Comparison of Open and Endoscopic Approaches in the Resection of Esthesioneuroblastoma

2020 ◽  
pp. 000348942093958
Author(s):  
Gregory L. Barinsky ◽  
Monica C. Azmy ◽  
Suat Kilic ◽  
Jordon G. Grube ◽  
Soly Baredes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endoscopic Surgery ◽  
Olfactory Neuroblastoma ◽  
Endoscopic Approach ◽  
Surgical Approaches ◽  
Open Approach ◽  
Chi Square ◽  
Kaplan Meier ◽  
Open Versus ◽  
Chi Square Analysis

Background: Olfactory neuroblastoma, or esthesioneuroblastoma (ENB), is an uncommon sinonasal malignancy arising from olfactory neuroepithelium that is optimally treated with surgical resection. The objective of this study is to determine preoperative predictors of undergoing open versus endoscopic approach for ENB and to investigate significant postoperative survival outcomes between the two surgical approaches. Methods: The National Cancer Database (NCDB) was queried for cases of ENB histology that were treated surgically from 2010 to 2015. Groups were stratified into open or endoscopic approach cohorts. Patient demographics, tumor characteristics, treatment modality, and 5-year overall survival were compared between the two groups using Chi-Square analysis and Kaplan-Meier survival analysis. Cases were classified as Kadish stage A, B, C, or D based on the “Collaborative Stage-Extension” codes in NCDB. Results: Of 533 patients meeting inclusion criteria, 276 (51.8%) patients underwent open, and 257 (48.2%) patients underwent endoscopic surgical approaches. Patients undergoing endoscopic surgery were more likely to be Kadish stages A and B and less likely to be stages C and D ( P = .020). Those undergoing endoscopic approach overall had a shorter mean hospital stay postoperatively (3.8 vs. 7.0 days, P < .001). Endoscopic cases had a greater 5-year overall survival (81.9% vs. 75.6%, P = .030); after multivariate regression, there was a trend toward survival benefit to endoscopic surgery that did not reach clinical significance (HR 0.644, [0.392-1.058], P = .083). Conclusion: Although not statistically significant, there is a trend toward increased overall survival with an endoscopic approach in patients undergoing surgery for ENB as compared to an open approach, regardless of Kadish stage. An endoscopic approach is an adequate alternative to an open approach for the surgical treatment of ENB.

scholarly journals Gastric Cancer Treatments and Survival Trends in the United States

2020 ◽  
Vol 28 (1) ◽  
pp. 138-151
Author(s):  
Kelly A. Stahl ◽  
Elizabeth J. Olecki ◽  
Matthew E. Dixon ◽  
June S. Peng ◽  
Madeline B. Torres ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Stage Iv ◽  
The United States ◽  
Current Treatment ◽  
Stage I ◽  
Stage Ii ◽  
Chi Square ◽  
Specific Guideline ◽  
Kaplan Meier

Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease.

Correlation of lymphovascular invasion and staging in patients undergoing lymphatic mapping for colon cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 498-498
Author(s):  
Alpesh K. Korant ◽  
Vikrom K. Dhar ◽  
Gregory Johnston ◽  
Supriya Kumar Saha ◽  
Mohammed Shaik ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Prognostic Factors ◽  
Lymphovascular Invasion ◽  
Sentinel Lymph Node Mapping ◽  
Categorical Variables ◽  
P Value ◽  
Chi Square ◽  
Lymph Node Mapping ◽  
Kaplan Meier ◽  
Chi Square Analysis

498 Background: Lymphovascular invasion (LVI) is known as a negative prognostic factor in colon cancer (CCa) patients (pts). Sentinel lymph node mapping (SLNM) is known to upstage more pts than conventional surgery. A retrospective study was undertaken to determine the relationship between LVI and other known prognostic factors in CCa pts undergoing SLNM. Methods: Pts with CCa underwent SLNM. Data was collected for tumor (T) and node (N) stage, distant metastasis (M), size, grade, recurrence, and 5-year overall survival (5yrOS). Chi-square analysis was used to calculate the association between categorical variables with a p value of 0.05 as significant. Kaplan-Meier method was used to calculate 5yrOS. Results: We studied 310 CCa pts undergoing SLNM. Success rate was 100%. Nodal positivity was 46%. LVI was present in 34% of pts overall, in 66% node +ve pts versus only 7% in node -ve pts (p<0.001). Pts with LVI were proportionately of higher grade, larger size, higher T-stage, node +ve and higher AJCC stage. Pts with LVI had significantly higher recurrence and lower 5yrOS (Table). Conclusions: Presence of LVI positively correlated with all known prognostic factors in CCa pts undergoing SLNM, with higher recurrence and significantly lower 5yrOS. [Table: see text]

Endoscopic Approach for Pituitary Surgery Improves Rhinologic Outcomes

2009 ◽  
Vol 118 (9) ◽  
pp. 630-635 ◽  
Author(s):  
Scott M. Graham ◽  
Tim A. Iseli ◽  
Lucy H. Karnell ◽  
John D. Clinger ◽  
Patrick W. Hitchon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Endoscopic Surgery ◽  
Open Surgery ◽  
Pituitary Surgery ◽  
Endoscopic Approach ◽  
Open Group ◽  
Open Approach ◽  
Endoscopic Procedures ◽  
The Mean

Objectives: We hypothesized that the endoscopic approach to pituitary surgery improves rhinology-specific quality of life and has satisfactory tumor outcomes compared with the open approach. Methods: Cases of pituitary surgery from the Department of Neurosurgery database included an inception cohort of all patients who had endoscopic procedures and consecutive patients who had open procedures between January 1998 and February 2008. The Sino-Nasal Outcome Test-22 was mailed. Results: Since January 1998, 71 endoscopic and 122 open pituitary surgeries had been performed. The mean follow-up was longer for open procedures (49.3 months) than for endoscopic procedures (18.8 months). Recurrence was more common after open surgery (28.4%) than after endoscopic surgery (18.2%; p = 0.219). The most common diagnosis was macroadenoma (77.1% of endoscopic procedures and 93.4% of open procedures). The mean hospital stay was shorter for endoscopic procedures (4.1 days) than for open procedures (6.0 days; p < 0.001). Of patients who presented with visual deterioration, 53.8% with endoscopic surgery and 46.7% with open surgery had improvement. Among patients with normal preoperative hormonal function, 27.5% of patients in the endoscopy group and 29.4% of patients in the open group required medication for more than 2 months after surgery. Complications occurred in 33.3% of endoscopic procedures and 43.4% of open procedures. Cerebrospinal fluid leaks were more common in the endoscopy group (p = 0.035), and diabetes insipidus lasting more than 30 days was more common in the open group (p = 0.017). The mean Sino-Nasal Outcome Test-22 score was lower for patients in the endoscopy group (20.4) than for those in the open group (23.2; p = 0.41). Patients in the endoscopy group had a significantly lower rhinology-specific mean score (6.5) than did patients in the open group (9.2; p = 0.03). Conclusions: The endoscopic approach to pituitary surgery offers tumor outcomes comparable to those of open surgery, with no greater incidence of complications and an improved rhinology-specific quality of life.

scholarly journals Surgical Treatment of Olfactory Neuroblastoma: Major Complication Rates, Progression Free and Overall Survival

2017 ◽  
Vol 79 (02) ◽  
pp. 151-155 ◽  
Author(s):  
Aileen Wertz ◽  
Todd Hollon ◽  
Lawrence Marentette ◽  
Stephen Sullivan ◽  
Jonathan McHugh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Major Complication ◽  
Olfactory Neuroblastoma ◽  
Csf Leak ◽  
Complication Rates ◽  
Care Hospital ◽  
Open Approach ◽  
Major Complications ◽  
Grading Systems ◽  
Significant Difference

Objective We aimed to compare major complication rates in patients undergoing open versus endoscopic resection of olfactory neuroblastoma (ONB) and to determine the prognostic utility of the Kadish staging and Hyams grading systems with respect to progression-free survival (PFS) and overall survival (OS). Methods It is a retrospective review of experience in treating ONB at a single tertiary care hospital from 1987 through 2015. Major complications were defined as cerebrospinal fluid (CSF) leak, meningitis, osteomyelitis, tracheostomy, and severe neurologic injury. Results Forty-one patients were included. An open approach was used in 34 (83%), endoscopic in 6 (15%), and combined in 1 (2%) case. Rates of major complications by surgical approach were 17% after endoscopic versus 31% after open (p = 0.65). There was no significant difference in PFS or OS based on Kadish B versus C (PFS, p = 0.28; OS, p = 0.11) or Hyams grade 1 and 2 versus Hyams grade 3 and 4 (PFS, p = 0.53; OS, p = 0.38). Conclusions There was no significant difference in major complications between open and endoscopic approaches for the treatment of ONB. Patient stratification using the Kadish staging and Hyams grading systems did not show significant differences in PFS or OS. Further research is needed to determine if a different staging system would better predict patient outcomes.

scholarly journals MicroRNA-124 alone might represent an indicator signifying cholangiocarcinoma prognosis

2020 ◽  
Author(s):  
Ning Wang ◽  
Yanni Li ◽  
Yanfang Zheng ◽  
Huoming Chen ◽  
Xiaolong Wen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cox Regression ◽  
Prognostic Biomarker ◽  
Prognostic Indicator ◽  
Rank Test ◽  
Chi Square ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
Polymerase Chain

Abstract Background: Previous studies have demonstrated that microRNAs (miRNAs) played a crucial role in various diseases, including cancers. The aim of the study was to evaluate the clinical significance of miR-124 in patients with cholangiocarcinoma (CCA).Methods: The expression pattern of miR-124 was detected in CCA tissues using quantitative reserve transcription polymerase chain reaction (qRT-PCR). The correlation of miR-124 expression with clinicopathological features and overall survival of patients were explored using chi-square test, Kaplan-Meier methods and Cox regression analyses.Results: The miR-124 expression level was strong down-regulated in CCA tissues compared with normal para-cancerous tissues (P<0.001). Moreover, aberrant miR-124 expression was significantly associated with differentiation (P=0.045) and lymph node metastasis (P=0.040). In addition, Kaplan-Meier method and log-rank test revealed that patients with low miR-124 expression has a poorer overall survival compared with those with high miR-124 expression (P=0.002). Furthermore, multivariate analysis confirmed that miR-124 expression (P=0.006; HR=2.006; 95%CI: 1.224-3.289) was an independent prognostic indicator in CCA.Conclusions: Collectively, our results defined miR-124 expression plays important roles in CCA patients. MiR-124 expression might used as a valuable prognostic biomarker for patients with CCA.

A novel preoperative inflammatory marker prognostic score in patients with clear cell and non-clear cell renal cell carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 530-530
Author(s):  
Rishi Robert Sekar ◽  
Dattatraya Patil ◽  
Jeff Pearl ◽  
Yoram Baum ◽  
Omer Kucuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Medical Decision ◽  
Chi Square ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cell Rcc ◽  
Chi Square Analysis

530 Background: Several inflammatory markers have been studied as potential biomarkers in clear cell renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies. We hypothesize that a combination of preoperative C-Reactive Protein (CRP), albumin, Erythrocyte Sedimentation Rate (ESR), corrected calcium, and AST/ALT ratio into a RCC Inflammatory Score (RISC) could serve as a rigorous prognostic indicator in patients with clear cell and non-clear cell RCC. Methods: Patients that underwent nephrectomy for localized RCC were queried from our nephrectomy database. The optimal threshold for individual biomarkers was determined using grid search methodology, receiver operating characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. The final score, RISC, was the sum of points accrued from each biomarker (Table). ROC and chi-square analysis was performed to compare the prognostic ability of RISC to SSIGN and UISS. Impact on overall survival was analyzed with multivariate logistic regression analysis. Results: 391 patients were included in the study. Area under the curve (AUC) for RISC, SSIGN, and UISS was 0.78, 0.78, and 0.81, respectively. Chi-square analysis of AUCs revealed no statistically significant difference between RISC, SSIGN, and UISS (p= 0.820, and p =0.317, respectively). On multivariate analysis, after adjusting for confounding variables, each unit increase in RISC was associated with a 32% increase in mortality (HR=1.32, 95%CI 1.17-1.49, p<0.001). Conclusions: RISC is an independent and significant predictor of overall survival in clear cell and non-clear cell RCC with accuracy at least as good as other established prognostic tools. Notably, RISC is composed of standardized preoperative laboratory markers, allowing crucial prognostic information to be integrated into medical decision making prior to surgery. [Table: see text]

scholarly journals The relationship between RECK Gene Polymorphisms and the prognosis of cholangiocarcinoma

2020 ◽  
Author(s):  
Ning Wang ◽  
Yanni Li ◽  
Yanfang Zheng ◽  
Huoming Chen ◽  
Xiaolong Wen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Overall Survival Rate ◽  
Chi Square ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
The Relationship

Abstract Background The study was designed to examine the reversion inducing cysteine rich protein with Kazal motifs (RECK) levels in patients with cholangiocarcinoma (CCA) and assess its role in CCA prognosis. Methods Quantitative real-time PCR (qRT-PCR) was used to determine the expression of RECK mRNA in 127 pairs of CCA samples and controls. Chi-square test was conducted to analyze the effects of clinical features on RECK expression. Kaplan-Meier curves were plotted to determine the overall survival rate of CCA patients with different RECK expression. The prognostic biomarkers for CCA patients were identified using the Cox regression analysis. Results Significantly down-regulated expression of RECK mRNA was determined in CCA tissues compared to noncancerous controls (P < 0.05). Chi-square test suggested reduced RECK expression was related with invasion depth (P = 0.026), differentiation (P = 0.025), lymphatic metastasis (P = 0.010) and TNM stage (P = 0.015). However, age, sex, tumor size and family history had no significant links with RECK expression (all, P > 0.05). The survival curves showed that patients with low RECK expression had a shorter overall survival rate than those with high RECK expression. Both the univariate analysis (P = 0.000, HR = 5.290, 95%CI = 3.195–8.758) and multivariate analysis (P = 0.000, HR = 5.376, 95%CI = 2.231–8.946) demonstrated that RECK was an independent biomarker for predicting the outcomes of CCA patients. Conclusions Taken together, the expression of RECK was down-regulated in CCA and it might be an efficient biomarker for CCA patients.

Ifosfamide (IFO) and doxorubicin (DOX) dose-intensities seem related to overall survival in adult soft-tissue sarcoma (STS) patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9581-9581
Author(s):  
G. F. Almeida ◽  
G. Castro ◽  
I. M. Snitcovsky ◽  
A. C. Bassani ◽  
M. E. Diz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Rank Test ◽  
Lower Grade ◽  
Chi Square ◽  
Outpatient Unit ◽  
Kaplan Meier ◽  
Chi Square Test ◽  
The Relationship ◽  
Palliative Setting

9581 Background: IFO/DOX dose intensities (DI) seem to impact on the outcome of STS. We explored retrospectively the relationship between DI and overall survival (OS) in STS. Methods: From Jan/00 to Jun/05, 70 untreated STS pts received IFO/DOX, 32 as neo/adjuvant and 38 in the palliative setting at our outpatient unit. Filgrastin was not mandatory. Median age 47 y (17–74 y), 44 male; mean tumor size 13.6 cm in the neo/adjuvant and 16.5 cm in the palliative group (p=0.202, t-test). Most frequent histologies: leiomyo (16 pts), synovial (13), malignant fibrous histiocytoma (8) and liposarcoma (8). 28 pts had lower/ 9 upper limb tumors, 9 retroperitoneal, 9 trunk, 6 mediastinal, 5 visceral and 4 head and neck. Kaplan-Meier survival curves were considered from diagnosis and compared by log-rank test. Results: For the 70 pts, the mean DI for IFO and DOX were 2.5±0.9 mg/m2/wk and 18.8±6.0 mg/m2/wk, respectively. There was no difference between neo/adjuvant and palliative IFO/DOX DI (p=0.314/p=0.247, respectively). With 19-mo median f-up, the median OS (mOS) was 43 mo in the neo/adjuvant group with an advantage for pts submitted to conservative surgeries (46.5 mo vs. 16.8 mo; HR 0.185, 95%CI 0.003–0.399, p=0.007) as well as in those diagnosed with tumors with less than 3 mitoses/10 HPF (48.3 mo vs. 18.8 mo; HR 0.272, 95%CI 0.058–0.871, p=0.031). No differences in mOS related to tumor size, margin status or primary sites were found. According to IFO DI, the mOS were 46.5 mo, not reached (NR), 14.5 mo and 43 mo for pts in the 1st and subsequent DI quartiles (chi-square test for trend, p=0.004). In the median f-up of 9.8 mo, pts in the palliative setting presented mOS 21.8 mo, superior in the lower grade subgroup (NR vs. 11.1 mo; HR 0.130, 95%CI 0.076–0.746, p=0.014) and in the STS not from extremities (40.9 mo vs. 10.8 mo; HR 2.152, 95%CI 0.959–5.137, p=0.063). According to IFO DI quartiles, we also found a direct correlation between mOS (11.3 mo, 19 mo, 45.1 mo, and NR) and DI (p=0.052), and similar trend was shown for DOX DI, with 11.3 mo, 10.3 mo, NR, and 40.9 mo mOS for the 1st, 2nd, 3rd and 4th quartiles (p=0.018). Conclusions: In these STS adult pts, we have found a relationship between IFO and DOX DI and OS. Further evaluations of more intensive chemotherapy schedules are warranted. No significant financial relationships to disclose.

A novel preoperative inflammatory marker prognostic score in patients with clear cell renal cell carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 566-566
Author(s):  
Rishi Robert Sekar ◽  
Dattatraya Patil ◽  
Jeff Pearl ◽  
Yoram Baum ◽  
Omer Kucuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Medical Decision ◽  
Chi Square ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cell Rcc ◽  
Chi Square Analysis

566 Background: Several inflammatory markers have been singularly studied as potential biomarkers in clear cell renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate. We hypothesize that a combination of preoperative C-Reactive Protein (CRP), albumin, Erythrocyte Sedimentation Rate (ESR), corrected calcium, and AST/ALT ratio into a RCC Inflammatory Score (RISC) could serve as a rigorous prognostic indicator in patients with clear cell RCC. Methods: Patients that underwent nephrectomy for localized clear cell RCC were queried from our nephrectomy database. The optimal threshold for individual biomarkers was determined using grid search methodology, receiver operating characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. The final score, RISC, was the sum of all points accrued from each biomarker (Table). ROC and chi-square analysis was performed to compare the prognostic ability of RISC to SSIGN and UISS. Impact on overall survival was analyzed with multivariate logistic regression analysis. Results: 280 patients were included in the study. Area under the curve (AUC) for RISC, SSIGN and UISS was 0.77, 0.78, and 0.81, respectively. Chi-square analysis of AUCs revealed no statistically significant difference between RISC, SSIGN, and UISS (p= 0.975 and p =0.299, respectively). On multivariate analysis, after adjusting for confounding variables, each unit increase in RISC was associated with a 31% increase in mortality (HR=1.31, 95%CI 1.13-1.50, p<0.001). Conclusions: RISC is an independent and significant predictor of overall survival in clear cell RCC with accuracy at least as good as other established prognostic tools. Notably, RISC is composed of standardized laboratory markers easily and cost-effectively obtained preoperatively, allowing crucial prognostic information to be integrated into medical decision making prior to surgery. [Table: see text]

Downregulation of reelin predicts poor prognosis for glioma

2020 ◽  
Vol 14 (8) ◽  
pp. 651-663
Author(s):  
Xueli Li ◽  
Wange Fan ◽  
Anhui Yao ◽  
Huiling Song ◽  
Yunxiao Ge ◽  
...  
Keyword(s):  
Overall Survival ◽  
Expression Profiles ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Chi Square ◽  
Cancer Pathways ◽  
Kaplan Meier ◽  
Promising Target ◽  
Chi Square Test ◽  
The Relationship

Aim: In the present study, we studied the relationship between RELN and prognosis in glioma. Materials & methods: Expression profiles and methylation data of RELN were obtained from bioinformatic datasets. Correlations between RELN and clinicopathological features and overall survival were respectively assessed using chi-square test and Kaplan–Meier analysis. Results: RELN was downregulated in glioma, and its downregulation correlated well with glioma malignancy and overall survival. Meanwhile, hypermethylation of RELN was significantly correlated with low RELN expression. Additionally, gene set enrichment analysis demonstrated that low expression of RELN correlated with many key cancer pathways, possibly highlighting the importance of RELN in carcinogenesis of brain. Conclusion: RELN may serve as a potential prognostic marker and promising target molecule for new therapy of glioma.

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