scholarly journals Evaluation of grading systems in stage I lung adenocarcinomas: a retrospective cohort study

2017 ◽  
Vol 71 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Tamás Zombori ◽  
József Furák ◽  
Tibor Nyári ◽  
Gábor Cserni ◽  
László Tiszlavicz
Keyword(s):  
Lung Adenocarcinoma ◽  
Disease Free Survival ◽  
Stage I ◽  
Low Grade ◽  
Intermediate Grade ◽  
Independent Prognostic Marker ◽  
Kaplan Meier ◽  
Grading Systems ◽  
Cox Proportional Hazard Regression ◽  
Resected Stage

AimsThere is no internationally accepted grading system for lung adenocarcinoma despite the new WHO classification. The architectural grade, the Kadota grade and the Sica score were evaluated and compared with overall (OS) and disease-free survival (DFS).MethodsComprehensive histological subtyping was used in a series of resected stage I lung adenocarcinoma to identify subtypes of adenocarcinomas, the architectural grade, the Kadota grade, the Sica grade, the mitotic count, nuclear atypia, the presence of lymphovascular, vascular and airway propagation, necrosis, and micropapillary or solid growth pattern in any percentage. Statistical models fitted included Kaplan-Meier estimates and Cox proportional hazard regression models.Results261 stage I adenocarcinomas were included. The 5-year survivals of different subtypes were as follows: lepidic (n=40, OS: 92.5%; DFS 91.6%), acinar (n=54, OS: 81.8%; DFS: 68.6%), papillary (n=49, OS: 73.6%; DFS: 61.0%), solid (n=95, OS: 64.7%; DFS: 57.8%) and micropapillary (n=23, OS: 34.8%; DFS: 33.5%). Concerning the architectural grade, there were significant differences between OS and DFS of low and intermediate (pOS=0.005, pDFS<0.001), low and high (pOS<0.001, pDFS<0.001) and intermediate and high grades (pOS=0.002, pDFS<0.001). Low-grade and intermediate grade tumours did not differ in survival according to Kadota grade and Sica grade. In the multivariable model, architectural grade was found to be an independent prognostic marker. In another model, architectural pattern proved to be superior to architectural grade.ConclusionsOf the three grading systems compared, the architectural grade makes the best distinction between the outcome of low-grade, intermediate-grade and high-grade stage I adenocarcinomas.

Radiation Therapy for Stage I Primary Orbital Non-Hodgkin's Lymphomas

1997 ◽  
Vol 83 (5) ◽  
pp. 822-825 ◽  
Author(s):  
Haldun Şükrü Erkal ◽  
Meltem Serin ◽  
Serpil Dizbay Sak ◽  
Ahmet Çakmak
Keyword(s):  
Radiation Therapy ◽  
Combination Chemotherapy ◽  
Disease Free Survival ◽  
Stage I ◽  
Entire Group ◽  
Low Grade ◽  
Intermediate Grade ◽  
Chop Regimen ◽  
Survival Probabilities ◽  
Hodgkin's Lymphomas

Aims and Background The orbit is an uncommon primary site for non-Hodgkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department of Radiation Oncology at Ankara University Faculty of Medicine with radiation therapy in treatment of patients with stage I primary orbital NHL. Methods From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. According to the Working Formulation classification, 8 patients had low-grade and 6 had intermediate-grade lymphomas. The most commonly used radiation therapy technique was a single anterior field with a Cobalt-60 unit, delivering 40 Gy in 2 Gy daily fractions. Two patients with intermediate-grade lymphomas received the CHOP regimen following radiation therapy. Results Follow-up ranged from 0.8 to 18.3 years (median, 10.3 years). Local control was achieved in all patients. Two patients with low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphomas failed systemically. Salvage therapy consisted of combination chemotherapy for 2 of them but was unsuccessful. Overall survival probabilities at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, for the entire group of 14 patients. Overall, cause-specific and disease-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients. Conclusions The study suggests that among stage I primary orbital NHL, low-grade lymphomas could be treated with radiation therapy alone, whereas combination chemotherapy could accompany radiation therapy for intermediate-grade lymphomas.

scholarly journals Impact on disease-free survival of adjuvant erlotinib or gefitinib in patients with resected lung adenocarcinomas that harbor epidermal growth factor receptor (EGFR) mutations

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7523-7523
Author(s):  
Y. Y. Janjigian ◽  
B. J. Park ◽  
M. G. Kris ◽  
V. A. Miller ◽  
G. J. Riely ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Egfr Mutation ◽  
Disease Free Survival ◽  
Stage I ◽  
Egfr Mutations ◽  
Free Survival ◽  
Resected Stage ◽  
Lung Adenocarcinomas ◽  
Disease Free ◽  
Exon 19

7523 Background: Patients with stage IV adenocarcinoma whose tumors harbor EGFR mutations have high rates of response (∼ 75%) and prolonged progression free survival after EGFR tyrosine kinase inhibitor (TKI) treatment. Adjuvant cisplatin-based chemotherapy improves disease free survival (DFS) and overall survival (OS) in patients with resected stages IB-IIIA NSCLC. To see if adjuvant treatment with EGFR TKI (gefitinib or erlotinib) improves DFS in patients with EGFR mutation NSCLC, we conducted a retrospective review of patients with resected lung adenocarcinoma harboring EGFR mutations, some of whom received EGFR TKIs postoperatively. Methods: With Institutional Review Board approval, clinical information was obtained on all patients with stage I-III lung adenocarcinoma harboring EGFR exon 19 or 21 mutations that underwent resection at MSKCC between May 2002 and August 2008. Age, gender, type of surgery, histology, EGFR mutation status (exon 19 deletions and exon 21 L858R), stage, perioperative therapy and survival were recorded. Kaplan-Meier analysis and Cox regression analysis were performed. Results: We studied 150 patients (112 women, 38 men) with completely resected stage I-III lung adenocarcinoma whose resection specimens contained EGFR activating mutations in exon 19 or 21. Median age was 69. Forty two patients (28%) received cytotoxic chemotherapy. Forty eight (32%) received either erlotinib (n=26) or gefitinib (n=22) postoperatively. The median time on TKI was 16 months. The median DFS was 43 months in the group that received a TKI vs. 31 months for those that did not. After controlling for stage, individuals who received adjuvant gefitinib or erlotinib had a better DFS (HR=0.38, 95%CI: 0.16–0.90) than the non-TKI group (p=0.03). The median overall survival has not been reached. Conclusions: These data indicate that the adjuvant use of either gefitinib or erlotinib improves DFS in patients with completely resected stage I -III lung adenocarcinomas with mutations in EGFR exons 19 and 21. These data justify a randomized trial in similar patients. [Table: see text]

scholarly journals Tumor-Associated CD204-Positive Macrophage Is a Prognostic Marker in Clinical Stage I Lung Adenocarcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yanbin Sun ◽  
Shun Xu
Keyword(s):  
Lung Adenocarcinoma ◽  
Proportional Hazards ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Biological Behavior ◽  
Smoking History ◽  
Kaplan Meier ◽  
Lung Adenocarcinomas

Objective. Macrophages are the dominant leukocytes in the tumor microenvironment. Accumulating evidence revealed that CD204-positive (CD204+) tumor-associated macrophages (TAMs) are associated with the aggressive behavior of various cancers; however, the clinical, pathological, and prognostic associations of CD204+ TAMs with the subtype of lung adenocarcinoma have not been reported. Methods. Tissue microarray and immunohistochemistry were constructed from clinical stage I lung adenocarcinomas with radical surgical resection. The intratumoral density of CD204+ cells was calculated using image analysis software for analyses. Survival analyses were performed using the Kaplan-Meier method and multivariate Cox proportional hazards regression models. Results. The intratumoral density of CD204 was correlated with T stage, nodal involvement, lymphovascular invasion, and cancer relapse after the surgery, but not with age, gender, or smoking history. The density of CD204 in non-LPD was significantly higher than that in LPD. The 5-year disease-free survival (DFS) rate of CD204 high-density group was significantly worse than that of CD204 low-density group. Conclusions. The expression of CD204 in TAMs is associated with the aggressiveness of lung adenocarcinoma. Our results suggest that a specific immune microenvironment may be associated with the biological behavior of lung adenocarcinoma.

Amplification and expression of c-MET correlate with poor prognosis of patients with gastric cancer and upregulate the expression of PDL1

2021 ◽  
Vol 53 (5) ◽  
pp. 547-557
Author(s):  
Ya’nan Yang ◽  
Chenchen Wang ◽  
Congqi Dai ◽  
Xinyang Liu ◽  
Wenhua Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Significance ◽  
Growth Factor Receptor ◽  
Disease Free Survival ◽  
Positive Association ◽  
Her2 Positive ◽  
Kaplan Meier ◽  
Met Amplification ◽  
Amplification Rate ◽  
Cox Proportional Hazard Regression

Abstract The prognostic significance of c-MET in gastric cancer (GC) remains uncertain. In the present study, we examined the amplification, expression, and the prognostic value of c-MET, human epidermal growth factor receptor 2 (HER2), and programmed cell death 1 ligand 1 (PDL1), together with the correlations among them in a large cohort of Chinese samples. A total of 444 patients were included. The immunohistochemistry (IHC) and the dual-color silver in situ hybridization (SISH) were performed to examine their expression and amplification. Univariate and multivariate analyses were performed by the Cox proportional hazard regression model, and survival curves were estimated by the Kaplan–Meier method. The positivity determined by IHC of c-MET was 24.8%, and the MET amplification rate was 2.3%. The positivity rates of HER2 and PDL1 were 8% and 34.7%, respectively. PDL1 expression had a significantly positive association with c-MET expression. c-MET positivity played a significant prognostic role in disease-free survival (DFS) (P = 0.032). Patients with mesenchymal-epithelial transition (MET) amplification had significantly poorer prognosis on both DFS and overall survival (OS). Subgroup analysis showed that in HER2-negative patients, but not in HER2-positive patients, MET-positive patients had significantly worse DFS (P = 0.000) and OS (P = 0.006). c-MET regulated the expression of PDL1 through an AKT-dependent pathway. c-MET inhibitor enhanced the T-cell killing ability and increased the efficacy of PD1 antibody. c-MET was found to be an independent prognostic factor for DFS of GC patients. A combination of c-MET inhibitors and PD1 antibodies could enhance the killing capacity of T cells, providing a preliminary basis for the clinical research on the same combination in GC treatment.

scholarly journals The chemotherapy and radiation in low-grade myofibroblastic sarcoma: is there a role?

2020 ◽  
Author(s):  
Yao Xu ◽  
Guijun Xu ◽  
Xin Wang ◽  
Min Mao ◽  
Haixiao Wu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Treatment ◽  
Head And Neck ◽  
Radiation Treatment ◽  
Treatment Strategies ◽  
Neck Region ◽  
Low Grade ◽  
Myofibroblastic Sarcoma ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Regression

Abstract Background: Low-grade myofibroblastic sarcoma (LGMS) is a rare entity with a predilection in the head and neck. There are still no optimal treatment strategies for LGMS. We aimed to investigate the role of chemotherapy and radiation treatment for LGMS. Survival estimate was performed and prognostic factors were identified.Methods: Based on the Surveillance, Epidemiology, and End Result (SEER) database, LGMS patients diagnosed between 2001 and 2015 were involved in our study. Kaplan-Meier curves and log-rank tests were used to estimate overall survival. Cox proportional hazard regression model was performed to identify prognostic factors.Results: A total of 96 eligible patients with LGMS were included, among which 86 (89.6%) received surgical treatment. Twenty-eight (29.2%) patients received radiation treatment while chemotherapy was offered to 20 (10.4%) patients. The median age was 55.0 years old with 22 cases occurred in head and neck region. The mean OS was 125.2 (95%CI 106.3-144.2) months while 1-, 3-, 5- and 10-year OS rates were 88%, 77%, 70% and 59%, respectively. Age older than 60 years, positive nodal status and no surgical treatment were independent prognostic factors for patients with LGMS. Chemotherapy and radiation were not independent prognostic factors for LGMS.Conclusions: Several prognostic factors for LGMS were revealed in this study. Surgical resection is the main therapy while chemotherapy and radiation showed limited effects on survival improvement. Thus, chemotherapy and/or radiation should not be routinely performed in LGMS.

Do patients with cardiovascular diseases have earlier relapse in stage I-III non-small cell lung cancer?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9603-9603
Author(s):  
Robert M. Crescentini ◽  
Richard R. Reich ◽  
Pooja Bardhan ◽  
Martine Extermann
Keyword(s):  
Cerebrovascular Disease ◽  
Cox Regression ◽  
Early Stage ◽  
Antihypertensive Agents ◽  
Disease Free Survival ◽  
Stage I ◽  
Cancer Center ◽  
Bivariate Analysis ◽  
Early Stage Disease ◽  
Kaplan Meier

9603 Background: Diabetes mellitus (DM) has been reported to be an independent risk factor in the development of recurrence of NSCLC following treatment of early stage disease. We evaluated to see if there was a similar effect of cardiovascular disease in patients with newly diagnosed NSCLC. Methods: Using the Moffitt Cancer Center (MCC) databases, patients were identified who were treated for stage I, II and III NSCLC at MCC from 2001-2003. Charts were reviewed and descriptive data were recorded including histories of DM, coronary artery disease (CAD), hypertension, cerebrovascular disease and congestive heart failure (CHF). The use of aspirin and antihypertensive agents at the time of diagnosis were also recorded. Primary endpoint was disease free survival (DFS). Overall survival (OS) was a secondary endpoint. Kaplan Meier curves and Cox regression analyses were used for DFS and OS. Results: A total of707 patients were identified. Ninety-seven patients had DM, 158 had CAD, 396 had hypertension, 43 had cerebrovascular disease and 56 had CHF. DFS was worse in patients with DM (p<0.001, OR 0.63, 95% CI 0.50-0.80), CAD (p<0.001, OR 0.70, 95% CI 0.57-0.85), hypertension (p=0.016, OR 0.81, 95% CI 0.67-0.96), cerebrovascular disease (p=0.006, OR 0.62, 95% CI 0.45-0.87) and CHF (p<0.001, OR 0.56, 95% CI 0.42-0.75). Bivariate analysis showed that CAD, cerebrovascular disease and CHF were associated with shorter DFS independent of DM. OS was also worse in patients with DM (p<0.001, 95% CI 0.50-0.81), CAD (p<0.001, OR 0.62, 95% CI 0.51-0.78), hypertension (p=0.004, OR 0.77, 95% CI 0.64-0.92), cerebrovascular disease (p=0.02, OR 0.66, 95% CI 0.47-0.94) and CHF (p<0.001, OR 0.54, 95% CI 0.41-0.73). In patients with hypertension, there was an improvement in DFS (p=0.047, OR 1.35, 95% CI 1.004-1.819) for those treated with thiazide diuretics. There were no other statistically significant differences in patients based on antihypertensive regimens or aspirin use. Conclusions: DM,CAD, hypertension, cerebrovascular disease and CHF are associated with shorter DFS and worse overall prognosis in patients with non-metastatic NSCLC. CAD, cerebrovascular disease and CHF are associated with shorter DFS independent of DM.

Low-grade endometrial stromal sarcoma: a single center's experience with 22 cases

2008 ◽  
Vol 18 (5) ◽  
pp. 1084-1089 ◽  
Author(s):  
W. Y. Kim ◽  
J.-W. Lee ◽  
C. H. Choi ◽  
H. Kang ◽  
T.-J. Kim ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
Disease Recurrence ◽  
Primary Treatment ◽  
Stage I ◽  
Low Grade ◽  
Stromal Sarcoma ◽  
Case Surgery ◽  
Abnormal Vaginal Bleeding ◽  
Disease Free

The aim of this retrospective study was to evaluate the clinical behavior and management outcome of low-grade endometrial stromal sarcoma (LGESS). From September 1994, to March 2007, 22 patients with histologically proven stage I LGESS were included in this study. Clinicopathologic variables, recurrence, and management outcomes were reviewed retrospectively. The median age of the 22 patients was 43 years. The most common presenting symptom was abnormal vaginal bleeding. All patients underwent a hysterectomy and had stage I disease. Six patients had adjuvant therapy after the hysterectomy. The median follow-up period was 77 months (range 12–202 months). Ten patients had disease recurrence. The median disease-free survival period was 111 months (range 6–182 months). The pelvis (eight cases) was the most common site of recurrence followed by the lung (four cases) and the liver (one case). Recurrent disease was treated with surgery (one case), surgery plus chemotherapy (five cases), chemotherapy (two cases), and surgery plus radiotherapy (two cases). Two patients died after 25 and 54 months after disease recurrence. Treatment with a bilateral salpingo-oophorectomy or adjuvant chemoradiation did not affect the disease-free interval. LGESS is usually a slow-growing neoplasm with an indolent clinical course. Surgery is the primary treatment for recurrent endometrial stromal sarcoma when feasible. Adjuvant treatment (radiotherapy, chemotherapy, or both) had no effect on the prognosis of patients with stage I disease

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