scholarly journals AB0274 USE OF TNF-INHIBITORS BIOSIMILARS IN CHRONIC INFLAMMATORY ARTHRITIDES: A THREE-YEAR EXPERIENCE IN A LARGE MONOCENTRIC COHORT OF PATIENTS FROM THE NORTH-EAST ITALY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1435.2-1436
Author(s):  
D. Astorri ◽  
F. Ometto ◽  
L. Friso ◽  
B. Raffeiner ◽  
C. Botsios ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Disease Duration ◽  
Cox Regression ◽  
University Hospital ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Factors Associated ◽  
Drug Survival ◽  
Log Rank Test ◽  
Kaplan Meier

Background::In recent years several biosimilars (BS) of tumour necrosis factor inhibitors (TNF-i) were introduced. At the Padova University Hospital the first BS of etanercept (bsETN) was available in October 2016 and the BS of adalimumab (bsADA) was available in November 2018.Objectives:The objectives of the study were to evaluate the rate of bioriginator-biosimilar (BO-BS) switch in all patients with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and axial spondiloarthritis (axSpA) in the cohort of the Padova University Hospital and to examine factors favouring BO-BS switch. Secondly, we investigated survival of BO-BS switch and BO treatment and factors associated with longer treatment survival.Methods:We considered all patients on ETN originator (boETN) treatment when the first bsETN was available (1st October 2016) and all patients on ADA originator (boADA) when bsADA was available (1st November 2018). Patients were followed until 30 August 2019 and were classified as BO-BS switchers if they underwent a switch from either boETN or boADA to BS during the follow-up, otherwise they were considered as continuing BO treatment. Factors associated with BO-BS switch were tested with a multivariable regression analysis. To test the survival of the BO-BS switch and of the BO treatment, Cox regression analysis was used including all variables achiving a p<0.10 in univariate analysis tested with Log-rank test and Kaplan-Meier curves.Results:Among 1208 patients (553 RA, 433 PSA, 215 axSpA), 560 (46.3%) patients switched to bsETN (391) or bsADA (169). Mean disease duration was 16 (14.2) years and mean duration of the bDMARD treatment was 96.3 (56.8) months. After adjustment for potential confounders, factors associated with BO-BS switch were a longer disease duration, a shorter duration of previous bDMARD treatments and diagnosis (Tab.1) RA patients had almost a 3 fold increased likelihood of being switched to BS compared to PSA and axSPA, while difference between PSA and axSPA was not significant.Following Cox regression analysis we observed a longer drug survival in BO-BS switchers compared to those continuing with BO (HR 1.38; 95% C.I. 1.2-1.58; p<0.001) (Fig. 1). A longer drug survival was also associated with a longer disease duration (.15years: HR 1.75; 95% C.I. 1.5-2; p<0.001), longer mean duration of previous bDMARDs (.5years: HR 4.1; 95% C.I. 3.5-4.7; p<0.001), and diagnosis (RA vs PSA: HR 1.22; 95% C.I. 1.02-1.47; p=0.030; RA vs axSpA: HR 0.89 95% C.I. 0.067-0.97; p=0.023; PSA vs axSpA: HR 0.66; 95% C.I. 0.57-0.77; p<0.001) (Fig 2).Figure 1.Kaplan-Meier curves for treatment survival, Log-rank test.Figure 2.Kaplan-Meier curves for treatment survival in all patients, Log-rank tesConclusion:BO-BS switch was undertaken in almost half of the patients. Patients with longer disease duration and longer bDMARD duration, were the most likely to be switched successfully to BS. BO-BS switching does not affect the survival of the treatment, indeed, it provides sustained effectiveness particularly if undertaken in patients with stable disease activity.Table 1.Factors associated with BO-BS switch, multivariate regression analysis.Disclosure of Interests:DAVIDE ASTORRI: None declared, Francesca Ometto: None declared, LARA FRISO: None declared, BERND RAFFEINER: None declared, Costantino Botsios: None declared, Andrea Doria Consultant of: GSK, Pfizer, Abbvie, Novartis, Ely Lilly, Speakers bureau: UCB pharma, GSK, Pfizer, Janssen, Abbvie, Novartis, Ely Lilly, BMS

Prognostic value of D-dimer/fibrinogen ratio in the adverse outcomes of patients hospitalized for heart failure

2020 ◽  
Vol 14 (18) ◽  
pp. 1733-1745
Author(s):  
Tian-Jun Zhao ◽  
Qian-Kun Yang ◽  
Chun-Yu Tan ◽  
Li-Dan Bi ◽  
Jie Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Cox Regression ◽  
Prognostic Indicator ◽  
Adverse Outcomes ◽  
Rank Test ◽  
Clinical Value ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
D Dimer

Aim: To evaluate the clinical value of plasma D-dimer/fibrinogen ratio (DFR) in patients hospitalized for heart failure (HF). Methods: Clinical data of 235 patients were retrospectively analyzed. Kaplan–Meier method and Cox regression analysis were used to identify significant prognosticators. Results: The Kaplan–Meier analysis showed that a higher DFR level was significantly associated with an increase in the end point outcomes, including HF readmission, thrombotic events and death (log-rank test: p < 0.001). The multivariate Cox regression analysis showed that the high tertile of DFR was significantly associated with the study end points (HR: 2.18; 95% CI: 1.31–3.62; p = 0.003), compared with the low tertile. Conclusion: DFR is a reliable prognostic indicator for patients hospitalized for HF.

Prognostic impact of LDH and HCG levels in marker-positive seminomas.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 392-392 ◽  
Author(s):  
Christoph Alexander Seidel ◽  
Gedske Daugaard ◽  
Tim Nestler ◽  
Alexey Tryakin ◽  
Christian Daniel Fankhauser ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Serum Levels ◽  
Rank Test ◽  
Prognostic Impact ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Oncological Outcomes ◽  
Log Rank Test

392 Background: The prognostic impact of LDH and HCG serum levels in marker positive metastatic seminoma patients is uncertain. This analysis evaluated the association between LDH and HCG levels with oncological outcomes in this patient population. Methods: Seminoma patients with elevated HCG levels were retrospectively analyzed. After stratification according to tumor marker levels pre- and post-orchiectomy, outcomes of subgroups were compared using log-rank test and cox-regression analysis. Study endpoints were cancer specific- (CSS) and recurrence-free survival (RFS). Results: In total, 429 HCG-positive metastatic seminoma patients (stage II n=291; stage III n=138) diagnosed between 1981 and 2018 were included. LDH + HCG levels ranged from 124 U/l to 8833 U/l (median: 619; IQR: 955) + 2 IU/l to 283,782 IU/l (median: 20; IQR: 63) pre- and from 107 U/l to 8650 U/l (median: 324; IQR: 481) + 0 IU/l to 36700 IU/l post-orchiectomy (median: 30; IQR: 121), respectively. Five-year CSS and RFS rates were 90% and 79%, respectively. Patients with LDH levels pre-orchiectomy <1.5 UNL (n=142) had a 5-year CSS (RFS) rate of 97% (88%), compared to 86% (81%) for ≥1.5 to 3 UNL (n=40), 83% (77%) for >3 to 5 UNL (n=44) and 83% (72%) for >5 UNL (n=44) (CSS p <0.001; RFS p=0.142). Concerning LDH levels post-orchiectomy this stratification was not significant but patients with LDH levels ≥3 UNL (n=77) displayed an impaired prognosis associated with a 5-year CSS (RFS) rate of 85% (79%) compared to 94% (82%) for levels <3 UNL (n=186) (CSS p=0.025; RFS p=0.447). Patients with HCG levels ≥2000 IU/l (n=17) pre- but not post-orchiectomy had a 5-year CSS (RFS) rate of 73% (60%) compared to 94% (79%) for patients with HCG levels <2000 IU/l (n=855) (CSS p=0.09; RFS p=0.04). In cox-regression analysis LDH ≥1.5 UNL (p=0.037; HR 3.32, CI95%1.08-10.26) and HCG levels ≥2000 IU/l (p=0.044; HR 3.69, 95%CI1.04-13.13) pre-orchiectomy were confirmed as prognostic factors for CSS. Conclusions: LDH levels inversely correlate with survival outcomes, suggesting ≥1.5 UNL pre- and ≥3 UNL post-orchiectomy as potential cut-off values for further risk assessment. Patients with extensive HCG elevations may represent an unfavorable subgroup concerning RFS and CSS, but only few patients were affected.

scholarly journals The lncRNAs RP1-261G23.7, RP11-69E11.4 and SATB2-AS1 are a novel clinical signature for predicting recurrent osteosarcoma

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Tang Ying ◽  
Jin-ling Dong ◽  
Cen Yuan ◽  
Peng Li ◽  
Qingshan Guo
Keyword(s):  
Regression Analysis ◽  
Signaling Pathway ◽  
Cox Regression ◽  
Wnt Signaling Pathway ◽  
Cox Proportional Hazards ◽  
Recurrence Time ◽  
Rank Test ◽  
Recurrence Rates ◽  
Cox Regression Analysis ◽  
Log Rank Test

Abstract Background: Osteosarcoma is the most common primary bone malignancy in children and adolescents. In order to find factors related to its recurrence, and thus improve recovery prospects, a powerful clinical signature is needed. Long noncoding RNAs (lncRNAs) are essential in osteosarcoma processes and development, and here we report significant lncRNAs to aid in earlier diagnosis of osteosarcoma. Methods: A univariate Cox proportional hazards regression analysis and a multivariate Cox regression analysis were used to analyze osteosarcoma patients’ lncRNA expression data from the Therapeutically Applicable Research To Generate Effective Treatments (TARGET), a public database. Results: A lncRNA signature consisting of three lncRNAs (RP1-261G23.7, RP11-69E11.4 and SATB2-AS1) was selected. The signature was used to sort patients into high-risk and low-risk groups with meaningful recurrence rates (median recurrence time 16.80 vs. &gt;128.22 months, log-rank test, P&lt;0.001) in the training group, and predictive ability was validated in a test dataset (median 16.32 vs. &gt;143.80 months, log-rank test, P=0.006). A multivariate Cox regression analysis showed that the significant lncRNA was an independent prognostic factor for osteosarcoma patients. Functional analysis suggests that these lncRNAs were related to the PI3K-Akt signaling pathway, the Wnt signaling pathway, and the G-protein coupled receptor signaling pathway, all of which have various, important roles in osteosarcoma development. The significant 3-lncRNA set could be a novel prediction biomarker that could aid in treatment and also predict the likelihood of recurrence of osteosarcoma in patients.

scholarly journals Decreased CO2 Levels as Indicators of Possible Mechanical Ventilation-Induced Hyperventilation in COVID-19 Patients: A Retrospective Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Di Hu ◽  
Jinpeng Li ◽  
Rongfen Gao ◽  
Shipei Wang ◽  
Qianqian Li ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Risk ◽  
Medical Records ◽  
Cox Regression ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Risk Of Mortality

Background: Six months since the outbreak of coronavirus disease (COVID-19), the pandemic continues to grow worldwide, although the outbreak in Wuhan, the worst-hit area, has been controlled. Thus, based on the clinical experience in Wuhan, we hypothesized that there is a relationship between the patient's CO2 levels and prognosis.Methods: COVID-19 patients' information was retrospectively collected from medical records at the Leishenshan Hospital, Wuhan. Logistic and Cox regression analyses were conducted to determine the correlation between decreased CO2 levels and disease severity or mortality risk. The Kaplan-Meier curve analysis was coupled with the log-rank test to understand COVID-19 progression in patients with decreased CO2 levels. Curve fitting was used to confirm the correlation between computed tomography scores and CO2 levels.Results: Cox regression analysis showed that the mortality risk of COVID-19 patients correlated with decreased CO2 levels. The adjusted hazard ratios for decreased CO2 levels in COVID-19 patients were 8.710 [95% confidence interval (CI): 2.773–27.365, P &lt; 0.001], and 4.754 (95% CI: 1.380–16.370, P = 0.013). The adjusted odds ratio was 0.950 (95% CI: 0.431–2.094, P = 0.900). The Kaplan-Meier survival curves demonstrated that patients with decreased CO2 levels had a higher risk of mortality.Conclusions: Decreased CO2 levels increased the mortality risk of COVID-19 patients, which might be caused by hyperventilation during mechanical ventilation. This finding provides important insights for clinical treatment recommendations.

scholarly journals The Role of Radiotherapy in Soft Tissue Sarcoma on Extremities With Lymph Nodes Metastasis: An IPTW Propensity Score Analysis of the SEER Database

2021 ◽  
Vol 11 ◽  
Author(s):  
Xinzhu Qiu ◽  
Hongbo He ◽  
Hao Zeng ◽  
Xiaopeng Tong ◽  
Qing Liu
Keyword(s):  
Soft Tissue ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Cox Regression ◽  
Rank Test ◽  
Seer Database ◽  
Cox Regression Analysis ◽  
Lymph Nodes Metastasis ◽  
Log Rank Test ◽  
Kaplan Meier

BackgroundSoft tissue sarcomas on extremities with regional lymph nodes metastasis (STSE-RLNM) is a devastating situation. Optimizing therapeutic approaches is vital but hampered by a shortage of randomized trials. We used a population-level database to evaluate radiotherapy’s impact on sarcoma-specific survival (SSS) and overall survival (OS) for surgery for STSE-RLNM.MethodsWe retrospectively screened data from the SEER database (2004–2015), and 265 patients with STSE-RLNM who received surgery, with (134) or without (131) radiotherapy, were enrolled in this study. A propensity-score-matched analysis with the inverse probability of treatment weighting (IPTW) Kaplan–Meier curve was created. The log-rank test and Cox regression analysis were performed to compare SSS and OS in patients with and without radiotherapy. Further analysis of radiotherapy time was conducted, and the Kaplan–Meier curve and the log-rank test were done. Landmark analysis was introduced to attenuate the immortal bias.ResultsIn the original unadjusted cohort, the radiotherapy + surgery group is associated with improved SSS [hazard ratio (HR), 0.66; 95% CI, 0.47–0.91; p = 0.011] and OS (HR, 0.64; 95% CI, 0.47–0.88; p = 0.006). This significant treatment effect was also noted in IPTW-adjusted Cox regression either on SSS (HR, 0.65; 95% CI, 0.45–0.93; p = 0.020) or on OS (HR, 0.64; 95% CI, 0.46–0.91; p = 0.013). The Kaplan–Meier curve and log-rank test showed that pre- and postoperative radiotherapy was not related to SSS (p = 0.980 or OS (p = 0.890).ConclusionRadiotherapy and surgery has a significant benefit on the prognosis of patients with STSE-RLNM compared to surgery alone. These findings should be considered when making treatment decisions for them.

scholarly journals Clinical significance of extranodal extension in sentinel lymph node positive breast cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xia Yang ◽  
XiaoXi Ma ◽  
Wentao Yang ◽  
Ruohong Shui
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Lymph Node ◽  
Cox Regression ◽  
Rank Test ◽  
Breast Cancers ◽  
Cox Regression Analysis ◽  
Extranodal Extension ◽  
Kaplan Meier ◽  
Nodal Burden

Abstract The precise stage of lymph node (LN) metastasis is a strong prognostic factor in breast cancers, and sentinel lymph node (SLN) is the first station of nodal metastasis. A number of patients have extranodal extension (ENE) in SLN, whereas the clinical values of ENE in SLN in breast cancers are still in exploration. The aim of our study was to evaluate the predictive and prognostic values of ENE in SLN in breast cancers, and to investigate the feasibility of ENE to predict non-SLN metastasis, nodal burden, disease free survival (DFS) and overall survival (OS) in clinical practice. 266 cases of primary invasive breast cancer (cT1-2N0 breast cancer) underwent SLN biopsy and axillary lymph node dissection (ALND) between 2008 and 2015 were extracted from the pathology database of Fudan University Shanghai Cancer Center. ENE in SLN was defined as extension of neoplastic cells through the lymph-nodal capsule into the peri-nodal adipose tissue, and was classified as no larger than 2 mm and larger than 2 mm group. The associations between ENE and clinicopathological features, non-SLN metastasis, nodal burden, DFS, and OS were analyzed. In the 266 patients with involved SLN, 100(37.6%) were positive for ENE in SLN. 67 (25.2%) cases had ENE no larger than 2 mm in diameter, and 33(12.4%) had ENE larger than 2 mm. Among the clinicopathological characteristics, the presence of ENE in SLN was associated with higher pT and pN stages, PR status, lympho-vascular invasion. Logistic regression analysis indicated that patients with ENE in SLN had higher rate of non-SLN metastasis (OR4.80, 95% CI 2.47–9.34, P < 0.001). Meanwhile, in patients with SLN micrometastasis or 1–2 SLNs involvement, ENE positive patients had higher rate of non-SLN metastasis, comparing with ENE negative patients (P < 0.001, P = 0.004 respectively). The presence of ENE in SLN was correlated with nodal burden, including the pattern and number of involved SLN (P < 0.001, P < 0.001 respectively), the number of involved non-SLN and total positive LNs (P < 0.001, P < 0.001 respectively). Patients with ENE had significantly higher frequency of pN2 disease (P < 0.001). For the disease recurrence and survival status, Cox regression analysis showed that patients with ENE in SLN had significantly reduced DFS (HR 3.05, 95%CI 1.13–10.48, P = 0.008) and OS (HR 3.34, 95%CI 0.74–14.52, P = 0.092) in multivariate analysis. Kaplan–Meier curves and log-rank test showed that patients with ENE in SLN had lower DFS and OS (for DFS: P < 0.001; and for OS: P < 0.001 respectively). Whereas no significant difference was found in nodal burden between ENE ≤ 2 mm and > 2 mm groups, except the number of SLN metastasis was higher in patients with ENE > 2 mm. Cox regression analysis, Kaplan–Meier curves and log-rank test indicated that the size of ENE was not an independent factor of DFS and OS. Our study indicated that ENE in SLN was a predictor for non-SLN metastasis, nodal burden and prognosis in breast cancers. Patients with ENE in SLN had a higher rate of non-SLN metastasis, higher frequency of pN2 disease, and poorer prognosis. Patients with ENE in SLN may benefit from additional ALND, even in SLN micrometastasis or 1–2 SLNs involvement patients. The presence of ENE in SLN should be evaluated in clinical practice. Size of ENE which was classified by a 2 mm cutoff value had no significant predictive and prognostic values in this study. The cutoff values of ENE in SLN need further investigation.

scholarly journals Serum Chemerin Predicts the Prognosis of Patients With Dilated Cardiomyopathy

2020 ◽  
Vol 23 (3) ◽  
pp. E276-E280
Author(s):  
Dan Chen ◽  
Juan Wang ◽  
Jianglin Fu
Keyword(s):  
Regression Analysis ◽  
Dilated Cardiomyopathy ◽  
Cox Regression ◽  
Survival Rates ◽  
Prognostic Indicator ◽  
Rank Test ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Potential Risk Factors

Background: Chemerin is a newly discovered adipokine, which has been reported to be associated with the presence of dilated cardiomyopathy (DCM). The present study aims to evaluate the prognostic value of serum chemerin in patients with DCM. Methods: A total of 214 patients with DCM was recruited and divided into 4 groups, according to quartiles of chemerin levels. Kaplan–Meier analysis was conducted to compare the survival rates among patients with different levels of chemerin, using the log-rank test. Multivariate Cox regression analysis was performed to assess the association of serum chemerin levels and occurrence of major adverse cardiac events (MACEs), including cardiac mortality, stroke and myocardial infarction. Results: The Kaplan-Meier survival analysis indicated that patients with higher concentration of chemerin had shorter event-free survivals for MACEs (P < .01). Cox regression analysis showed that chemerin was a significant predictor of MACEs (Quartile 3 versus Quartile 1: HR=1.79, 95% CI: 1.31-2.79; Quartile 4 versus Quartile 1: HR=2.87, 95% CI: 1.79-4.25) and all-cause death (Quartile 3 versus Quartile 1: HR=1.56, 95% CI: 1.20-2.42; Quartile 4 versus Quartile 1: HR=2.28, 95% CI: 1.52-3.96) after adjusting for potential risk factors. Conclusion: Serum chemerin should be a potential prognostic indicator in patients with DCM.

scholarly journals Low-Dose Aspirin as Primary Prophylaxis for Cardiovascular Events in Rheumatoid Arthritis: An Italian Multicentre Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Daniela Iacono ◽  
Serena Fasano ◽  
Ilenia Pantano ◽  
Virginia D’Abrosca ◽  
Piero Ruscitti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Low Dose ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Primary Prophylaxis ◽  
Treated Group ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Kaplan Meier

Objective. To investigate the role of acetylsalicylic acid (ASA) in reducing the incidence of cardiovascular (CV) events in an Italian multicentre rheumatoid arthritis (RA) inception cohort. Methods. The clinical charts of RA patients consecutively admitted to 4 Italian centres for their 1st visit from November 1, 2000, to December 31, 2015, and followed up till December 2016 were retrospectively investigated for the incidence of CV events. Patients were subdivided into two groups, namely, ASA- and non-ASA-treated groups. The Kaplan–Meier curve and log-rank test were used to investigate differences in event-free survival. Cox regression analysis was carried out to identify factors associated with CV event occurrence. Results. Seven hundred forty-six consecutive RA patients were enrolled and followed up for a median of 5.6 years (range 2.9–8.9 years). The incidence rate (IR) of CV events was 8/1000 person-years (p-ys) in the overall cohort. The IR of CV events was significantly lower in the ASA-treated group with respect to the non-ASA-treated group (IR 1.7 vs. 11.8/1000 p-ys; p=0.0002). The CV event-free rate was longer in ASA-treated patients than in non-ASA-treated patients (log-rank test 12.8; p=0.0003). At multivariable analysis, arterial hypertension (HR 9.3) and hypercholesterolemia (HR 2.8) resulted to be positive predictors and ASA (HR 0.09) and hydroxychloroquine (HCQ) (HR 0.22) to be negative predictors. Conclusion. The IR of CV events in our Italian multicentre cohort was lower than that reported in other European and non-European cohorts. Low-dose ASA may have a role in the primary prophylaxis of CV events in RA patients.

Prognostic factors for survival in patients with metastatic malign melanoma treated with ipilimumab: Turkish Oncology Group study

2018 ◽  
Vol 25 (7) ◽  
pp. 1658-1664 ◽  
Author(s):  
Yuksel Urun ◽  
H Arzu Yasar ◽  
Hande Turna ◽  
Ece Esin ◽  
A Murat Sedef ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Survival Rates ◽  
Lactic Dehydrogenase ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Metastatic Sites ◽  
Ecog Ps

Purpose Studies in the last decade show survival improvement with checkpoint blocker therapy in patients with metastatic malign melanoma. Our purpose was to define the efficacy of ipilimumab according to the patient's baseline characteristics including absolute lymphocytes count. Methods We collected the data of 97 patients with advanced malign melanoma treated with ipilimumab (3 mg/kg, q3w) retrospectively. Log-rank test was used to analyze the univariate effects of patient's characteristics (age, gender, metastatic sites, ECOG PS, type of melanoma, lactic dehydrogenase levels, anemia, lymphocytes (L), neutrophils (N), N/L ratio), c-kit and BRAF status. Survival analyses were estimated with Kaplan–Meier method. Cox regression analysis was used to assess the possible factors identified with log-rank test. Results The median age was 58, and 58% were male and 90% of patients had at least one prior systemic therapy. The median survival was 9.7 months for all patients; and the 12- and 24-month survival rates were 43% and 19%, respectively. Absolute lymphocytes count, lactic dehydrogenase level, bone metastasis, the number of metastatic sites, and RECIST response were significantly related to survival. After Cox regression analysis, RECIST response (complete or partial response), absolute lymphocytes count (more than 1500/mm3) and the number of metastatic sites (less than three sites) remained as significant independent prognostic factors for longer survival. Conclusion Ipilimumab improved survival of patients with metastatic malign melanoma. However, patients with fewer metastatic sites and higher absolute lymphocytes count have a significantly better benefit. To determine if these markers could be used to direct patient therapy, further validation analysis is needed.

scholarly journals The Role of Chemotherapy in the Survival Benefits of Patients Aged Older Than 40 Years With Osteosarcoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110661
Author(s):  
Zhiyou Cao ◽  
Yuelin Zhang ◽  
Qiang Xu ◽  
Xiaolong Yu ◽  
Xuqiang Liu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Survival Benefit ◽  
Cox Regression ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Stratified Analysis ◽  
The Impact ◽  
Grade Iii

Objectives: The value of chemotherapy in the survival benefits of patients aged > 40 years with osteosarcoma is controversial. We aimed to explore the impact of chemotherapy on the survival benefits of patients aged >40 years with osteosarcoma. Methods: The Surveillance, Epidemiology, and End Results database was used to select eligible patients. The selected patients were divided into the chemotherapy and non-chemotherapy groups. Logistic regression analysis was performed to investigate the potential factors contributing to the selection of chemotherapy. The overall survival (OS) and cancer-specific survival (CSS) of the two groups were compared using the Kaplan–Meier method with a log-rank test. Cox proportional risk models were used to determine the prognostic factors for OS and CSS. Stratified analysis was performed according to tumour grade and stage. Results: A total of 1032 eligible patients were included in our analysis. Of these, 586 and 446 patients were in the chemotherapy and nonchemotherapy groups, respectively. Multivariate logistic analysis indicated that grade III/IV and distant stage were associated with chemotherapy. Kaplan–Meier plots showed that patients did not achieve an improved OS or CSS after receiving chemotherapy. Cox regression analysis indicated that age > 60 years, axial, grade III/IV, and regional and distant stage were independent risk factors for poor prognosis in both OS and CSS. Stratified analysis revealed a survival benefit from chemotherapy in patients with grade III/IV and distant stage. Conclusions: Chemotherapy did not significantly improve OS and CSS in patients aged > 40 years with osteosarcoma. In this age group, survival benefit from chemotherapy was observed in patients with high-grade tumours (grade III/IV) and metastasis (distant stage).

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