scholarly journals Tumor size measured by multidetector CT in resectable colon cancer: correlation with regional lymph node metastasis and N stage

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Anna Mou ◽  
Hang Li ◽  
Xiao-li Chen ◽  
Yang-hua Fan ◽  
Hong Pu
Keyword(s):  
Colon Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Logistic Regression Analysis ◽  
Tumor Size ◽  
Odds Ratio ◽  
Univariate Logistic Regression Analysis ◽  
Node Metastasis ◽  
N Stage

Abstract Background Lymph node metastasis (LNM) is a risk factor for poor long-term outcomes and a prognostic factor for disease-free survival in colon cancer. Preoperative lymph node status evaluation remains a challenge. The purpose of this study is to determine whether tumor size measured by multidetector computed tomography (MDCT) could be used to predict LNM and N stage in colon cancer. Material and methods One hundred six patients with colon cancer who underwent radical surgery within 1 week of MDCT scan were enrolled. Tumor size including tumor length (Tlen), tumor maximum diameter (Tdia), tumor maximum cross-sectional area (Tare), and tumor volume (Tvol) were measured to be correlated with pathologic LNM and N stage using univariate logistic regression analysis, multivariate logistic analysis, and receiver operating characteristic (ROC) curve analysis. Results The inter- and intraobserver reproducibility of Tlen (intraclass correlation coefficient [ICC] = 0.94, 0.95, respectively), Tdia (ICC = 0.81, 0.93, respectively), Tare (ICC = 0.97, 0.91, respectively), and Tvol (ICC = 0.99, 0.99, respectively) parameters measurement are excellent. Univariate logistic regression analysis showed that there were significant differences in Tlen, Tdia, Tare, and Tvol between positive and negative LNM (p < 0.001, 0.001, < 0.001, < 0.001, respectively). Multivariate logistic regression analysis revealed that Tvol was independent risk factor for predicting LNM (odds ratio, 1.082; 95% confidence interval for odds ratio, 1.039, 1.127, p<0.001). Tlen, Tdia, Tare, and Tvol could distinguish N0 from N1 stage (p < 0.001, 0.041, < 0.001, < 0.001, respectively), N0 from N2 (all p < 0.001), N0 from N1-2 (p < 0.001, 0.001, < 0.001, < 0.001, respectively), and N0-1 from N2 (p < 0.001, 0.001, < 0.001, < 0.001, respectively). The area under the ROC curve (AUC) was higher for Tvol than that of Tlen, Tdia, and Tare in identifying LNM (AUC = 0.83, 0.82, 0.69, 0.79), and distinguishing N0 from N1 stage (AUC = 0.79, 0.78, 0.63, 0.74), N0 from N2 stage (AUC = 0.92, 0.89, 0.80, 0.89, respectively), and N0-1 from N2 stage (AUC = 0.84, 0.79, 0.76, 0.83, respectively). Conclusion Tumor size was correlated with regional LNM in resectable colon cancer. In particularly, Tvol showed the most potential for noninvasive preoperative prediction of regional LNM and N stage.

scholarly journals The prognostic value of tumor size in penile cancer: A Surveillance,Epidemiology, and End Results database study

2020 ◽  
Author(s):  
Wenwen Zheng ◽  
Zhiyu Zhang ◽  
Xilei Xie ◽  
Weiwei Zhu ◽  
Kangqi Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Logistic Regression Analysis ◽  
Tumor Size ◽  
Prognostic Value ◽  
Penile Cancer ◽  
Node Metastasis ◽  
End Results

Abstract Background: The objective of this study was to investigate the prognostic value of tumor size on cancer-specific mortality (CSM) and lymph node metastasis for patients with penile squamous cell carcinoma (PSCC).Method: The patients diagnosed with PSCC between 2004 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Restricted cubic spline functions were calculated to characterize the association between tumor size and the risk of CSM. The competing-risks model was used to evaluate the impact of tumor size on the cumulative incidence of CSM. The logistic regression analysis was performed to examine the association between tumor size and lymph node metastasis.Results: Totally, 1365 PSCC patients were analyzed, with 52.3% having tumors ≤30 mm, and 47.7% >30 mm. The restricted cubic splines showed that the risks of CSM increased as tumors enlarged. Following adjustment of competing events, the PSCC patients with tumors >30 mm were more likely to succumb to CSM in comparison with those with tumors ≤30 mm (hazard ratio [HR]=1.57, 95% confidence interval [CI]: 1.23-2.01, P<0.001). In subgroup analyses, tumor size >30 mm was significantly associated with an increased risk of CSM relative to tumor size ≤30 mm among patients with T1 (HR=1.56, 95%CI: 1.03-2.37, P=0.036) and T3 (HR=2.51, 95%CI: 1.41-4.45, P=0.002) classifications. On logistic regression analysis, tumors >30 mm were significantly associated with lymph node metastasis (odds ratio [OR]=1.46, 95% CI: 1.03-2.07, P=0.034).Conclusion: Larger tumors (>30 mm) were significantly associated with higher risks of CSM and increased likelihood of lymph node metastasis for PSCC patients, which could be integrated into the development of a staging system for penile cancer.

scholarly journals The prognostic value of tumor size in penile cancer: A Surveillance, Epidemiology, and End Results database study

2021 ◽  
Author(s):  
Wenwen Zheng ◽  
Zhiyu Zhang ◽  
Wei Jiang ◽  
Jiaojiao Chen ◽  
Shengqiang Yu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Logistic Regression Analysis ◽  
Tumor Size ◽  
Prognostic Value ◽  
Penile Cancer ◽  
Node Metastasis ◽  
End Results

Abstract Background The objective of this study was to investigate the prognostic value of tumor size on cancer-specific mortality (CSM) and lymph node metastasis for patients with penile squamous cell carcinoma (PSCC). Methods The patients diagnosed with PSCC between 2004 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Restricted cubic spline functions were calculated to characterize the association between tumor size and the risk of CSM. The competing-risks model was used to evaluate the impact of tumor size on the cumulative incidence of CSM. The logistic regression analysis was performed to examine the association between tumor size and lymph node metastasis. Results Totally, 1365 PSCC patients were analyzed, with 52.3% having tumors ≤ 30 mm, and 47.7% >30 mm. The restricted cubic splines showed that the risks of CSM increased as tumors enlarged. Following adjustment of competing events, the PSCC patients with tumors > 30 mm were more likely to succumb to CSM in comparison with those with tumors ≤ 30 mm (hazard ratio [HR] = 1.57, 95% confidence interval [CI]: 1.23–2.01, P < 0.001). In subgroup analyses, tumor size > 30 mm was significantly associated with an increased risk of CSM relative to tumor size ≤ 30 mm among patients with T1 (HR = 1.56, 95%CI: 1.03–2.37, P = 0.036) and T3 (HR = 2.51, 95%CI: 1.41–4.45, P = 0.002) classifications. On logistic regression analysis, tumors > 30 mm were significantly associated with lymph node metastasis (odds ratio [OR] = 1.46, 95% CI: 1.03–2.07, P = 0.034). Conclusions Larger tumors (> 30 mm) were significantly associated with higher risks of CSM and increased likelihood of lymph node metastasis for PSCC patients, which could be integrated into the development of a staging system for penile cancer.

scholarly journals Tumor size measured by multidetector CT in resectable colon cancer: Correlation with regional lymph node metastasis

2020 ◽  
Author(s):  
Anna Mou ◽  
Hang Li ◽  
Xiaoli Chen ◽  
Fanghua Fan ◽  
Hong Pu
Keyword(s):  
Colon Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Node Metastasis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background : The aim of our study was to determine whether tumor size measured by multidetector computed tomography (MDCT) could be used to evaluate lymph node metastasis (LNM) in patients with resectable colon cancer. Methods: This retrospective study consisted of 106 consecutive patients with colon cancer who underwent radical surgery within 1 week after contrast enhanced-CT scan. Tumor size including tumor length (Tlen), tumor maximum diameter (Tdia), t umor maximum cross-sectional area (Tare) and tumor volume (Tvol) were measured on contrast enhanced-CT images and correlated with pathologic LNM and N stages using univariate analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results: The inter - (intraclass correlation coefficient [ICC]=0.94, 0.81, 0.97, 0.99) and intraobserver (ICC=0.95, 0.93, 0.91 and 0.99) reproducibility of Tlen, Tdia, Tare and Tvol parameters measurement is excellent. Univariate analysis showed Tlen, Tdia, Tare, and Tvol could predict LNM (all P <0.05), whereas Tvol was an independent risk factor for LNM (odds ratio =1.09; 95% confidence interval, 1.02-1.17; P =0.017) by logistic regression analysis. Tlen, Tdia, Tare and Tvol could distinguish between N0 and N1, N0 and N2, N0 and N1-2, and N0-1 and N2 disease (all P < 0.05). The area under the ROC (AUC) was higher for Tvol than for Tlen, Tdia and Tare in identifying LNM (AUC =0.83, 0.82, 0.69, 0.79, respectively) and distinguishing N0 from N1 (AUC =0.79, 0.78, 0.63, 0.74, respectively), N0 from N2 (AUC =0.92, 0.89, 0.80, 0.89, respectively), and N0-1 from N2 (AUC =0.84, 0.79, 0.76, 0.83, respectively). Conclusion: Tlen , Tdia, Tare and Tvol measured with MDCT correlated with regional LNM in resectable colon cancer. In particular, Tvol showed the most potential for noninvasive preoperative evaluation of regional LNM.

scholarly journals Can CA-125 Predict Lymph Node Metastasis in Epithelial Ovarian Cancers in Turkish Population?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sinem Sudolmuş ◽  
Nadiye Köroğlu ◽  
Gökhan Yıldırım ◽  
Volkan Ülker ◽  
Ahmet Gülkılık ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Logistic Regression Analysis ◽  
Geometric Mean ◽  
Turkish Population ◽  
Ca 125 ◽  
Node Metastasis ◽  
Preoperative Serum

Objective. The role of single preoperative serum CA-125 levels in predicting pelvic or paraaortic lymph node metastasis in patients operated for epithelial ovarian cancer has been investigated.Methods. 176 patients diagnosed with epithelial ovarian carcinoma after staging laparotomy between January 2002 and May 2010 were evaluated retrospectively.Results. The mean, geometric mean, and median of preoperative serum CA-125 levels were 632,6, 200,29, and 191,5 U/mL, respectively. The cut-off value predicting lymph node metastases in the ROC curve was 71,92 U/mL, which is significant in logistic regression analysis (P=0.005). The preoperative log CA-125 levels were also statistically significant in predicting lymph node metastasis in logistic regression analysis (P=0.008).Conclusions. The tumor marker CA-125, which increases with grade independent of the effect of stage in EOC, is predictive of lymph node metastasis with a high rate of false positivity in Turkish population. The high false positive rate may obscure the predictive value of CA-125.

scholarly journals Population-based analysis on predictors for lymph node metastasis in T1 colon cancer

2019 ◽  
Vol 34 (9) ◽  
pp. 4030-4040 ◽  
Author(s):  
Xin Xu ◽  
Chihao Zhang ◽  
Xiaochun Ni ◽  
Jugang Wu ◽  
Chunpeng Pan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Competing Risks ◽  
Predictive Factors ◽  
Cox Regression ◽  
Mucinous Carcinoma ◽  
Population Based ◽  
Node Metastasis

Abstract Background In this study, we aimed to identify independent predictive factors for lymph node metastasis (LNM) in T1 colon cancer. Methods Data of 8056 eligible patients were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database during 2004–2012. We performed logistic regression analysis to identify predictive factors for LNM. Both unadjusted and adjusted Cox regression analyses were used to determine the association between LNM and patient survival. Finally, we used competing risks analysis and the cumulative incidence function (CIF) to further confirm the prognostic role of LNM in cancer-specific survival (CSS). Results The overall risk of LNM in patients with T1 colon cancer was 12.0% (N = 967). Adjusted logistic regression models revealed that mucinous carcinoma [odds ratio (OR) = 2.26, P < 0.001], moderately differentiated (OR 1.74, P < 0.001), poorly differentiated (OR 5.16, P < 0.001), and undifferentiated carcinoma (OR 3.01, P = 0.003); older age (OR 0.66, P < 0.001 for age 65–79 years, OR 0.44, P < 0.001 for age over 80 years); and carcinoma located in the ascending colon (OR 0.77, P = 0.018) and sigmoid colon (OR 1.24, P = 0.014) were independent predictive factors for LNM. Adjusted Cox regression analysis showed that positive lymph node involvement was significantly associated with CSS [hazard ratio (HR) = 3.02, P < 0.001], which was further robustly confirmed using a competing risks model and the CIF. Conclusions This population-based study showed that mucinous carcinoma, tumor grade, age, and primary tumor location were independent predictive factors for LNM in T1 colon cancer. The risk of LNM should be carefully evaluated in patients with T1 colon cancer, before clinical management.

scholarly journals The Risk Factors Associated with Immune Checkpoint Inhibitor-Related Pneumonitis

Oncology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Mizuho Asada ◽  
Takahisa Mikami ◽  
Takahiro Niimura ◽  
Yoshito Zamami ◽  
Yoshihiro Uesawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Event ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Immune Checkpoint ◽  
Odds Ratio ◽  
The United States ◽  
Univariate Logistic Regression Analysis ◽  
Us Fda

<b><i>Background:</i></b> Pneumonitis is a serious adverse event in patients treated with immune checkpoint inhibitors (ICIs), with a mortality rate of up to 20%. The risk factors for ICI-related pneumonitis remain unclear due to the scarce data and infrequent event rate of 0–10% for all grades in patients using ICIs. <b><i>Objectives:</i></b> This study evaluated the risk factors for ICI-related pneumonitis using the United States Food and Drug Administration (US FDA) Adverse Event Reporting System (FAERS) database. <b><i>Method:</i></b> To investigate the association between pneumonitis and ICIs, the FAERS database, which contains spontaneous adverse event reports submitted to the US FDA, was utilized. Data between January 2014 and December 2019 were collected. Univariate logistic regression analysis with covariates, including age, sex, and ICI use, was performed to assess the risk of ICI-related pneumonitis. The relative risk of pneumonitis was estimated using by the odds ratio. <b><i>Results:</i></b> We identified 4,248,808 reports, including 51,166 cases of those who received eight different ICIs. Nivolumab was the most common ICI (<i>n</i> = 27,273 of 51,166 [53.3%] patients). Reporting rates of pneumonitis were significantly high in ICI users (odds ratio 29.48; 95% confidence interval [CI], 27.49–31.62). Univariate logistic regression analysis showed that pneumonitis risk was significantly associated with age. Age ≤60 years old was associated with an increase in the reported frequency of pneumonitis. <b><i>Conclusions:</i></b> Our data suggest that the risk of ICI-related pneumonitis may increase in certain populations, including younger age (age &#x3c;60 years) and ICIs users. These patients require careful monitoring.

scholarly journals Preoperative Predictors of Lymph Node Metastasis in Colon Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Yansong Xu ◽  
Yi Chen ◽  
Chenyan Long ◽  
Huage Zhong ◽  
Fangfang Liang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Node Metastasis ◽  
Logistic Analysis ◽  
Primary Colon Cancer ◽  
Primary Colon

BackgroundLymph node metastasis (LNM) is a well-established prognostic factor for colon cancer. Preoperative LNM evaluation is relevant for planning colon cancer treatment. The aim of this study was to construct and evaluate a nomogram for predicting LNM in primary colon cancer according to pathological features.Patients and MethodsSix-hundred patients with clinicopathologically confirmed colon cancer (481 cases in the training set and 119 cases in the validation set) were enrolled in the Affiliated Cancer Hospital of Guangxi Medical University from January 2010 to December 2019. The expression of molecular markers (p53 and β-catenin) was determined by immunohistochemistry. Multivariate logistic regression was used to screen out independent risk factors, and a nomogram was established. The accuracy and discriminability of the nomogram were evaluated by consistency index and calibration curve.ResultsUnivariate logistic analysis revealed that LNM in colon cancer is significantly correlated (P &lt;0.05) with tumor size, grading, stage, preoperative carcinoembryonic antigen (CEA) level, and peripheral nerve infiltration (PNI). Multivariate logistic regression analysis confirmed that CEA, grading, and PNI were independent prognostic factors of LNM (P &lt;0.05). The nomogram for predicting LNM risk showed acceptable consistency and calibration capability in the training and validation sets.ConclusionsPreoperative CEA level, grading, and PNI were independent risk factor for LNM. Based on the present parameters, the constructed prediction model of LNM has potential application value.

scholarly journals SAT-564 Effectiveness of Treatment with Mineralocorticoid Receptor Antagonistsin Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yuta Tezuka ◽  
Adina Turcu
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Primary Aldosteronism ◽  
Odds Ratio ◽  
Mineralocorticoid Receptor ◽  
Beta Blockers ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Low Renin Hypertension

Abstract Background: Medical treatment with mineralocorticoid receptor antagonists (MRAs) is preferred for patients with primary aldosteronism (PA) who are not surgical candidates. Adequate mineralocorticoid receptor blockade, as suggested by renin elevation above suppression levels, has been associated with lower rates of cardiovascular and renal complications as compared with PA with sustained renin suppression. Objectives: To assess the timeline and rates of achieving target renin levels in patients with PA and low renin hypertension treated with MRAs. Patients and Methods: We conducted a retrospective cohort study of adult patients with hypertension who were treated with MRAs in an academic center between 2003-2019. Of these, we included patients who had suppressed renin at baseline, and repeated renin measurement(s) during MRAs therapy. Renin suppression was defined as plasma renin activity (PRA) 1.0 ng/mL/h or direct renin concentration (DRC) 8.0 pg/mL. We excluded patients with adrenal cancer, end-stage renal disease, exogenous glucocorticoids, and critically ill. Mann-Whitney test, Wilcoxon signed rank test, Chi-Square test and multiple logistic regression analysis were employed, as appropriate. Results: So far, 89 patients (45 men), median age 56 (range, 19-84), have been included. Of these, 46% had confirmed PA; 25% had positive PA screening, but no confirmatory tests; and 29% had other forms of low-renin hypertension. On average, patients were on 2.9 1.6 antihypertensive agents; 62% of patients were prescribed beta blockers, and 38% were on K+ supplements. Overall, renin (PRA in 69 cases, and DRC in 20 cases) increased after MRA treatment (from 0.40 [0.10, 0.60] ng/mL/h to 1.10 [0.60, 2.23] ng/mL/h; and from 2.1 [2.1, 3.7] pg/mL to 5.7 [2.9, 16.7] pg/mL, respectively, p&lt;0.0001 for both). The cumulative proportions of patients in whom renin reached target levels during MRA treatment were: 25% at 2 weeks; 38.9% at 1 month; 34.2% at 3 months; 39.5% at 6 months; and 47.2% at 1 year. Age, sex, race, blood pressure, use of beta blockers, renal function, serum K+ and aldosterone concentrations were similar between patients with target vs. suppressed renin. Multiple logistic regression analysis suggested that after adjusting for age and sex, higher MRA dose and higher BMI were associated with higher likelihood of achieving target renin during MRA therapy (odds ratio (95%CI): 1.021 (1.001-1.041) and 1.097 (1.008-1.193), respectively, p&lt;0.05 for both); conversely, beta blockers use tended to be less often associated with target renin (odds ratio, 0.37 (0.13-1.008), p=0.052). Conclusion: Although raising renin above suppression levels is important for reducing the cardiovascular risk associated with PA, this goal is achieved in less than half of patients, even after one year of treatment with MRAs, in an academic setting. Strategies for optimizing PA treatment are critically needed.

scholarly journals A Novel RNA-Seq-Based Model for Preoperative Prediction of Lymph Node Metastasis in Oral Squamous Cell Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Bo Qiao ◽  
Min Zhao ◽  
Jing Wu ◽  
Huan Wu ◽  
Yiming Zhao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Rna Seq ◽  
Node Metastasis ◽  
Preoperative Prediction

Objective. To develop and validate a novel RNA-seq-based nomogram for preoperative prediction of lymph node metastasis (LNM) for patients with oral squamous cell carcinoma (OSCC). Methods. RNA-seq data for 276 OSCC patients (including 157 samples with LNM and 119 without LNM) were downloaded from TCGA database. Differential expression analysis was performed between LNM and non-LNM of OSCC. These samples were divided into a training set and a test set by a ratio of 9 : 1 while the relative proportion of the non-LNM and LNM groups was kept balanced within each dataset. Based on clinical features and seven candidate RNAs, we established a prediction model of LNM for OSCC using logistic regression analysis. Tenfold crossvalidation was utilized to examine the accuracy of the nomogram. Decision curve analysis was performed to evaluate the clinical utility of the nomogram. Results. A total of 139 differentially expressed RNAs were identified between LNM and non-LNM of OSCC. Seven candidate RNAs were screened based on FPKM values, including NEURL1, AL162581.1 (miscRNA), AP002336.2 (lncRNA), CCBE1, CORO6, RDH12, and AC129492.6 (pseudogene). Logistic regression analysis revealed that the clinical N stage (p<0.001) was an important factor to predict LNM. Moreover, three RNAs including RDH12 (p value < 0.05), CCBE1 (p value < 0.01), and AL162581.1 (p value < 0.05) could be predictive biomarkers for LNM in OSCC patients. The average accuracy rate of the model was 0.7661, indicating a good performance of the model. Conclusion. Our findings constructed an RNA-seq-based nomogram combined with clinicopathology, which could potentially provide clinicians with a useful tool for preoperative prediction of LNM and be tailored for individualized therapy in patients with OSCC.

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