Cisplatin-Based versus Carboplatin-Based Chemotherapy for Extra-Pulmonary Neuroendocrine Carcinomas; A Real-World Study.

2021 ◽  
Author(s):  
Omar Abdel-Rahman ◽  
Sheryl L. Koski
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Cox Regression ◽  
Survival Outcomes ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Platinum Agent ◽  
Extra Pulmonary ◽  
The Impact ◽  
Neuroendocrine Carcinomas

Objective: To assess the survival differences between cisplatin/etoposide versus carboplatin/etoposide chemotherapy regimens in the management of extra-pulmonary neuroendocrine carcinomas (NECs). Methods: Administrative cancer care databases in the province of Alberta, Canada were reviewed, and patients with extra-pulmonary NECs (including those with small cell and large cell neuroendocrine carcinomas) who were treated with either cisplatin/ etoposide or carboplatin/ etoposide, 2004-2019, were reviewed. Kaplan-Meier survival estimates were used to compare the survival outcomes according to the type of platinum agent, and multivariable Cox regression analysis was used to assess the impact of the type of platinum agent on overall survival outcomes. Results: A total of 263 eligible patients were included in this analysis. These include 176 patients who received cisplatin/ etoposide and 87 patients who received carboplatin/etoposide. Using Kaplan-Meier survival estimates, patients treated with cisplatin have better overall survival compared to patients treated with carboplatin (P=0.005). Multivariable Cox regression analysis suggested that the following factors were associated with worse overall survival: higher Charlson comorbidity index (HR: 1.17; 95% CI: 1.05-1.30), gastrointestinal primary site (HR: 1.55; 95% CI: 1.12-2.14), stage IV disease (HR: 1.75; 95% CI: 1.28-2.38) and use of carboplatin (HR: 1.40; 95% CI: 1.02-1.92). Conclusions: The current study suggested that cisplatin/etoposide might be associated with better overall survival compared to carboplatin/etoposide among patients with extra-pulmonary NECs. It is unclear if this is related to differences in inherent responsiveness to the two platinum agents, or due to differences in comorbidity burden between the two treatment groups.

scholarly journals Outcomes of Patients With Advanced Gastrointestinal Cancer in Relationship to Opioid Use: Findings From Eight Clinical Trials

2020 ◽  
Vol 18 (5) ◽  
pp. 575-581
Author(s):  
Omar Abdel-Rahman ◽  
Hatim Karachiwala ◽  
Jacob C. Easaw
Keyword(s):  
Clinical Trials ◽  
Regression Analysis ◽  
Cox Regression ◽  
Survival Outcomes ◽  
Disease Entity ◽  
Gastrointestinal Cancers ◽  
Opioid Use ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
The Impact

Background: This study assessed the patterns of opioid use among patients with advanced gastrointestinal cancers who were included in 8 clinical trials and evaluated the impact of opioid use on survival outcomes of included patients. Methods: Deidentified datasets from 8 clinical trials evaluating first-line systemic treatment of advanced gastrointestinal cancers were accessed from the Project Data Sphere platform (ClinicalTrial.gov identifiers: NCT01124786, NCT00844649, NCT00290966, NCT00678535, NCT00699374, NCT00272051, NCT00305188, and NCT00384176). These trials evaluated patients with pancreatic carcinoma, gastric carcinoma, hepatocellular carcinoma (HCC), and colorectal carcinoma. Multivariable logistic regression analysis was used to evaluate factors predicting the use of opioids. Kaplan-Meier survival estimates were used to compare survival outcomes in each disease entity among patients who did or did not receive opioid treatment. Multivariable Cox regression analysis was then used to further assess the impact of opioid use on survival outcomes in each disease entity. Results: A total of 3,441 participants were included in the current analysis. The following factors predicted a higher probability of opioid use within logistic regression analysis: younger age at diagnosis (odds ratio [OR], 0.990; 95% CI, 0.984–0.997; P=.004), nonwhite race (OR for white vs nonwhite, 0.749; 95% CI, 0.600–0.933; P=.010), higher ECOG score (OR for 1 vs 0, 1.751; 95% CI, 1.490–2.058; P<.001), and pancreatic primary site (OR for colorectal vs pancreatic, 0.241; 95% CI, 0.198–0.295; P<.001). Use of opioids was consistently associated with worse overall survival (OS) in Kaplan-Meier survival estimates of each disease entity (P=.008 for pancreatic cancer; P<.001 for gastric cancer, HCC, and colorectal cancer). In multivariable Cox regression analysis, opioid use was associated with worse OS among patients with pancreatic cancer (hazard ratio [HR], 1.245; 95% CI, 1.063–1.459; P=.007), gastric cancer (HR, 1.725; 95% CI, 1.403–2.122; P<.001), HCC (HR, 1.841; 95% CI, 1.480–2.290; P<.001), and colorectal cancer (HR, 1.651; 95% CI, 1.380–1.975; P<.001). Conclusions: Study findings suggest that opioid use is consistently associated with worse OS among patients with different gastrointestinal cancers. Further studies are needed to understand the underlying mechanisms of this observation and its potential implications.

Outcomes of advanced gastrointestinal (GI) cancer patients in relationship to opioid use: An individual patient data pooled analysis from eight clinical trials.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 687-687
Author(s):  
Omar Abdel-Rahman ◽  
Hatim Karachiwala ◽  
Jacob C. Easaw
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Regression Analysis ◽  
Cox Regression ◽  
Survival Outcomes ◽  
Disease Entity ◽  
Opioid Use ◽  
Cox Regression Analysis ◽  
Gi Cancers ◽  
The Impact

687 Background: The current study aims at assessing the patterns of opioid use, and evaluating the impact of opioid use on survival outcomes among patients with advanced GI cancers who were included in eight clinical trials. Methods: De-identified datasets of eight clinical trials evaluating first-line systemic treatment for advanced GI cancers (NCT01124786; NCT00844649; NCT00290966; NCT00678535; NCT00699374; NCT00272051; NCT00305188; NCT00384176) were accessed from the Project Data Sphere platform. These trials evaluated patients with pancreatic, gastric, hepatocellular and colorectal carcinoma. Multivariable logistic regression analysis was used to evaluate factors predicting the use of opioids. Kaplan-Meier survival estimates were used to compare survival outcomes in each disease entity among patients who did or did not receive opioid treatment. Multivariable Cox regression analysis was used to assess the impact of opioid use on survival outcomes in each disease entity. Results: A total of 3441 participants were included in the current analysis. The following factors predicted a higher probability of opioid use within logistic regression analysis: younger age (P = 0.004), non-white race (P = 0.010), higher ECOG score (P < 0.001) and pancreatic primary site (P < 0.001). Use of opioids was consistently associated with worse overall survival in Kaplan-Meier survival estimates of each disease entity (for pancreatic cancer: P = 0.008; for gastric cancer: P < 0.001; for hepatocellular carcinoma: P < 0.001 and for colorectal cancer: P < 0.001). Within multivariable Cox regression analysis, opioid use was associated with worse overall survival among patients with pancreatic cancer (HR = 1.245; 95% CI: 1.063-1.459; P = 0.007), gastric cancer (HR = 1.725; 95% CI: 1.403-2.122; P < 0.001), hepatocellular carcinoma (HR = 1.841; 95 CI: 1.480-2.290; P < 0.001) and colorectal cancer (HR = 1.651; 95% CI: 1.380-1.975; P < 0.001). Conclusions: Opioid use is consistently associated with worse overall survival among patients with different GI cancers. Further studies are needed to evaluate the underlying mechanisms of this observation.

scholarly journals Distant Survival for Patients Undergoing Surgery Using Volatile versus IV Anesthesia for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:A Retrospective study.

2020 ◽  
Author(s):  
Xiao-Yan Meng ◽  
Xiu-Ping Zhang ◽  
Hong-Qian Wang ◽  
Weifeng Yu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Portal Vein ◽  
Cox Regression ◽  
Cancer Recurrence ◽  
Survival Outcomes ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Underlying Causes ◽  
The Impact

Abstract Background Whether anesthesia type is associate with the surgical outcome of Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) remains to be determined. This study aims to investigate the impact of volatile inhalational anesthesia (INHA) versus total IV anesthesia (TIVA) on the survival outcomes in HCC patients with PVTT. Methods A cohort of in-patients whom were diagnosed of HCC with PVTT in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012 were identified. Surgical patients receiving the INHA and TIVA were screened out. The overall survival (OS), recurrence-free survival (RFS) and several postoperative adverse events were compared according to anesthesia types. Results A total of 1513 patients were included in this study. After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA have a lower 5-year overall survival rate than that of patients receiving TIVA [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P=0.024]. Results of multivariable Cox-regression analysis also identify that INHA anesthesia is significantly associated with mortality and cancer recurrence after surgery compare to TIVA, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant. Conclusion This retrospective analysis identifies that TIVA has better survival outcomes compare to INHA in HCC patients with PVTT. Future prospective researches are urgent to verify this difference and figure out underlying causes of it.

Impact of cytoreductive surgery on outcomes of metastatic appendiceal carcinoma: a real-world, population-based study

2020 ◽  
Vol 9 (6) ◽  
pp. 431-439
Author(s):  
Omar Abdel-Rahman
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Metastatic Disease ◽  
Cytoreductive Surgery ◽  
Mucinous Adenocarcinoma ◽  
Cox Regression ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Appendiceal Carcinoma

Aim: To evaluate the impact of cytoreductive surgery on the outcomes of patients with metastatic appendiceal carcinoma. Methods: Surveillance, Epidemiology and End Results (SEER) database was accessed and patients with metastatic appendiceal carcinoma diagnosed (2010–2015) were reviewed. Kaplan–Meier survival estimates/log-rank testing were then used to assess overall survival outcomes according to cytoreductive surgery. Multivariable Cox regression analysis was then used to evaluate factors affecting cancer-specific survival. Factors included in this model were age, race, sex, stage and histology and cytoreductive surgery. Results: A total of 1339 patients with metastatic appendiceal carcinoma were included in the current study. Using Kaplan–Meier survival estimates to evaluate overall survival, patients with surgery for metastatic disease have better overall survival compared with patients without surgery for metastatic disease (p < 0.001). Stratifying survival analysis according to histology, the overall survival benefit from surgery for the metastases seems to be limited to patients with mucinous adenocarcinoma (p = 0.002) rather than patients with nonmucinous adenocarcinoma (p = 0.401). Multivariable Cox regression analysis was then conducted to evaluate factors predicting cancer-specific survival. The following factors were associated with worse cancer-specific survival: African-American race (hazard ratio [HR]: 1.356; 95% CI: 1.036–1.774; p = 0.026), more advanced stage (HR: 3.910; 95% CI: 2.735–5.588; p < 0.001), nonmucinous adenocarcinoma (HR for signet ring carcinoma vs mucinous adenocarcinoma: 2.119; 95% CI: 1.674–2.683; p < 0.001) and no surgical resection of metastatic disease (HR: 1.273; 95% CI: 1.067–1.519; p < 0.001). Conclusion: The current study suggests that among patients with metastatic appendiceal carcinoma, surgical cytoreduction of metastatic disease is associated with improved outcomes for patients with mucinous adenocarcinoma but not in patients with nonmucinous adenocarcinoma.

scholarly journals Multiplex Immunoassay of Cytokines for The Short-Term Prognosis Predictive Value of Patients With Acute-on-Chronic Liver Failure

2021 ◽  
Author(s):  
Yongyuan Zheng ◽  
Genglin Zhang ◽  
Lina Wu ◽  
Jing Xiong ◽  
Lu Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Hepatitis B ◽  
Cox Regression ◽  
Curve Analysis ◽  
Chronic Liver Failure ◽  
Roc Curve Analysis ◽  
Cox Regression Analysis ◽  
Multiplex Immunoassay ◽  
Kaplan Meier

Abstract Background: Since the systemic inflammation has been found to be associated with disease progression and mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF), the objective of this study was to detect inflammatory factors in ACLF patients by a Luminex-based multiplex immunoassay system for high throughput screening of the cytokine with the most prognostic value.Methods: Luminex-based multiplex immunoassay technology was used to determine the concentrations of 48 cytokines in total at once in serum samples from 40 patients with HBV-ACLF, 30 patients with chronic hepatitis B (CHB) and 25 healthy volunteers as normal controls (NC). Then, the receiver operating characteristic (ROC) curve analysis was applied to evaluate the prognostic prediction accuracy. Besides, Kaplan–Meier curves was used to analyze survival, while the Cox regression analysis to determine the mortality predictors.Results: The level of IL-6, IL-10, IL-15, IL-18, M-CSF, IP-10 and CXCL9 were significantly higher in patients with HBV-ACLF than in either patients with CHB or NC subjects, while the level of EGF, PDGF-AA, PDGF-AB/BB, MDC and sCD40L were significantly lower. The concentrations of IL-6, CXCL9, and IL-15 was higher in non-surviving patients with HBV-ACLF than in surviving patients while MDC was lower. Increased serum IL-6 was positively correlated with disease severity. The ROC curve analysis showed that IL-6 and CXCL-9 accurately predicted 90-day survival in patients with HBV-ACLF, with an accuracy equivalent to those of the Model for End-Stage Liver Disease (MELD), MELD-Na. Kaplan–Meier analysis showed an association between the increase in serum concentration of IL-6 as well as CXCL9 and poor overall survival in patients with HBV-ACLF. Moreover, the multivariate Cox regression analysis showed that only serum IL-6 was an independent predictor of overall survival in patients with HBV-ACLF.Conclusion: Although HBV-related ACLF patients have significantly increased serum levels of multiple cytokines, only serum IL-6 levels could be an independent prognostic biomarker in patients with HBV-ACLF.

scholarly journals Identification of a Seven-Gene Signature and Establishment of a Nomogram Predicting Overall Survival in Head and Neck Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Haige Zheng ◽  
Xiangkun Wu ◽  
Huixian Liu ◽  
Yumin Lu ◽  
Hengguo Li
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
High Risk ◽  
Cell Carcinoma ◽  
Cox Regression ◽  
Risk Groups ◽  
Gene Signature ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Abstract Background: Head and neck squamous cell carcinoma (HNSCC) is a highly heterogeneous tumor with high incidence and poor prognosis. Therefore, effective predictive models are needed to evaluate patient outcomes and optimize treatment. Methods: Ten gene microarray datasets were obtained from the gene expression omnibus (GEO) database. Level 3 mRNA expression and clinical data were obtained in The Cancer Genome Atlas (TCGA) database. We identified highly robust differentially-expressed genes (DEGs) between HNSCC and normal tissue in nine GEO and TCGA datasets using Robust Rank Aggregation (RRA) method. Univariate Cox regression analysis and lasso Cox regression analysis were performed to identify DEGs related to the Overall-survival (OS) and to construct a prognostic gene signature. External validation was performed using GSE65858. Moreover, gene set enrichment analyses (GSEA) analysis was used to analyze significantly rich pathways in high-risk and low-risk groups, and tumor immunoassays were used to clarify immune correlation of the prognostic gene. Finally, integrate multiple forecast indicators were used to build a nomogram using the TCGA-HNSCC dataset. Kaplan–Meier analysis, receiver operating characteristic (ROC), a calibration plot, Harrell’s concordance index (C-index), and decision curve analysis (DCA) were used to test the predictive capability of the seven genetic signals and the nomogram. Results: A novel seven-gene signature (including SLURP1, SCARA5, CLDN10, MYH11, CXCL13, HLF, and ITGA3) was established to predict overall survival in HNSCC patients. ROC curve performed well in the training and validation data sets. Kaplan–Meier analysis demonstrated that low-risk groups had a longer survival time. The nomogram containing seven genetic markers and clinical prognostic factors was a good predictor of HNSCC survival and showed a certain net clinical benefit through the DCA curve. Further research demonstrated that the infiltration degree of CD8 + T cells, B cells, neutrophils, and NK cells were significantly lower in the high-risk group.Conclusion: Our analysis established a seven-gene model and nomogram to accurately predict the prognosis status of HNSCC patients, immune relevance was also described, which may provide a new possibility for individual treatment and medical decision-making.

scholarly journals Impact of Body Mass Index on Survival Outcome in Patients with Newly Diagnosed Glioblastoma: A Retrospective Single-Center Study

2021 ◽  
Vol 20 ◽  
pp. 153473542199123
Author(s):  
Jun-Yong Cha ◽  
Jae-Sung Park ◽  
Yong-Kil Hong ◽  
Sin-Soo Jeun ◽  
Stephen Ahn
Keyword(s):  
Cox Regression ◽  
Survival Outcomes ◽  
Newly Diagnosed ◽  
Eligibility Criteria ◽  
Cox Regression Analysis ◽  
Asian Populations ◽  
Kaplan Meier ◽  
Single Center Study ◽  
Newly Diagnosed Glioblastoma ◽  
The Impact

Introduction: The impact of obesity on survival outcomes in patients with glioblastoma (GBM) has not been well reported and the results for patients are currently unclear. We investigated the effect of obesity on survival outcomes in patients with newly diagnosed GBM. Methods: Using electronic medical records, all GBM patients that visited the Seoul St. Mary’s Hospital between 2008 and 2018 were reviewed. A total of 177 patients met our eligibility criteria. The cut-off point for BMI was 23.0 kg/m2 based on previous studies which focused on Asian populations. Results: A total of 177 patients met our eligibility criteria. The overall median BMI of patients was 24.5 kg/m2 (range 15.82-39.26). About 62 patients who had a BMI less than the cut-off value were assigned to the “lower BMI” group, while 115 patients who had a BMI greater than the cut-off value were assigned to the “higher BMI” group. In Kaplan-Meier survival analysis, the median OS of the higher BMI group was longer than that of the lower BMI group (21.3 months vs 15.3 months, P = .002). In multivariate Cox regression analysis for OS, lower BMI was associated with inferior OS (HR 1.48 CI 1.06-2.08, P = .002). Conclusion: Our findings suggest that elevated BMI may be associated with better survival in patients with newly diagnosed GBM. Additional larger prospective studies could help validate our findings to confirm the effect of body composition and survival outcomes in GBM patients.

scholarly journals Development and Validation of a Robust Ferroptosis-Related Prognostic Signature to Predict Overall Survival in Clear Cell Renal Cell Carcinoma

2021 ◽  
Author(s):  
Yen-ting Lin ◽  
Can-Xuan Li ◽  
Jie Chen
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Roc Curve ◽  
Prognostic Value ◽  
Cox Regression ◽  
Expression Patterns ◽  
The Cancer Genome Atlas ◽  
Entire Group ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Abstract Background: Ferroptosis is a novel defined type of programmed cell death (PCD) with widespread functions involved in physical conditions or multiple diseases including malignancies. However, the relationship between ccRCC and ferroptosis-related regulators remains poorly known. Herein, we investigate the prognostic values and potential mechanisms of ferroptosis-related genes (FRGs) in ccRCC.Methods: Ferroptosis-related genes were obtained from FerrDb database, GeneCards database and previously published literatures. The gene expression profile of ferroptosis-related regulators and corresponding clinicopathological information were downloaded from The Cancer Genome Atlas (TCGA). Differentially expressed ferroptosis-related genes (DE-FRGs) were screened between ccRCC specimens and noncancerous specimens. Among these genes, prognostic DE-FRGs were identified using univariate COX analysis and LASSO regression analysis. Further multivariate COX regression was employed to identify prognosis-related hub DE-FRGs and establish a prognostic model. Results: We identified seven hub genes (HMGCR, MT1G, BID, EIF4A1, FOXM1, TFAP2C and CHAC1) from the DE-FRGs using univariate Cox regression analysis, LASSO and multivariate Cox regression analysis, and used them to establish a novel clinical predictive model in the TCGA train cohort (n = 374). Subsequently, we assessed the prognostic value of the model. Survival analysis showed that high-risk patients had a reduced overall survival (OS), the time-dependent receiver operating characteristic (ROC) curve analysis confirmed the signature's diagnostic performance. Additionally, multivariate Cox regression analysis suggested that the risk score was an independent prognostic factor. Additionally, we verified the prognostic performance of the risk model in the testing cohort (n=156), and the entire group (n=530) using Kaplan-Meier curve and ROC curve analyses. Functional analysis indicated that several carcinogenic pathways were enriched, and tumor-infiltrating immune cell abundances, and the expression levels of immunosuppressive molecules were different between two risk groups. Finally, external databases (ONCMINE, GEPIA, HPA, Kaplan-Meier plotter and cbioportal) were used to confirm the expression patterns, prognostic value, and genetic mutations of 7 hub FRGs in ccRCC.Conclusions: Collectively, we successfully constructed a novel ferroptosis-related risk signature that was significantly associated with the prognosis of ccRCC.

scholarly journals High expression of junctional adhesion molecule-A is associated with poor survival in patients with epithelial ovarian cancer

2019 ◽  
Vol 34 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Boljevic Ivana ◽  
Malisic Emina ◽  
Milovic-Kovacevic Marijana ◽  
Jovanic Irena ◽  
Bukumiric Zoran ◽  
...  
Keyword(s):  
Gene Expression ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Regression Analysis ◽  
Epithelial Ovarian Cancer ◽  
Adhesion Molecule ◽  
Cox Regression ◽  
Figo Stage ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Purpose: Aberrant expression of different tight junction proteins, including the junctional adhesion molecule-A (JAM-A), has been frequently reported in association with tumor progression of several malignancies. To our knowledge, this is the first study examining the clinical significance of JAM-A gene expression in epithelial ovarian cancer. Methods: JAM-A expression levels in 44 epithelial ovarian cancer and 12 benign formalin-fixed paraffin-embedded samples were determined by reverse transcription quantitative polymerase chain reaction. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic and prognostic potential of JAM-A. Associations between JAM-A expression and clinicopathological characteristics of epithelial ovarian cancer were analyzed using Fisher’s exact test. The Kaplan–Meier method and univariate Cox regression analysis were used for the survival analysis. P ⩽ 0.05 was considered statistically significant. Results: ROC curve analyses showed that JAM-A gene expression exhibits both diagnostic and prognostic performance in epithelial ovarian cancer (area under the curve (AUC) 0.640, 95% confidence interval (CI) 0.488, 0.792, sensitivity 43.18%, specificity 100% and AUC 0.621, 95% CI 0.427, 0.816, sensitivity 52.63%, specificity 85%, respectively). JAM-A expression was significantly associated with International Federation of Gynecologists and Obstetricians (FIGO) stage ( P =0.049) and the Kaplan–Meier method demonstrated that patients with high expression of JAM-A had significantly worse overall survival compared to patients with low JAM-A expression ( P =0.004). Moreover, univariate Cox regression analysis showed that FIGO stage, peritoneal metastasis, residual tumor and JAM-A expression were significantly associated with reduced overall survival in epithelial ovarian cancer. Conclusions: Our results indicate that high levels of JAM-A expression are associated with an advanced clinicopathological feature and may have diagnostic potential; also, it could be a predictor of poor overall survival in patients with epithelial ovarian cancer.

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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