scholarly journals The Role of Hyponatraemia Before Surgery in Patients With Radical Resected Pancreatic Cancer

2020 ◽  
Vol 14 ◽  
pp. 117955492093660
Author(s):  
Rossana Berardi ◽  
Silvia Rinaldi ◽  
Giulio Belfiori ◽  
Stefano Partelli ◽  
Stefano Crippa ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Cox Regression ◽  
Radical Surgery ◽  
Ductal Adenocarcinoma ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Kaplan Meier ◽  
Negative Prognostic Factor ◽  
Significant Difference

Objectives: Hyponatraemia represents a negative prognostic factor in patients with cancer. The aim of this study was to assess, for the first time, the role of hyponatraemia in patients undergoing radical surgery for pancreatic ductal adenocarcinoma. Methods: A total of 89 patients with stage I-III pancreatic ductal adenocarcinoma underwent radical surgery between November 2012 and October 2014. Relapse-free survival (RFS) and disease-specific survival (DSS) were estimated using Kaplan-Meier method. A Cox regression model was carried out for univariate and multivariate analyses. Fisher exact test was used to estimate correlation between variables. Results: In total, 12 patients (14%) presented with hyponatraemia at diagnosis. The median DSS was 20 months in patients with hyponatraemia and not reached in patients with eunatraemia ( P < .1073), while a statistical significant difference was observed in terms of median RFS (10 months vs 17 months, respectively; P = .0233). Considering clinical features (hyponatraemia, smoke and alcoholic habit, diabetes, pain, and jaundice), patients with 4 or more of these factors had a worse prognosis (mDSS: 30 months vs not reached; hazard ratio [HR]: 0.40, 95% confidence interval [CI] = 0.16-0.80; P = .0120). Conclusions: The presence of hyponatraemia and its prompt correction at the diagnosis time should be considered for the correct management of patients with pancreatic carcinoma.

scholarly journals The prognosis of hepatoid adenocarcinoma of the stomach: a propensity score-based analysis

2020 ◽  
Author(s):  
Kai Zhou ◽  
Anqiang Wang ◽  
Sheng Ao ◽  
Jiahui Chen ◽  
Ke Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Rates ◽  
Cancer Type ◽  
Radical Gastrectomy ◽  
Hepatoid Adenocarcinoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Propensity Matching

Abstract Background : To investigate whether there is a distinct difference in prognosis between hepatoid adenocarcinoma of the stomach ( HAS) and non-hepatoid adenocarcinoma of the stomach (non-HAS) and whether HAS can benefit from radical surgery. Methods : We retrospectively reviewed 722 patients with non-HAS and 75 patients with HAS who underwent radical gastrectomy between 3 November 2009 and 17 December 2018. Propensity score matching (PSM) analysis was used to eliminate the bias among the patients in our study. The relationships between gastric cancer type and overall survival (OS) were evaluated by the Kaplan-Meier method and Cox regression. Results : Our data demonstrate that there was no statistically significant difference in the OS between HAS and non-HAS {K-M, P=log rank (Mantel-Cox), (before PSM P=0.397); (1:1 PSM P=0.345); (1:2 PSM P=0.195)}. Moreover, there were no significant differences in the 1-, 2-, or 3-year survival rates between patients with non-HAS and patients with HAS (before propensity matching, after 1:1 propensity matching, and after 1:2 propensity matching). Conclusion : HAS was generally considered to be an aggressive gastric neoplasm, but its prognosis may not be as unsatisfactory as previously believed.

scholarly journals The role of radiotherapy in neuroendocrine cervical cancer: SEER-based study

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110093
Author(s):  
Meilian Dong ◽  
Xiaobin Gu ◽  
Taoran Ma ◽  
Yin Mi ◽  
Yonggang Shi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cox Regression ◽  
Local Treatment ◽  
Seer Database ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Chi Squared ◽  
Seer Data

Background: There are few randomised prospective data or guidelines for the treatment of neuroendocrine cervical cancer (NECC). In addition, the role of radiotherapy (RT) in NECC remains controversial. We used the Surveillance Epidemiology and End Results (SEER) database to investigate the role of RT for the treatment of NECC. Particular attention was paid to the different role of RT in patients with or without a metastasis (M1 or M0). Methods: The SEER database was queried for studies on NECC. We limited the year of diagnosis to the years 2000 to 2015. A Pearson’s two-sided Chi-squared test, the Kaplan–Meier method and Cox regression analysis models were used for statistical analyses. The overall survival (OS) was studied for the overall group and between-subgroup groups. Results: NECC was an aggressive disease with a mean OS of only 46.3 months (range of 0–196 months, median of 23 months). No significant differences were shown between the surgery (S) and S + RT groups ( p = 0.146) in the M0 (without metastasis) arm. However, there was a statistically significant difference in OS between the S and S + RT groups in the M1 (with metastasis) arm (median of 44.6 months for the S group and 80.9 months for the S + RT group), p = 0.004. The mean survival was significantly longer for M0 patients than for M1 patients when treated with S only (S arm), that is, 82.1 months versus 44.6 months, respectively (log-rank p = 0.000). We also noted that when patients received adjuvant RT (S + RT arm), there were no significant differences between the M0 and M1 groups (median of 90.6 and 81.0 months, p = 0.704, respectively). Age at diagnosis, chemotherapy, T stage and N stage were significant factors for OS in the M0 arm. Interestingly, radiotherapy was the only significant factor for OS with a multivariate HR for death of 0.502 (95% CI 0.206–0.750, p = 0.006) in the M1 arm. Conclusions: RT may be carefully used in patients who are negative for metastases. Using SEER data, we identified a significant survival advantage with the combination of radiotherapy and surgery in NECC with metastases. This suggests that active local treatment should be conducted and has a significant impact on OS, even if a distant metastasis has occurred.

scholarly journals A More Important Role of Diabetes Mellitus in Mortality in Elderly Critical COVID-19 Patients: a Single-center Retrospective Study

2022 ◽  
Author(s):  
Yuming Li ◽  
Xiantao Li ◽  
Yu Zhou ◽  
Yi Yang ◽  
Yake Yao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Critically Ill ◽  
Cox Regression ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Survivor Group ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Family Aggregation

Abstract BackgroundCOVID-19 has been circulating worldwide since December 2019. However, its independent risk factors of mortality need further insights in elderly critical COVID-19 patients.MethodsTotally 48 elderly and critically ill COVID-19 patients with clear end point were enrolled when the data were collected, with 16 discharged and 32 died. Kaplan-Meier analysis and Cox regression were performed to identify the risk factors of mortality in elderly critical COVID-19 patients. Survival curve was conducted to present the impact of Diabetes Mellitus on mortality. Mann-Whitney U and t tests were used to 39 clinical variates between the survivor and non-survivor groups.ResultsAs Kaplan-Meier analysis confirmed, only three variates Diabetes Mellitus, chronic obstructive pulmonary disease and family aggregation showed significant difference between the survivor and non-survivor groups. However, only variate Diabetes Mellitus presented significance in Cox regression. Higher C-reaction protein, interleukin-2 (IL-2), IL-8 and creatinine were detected in survivor group than non-survivor group, which was reverse to estimated glomerular filtration rate. The other laboratory finding showed no significant difference between survivor and non-survivor groups.ConclusionsDiabetes Mellitus, chronic obstructive pulmonary disease and family aggregation can contribute to mortality by COVID-19 while Diabetes Mellitus also reduces the survival time of elderly and critically ill COVID-19 patients, highlighting the more important role of Diabetes Mellitus. Laboratory findings could not serve as good predictors of death for elderly and critically ill COVID-19 patients.

Early initiation of chemotherapy after histological diagnosis to improve the prognosis of metastatic pancreatic ductal adenocarcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 273-273 ◽  
Author(s):  
Rei Suzuki ◽  
Tadayuki Takagi ◽  
Takuto Hikichi ◽  
Ai Sato ◽  
Ko Watanabe ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Waiting Time ◽  
Early Initiation ◽  
Histological Diagnosis ◽  
Ductal Adenocarcinoma ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Detection And Diagnosis ◽  
Medical University

273 Background: Since pancreatic ductal adenocarcinoma (PDAC) shows aggressive progression, we speculate that prolonged waiting time after detection of disease until initiation of treatment may relate to prognosis of patients with advanced diseases. Methods: We included patients diagnosed to have metastatic PDAC in Fukushima Medical University between September 2006 and January 2014. All patients underwent more than 2 cycles of gemcitabine treatment (1,000 mg/m2 on days 1, 8, and 15 of a 28-day cycle) after confirming histological diagnosis. We classified waiting time as Time A (detection-to-diagnosis waiting time) and Time B (diagnosis-to-treatment waiting time). Each period was further divided into 2 groups (shorter [-short] or longer [-long] waiting time than median length of each waiting time group). Kaplan-Meier methods, log-rank test and Cox proportional hazard methods were used to analyze overall survival (OS). Results: Twenty three patients were included. Median age was 64 (49-75) and length of waiting time was 19.5 days (4-78) in Time A and 9.0 days (2-34) in Time B. Regarding Time A, there was no significant difference in median OS between Time A-short and Time A-long (198.5 vs. 197.0 days; hazard ration [HR] 1.096; 95% confidential interval [CI] 0.4822-2.537; P=0.81). On the other hand, median OS was significantly better in Time B-short than Time B-long (median OS 290 vs. 160 days; HR, 0.381; 95% CI, 0.096-0.622; P= 0.0078). Conclusions: We foundthat waiting time between disease detection and diagnosis didn’t impact on prognosis of metastatic PDAC contrary to our speculation. However, patients with short waiting time (less than 9 days) after diagnosis until initiation of first chemotherapy had better prognosis than patients who had long waiting time. These findings suggest that early initiation of chemotherapy after histological diagnosis can improve the prognosis of metastatic PDAC.

scholarly journals Decreased LKB1 predicts poor prognosis in Pancreatic Ductal Adenocarcinoma

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Jian-Yu Yang ◽  
Shu-Heng Jiang ◽  
De-Jun Liu ◽  
Xiao-Mei Yang ◽  
Yan-Miao Huo ◽  
...  
Keyword(s):  
Protein Expression ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Cox Regression ◽  
Clinical Stage ◽  
Ductal Adenocarcinoma ◽  
Kaplan Meier ◽  
Tumor Tissues ◽  
N Classification ◽  
Liver Kinase B1 ◽  
T Classification

Abstract Liver kinase B1 (LKB1) has been identified as a critical modulator involved in cell proliferation and polarity. The purpose of the current study was to characterize the expression pattern of LKB1 and assess the clinical significance of LKB1 expression in pancreatic ductal adenocarcinoma (PDAC) patients. LKB1 mRNA expression which was analyzed in 32 PDAC lesions and matched non-tumor tissues, was downregulated in 50% (16/32) of PDAC lesions. Similar results were also obtained by analyzing three independent datasets from Oncomine. Protein expression of LKB1 was significantly reduced in 6 PDAC cell lines and downregulated in 31.3% (10/32) of PDAC lesions compared to matched non-tumorous tissues, as determined by Western blot analysis. Additionally, tissue microarray containing 205 PDAC specimens was evaluated for LKB1 expression by IHC and demonstrated that reduced expression of LKB1 in 17.6% (36/205) of PDAC tissues was significantly correlated with clinical stage, T classification, N classification, liver metastasis and vascular invasion. Importantly, Kaplan-Meier survival and Cox regression analyses were executed to evaluate the prognosis of PDAC and found that LKB1 protein expression was one of the independent prognostic factors for overall survival of PDAC patients.

scholarly journals High GFPT1 expression predicts unfavorable outcomes in patients with resectable pancreatic ductal adenocarcinoma

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yitao Gong ◽  
Yunzhen Qian ◽  
Guopei Luo ◽  
Yu Liu ◽  
Ruijie Wang ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Cox Regression ◽  
Prognostic Significance ◽  
High Rate ◽  
Ductal Adenocarcinoma ◽  
Poor Overall Survival ◽  
Logistic Regression Models ◽  
Kaplan Meier ◽  
Hexosamine Biosynthesis ◽  
Public Datasets

Abstract Background Glutamine-fructose-6-phosphate transaminase 1 (GFPT1) is the first rate-limiting enzyme of the hexosamine biosynthesis pathway (HBP), which plays a pivotal role in the progression of pancreatic ductal adenocarcinoma (PDAC). Therefore, we investigated the prognostic significance of GFPT1 expression in patients with resectable PDAC. Methods We analyzed public datasets to compare GFPT1 expression in tumor tissues and normal/adjacent pancreatic tissues. We measured the relative GFPT1 expression of 134 resected PDAC specimens in our institution, using real-time polymerase chain reaction (PCR). Survival was compared between high and low GFPT1 expression groups using Kaplan-Meier curves and log-rank tests. Multivariate analyses were estimated using Cox regression and logistic regression models. Results GFPT1 is generally upregulated in PDAC tissues, according to the analysis of public datasets. The data from our institution shows that high GFPT1 expression was correlated with a high rate of lymph node (LN) metastasis (p = 0.038) and was an independent risk factor for LN metastasis (odds ratio (OR) = 3.14, 95% confidence interval (CI) = 1.42 to 6.90, P = 0.005). High GFPT1 expression was significantly associated with poor overall survival (OS; P = 0.019) in patients with resected PDAC. The multivariable-adjusted hazard ratio (HR) for mortality when comparing patients with high and low GFPT1 expression was 2.54 (95% CI = 1.35 to 4.79, P = 0.004). Conclusions GFPT1 is generally upregulated in PDAC tissue and is associated with a high risk of LN metastasis and an unfavorable outcome in patients with resectable PDAC, suggesting its crucial role in PDAC progression.

scholarly journals FOXF1 as an Immunohistochemical Marker of Hilar Cholangiocarcinoma or Metastatic Pancreatic Ductal Adenocarcinoma. Single Institution Experience

2021 ◽  
Vol 27 ◽  
Author(s):  
Jan Hrudka ◽  
Zuzana Prouzová ◽  
Katarína Mydlíková ◽  
Kristína Jedličková ◽  
Michal Holešta ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Prognostic Significance ◽  
High Sensitivity ◽  
Ductal Adenocarcinoma ◽  
Fisher Exact Test ◽  
C Reactive Protein ◽  
Single Institution ◽  
Liver Malignancy ◽  
Exact Test ◽  
Reactive Protein

Cholangiocarcinoma (CCA) is a liver malignancy associated with a poor prognosis. Its main subtypes are peripheral/intrahepatic and hilar/extrahepatic CCA. Several molecular, morphological and clinical similarities between hilar/extrahepatic CCA and pancreatic ductal adenocarcinoma (PDAC) have been described. FOXF1 is a transcription factor which has been described to have prognostic significance in various tumors and it is involved in the development of bile ducts. The aim of this study is to determine occurrence of nuclear expression of FOXF1 in both subtypes of CCA and metastatic PDAC and assess its potential usefulness as a diagnostic marker. Secondary aims were to investigate the use of C-reactive protein (CRP) immunohistochemistry for diagnosing intrahepatic peripheral CCA and the significance of histological features in CCA subtypes. 32 archive specimens of CCA, combined hepatocellular carcinoma-CCA (HCC-CCA) and liver metastasis of PDAC were stained by FOXF1 and CRP immunohistochemistry and evaluated to determine histological pattern. The CCAs were classified radiologically into peripheral/intrahepatic and hilar subtype. Using Fisher exact test, we identified nuclear FOXF1 as a fairly specific (87%) but insensitive (65%) marker of hilar and extrahepatic CCA and metastatic PDAC (p = 0.005). CRP immunohistochemistry was characterized by a high sensitivity and specificity, of 79% and 88%, respectively (p = 0.001). We did not identify any histomorphological features associated with either types of CCA or metastatic PDAC. As a conclusion of novel finding, FOXF1 immunohistochemistry may be regarded as a specific but insensitive marker of hilar/extrahepatic CCA and metastatic PDAC and it may help distinguish them from peripheral CCA.

scholarly journals Prognostic Estimator of Survival for Patients with Localized and Extended Pancreatic Ductal Adenocarcinoma

2013 ◽  
Vol 12 ◽  
pp. CIN.S11496 ◽  
Author(s):  
Michael X. Gleason ◽  
Tengiz Mdzinarishvili ◽  
Chandrakanth Are ◽  
Aaron Sasson ◽  
Alexander Sherman ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Tumor Grade ◽  
Ductal Adenocarcinoma ◽  
Model Parameters ◽  
Web Based ◽  
T Stage ◽  
Kaplan Meier ◽  
Group A

The 18,352 pancreatic ductal adenocarcinoma (PDAC) cases from the Surveillance Epidemiology and End Results (SEER) database were analyzed using the Kaplan-Meier method for the following variables: race, gender, marital status, year of diagnosis, age at diagnosis, pancreatic subsite, T-stage, N-stage, M-stage, tumor size, tumor grade, performed surgery, and radiation therapy. Because the T-stage variable did not satisfy the proportional hazards assumption, the cases were divided into cases with T1- and T2-stages (localized tumor) and cases with T3- and T4-stages (extended tumor). For estimating survival and conditional survival probabilities in each group, a multivariate Cox regression model adjusted for the remaining covariates was developed. Testing the reproducibility of model parameters and generalizability of these models showed that the models are well calibrated and have concordance indexes equal to 0.702 and 0.712, respectively. Based on these models, a prognostic estimator of survival for patients diagnosed with PDAC was developed and implemented as a computerized web-based tool.

scholarly journals The prognosis of hepatoid adenocarcinoma of the stomach: a propensity score-based analysis

2020 ◽  
Author(s):  
Kai Zhou ◽  
Anqiang Wang ◽  
Sheng Ao ◽  
Jiahui Chen ◽  
Ke Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Rates ◽  
Cancer Type ◽  
Radical Gastrectomy ◽  
Hepatoid Adenocarcinoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Propensity Matching

Abstract Background: To investigate whether there is a distinct difference in prognosis between hepatoid adenocarcinoma of the stomach (HAS) and non-hepatoid adenocarcinoma of the stomach (non-HAS) and whether HAS can benefit from radical surgery. Methods: We retrospectively reviewed 722 patients with non-HAS and 75 patients with HAS who underwent radical gastrectomy between 3 November 2009 and 17 December 2018. Propensity score matching (PSM) analysis was used to eliminate the bias among the patients in our study. The relationships between gastric cancer type and overall survival (OS) were evaluated by the Kaplan-Meier method and Cox regression.Results: Our data demonstrate that there was no statistically significant difference in the OS between HAS and non-HAS {K-M, P=log rank (Mantel-Cox), (before PSM P=0.397); (1:1 PSM P=0.345); (1:2 PSM P=0.195)}. Moreover, there were no significant differences in the 1-, 2-, or 3-year survival rates between patients with non-HAS and patients with HAS (before propensity matching, after 1:1 propensity matching, and after 1:2 propensity matching).Conclusion: HAS was generally considered to be an aggressive gastric neoplasm, but its prognosis may not be as unsatisfactory as previously believed.

Association of the CC genotype of the regulatory BCL2 promoter polymorphism (−938C>A) with better 2-year survival in patients with glioblastoma multiforme

2011 ◽  
Vol 114 (6) ◽  
pp. 1631-1639 ◽  
Author(s):  
Nicolai El Hindy ◽  
Hagen S. Bachmann ◽  
Nicole Lambertz ◽  
Michael Adamzik ◽  
Holger Nückel ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Cox Regression ◽  
Reference Group ◽  
Promoter Polymorphism ◽  
High Risk Group ◽  
Kaplan Meier ◽  
Negative Prognostic Factor ◽  
P2 Promoter

Object Bcl-2 plays a key role in the downregulation of apoptosis and proliferation and leads to increased chemoresistance in glioblastoma multiforme (GBM). The authors investigated the role of a common regulatory single-nucleotide polymorphism (−938C>A), which is located in the inhibitory P2 promoter of BCL2. Methods Data from 160 patients suffering from GBM were retrospectively evaluated. Study inclusion criteria consisted of available DNA and, in patients still alive, a follow-up of at least 24 months. Results were analyzed with respect to the basic clinical data, type of surgical intervention (gross-total resection [GTR] versus stereotactic biopsy [SB]), adjuvant therapy, MGMT promoter methylation, and survival at the 2-year follow-up. Results At the 2-year follow-up, 127 (79.4%) of the 160 patients had died. Kaplan-Meier curves revealed a significantly higher rate of survival for homo- and heterozygous C-allele carriers (p = 0.031). In the GTR group, the survival rate was 47.1% for homozygous C-allele carriers, 32.0% for heterozygous C-allele carriers, and only 21.4% for homozygous A-allele carriers (p = 0.024). The SB group showed no genotype-dependent differences. Multivariable Cox regression revealed that the BCL2 (−938AA) genotype was an independent negative prognostic factor for 2-year survival in the GTR group according to the BCL2 (−938CC) genotype reference group (hazard ratio 2.50, 95% CI 1.14–5.48, p = 0.022). Conclusions These results suggested that the (−938C>A) polymorphism is a survival prognosticator as well as a marker for a high-risk group among patients with GBM who underwent GTR.

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