scholarly journals Effects of Different Treatment Strategies and Tumor Stage on Survival of Patients with Advanced Laryngeal Carcinoma: A 15-Year Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Nima Daneshi ◽  
Mohammad Fararouei ◽  
Mohammad Mohammadianpanah ◽  
Mohammad Zare-Bandamiri ◽  
Somayeh Parvin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Laryngeal Cancer ◽  
Treatment Strategy ◽  
Cox Regression ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Disease Stage ◽  
Cancer Management

Background. Laryngeal cancer is the second most common cancer in the head and neck. Since laryngeal cancer management is a complex process, there is still no standard strategy to treat this disease in order to increase the survival rate of the patients especially among those with advanced form of the disease. Methods. A cohort study was undertaken to analyze factors predicting survival of the patients in advanced stage laryngeal cancer in the Southern Iran among all patients newly diagnosed with laryngeal cancer between 2000 and 2015. Results. Data of a total number of 415 patients who have had been diagnosed with advanced laryngeal cancer during this period was used for analysis. The patients’ 1-, 3-, 5-, and 10-year survival rates were 81%, 62%, 53%, and 38%, respectively. Multivariable Cox regression analyses indicated a significant relationship between patients’ survival and age at diagnosis (P<0.001), disease stage (P=0.002), tumor grade (P=0.008), positive L. node (P=0.008), and type of treatment (P<0.001). As expected, treatment strategy was identified as the most effective factor in survival of the patients. According to the results, patients who undergone surgical treatment experienced a longer survival than those who received other treatments. Conclusion. This study showed that the survival of patients depends on several factors, among which, treatment strategy is the most important. Combination of total laryngectomy plus chemoradiation provides superior local control and better survival compared to either radiotherapy or chemoradiation in patients with advanced laryngeal cancer.

Radiation Therapy for Squamous Cell Carcinoma of the Tonsillar Region: A Preferred Alternative to Surgery?

2000 ◽  
Vol 18 (11) ◽  
pp. 2219-2225 ◽  
Author(s):  
William M. Mendenhall ◽  
Robert J. Amdur ◽  
Scott P. Stringer ◽  
Douglas B. Villaret ◽  
Nicholas J. Cassisi
Keyword(s):  
Multivariate Analysis ◽  
Neck Dissection ◽  
Local Control ◽  
Early Stage ◽  
Survival Rates ◽  
Tumor Stage ◽  
Late Complications ◽  
Disease Stage ◽  
Fractionation Schedule ◽  
Cause Specific Survival

PURPOSE: There are no definitive randomized studies that compare radiotherapy (RT) with surgery for tonsillar cancer. The purpose of this study was to evaluate the results of RT alone and RT combined with a planned neck dissection for carcinoma of the tonsillar area and to compare these data with the results of treatment with primary surgery.PATIENTS AND METHODS: Four hundred patients were treated between October 1964 and December 1997 and observed for at least 2 years. One hundred forty-one patients underwent planned neck dissection, and 18 patients received induction (17 patients) or concomitant (one patient) chemotherapy.RESULTS: Five-year local control rates, by tumor stage, were as follows: T1, 83%; T2, 81%; T3, 74%; and T4, 60%. Multivariate analysis revealed that local control was significantly influenced by tumor stage (P = .0001), fractionation schedule (P = .0038), and external beam dose (P = .0227). Local control after RT for early-stage cancers was higher for tonsillar fossa/posterior pillar cancers than for those arising from the anterior tonsillar pillar. Five-year cause-specific survival rates, by disease stage, were as follows: I, 100%; II, 86%; III, 82%; IVa, 63%; and IVb, 22%. Multivariate analysis revealed that cause-specific survival was significantly influenced by overall stage (P = .0001), planned neck dissection (P = .0074), and histologic differentiation (P = .0307). The incidence of severe late complications after treatment was 5%.CONCLUSION: RT alone or combined with a planned neck dissection provides cure rates that are as good as those after surgery and is associated with a lower rate of severe complications.

Baseline anemia in patients with biliary tract cancer (BTC) and its association with survival: A retrospective cohort study.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 426-426
Author(s):  
Mark Doherty ◽  
Stephanie Moignard ◽  
Gonzalo Sapisochin ◽  
Grainne M. O'Kane ◽  
Mairead Geraldine McNamara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cancer Staging ◽  
Tumor Stage ◽  
Factors Associated ◽  
Tract Cancer ◽  
Ecog Ps ◽  
Baseline Hemoglobin ◽  
Relevant Covariates

426 Background: The prognostic significance of anemia in BTC is unknown, but is common and may be multifactorial; data regarding its causes are limited. This study interrogated a large institutional database to examine the effect of anemia on overall survival (OS) in BTC, and explore factors associated with anemia. Methods: This Princess Margaret Cancer Centre cohort study included patients with BTC with available baseline hemoglobin (Hb) (1987-2016). Anemia was defined as Hb < 132 mg/dL for men > 60 years, < 137mg/dL for men aged 20-59, and < 122mg/dL in women. Additional relevant covariates were included in multivariable Cox regression for OS, and linear regression for association with Hb. Results: Of 1398 patients included, 711 (51%) were anemic at baseline (mean Hb 112 mg/dL). Anemic versus non-anemic patients were older (median age 66 vs 64 yrs, p = 0.006), had worse ECOG PS (12% ECOG 2-3 vs 6%, p < .001), BMI < 20 (31% vs 27%, p = 0.006) and elevated neutrophil:lymphocyte ratio (NLR), (64% vs 47%, p < .001), but cancer staging was not significantly different. Anemia was associated with shorter OS on univariate (HR 1.35, p < .001) and multivariable (HR 1.39, p < .001) regression (Table). Factors associated with lower Hb included older age, male gender, worse ECOG PS, tumor site, thrombocytopenia, elevated NLR. Conclusions: Baseline anemia was associated with shorter survival following diagnosis of BTC, independent of tumor stage or ECOG PS. Clinicians should be aware of this prognostic marker; validation in prospective datasets is warranted. [Table: see text]

The influence of obesity on tumor recurrence in vulvar cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17130-e17130 ◽  
Author(s):  
Rüdiger Klapdor ◽  
Peter Hillemanns ◽  
Linn Lena Woelber ◽  
Julia Kathrin Jueckstock ◽  
Felix Hilpert ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Vulvar Cancer ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Tumor Diameter ◽  
Cox Regression Analysis

e17130 Background: Obesity is associated with worse patients’ survival in several cancer entities. Vulvar cancer as well as obesity show increasing incidence over the last years. The influence of obesity on prognosis of vulvar cancer patients is not clear. However, knowledge about this may have consequences on prevention, treatment, and follow-up. Methods: This is an analysis of the large AGO-CaRE-1 study. Patients suffering from squamous cell vulvar cancer (UICC stage IB and higher), treated in 29 cancer centers between 1998 and 2008, were categorized in a database, in order to analyze treatment patterns and prognostic factors in a retrospective setting. Results: In total, 849 patients with documented height and weight were divided into two groups depending on their body mass index (BMI, < 30 vs. ≥30 kg/m²). There was no difference in the baseline variables (age, tumor diameter, depth of infiltration, tumor stage, nodal invasion, tumor grade) between both groups (p > 0.05). However, we identified differences regarding ECOG status and preexistent comorbidities (cardiovascular, dementia) towards healthier patients with BMI < 30 kg/m². Treatment variables (R0 resection, chemotherapy, radiotherapy, continuation of adjuvant therapy) did not differ (p > 0.05). Patients with BMI ≥30 kg/m² underwent radical vulvectomy more often (61.1 % vs. 51.8%, p = 0.042). During follow-up, there was a higher recurrence rate in the group having a BMI ≥30 kg/m² (43.4%, vs. 28.3%, p < 0.01) due to an increased rate of local recurrences (33.3% vs. 18.5%, p < 0.01). The rate of groin and distant recurrences was similar between both groups (p > 0.05). Noteworthy, we observed a significantly shorter disease free survival (DSF) of the obese patients in univariate analysis (HR 1.362, 95%CI 1.093-1.696, p = 0.006). Even in multivariate Cox-regression analysis including age, ECOG, tumor stage, type of surgery, nodal invasion, tumor grade, and comorbidities patients with BMI ≥30 kg/m² had a significantly shorter DFS (HR 1.811, 95%CI 1.005-3.262, p = 0.048). Conclusions: In this first large study about the association between obesity and prognosis of vulvar cancer patients, we observed that a BMI ≥30kg/m² was associated with shorter DFS, mainly attributed to a higher risk for local recurrence.

scholarly journals Prognostic Value of Heterotypic Neutrophil-in-Tumor Structure in Tongue Squamous Cell Carcinoma Patients

2020 ◽  
Author(s):  
Jie Fan ◽  
Yang Yang ◽  
Qigen Fang ◽  
Meng Cui ◽  
Wei Du ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Value ◽  
Lymphovascular Invasion ◽  
Cox Model ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Tongue Squamous Cell Carcinoma ◽  
Disease Stage

Abstract Objective: To analyze the prognostic value of frequency of heterotypic neutrophil-in-tumor structure(FNiT) in patients with tongue squamous cell carcinoma(TSCC).Methods: In vitro, we cocultured TSCC cell line-CAL33 with neutrophils to form heterotypic neutrophil-in-tumor structures, which were then subject to fluorescence staining. Clinically, 197 patients were enrolled. Information including age, sex, FNiT, ECOG PS(Performance Status), FH (family history) of cancer, complications, and pathological characteristics such as tumor stage, node stage, metastasis, disease stage, lymphovascular invasion, perineural invasion, tumor grade, and follow-up results was extracted and analyzed.Results: Fluorescent staining results of typical heterotypic neutrophil-in-tumor structure showed that well-differentiated CAL-33-2 had stronger ability to internalize more neutrophils than poorly-differentiated CAL-33-1 did, the latter often internalizing only one neutrophil. The mean FNiT was 4.8‰,with a range from 2.1‰ to 8.9‰. The FNiT was significantly associated with tumor stage, disease stage and tumor grade. A total of 119 patients died of the disease, and the 5-year disease-specific survival(DSS) rate was 36%. The median survival time was 52.6 months. In patients with an FNiT<4.8‰, the 5-year DSS rate was 40%; in patients with an FNiT>=4.8‰, the 5-year DSS was 28%, and the difference was significant(P=0.001). Cox model analysis showed that FNiT along with disease stage, lymphovascular invasion and tumor grade was an independent prognostic factor for DSS.Conclusion: The FNiT as a novel predictor is positively correlated with adverse prognosis of patients with TSCC.

scholarly journals Management and prognosis of cancers in the accessory parotid gland

2018 ◽  
Vol 46 (12) ◽  
pp. 4930-4933 ◽  
Author(s):  
Xiaoxue Han ◽  
Xifeng Zhang ◽  
Yuqin Gao ◽  
Pai Pang ◽  
Fayu Liu ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Neck Dissection ◽  
Facial Paralysis ◽  
Medical Center ◽  
Survival Rates ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Selective Neck Dissection ◽  
High Survival ◽  
Accessory Parotid Gland

Objective This study was performed to analyze the clinical management of accessory parotid gland (APG) cancer and possible risk factors for disease-related death. Methods Patients diagnosed with primary APG cancers in the largest medical center in Northeast China were enrolled from January 1990 to December 2016. Results All 43 patients underwent resection of the tumors and superficial parotid gland by a standard Blair incision. Seven (16.3%) patients also required selective neck dissection. The most common lesion was mucoepidermoid carcinoma. Temporary facial paralysis occurred in 11 (25.6%) patients, and permanent facial paralysis occurred in 3 (7.0%) patients because of surgical resection of the facial nerve, which was involved with the tumor. The 5- and 10-year disease-specific survival rates were 86.0% and 66.0%, respectively. The tumor stage, neck status, neck dissection, and tumor grade were significantly associated with disease-related death, but only the tumor grade was an independent risk factor. Conclusion Superficial parotidectomy is a reliable surgical procedure associated with a high survival rate and low morbidity in treating APG cancers. The tumor grade is the key prognostic factor.

The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer

2015 ◽  
Vol 53 (3) ◽  
Author(s):  
Michael Stotz ◽  
Joanna Szkandera ◽  
Tatjana Stojakovic ◽  
Julia Seidel ◽  
Hellmut Samonigg ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Peripheral Blood ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Independent Prognostic Factor ◽  
Lymphocyte To Monocyte Ratio

AbstractIntra-tumoral macrophages have been involved as important players in the pathogenesis and progression of cancer. Recently, inflammatory parameters of the systemic inflammatory response have also been proposed as usefully prognostic biomarkers. One of these, the lymphocyte to monocyte ratio (LMR) in peripheral blood has been shown as a prognostic factor in hematologic and some solid tumors. In this study we analyzed for the first time the prognostic value of LMR in a large middle European cohort of pancreatic cancer (PC) patients.Data from 474 consecutive patients with ductal adenocarcinoma of the pancreas were evaluated retrospectively. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method. To further evaluate the prognostic significance of the LMR, univariate and multivariate Cox regression models were calculated.Increased LMR at diagnosis was significantly associated with well-established prognostic factors, including high tumor stage and tumor grade (p<0.05). In univariate analysis, we observed that an increased LMR was a significant factor for better CSS in PC patients (HR 0.70; 95% CI 0.57–0.85; p<0.001). In multivariate analysis including age, Karnofsky Index, tumor grade, tumor stage, administration of chemotherapy, LMR and surgical resection, we confirmed increased LMR as an independent prognostic factor for CSS (HR 0.81; 95% CI 0.66–0.99; p=0.04).In conclusion, we identified LMR as an independent prognostic factor in PC patients. Our results indicate that the LMR might represent a novel and useful marker for patient stratification in PC management.

scholarly journals Survival outcomes in surgically treated patients with advanced laryngeal cancer in Serbia

2020 ◽  
Vol 77 (9) ◽  
pp. 885-892
Author(s):  
Jovica Milovanovic ◽  
Ana Jotic ◽  
Ljiljana Tesic-Vidovic ◽  
Vojko Djukic ◽  
Aleksandar Trivic ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Postoperative Radiotherapy ◽  
Survival Rates ◽  
Tumor Resection ◽  
Tumor Grade ◽  
Survival Outcomes ◽  
Disease Specific Survival ◽  
Laryngeal Carcinomas ◽  
Laryngeal Tumors ◽  
Disease Specific

Background/Aim. Laryngeal carcinomas make 1%?3% of all head and neck malignancies.Treatment outcome and survival rates depend greatly on established stage of the disease. The purpose of this study was to examine the survival of the patients with advanced laryngeal carcinoma depending on gender, age, common risk factors (tobacco and alcohol use), primary tumor localization, histopathological tumor grade, clinical TNM (tumor, node and metastasis) stage and surgical treatment of the disease. Methods. Retrospective study included 252 patients treated surgically for advanced squamocellular carcinoma of the larynx in a threeyear period with five-year follow-up. Patients included in the study were treated primary with surgery, with postoperative radiotherapy and chemotherapy depending on the stage of the disease, intraoperative findings and tumor resection borders. Overall survival and disease-specific five-year survival of patients was calculated for demographical and clinical characteristics of the patients. Results. Overall 5-year survival of patients with operable advanced laryngeal cancer included in the study was 86.14% and disease-specific survival 86.51%. Lower overall and the disease-specific survival was associated with age, higher histological tumor grade and more extensive neck dissections. Conclusion. Primary total laryngectomy results in higher survival outcomes in cases of transglottic T3 and T4a laryngeal tumors. Patients should be informed of the likely increased mortality risks tied to the choice of surgical resection and treatment modality before their decision.

Characterizing patients with breast cancer who seek second opinions at an academic cancer center.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19229-e19229
Author(s):  
Sarah Fracci ◽  
Alexandrina Balanean ◽  
Heli Kapadia ◽  
Sidarth Swamy ◽  
Cathy Grace-Louthen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Disease Stage ◽  
Cancer Center ◽  
Advanced Stage ◽  
Newly Diagnosed ◽  
Primary Tumors ◽  
Multiple Primary

e19229 Background: Although second-opinion (SO) seeking is common in the field of oncology, there is limited empirical research on its drivers and consequences. This study’s objective is to compare the demographic and tumor characteristics between patients with newly diagnosed breast cancer who seek out SOs for treatment planning purposes with those who do not. Methods: This retrospective study includes women with newly diagnosed breast cancer who attended a single academic cancer center between 2017 and 2018 for an initial treatment consultation. Data elements were extracted from the medical record. Characteristics of first opinion and SO seekers were compared using descriptive statistics and chi-square testing. Multivariate logistic regression was used to identify predictors of SO seeking. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated. Results: Of the 547 newly diagnosed patients, 147 (26.8%) were SO seekers. Compared to those seeking a first opinion, SO seekers were statistically significantly more likely to be younger and White and to have multiple primary (versus single) tumors, and have more advanced stage (II-IV) tumors. The two groups did not differ in terms of marital status, insurance, tumor grade, and tumor hormone receptor status. In the multivariate analysis, age, race/ethnicity, and tumor stage remained statistically significant. Compared to those age 65 and older, those age <54 (OR=2.28; 95% CI:1.38-3.79) and those age 55-64 (OR=1.83; 95% CI:1.10-3.06) had a higher odds of seeking a SO. Compared to White women, Black (OR=0.33; 95% CI:0.18-0.63) and Hispanic women (OR=0.51; 95% CI:0.25-1.05) had a lower odds of SO seeking. Women with advanced stage tumors (OR=1.86; 95% CI:1.22-2.86) had a higher odds of seeking a SO compared to those with earlier stage tumors. Additionally, SO seekers had higher odds of multiple primary tumors (OR=1.63; 95% CI:0.99-2.69). Conclusions: In this study, SOs for breast cancer care were relatively common. SO seekers were more likely to be younger, White, and to have more advanced disease stage. Further analyses will include investigating the role of psychosocial factors in SO seeking and treatment changes resulting from SOs. More research on the value of SOs is needed to help guide patients and providers.

scholarly journals RARE-01. MANAGEMENT AND OUTCOMES OF PAEDIATRIC CRANIOPHARYNGIOMA: A 15-YEAR EXPERIENCE IN SINGAPORE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii441-iii442
Author(s):  
Mervyn Jun Rui Lim ◽  
Sherry Jiani Liu ◽  
Cindy Wei Li Ho ◽  
Kejia Teo ◽  
Sein Lwin ◽  
...  
Keyword(s):  
Cox Regression ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Residual Tumor ◽  
University Hospital ◽  
High Morbidity ◽  
High Survival ◽  
Recurrence Rates ◽  
Institutional Ethics

Abstract BACKGROUND Craniopharyngiomas are rare embryonic malformations of the sellar region with high survival rates but high morbidity due to long-term sequelae caused by the location of the tumour. We summarise our institution’s experience on the management and outcomes of paediatric craniopharyngiomas in Singapore. METHODS This was a retrospective review of all paediatric patients (18 years and below) with histologically diagnosed craniopharyngioma managed by the National University Hospital, Singapore from January 2002 to June 2017. Data on clinical presentation, imaging, treatments, and outcomes were extracted from the electronic medical records using a standardized data collection form. Data analysis was conducted using RStudio (Version 1.2.5033). Institutional ethics approval was obtained for the study. RESULTS We identified 12 cases of paediatric craniopharyngiomas. The majority of cases were male (8, 66.7%) and the median age at presentation was 6.0 (IQR 3.8 – 9.5). Initial surgical management was tumour excision (11, 91.7%) or insertion of a reservoir into the cyst cavity (1, 8.3%). All cases had diabetes insipidus, 10 (83.3%) had endocrine dysfunction, and 8 (66.7%) had visual impairment on long term follow up. 7 (58.3%) cases had recurrence, and 3 (25.0%) had demised. Cox-regression showed that females (HR=33.9, p=0.049), and Chinese race (HR=13.3, p=0.034) were at higher risk for recurrence, but age at diagnosis and residual tumor on post-operative MRI was not significant. CONCLUSION The management of craniopharyngioma is complex as it is complicated by high recurrence rates and significant long-term morbidity. Further research on treatment strategies focusing on maintaining quality of life is important.

scholarly journals The prognostic value of an autophagy-related lncRNA signature in hepatocellular carcinoma

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shiming Yang ◽  
Yaping Zhou ◽  
Xiangxin Zhang ◽  
Lu Wang ◽  
Jianfeng Fu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Score ◽  
Rna Splicing ◽  
Cox Regression ◽  
Survival Rates ◽  
Treatment Strategies ◽  
Cox Regression Analysis ◽  
Risk Patients ◽  
Prognostic Prediction ◽  
Cox Analysis

Abstract Background lncRNA may be involved in the occurrence, metastasis, and chemical reaction of hepatocellular carcinoma (HCC) through various pathways associated with autophagy. Therefore, it is urgent to reveal more autophagy-related lncRNAs, explore these lncRNAs’ clinical significance, and find new targeted treatment strategies. Methods The corresponding data of HCC patients and autophagy genes were obtained from the TCGA database, and the human autophagy database respectively. Based on the co-expression and Cox regression analysis to construct prognostic prediction signature. Results Finally, a signature containing seven autophagy-related lncRNAs (PRRT3-AS1, RP11-479G22.8, RP11-73M18.8, LINC01138, CTD-2510F5.4, CTC-297N7.9, RP11-324I22.4) was constructed. Based on the risk score of signature, Overall survival (OS) curves show that the OS of high-risk patients is significantly lower than that of low-risk patients (P = 2.292e−10), and the prognostic prediction accuracy of risk score (AUC = 0.786) is significantly higher than that of ALBI (0.532), child_pugh (0.573), AFP (0.5751), and AJCC_stage (0.631). Moreover, multivariate Cox analysis and Nomogram of risk score are indicated that the 1-year and 3-year survival rates of patients are obviously accuracy by the combined analysis of the risk score, child_pugh, age, M_stage, and Grade (The AUC of 1- and 3-years are 0.87, and 0.855). Remarkably, the 7 autophagy-related lncRNAs may participate in Spliceosome, Cell cycle, RNA transport, DNA replication, and mRNA surveillance pathway and be related to the biological process of RNA splicing and mRNA splicing. Conclusion In conclusion, the 7 autophagy-related lncRNAs might be promising prognostic and therapeutic targets for HCC.

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