Clinical Characteristics and Prognostic Factors of Small Intestine Angiosarcoma: a Retrospective Clinical Analysis of 66 Cases

Background/Aims: Primary angiosarcoma of the small intestine is a rare neoplasia, and there are limited data from systematic analyses. The aim of this study is to describe the clinical and pathological characteristics in addition to the prognostic factors for this rare neoplasia. Methods: We retrospectively collected the clinical records and prognostic information of 66 patients with small intestine angiosarcoma reported between 1970 and 2017. We used the Chi-square test, the log-rank test, and Cox regression analyses to evaluate the data. Results: There were 66 patients diagnosed with small intestine angiosarcoma. The onset age ranged from 24–92 years old. There were 24 patients diagnosed before the year 2000, and 42 patients were diagnosed after 2000. The data indicated that 49 cases were diagnosed as primary disease, and the remaining 15 cases were secondary disease. The main clinical symptoms were nonspecific and included gastrointestinal (GI) bleeding and abdominal pain. Additionally, we found multi-center foci were one of the characteristics of this disease. Radiation-induced small intestine angiosarcoma (RSIA) is a special type of disease with a similar prognosis. This type was more frequent in females and decreased after the year 2000. We also found that GI bleeding was less common in RSIA cases. The log-rank test results revealed that old-age, poor differentiation, and GI bleeding were associated with worse prognosis. Surgical treatment showed a trend toward a prolonged survival time. However, the result was not statistically significant. Our results show treatment with adjuvant therapy improved prognosis. The multivariate Cox analysis demonstrated adjuvant therapy was an independent indicator of a favorable outcome in small intestine angiosarcoma patients. Conclusion: Pay attention to the unexplained gastrointestinal bleeding could lead to a faster diagnosis and control of small intestine angiosarcoma. Furthermore, treatments including adjuvant therapy can effectively improve the prognosis.

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BCIRG 001 molecular analysis: Identification of prognostic factors in patients (pts) receiving adjuvant therapy for node- positive (N+) breast cancer (BC)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.525 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 525-525

Author(s):

C. M. Dumontet ◽

J. C. Reed ◽

M. Krajewska ◽

I. Treilleux ◽

J. R. Mackey ◽

...

Keyword(s):

Prognostic Factors ◽

Adjuvant Therapy ◽

Tau Protein ◽

Cox Regression ◽

Disease Free Survival ◽

Rank Test ◽

Lymph Node Status ◽

Training Set ◽

Primary Tumors ◽

Cox Regression Analysis

525 Background: BCIRG 001 (1,491 pts) demonstrated significant superiority of docetaxel/doxorubicin/cyclophosphamide (TAC) over fluorouracil/doxorubicin/cyclophosphamide (FAC) given as adjuvant therapy for N+ operable BC in terms of disease-free survival (DFS) and overall survival (OS) (Martin et al, N Eng J Med, 2005). This ancillary study was aimed to identify tumor-associated factors related to DFS and OS. Methods: Formalin-fixed primary tumors from pts in BCIRG 001 were analysed by immunohistochemistry. Protocol- specified assessment of histological grade (GR), tumor size (TS), estrogen (ER) and progesterone receptors (PR), lymph node status (LN), HER2, MUC1, Mib, p53, Bcl-2, Bax, Bcl-X, Bag-1, tubulin β isotypes II, III and IV, tau protein and detyrosinated a tubulin was performed. Parameters were scored as the percentage of positive cells and analysed as lower or greater than median values. The samples were randomly split into training (2/3) and validation (1/3) sets. Associations between selected parameters and DFS or OS were tested through univariate analyses using the Kaplan Meier method (log-rank test) on the training set. A backward stepwise Cox regression analysis was performed to identify the final model of prognostic factors on the training set. Multivariate analyses were applied to the validation set. Results: 1,350 samples were split into a training (n=906) and a validation (n=444) set. In univariate GR, TS, LN, ER and PR, Mib, tau protein and HER2 were correlated with DFS in both sets. In multivariate ER, PR, TS, LN, Mib (all p<0.01) and tau (p=0.043) were significantly associated with DFS in the training set. In univariate GR, TS, LN, ER and PR, Mib, MUC1, Bcl-2, tubulin III and IV and tau were correlated with OS in both sets, with a trend for p53. In multivariate ER, TS, LN, Mib, p53 (all p<0.01) and PR (p=0.028) were independently correlated with OS in the training set. Conclusions: These data suggest that tau and p53 are independent markers of DFS and OS, respectively, while Mib is correlated with both DFS and OS in pts receiving these forms of adjuvant chemotherapy for N+ BC. Complementary analyses will be presented. No significant financial relationships to disclose.

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Prognostic Factors in CBFB-MYH11 Positive AML: Trisomy 21, AGE, and t(16;16) Are Associated with Inferior Outcome.

Blood ◽

10.1182/blood.v106.11.486.486 ◽

2005 ◽

Vol 106 (11) ◽

pp. 486-486 ◽

Cited By ~ 2

Author(s):

Martin Weisser ◽

Susanne Schnittger ◽

Wolfgang Kern ◽

Wolfgang Hiddemann ◽

Torsten Haferllach ◽

...

Keyword(s):

Prognostic Factors ◽

Trisomy 21 ◽

Cox Regression ◽

De Novo ◽

Fusion Transcript ◽

Rank Test ◽

Cox Regression Analysis ◽

Log Rank Test ◽

De Novo Aml ◽

Worse Prognosis

Abstract The fusion transcript CBFB-MYH11 is the molecular correlate of inv(16)/t(16;16) and strictly associated with FAB subtype M4eo. This subgroup is associated with a favorable prognosis in AML. However, approximately 30% of the patients relapse. Our intention was to examine prognostic factors for the outcome within this subgroup. Therefore 153 CBFB-MYH11 positive AML patients were analyzed. The median age was 52 years (range 18–83), 80 patients were female, 73 were male. In 22 cases AML was therapy-related, in 131 cases a de novo AML was diagnosed. Inv(16) was detected in 138 and t(16;16) in 12 cases. In 3 cases neither inv(16) nor t(16;16) were detectable despite PCR and FISH positivity for CBFB-MYH11 suggesting cryptic rearrangements. The most frequent additional cytogenetic abnormalities were +8 (n=19), +9 (n=3), +21 (n=7), +22 (n=23). Cox regression analysis revealed that advanced age (OS: p=0.026; EFS: p=0.029) and increased CBFB-MYH11/ABL ratio at diagnosis (OS: 0.016, EFS: p=0.064) were associated with a worse prognosis. Using log rank test additional factors influencing survival were detected. These included: t(16;16) vs inv(16) (OS: n=8, censored 4, median 362 days vs n=118, censored 92, median not reached, p=0.018; EFS: n=8, censored 4, median 232 days vs n=118, censored 70, median 918 days, p=0.048) and trisomy 21 vs no additional aberrations (OS: n=6, censored 3, median 435 days vs n=74, censored 59, median not reached, p=0.024; EFS: n=6, censored 2, median 293 d vs n=74, censored 44, median 764 days, p=0.0047). Therapy related AML was associated with worse EFS than de novo AML (n=16, censored 6, median 371 days vs n=112, censored 70, median 1179 days, p=0.0167) and there was a trend towards worse OS (p=0.157 n=16, censored 10, median 764 days vs n=112, censored 88, median not reached). A multivariate analysis including t(16;16), age, CBFB-MYH11/ABL ratio, therapy related AML and +21 as covariates revealed t(16;16) and age as independent factor for OS (p=0.014 and p=0.015, respectively) and age, t(16;16), and +21 as independent factors for EFS (p=0.047, p=0.013, and p=0.016, respectively). There was no evidence that the additional aberrations +22 or +8 had an influence on survival. Taken together our data suggest that t(16;16) as compared to inv(16), trisomy 21 and age are associated with worse prognosis in patients with CBFB-MYH11 positive AML.

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A practical nomogram from the SEER database to predict the prognosis of hepatocellular carcinoma patients with lymph node metastasis

10.21203/rs.3.rs-29257/v1 ◽

2020 ◽

Author(s):

Kai Zhang ◽

Changcheng Tao ◽

Jianxiong Wu ◽

Weiqi Rong

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cox Regression ◽

Rank Test ◽

Seer Database ◽

Survival Curves ◽

Node Metastasis ◽

Log Rank Test

Abstract Background: The presence of lymph node metastases is related to poor survival outcomes in hepatocellular carcinoma patients and because of the reported low probability of lymph node metastasis, research into the prognoses of such patients is difficult to conduct. In this study, we aimed to develop a nomogram model to predict the prognosis of HCC patients with lymph node metastasis and provided a reasonable basis for the choice of follow-up treatment.Methods: HCC patients diagnosed with LN metastasis from 2010 to 2015 were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate Cox regression and lasso regression were used to screen prognostic factors. Cox multiple-factor analysis was employed to investigate the independent prognostic factors for survival. The concordance index (C-index) and calibration curve were used to evaluate the predictive performance of our model. The clinical benefit was assessed via decision curve analysis (DCA). The survival was analyzed using Kaplan-Meier method and the differences among survival curves were compared by the log-rank test.Results: Patients were randomized into the training group (944 patients) and the validation group (402 patients) in a 70:30 ratio. Grade, T stage, surgery to the liver, chemotherapy, radiation recode, AFP, fibrosis score, tumor size group, M stage were selected as independent prognostic factors, and we developed nomograms using these variables. The c-indices of the training and validation groups were 0.70 and 0.73, respectively. The calibration curves for probability of survival showed good agreement. The DCA indicated that the nomogram had positive net benefits. Patients were divided into two risk groups according to our model, survival curves were drawn, and the log-rank test was performed, the p-value of which was <0.001.Conclusions: The nomogram can accurately predict the prognosis of HCC patients with lymph nodes metastasis and provide a reasonable basis for treatment.

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

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155218805539 ◽

2018 ◽

Vol 25 (7) ◽

pp. 1658-1664 ◽

Cited By ~ 3

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.

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Poorly differentiated neuroendocrine carcinoma (NEC G3): Prognostic factors and potential novel targets.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15071 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15071-e15071 ◽

Cited By ~ 2

Author(s):

Maximilian Heetfeld ◽

Atsuko Kasajima ◽

Arend Koch ◽

Francesco Milone ◽

Ingo Steffen ◽

...

Keyword(s):

Prognostic Factors ◽

Cell Size ◽

Cox Regression ◽

Objective Response ◽

Rank Test ◽

First Line ◽

Log Rank Test ◽

Line Therapy ◽

Poorly Differentiated Neuroendocrine Carcinoma ◽

Poorly Differentiated

e15071 Background: Poorly differentiated neuroendocrine carcinomas (NEC G3) represent a subgroup of neuroendocrine neoplasms with aggressive clinical behavior and poor prognosis, but showing quite variable clinical courses. In metastatic disease objective response to first-line therapy with cisplatin/ etoposide ranges between 40-67%, however median duration of response is short (4 to 9 months). There is no established second-line therapy. Methods: Clinical data of 42 patients with gastro-entero-pancreatic NEC G3 were analyzed in retrospect. In 26 cases tissue was analyzed for cell size, expression of p-mTOR and downstream effectors (p-eIF4E and p-4EBP1), somatostatin receptor (SSTR)-subtypes and growth factor receptors (EGFR and IGF-1R). Histopathological findings were analyzed using Kaplan-Meier curve, log rank test and Cox regression. Results: Patients with large cell NEC showed a more favorable survival than patients with small cell NEC. Median overall survival (mOS) was 31 versus 11 months (P=0.034). Expression of p-mTOR and p-eIF4E was seen in 64% and 24% of cases. High expression levels of p-mTOR (mOS 9 vs 25 months, P=0.026) and expression of p-eIF4E (mOS 9 vs 25 months, P=0.015) was significantly associated with shorter survival. In multivariate Cox regression p-mTOR and p-eIF4E proved to be independent prognostic factors for survival taking cell size and TNM staging into account. EGFR (cytoplasmatic and nuclear) and IGF-1R expression was found in 73.1%, 65.4% and 69.2% of the cases respectively, without significant association to survival. Expression of SSTR subtypes, Ki67 value and response to first line chemotherapy was not of prognostic value analyzed by log rank test. Conclusions: The clinical impact of cell size discrimination requires further evaluation in NEC G3. The mTOR pathway seems to play a role in tumor growth in some NEC and may represent a novel therapeutic target.

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Thyroid Dysfunction in Lung Cancer Patients Treated with Immune Checkpoint Inhibitors (ICIs): Outcomes in a Multiethnic Urban Cohort

Cancers ◽

10.3390/cancers13061464 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1464

Author(s):

Angelica D’Aiello ◽

Juan Lin ◽

Rasim Gucalp ◽

Vafa Tabatabaie ◽

Haiying Cheng ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Thyroid Dysfunction ◽

Cox Regression ◽

Clinical Symptoms ◽

Checkpoint Inhibitors ◽

Rank Test ◽

Lung Cancer Patients ◽

Log Rank Test ◽

Treatment Type

We sought to characterize thyroid dysfunction and its association with baseline clinical and demographic characteristics, as well as progression-free survival (PFS), in a multiethnic cohort of lung cancer patients treated with ICIs. A retrospective chart review of lung cancer patients receiving an anti-PD1 or PD-L1 agent was performed. Multivariate Cox proportional hazards were fitted to compare time to thyroid dysfunction among race subgroups controlling for age, gender, treatment type, and duration. Thyroid dysfunction was based on laboratory testing; clinical symptoms were not required. PFS at a 24-week landmark analysis point among patients with and without thyroid dysfunction was compared using a log-rank test. We identified 205 subjects that received ICIs, including 76 (37.1%) who developed thyroid dysfunction. Rates of thyroid dysfunction by one year occurred at similar frequencies among all races (p = 0.92). Gender and concurrent chemotherapy showed no significant association with thyroid dysfunction (p = 0.81 and p = 0.67, respectively). Thyrotoxicosis occurred at higher rates in Black (25, 31.6%) subjects than in White (7, 16.7%) and Hispanic (8, 12.7%) subjects when employing the log-rank test (p = 0.016) and multivariate Cox regression (HR 0.48, p = 0.09 for White and HR 0.36, p = 0.01 for Hispanic compared to Black subjects). PFS was similar among subjects with and without thyroid dysfunction when applying the log-rank test (p = 0.353). Gender, concurrent treatment with chemotherapy, and PFS were not associated with thyroid dysfunction in patients receiving ICIs; however, Black race was a risk factor for thyrotoxicosis. The mechanisms underlying the role of race in the development of irAEs warrant further study.

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Predictive impact of PVL assessments on clinical outcomes in patients undergoing TAVR

European Heart Journal ◽

10.1093/ehjci/ehaa946.2581 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Matsushita ◽

B Marchandot ◽

M Kibler ◽

C Sato ◽

J Heger ◽

...

Keyword(s):

Clinical Outcomes ◽

Cox Regression ◽

Adenosine Diphosphate ◽

Rank Test ◽

Multicenter Studies ◽

Cox Regression Analysis ◽

Paravalvular Leakage ◽

Transcatheter Aortic Valve ◽

Log Rank Test ◽

Cerebrovascular Events

Abstract Introduction Paravalvular leakage (PVL) following transcatheter aortic valve replacement (TAVR) is associated with greater mortality. In clinical practice, determining PVL severity after TAVR remains challenging and often requires multiparametric assessment. Purpose This study sought to evaluate the respective value of various modalities of PVL assessments, including transthoracic echocardiography (TTE), cine-angiography, aortic regurgitation index (ARI), and closure time with adenosine diphosphate (CT-ADP), in the prediction of adverse clinical outcomes. Methods We included 1044 patients from our prospective TAVR registry between February 2010 and May 2019. Major adverse cardiac and cerebrovascular events (MACCE) was defined as a composite of all-cause death, myocardial infarction, stroke, and heart failure hospitalization within 1-year. Established cutoff values of ARI (<25) and CT-ADP (>180 sec) were used to assess the presence of PVL after TAVR. Results Moderate to severe PVL occurred in 14.2% and 5.2% of patients as measured by TTE and angiography. The rate of patients with ARI <25 and CT-ADP >180 sec were 36.5% and 24.9%, respectively. Among the four modalities, PVL evaluated by angiography predicted poorer clinical outcomes (Log rank test; p=0.001), whereas TTE, ARI <25, and CT-ADP >180 sec were not associated with 1-year MACCE. By multivariate Cox regression analysis, moderate to severe PVL by angiography was an independent predictor of 1-year MACCE (hazard ratio: 1.96; 95% confidence interval: 1.22–3.00; p=0.007). Conclusions Paravalvular leakage measured by angiography was evidenced as the most meaningful modality in the prediction of adverse clinical outcomes. Future multicenter studies are warranted to ensure these findings in the current TAVR era. Figure 1 Funding Acknowledgement Type of funding source: None

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Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-020-01579-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

K. P. Thompson ◽

◽

J. Nelson ◽

H. Kim ◽

L. Pawlikowska ◽

...

Keyword(s):

Hereditary Hemorrhagic Telangiectasia ◽

Cox Regression ◽

Clinical Symptoms ◽

Vascular Malformations ◽

Smoking Status ◽

Treatment Options ◽

Gi Bleeding ◽

Cox Regression Analysis ◽

Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

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Survival Outcomes for Induction vs Adjuvant Chemotherapy in Squamous Cell Carcinoma of the Maxillary Sinus

Otolaryngology ◽

10.1177/0194599818804777 ◽

2018 ◽

Vol 160 (4) ◽

pp. 658-663 ◽

Cited By ~ 4

Author(s):

Phoebe Kuo ◽

Sina J. Torabi ◽

Dennis Kraus ◽

Benjamin L. Judson

Keyword(s):

Overall Survival ◽

Adjuvant Chemotherapy ◽

Maxillary Sinus ◽

Induction Chemotherapy ◽

Squamous Cell ◽

Cox Regression ◽

Rank Test ◽

Controlled Clinical Trial ◽

Log Rank Test ◽

Kaplan Meier

Objective In advanced maxillary sinus cancers treated with surgery and radiotherapy, poor local control rates and the potential for organ preservation have prompted interest in the use of systemic therapy. Our objective was to present outcomes for induction compared to adjuvant chemotherapy in the maxillary sinus. Study Design Secondary database analysis. Setting National Cancer Database (NCDB). Subjects and Methods In total, 218 cases of squamous cell maxillary sinus cancer treated with surgery, radiation, and chemotherapy between 2004 and 2012 were identified from the NCDB and stratified into induction chemotherapy and adjuvant chemotherapy cohorts. Univariate Kaplan-Meier analyses were compared by log-rank test, and multivariate Cox regression was performed to evaluate overall survival when adjusting for other prognostic factors. Propensity score matching was also used for further comparison. Results Twenty-three patients received induction chemotherapy (10.6%) and 195 adjuvant chemotherapy (89.4%). The log-rank test comparing induction to adjuvant chemotherapy was not significant ( P = .076). In multivariate Cox regression when adjusting for age, sex, race, comorbidity, grade, insurance, and T/N stage, there was a significant mortality hazard ratio of 2.305 for adjuvant relative to induction chemotherapy (confidence interval, 1.076-4.937; P = .032). Conclusion Induction chemotherapy was associated with improved overall survival in comparison to adjuvant chemotherapy in a relatively small cohort of patients (in whom treatment choice cannot be characterized), suggesting that this question warrants further investigation in a controlled clinical trial before any recommendations are made.

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Tumor Volume Reduction Rate to Induction Chemotherapy Is a Prognostic Factor for Locally Advanced Head and Neck Squamous Cell Carcinoma: a Retrospective Cohort Study

10.21203/rs.3.rs-993291/v1 ◽

2021 ◽

Author(s):

Chi-hsien Huang ◽

Ting-Chun Lin ◽

Ming-Yu Lien ◽

Fu-Ming Cheng ◽

Kai-Chiun Li ◽

...

Keyword(s):

Tumor Volume ◽

Cox Regression ◽

Reduction Rate ◽

Volume Reduction ◽

Cancer Site ◽

Rank Test ◽

Primary Cancer ◽

Cox Regression Analysis ◽

Log Rank Test ◽

Tumor Volume Reduction

Abstract BackgroundAim of this study was to evaluate the prognostic of tumor volume reduction rate (TVRR) status post induction chemotherapy (IC) in LA-HNSCC.MethodsPatients with newly diagnosed LA-HNSCC from year 2007 to 2016 at a single center were included in this retrospective study. All patients had received IC as TPF (taxotere, platinum, fluorouracil) followed by daily definitive intensity-modulated radiotherapy (IMRT) for 70 Gy in 35 fractions concurrent with or without cisplatin-based chemotherapy. Tumor volume reduction rate of the primary tumor (TVRR-T) and lymph node (TVRR-N) was measured and calculated by contrast-enhanced CT images at diagnosis, and one month after final IC cycle, and analyzed though a univariate and multivariate Cox regression model.ResultsNinety patients of the primary cancer sites at hypopharynx (31/90, 34.4%), oropharynx (29/90, 32.2%), oral cavity (19/90, 21.1%) and larynx (11/90, 12.2%) were included in this study, with a median follow-up time interval of 3.9 years. In univariate Cox regression analysis, the TVRR-T as the only variable showed a significant difference for disease-free survival (DFS) (hazard ratio [HR] 0.77, 95% confidence interval (CI) 0.63 to 0.96; P = 0.02), aside from cancer site, RECIST, age and IC dose. In multivariate Cox regression analysis, The TVRR-T was also an independently significant prognostic factor for DFS (HR 0.77, 95% CI 0.62 to 0.97; P = 0.02). At a cutoff value using TVRR-T of 50% in Kaplan-Meier survival analysis, the DFS was significant higher with TVRR-T ≥ 50% group (log-rank test, p = 0.024), and also a trend of improved OS. (log-rank test, p = 0.069).ConclusionsTVRR-T was related to improved DFS and trend of improved OS. Other factors including patient’s age at diagnosis, the primary cancer site, and RECIST, were not significantly related to DFS.

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