCM. These risk factors can be used to identify patients at high risk for progression to multiple myeloma. Those at highest risk could be considered for future trials comparing adjuvant systemic therapy compared to local therapy alone. Table 1. Multivariate Analysis of Prognostic Factors Disease Specific Survival Overall Survival Variable Category HR 95% CI P HR 95%CI P Abbreviations: HR, Hazard Ratio; Q, Confidence Inverval Sex Female --- -- --- -- --- --- Male 0.74 0.58~ 0.94 0.01 0.95 0.80~1.13 0.57 Age <40yo --- --- --- --- --- --- 40–60yo 2.68 115~ 6.2 0.02 1.74 1.04~2.91 0.03 >60yo 6.94 3.06~ 15.73 <0.01 5.55 3.40~9.06 <0.01 Race Black --- --- --- --- --- --- White 0.74 0.52~ 1.06 0.1 0.72 0.56~0.92 0.01 Others 0.31 0.13~ 0.75 <0.01 0.48 0.29~0.79 <0.01 Primary Site Extramedullary --- --- --- --- --- --- Medullary 2.35 1.74~.3.18 <0.01 1.37 1.13~1.65 <0.01 Treatment Surgery Only --- --- --- --- --- --- XRT Only 0.90 0.62~ 1.31 0.59 0.82 0.64~1.04 0.10 XRT + Surgery 0.84 0.55~1.26 0.39 0.68 0.52~0.89 <0.01 Period 1988–1993 --- --- --- --- --- --- 1994–1999 0.96 0.72~1.30 0.8 0.96 0.78~1.19 0.74 2000–2004 0.94 0.68~1.30 0.7 0.94 0.75~1.18 0.6 Figure 1: Figure 1:.

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Cancer risk and overall survival in APC I1307K carriers.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.1592 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 1592-1592

Author(s):

Stephen B. Gruber ◽

Joseph D Bonner ◽

Flavio Lejbkowicz ◽

Stephanie Schmit ◽

Hedy Rennert ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Confidence Interval ◽

Molecular Epidemiology ◽

Population Distribution ◽

Lifetime Risk ◽

Disease Specific Survival ◽

Cancer Study ◽

Apc I1307k ◽

Disease Specific

1592 Background: The germline variant APC I1307K is one of the most commonly identified pathogenic variants on germline genetic testing panels. The purpose of the Molecular Epidemiology of Colorectal Cancer study was to quantify the risk of colorectal cancer among carriers, characterize the clinical, pathologic, and molecular features of colorectal cancers arising in patients with APC I1307K, and to describe the overall and disease-specific survival of carriers with colorectal cancer. Here, the final results of the Molecular Epidemiology of Colorectal Cancer Study are reported with respect to APC I1307K. Methods: We consented 6,006 incident, pathologically confirmed cases of colorectal adenocarcinoma and 5,023 age, sex, and ethnicity matched controls without colorectal cancer between March 31, 1998 and July 1, 2017 within a geographically defined area of Northern Israel. Comprehensive, in-person epidemiologic interviews were conducted for cases and controls, with uniform histopathologic review, detailed molecular analysis, medical record review and clinical follow-up for up to 21 years. Results: The demographic and clinical features of incident colorectal cancer cases matched the population distribution of colorectal cancer in Israel. APC I1307K was identified in 429 (7.1%) of cases and 201 (4.0%) of controls. The estimated relative risk of colorectal cancer among carriers was 1.89 (95% confidence interval, 1.59 - 2.24), p < 0.0001. The prevalence and odds ratios differed by ethnic group. Homozygous carriers were at especially high risk, with an odds ratio of 3.90 (95% confidence interval 1.11–13.71). APC I1307K carriers were significantly less likely to have microsatellite instable tumors (p = 0.04). Overall survival of APC I1307K carriers was not significantly different than survival of non-carriers, after adjustment for age, stage, sex, ethnicity, and microsatellite instability. Conclusions: APC I1307K is an actionable germline mutation that confers meaningful lifetime risk of colorectal cancer in heterozygous and homozygous carriers. APC I1307K is not an independent prognostic factor for overall survival or disease specific survival and is not associated with the MSI phenotype. Cumulative lifetime risk estimates inform genetic counseling and provide data for policies regarding the timing and frequency of screening and other preventive strategies.

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Prevalence of human papillomavirus in oropharyngeal squamous cell carcinoma in Serbia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1806271m ◽

2018 ◽

Vol 146 (5-6) ◽

pp. 271-278

Author(s):

Jovica Milovanovic ◽

Ana Jotic ◽

Dragoslava Andrejic ◽

Aleksandar Trivic ◽

Bojan Pavlovic ◽

...

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Disease Free Survival ◽

Tnm Stage ◽

Treatment Modalities ◽

Oropharyngeal Carcinoma ◽

Disease Specific Survival ◽

Cancer Etiology ◽

Hpv Status ◽

Disease Specific

Introduction/Objective. Oropharyngeal carcinoma makes up to 3% of all newly diagnosed carcinomas in the world. In Serbia, oropharyngeal carcinoma constitutes 1.8% of all malignancies. Studies have shown a growing role of infections with human papilloma viruses (HPV) in oropharyngeal cancer etiology. HPV positive patients have a more favorable prognosis and significantly higher rate of overall survival. The purpose of this paper was to establish how HPV status influenced Serbian patients? overall survival and the disease-free survival according to known risk factors (tobacco and alcohol consummation), clinical TNM stage of the disease, and modality of treatment. Methods. The study included 87 patients treated for oropharyngeal carcinoma in a one-year period with a five-year follow-up. Treatment modalities included surgery with or without postoperative radio- or chemoradiotherapy, only radiotherapy or chemoradiotherapy. Sex, common risk factors, TNM stage, and treatment method were considered, as well as the influence of HPV status on the overall survival and the disease-specific survival depending on the presence of risk factors. Results. HPV-positive patients with oropharyngeal carcinoma were more frequently men, smokers, and alcohol consumers. Considering clinical T, N, and M stage of the disease, the overall survival and the disease-specific survival rates were better in HPV-positive patients, who had better survival if they were treated with primary surgical therapy rather than primary radiotherapy. Conclusion. HPV status significantly influenced survival and locoregional control in Serbian patients with oropharyngeal carcinoma. This implies possible modifications of treatment strategies for these patients in order to further improve their prognosis and treatment outcomes.

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Oral Presentation V

World Journal of Endocrine Surgery ◽

10.5005/wjoes-8-1-28 ◽

2016 ◽

Vol 8 (1) ◽

pp. 28-33

Author(s):

Jandee Lee ◽

Jung Bum Choi ◽

SeulGi Lee ◽

Min Jhi Kim ◽

Tae Hyung Kim ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Total Thyroidectomy ◽

Tumor Size ◽

Disease Specific Survival ◽

Node Metastasis ◽

Independent Risk Factors ◽

The Mean ◽

Disease Free ◽

Disease Specific

ABSTRACT BACKGROUND AND AIMS Some recent guidelines recommend unilateral thyroidectomy for low-risk differentiated thyroid cancer (DTC) sized > 1 and < 4 cm. The present study was designed to evaluate the proper extent of thyroidectomy for patients who have DTC sized > 1 and < 4 cm. METHODS From April 1967 to December 2011, a total of 16,065 DTC patients underwent thyroidectomy at Yonsei University Hospital. Among them, 5,427 (33.7%) patients were classified as having DTC > 1 and < 4 cm and were enrolled in this study. Clinicopathologic features and prognostic results (disease-free and disease-specific survival rates) were analyzed by retrospective medical chart review. The mean follow-up duration was 57.3 ± 58.1 months. RESULTS In the subtypes of tumors, papillary thyroid carcinoma (PTC) was the most common cancer (96.9%) and follicular and poorly differentiated carcinoma comprised 2.7 and 0.1% respectively. The mean tumor size was 1.84 ± 0.74 cm. Patients had extrathyroidal extension (69.3%), multiplicity (35.0%), bilaterality (26.3%), central lymph node metastasis (35.8%), and lateral neck node metastases (20.2%). Of a total of 5,427 patients, 4,353 (80.2%) underwent total thyroidectomy and 1,043 (19.2%) patients underwent less- than-total thyroidectomy. The recurrence rates in total thyroidectomic and less-than-total thyroidectomic groups were 3.9 and 10.0% respectively. The less-than-total thyroidectomic group showed lower disease-free survival (DFS) rate (p= 0.039) and higher disease-specific survival (DSS) (p = 0.035) rate compared with the total thyroidectomic group. In multivariate analysis for DFS, tumor size, N stage, and the extent of thyroidectomy were independent risk factors. In multivariate analysis for DSS, age, gender, tumor size, and N and M stage were independent risk factors. CONCLUSION In patients with tumor size > 1 and ≤ 4 cm, total thyroidectomy was beneficial in reducing recurrence. However, our study confirmed that risk factors for DSS were not the extent of thyroidectomy but traditional prognostic factors, such as older age, male sex, large tumor size, lymph node metastasis, and distant metastasis.

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Survival of upper tract urothelial carcinoma: A population-based analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.257 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 257-257 ◽

Cited By ~ 1

Author(s):

Sima P. Porten ◽

Vancheswaran Gopalakrishnan ◽

Graciela M. Nogueras-Gonzalez ◽

Ashish M. Kamat ◽

Arlene O. Siefker-Radtke ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Urothelial Carcinoma ◽

Competing Risks ◽

Renal Pelvis ◽

Population Based ◽

Disease Specific Survival ◽

Gender And Race ◽

Upper Tract ◽

Disease Specific

257 Background: Urothelial carcinoma involving the upper tract (UTUC) accounts for only 5% of urothelial malignancies; thus the majority of data are from single institution series or highly selected patient populations. We sought to examine contemporary trends in overall (OS) and disease-specific survival (DSS) for UTUC using a large, population based dataset. Methods: Patients within the Surveillance, Epidemiology, and End Results (SEER) database with de novo UTUC from 1973-2008 were included and analyzed in 5 year increments to evaluate disease trends. Univariate and multivariate for OS and DSS competing risks analysis were performed adjusting for age, gender, and race for renal pelvis and ureteral tumors. Results: A total of 14,237 patients met inclusion criteria. For renal pelvis tumors (n=9,318), overall survival was 54.4% at 3 years. On multivariate analysis factors that were significant predictors of OS were: age (HR 1.03, p<0.001), and year of diagnosis (HR 1.32, p<0.001). Competing risks regression estimated DSS of 60.5% at 5 years, with male gender, black race, and year of diagnosis remaining significant after adjusting for covariates (p<0.05). For ureteral tumors (n=4,919), overall survival was 56.1% at 3 years. On multivariate analysis, age was a significant predictor of OS (2.73, 95%CI 2.52-2.93, p<0.001). Competing risks regression estimated DSS of 61.9% at 5 years, with female race, and year of diagnosis remaining significant after adjusting for covariates (p<0.05). For both renal pelvis and ureteral tumors, the more contemporary era (1997-2002, 2003-2008) showed worse survival than prior eras (p<0.05). Conclusions: Disease-specific survival for patients with renal pelvis and ureteral UTUC appears to be worse in the contemporary era. While sociodemographic factors (age, gender, and race) appear to impact prognosis, it is unclear what factors may be contributing to this decline. This data adds to the growing literature supporting a paradigm change in the treatment of this disease.

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Oral cavity squamous cell carcinoma in patients aged 80 or older: Risk factors, treatment, and outcome

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.6064 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 6064-6064

Author(s):

C. Ortholan ◽

R. Bensadoun ◽

A. Italiano ◽

S. Teman ◽

O. Dassonville ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Oral Cavity ◽

Elderly Patients ◽

Squamous Cell ◽

Early Stage ◽

Disease Specific Survival ◽

Curative Intent ◽

Disease Specific

6064 Background: We have recently reported a large series of patients aged ≥ 80 years showing that in this population about half of head and neck squamous cell carcinomas (SCC) are located in the oral cavity. There are no specific data on this cancer location outcome in elderly patients. Therefore, we report here the experience of two French cancer centers in the treatment of oral cavity SCC in patients aged ≥ 80 years. Methods: Two hundred sixty patients aged ≥ 80 years with a primary oral cavity SCC were included in this retrospective analysis. Results: Sex ratio was near to 1. The risk factor distribution was significantly different between men and women: tobacco/alcohol consumption (66.3% vs 15.8%, p < 0.001), history of leukoplakia/lichen planus/oral traumatism (10.8% vs 55.3%, p = 0.002). Two hundred patients received a loco regional (LR) treatment with a curative intent (surgery and/or radiotherapy), 29 with a palliative intent and 31 did not receive a LR treatment. Curative treatments were delivered according to the institution policy in 56 patients (28%).The median disease specific survival (DSS) was 16.9 months. In multivariate analysis, independent prognostic factors were stage (HR = 0.45 [0.29–0.69], p < 0.001), and curative intent of treatment (HR = 0.28 [0.17–0.45], p < 0.001). Median overall survival (OS) was 13.9 months. In multivariate analysis, the independent prognostic factors for OS were age (HR = 0.63 [0.33–0.76], p < 0.001), stage (HR = 0.61 [0.40–0.91], p = 0,016), and curative intent of treatment (HR = 0.41 [0.23–0.71], p < 0.001. In patients treated with a curative intent, the standard treatment was not associated with improved overall survival or disease specific survival as compared with those treated with an adapted treatment. However, prophylactic lymph node treatment in early stage cancer decreased the rate of nodal recurrence from 38% to 6% (p = 0.01). Conclusions: This study emphasizes the need for prospective evaluation of standard and adapted schedules in elderly patients with oral cavity cancer. No significant financial relationships to disclose.

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Obesity is associated with worse overall survival in women with low-grade papillary serous epithelial ovarian cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2013.04.328 ◽

2013 ◽

Vol 130 (1) ◽

pp. e113 ◽

Cited By ~ 1

Author(s):

R. Previs ◽

J. Kilgore ◽

R. Craven ◽

G. Broadwater ◽

S. Bean ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Epithelial Ovarian Cancer ◽

Low Grade ◽

Serous Epithelial Ovarian Cancer

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Trace Amine-Associated Receptor 1 (TAAR1) Is a Positive Prognosticator for Epithelial Ovarian Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms22168479 ◽

2021 ◽

Vol 22 (16) ◽

pp. 8479

Author(s):

Tilman L. R. Vogelsang ◽

Aurelia Vattai ◽

Elisa Schmoeckel ◽

Till Kaltofen ◽

Anca Chelariu-Raicu ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Epithelial Ovarian Cancer ◽

Tnm Classification ◽

Rank Correlation ◽

University Hospital ◽

Cancer Tissue ◽

Low Grade ◽

High Grade ◽

Trace Amine

Trace amine-associated receptor 1 (TAAR1) is a Gαs- protein coupled receptor that plays an important role in the regulation of the immune system and neurotransmission in the CNS. In ovarian cancer cell lines, stimulation of TAAR1 via 3-iodothyronamine (T1AM) reduces cell viability and induces cell death and DNA damage. Aim of this study was to evaluate the prognostic value of TAAR1 on overall survival of ovarian carcinoma patients and the correlation of TAAR1 expression with clinical parameters. Ovarian cancer tissue of n = 156 patients who were diagnosed with epithelial ovarian cancer (serous, n = 110 (high-grade, n = 80; low-grade, n = 24; unknown, n = 6); clear cell, n = 12; endometrioid, n = 21; mucinous, n = 13), and who underwent surgery at the Department of Obstetrics and Gynecology, University Hospital of the Ludwig-Maximilians University Munich, Germany between 1990 and 2002, were analyzed. The tissue was stained immunohistochemically with anti-TAAR1 and evaluated with the semiquantitative immunoreactive score (IRS). TAAR1 expression was correlated with grading, FIGO and TNM-classification, and analyzed via the Spearman’s rank correlation coefficient. Further statistical analysis was obtained using nonparametric Kruskal-Wallis rank-sum test and Mann-Whitney-U-test. This study shows that high TAAR1 expression is a positive prognosticator for overall survival in ovarian cancer patients and is significantly enhanced in low-grade serous carcinomas compared to high-grade serous carcinomas. The influence of TAAR1 as a positive prognosticator on overall survival indicates a potential prognostic relevance of signal transduction of thyroid hormone derivatives in epithelial ovarian cancer. Further studies are required to evaluate TAAR1 and its role in the development of ovarian cancer.

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Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

Insights into Imaging ◽

10.1186/s13244-021-01004-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Sofia Amante ◽

Filipa Santos ◽

Teresa Margarida Cunha

Keyword(s):

Ovarian Cancer ◽

Serous Carcinoma ◽

Low Grade ◽

Resonance Imaging ◽

Clinicopathologic Characteristics ◽

Borderline Tumour ◽

Molecular Features ◽

Serous Epithelial Ovarian Cancer ◽

The Difference

AbstractLow-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.

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Prognostic Significance of CD44, Platelet-Derived Growth Factor Receptor α, and Cyclooxygenase 2 Expression in Renal Cell Carcinoma

Archives of Pathology & Laboratory Medicine ◽

10.5858/2007-131-261-psocpg ◽

2007 ◽

Vol 131 (2) ◽

pp. 261-267 ◽

Cited By ~ 3

Author(s):

Ossama W. Tawfik ◽

Brandan Kramer ◽

Barbara Shideler ◽

Marsha Danley ◽

Bruce F. Kimler ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Multivariate Analysis ◽

Univariate Analysis ◽

Growth Factor Receptor ◽

Cyclooxygenase 2 ◽

Nuclear Grade ◽

Platelet Derived Growth Factor ◽

Pathologic Stage ◽

Disease Specific

Abstract Context.—Pathologic stage is the main prognostic factor for predicting outcome in renal cell carcinoma (RCC). Because of its unreliability in predicting tumor progression, other factors are needed to provide additional prognostic information. Objective.—The expression of CD44, cyclooxygenase 2, and platelet-derived growth factor receptor α (PDGFR-α) was evaluated as a potential prognostic factor for survival in patients with RCC. Design.—Sixty-two patients (42 men and 20 women; median age, 61 years), undergoing partial (10 cases) or radical (55 cases) nephrectomy for RCC were retrospectively analyzed by immunohistochemical analysis for CD44, cyclooxygenase 2, and PDGFR-α expression. Impact of various factors on disease-specific and overall survival was calculated using Cox proportional hazards models. Results.—There was a gradual increase in CD44 and cyclooxygenase 2 expression with increasing RCC nuclear grade. In contrast, PDGFR-α expression showed no consistent relationship with nuclear grade. On univariate analysis, metastasis at time of surgery (P < .001), tumor size (P = .004), pathologic stage group (P = .001), and nuclear grade (P = .004) were correlated with disease-specific survival. On multivariate analysis, only the presence of metastasis at diagnosis (P < .001) was significant. For overall survival, metastasis (P < .001), tumor size (P = .02), pathologic stage group (P = .01), nuclear grade (P = .003), and PDGFR-α (P = .03) were significant on univariate analysis. Only metastasis (P = .001) and PDGFR-α (P = .03) were significant on multivariate analysis. Conclusions.—When combined with other variables, PDGFR-α expression in RCC may provide additional predictive value related to the patient's overall survival. However, CD44 and cyclooxygenase 2 do not seem to be independent prognostic indicators in predicting outcomes for patients with RCC.

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