scholarly journals The role of prognostic nutritional index in the management of pulmonary sarcomatoid carcinoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yan Wang ◽  
Yu Cao ◽  
Junfeng Liu
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Sarcomatoid Carcinoma ◽  
Prognostic Nutritional Index ◽  
Postoperative Chemotherapy ◽  
Pathological Stage ◽  
Nutritional Index ◽  
Pulmonary Sarcomatoid Carcinoma

Abstract Background Pulmonary sarcomatoid carcinoma is characterized by poor survival rates compared with other non-small cell lung cancer. Prognostic nutritional index has significant prognostic value in many malignant tumors. We conducted this retrospective study to investigate the role of prognostic nutritional index in patients with pulmonary sarcomatoid carcinoma and to determine prognostic factors. Methods Of 8176 patients with resected lung cancer in a single high-volume institution between 2008 and 2015, 91 patients with pathologically diagnosed sarcomatoid carcinoma were included in our study and evaluated. Kaplan–Meier analysis and Cox regression analysis were conducted to analyze clinicopathologic data. Subgroup analysis of overall survival (OS) and recurrence-free survival (RFS) among pulmonary sarcomatoid carcinoma patients were also conducted. Results Univariable analysis showed that tumor size (P = 0.018 in OS), and P = 0.021 in RFS), tumor stage(P < 0.001 in OS, and P = 0.002 in RFS), nodal metastasis (P < 0.001 in OS, and P < 0.001 in RFS), pathological stage (P < 0.001 in OS, and P < 0.001 in RFS), treatment modality (P = 0.032 in OS, and P = 0.059 in RFS) and PNI (P < 0.001 in OS, and P < 0.001 in RFS), were significant factors of both OS and RFS. In multivariable analysis, for OS, the pathological stage (Hazard ratio (HR) 1.432; 95% confidence interval (95% CI) 1.210–1.695; P < 0.001) and PNI (HR 0.812; 95% CI 0.761–0.865; P < 0.001) were independent prognostic factors. And for RFS, We found PNI as an independent prognostic factor (HR 0.792; 95% CI 0.739–0.848; P < 0.001), and the pathological stage (HR 1.373; 95% CI 1.160–1.625; P < 0.001). In the subgroup of patients with PNI ≥ 49.4, univariable analysis showed treatment modality was a significant factor of overall survival (P = 0.001); multivariable analysis showed patients received postoperative chemotherapy (HR 0.288; 95% CI 0.095–0.874; P = 0.028) or postoperative chemotherapy with targeted therapy (HR 0.148; 95% CI 0.030–0.726; P = 0.019) has better overall survival rates. Conclusion The PNI and the pathological TNM stage are independent prognostic factors for pulmonary sarcomatoid carcinoma. PNI is an important indicator for the selection of postoperative adjuvant therapy. Patients with PNI ≥ 49.4 may benefit from postoperative chemotherapy and targeted therapy. We still need further prospective studies to confirm these results.

scholarly journals PCV for Oligodendroglial Tumors: In Search of Prognostic Factors for Response and Survival

2001 ◽  
Vol 28 (3) ◽  
pp. 215-223 ◽  
Author(s):  
David Fortin ◽  
David. R. Macdonald ◽  
J. Gregory Cairncross ◽  
Larry Stitt
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Cancer Center ◽  
Chemotherapy Response ◽  
Initial Symptom ◽  
Oligodendroglial Tumors ◽  
Vascular Proliferation ◽  
Predicting Outcome

Background:We report survival and pretreatment prognostic factors for survival and chemosensitivity in 53 oligodendrogliomas treated with PCV (procarbazine, lomustine and vincristine) chemotherapy.Methods:A total of 53 patients with histologically proven oligodendroglioma, anaplastic oligodendroglioma or oligo-astrocytoma and treated with PCVwere extracted from the London Regional Cancer Center database. A retrospective review was conducted to evaluate overall survival and pretreatment prognostic factors for survival and chemosensitivity.Results:The median survival time from diagnosis was 123.6 months. The overall five- and ten-year survival rates were 72.7% and 52.7% respectively. Age <40, seizure as an initial symptom, absence of cognitive deficit and presence of a homogeneous hypodense lesion without contrast enhancement on the initial pretreatment CT scan were all factors independently associated with favorable outcome. The presence of increased cellularity, pleomorphism, mitosis, vascular proliferation and grading as an anaplastic lesion using these surrogates on pathological assessment, were all associated with an unfavorable outcome in univariable analysis. In multivariable analysis, only the anaplastic grading and presence of increased cellularity were significant determinants of unfavorable survival. The only factor adversely associated with chemosensitivity was the presence of a focal symptom at presentation.Conclusion:Overall survival is significantly longer in oligodendroglial lesions than in fibrillary astrocytic tumors. A two tier grading system using standard morphological features seems accurate in predicting outcome in these patients. The presence of a neoplastic astrocytic component does not seem to impact the outcome. No clinical, radiological or pathological factor could be identified to reliably predict chemotherapy response.

Outcome of patients with colorectal cancer undergoing lung metastases resection: a single-institution retrospective analysis

2020 ◽  
pp. 030089162093079
Author(s):  
Marco Mammana ◽  
Francesca Bergamo ◽  
Letizia Procaccio ◽  
Marco Schiavon ◽  
Fotios Loupakis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Postoperative Chemotherapy ◽  
Single Institution ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Lung Metastasectomy

Introduction: This study was undertaken to review a single-institution cohort of patients with metastatic colorectal cancer undergoing lung resection after a multidisciplinary evaluation and to investigate the main prognostic factors for survival. Methods: Medical records of 129 patients undergoing lung metastasectomy for colorectal cancer with curative intent from 2001 to 2017 were reviewed. Tissue samples from the primary tumor were analyzed with a multiplex genotyping system for the detection of mutations in RAS and BRAF genes. Survival analyses were carried out by the Kaplan-Meier method. Univariate and multivariable analyses were performed using the log-rank test and the Cox regression model. Results: Postoperative morbidity and mortality were 13.2% and 0%, respectively. At a median follow-up time of 62.5 months, median overall survival was 90.5 months and median relapse-free survival was 42.8 months. Multivariable analysis for overall survival identified synchronous versus metachronous metastatic presentation as the only prognostic factor, whereas relapse-free survival was independently associated with synchronous versus metachronous metastatic presentation, number of metastases, and postoperative chemotherapy. Conclusions: This study shows particularly favorable survival outcomes for patients undergoing lung metastasectomy. The validity of some of the main prognostic factors was confirmed and a positive effect of postoperative chemotherapy on relapse-free survival was shown. Contrary to other reports, the presence of KRAS mutations was not associated with significant survival differences. Further studies are needed in order to clarify the interactions between molecular, clinical, and pathologic characteristics and treatment-related factors.

scholarly journals Prognostic Factors for Elderly Gastric Cancer Patients who Underwent Gastrectomy

2021 ◽  
Author(s):  
Shunji Endo ◽  
Tomoki Yamatsuji ◽  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Performance Status ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Pathological Stage ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Abstract Background: Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed.Methods: The medical records of 166 patients aged ≥80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival.Results: In univariate analyses, age (≥90 vs. ≥80, <85), performance status (3 vs. 0), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥40 vs. ≥20, ≤29), Onodera’s prognostic nutritional index (<40 vs. ≥45), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥D2), pathological stage (II-IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24-4.24], extent of gastrectomy (total vs distal, HR 2.17, 95% CI 1.10-4.31), (proximal vs. distal, HR 4.05, 95% CI 1.45-11.3), extent of lymphadenectomy (D0 vs. ≥D2, HR 12.4, 95% CI 1.58-97.7) and pathological stage were independent risk factors for mortality.Conclusions: ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia and excessive limitation of lymphadenectomy are best avoided.

scholarly journals Survival impact of perioperative changes in prognostic nutritional index levels after esophagectomy

Esophagus ◽  
2021 ◽  
Author(s):  
Ryoma Haneda ◽  
Yoshihiro Hiramatsu ◽  
Sanshiro Kawata ◽  
Junko Honke ◽  
Wataru Soneda ◽  
...  
Keyword(s):  
Overall Survival ◽  
Confidence Interval ◽  
Nutritional Status ◽  
Multivariable Analysis ◽  
Prognostic Nutritional Index ◽  
Hazard Ratio ◽  
High Group ◽  
Nutritional Index ◽  
Significant Difference ◽  
The Impact

Abstract Background The correlation between perioperative changes in nutritional status during esophagectomy and prognosis remains unclear. This study aimed to evaluate the impact of changes in prognostic nutritional index levels during the perioperative period on esophageal cancer patient survivals. Methods From January 2009 to May 2019, 158 patients with esophageal squamous cell carcinoma were enrolled. From the time-dependent ROC analysis, the cutoff values of preoperative and postoperative prognostic nutritional index levels were 46.9 and 40.9. Patients were divided into preoperative-high group (Group H) and preoperative-low group (Group L). Then, patients in Group L were divided into preoperative-low and postoperative-high group (Group L–H) and preoperative-low and postoperative-low group (Group L–L). Long-term outcomes and prognostic factors were evaluated. Results Patients in Group L had significantly worse overall survival than those in Group H (p = 0.001). Patients in Group L–L had significantly worse overall survival than those in Group L–H (p = 0.023). However, there was no significant difference in overall survival between Groups H and L–H (p = 0.224). In multivariable analysis, advanced pathological stage (hazard ratio 10.947, 95% confidence interval 2.590–46.268, p = 0.001) and Group L–L (hazard ratio 2.171, 95% confidence interval 1.249–3.775, p = 0.006) were independent predictors of poor overall survival. Conclusions Patients in Group L–H had a good prognosis, similar to those in Group H. This result indicated that increasing the postoperative prognostic nutritional index level sufficiently using various intensive perioperative support methods could improve prognosis after esophagectomy in patients with poor preoperative nutritional status.

Clinical application value of prognostic nutritional index for predicting survival in patients with esophageal squamous cell carcinoma undergoing chemoradiotherapy (CRT) or radiotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24075-e24075
Author(s):  
Tao Li
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Application ◽  
Squamous Cell ◽  
Survival Rates ◽  
Prognostic Nutritional Index ◽  
Nutritional Index ◽  
Overall Survival Rates

e24075 Background: The prognostic nutrition index (PNI) has been shown to have prognostic value in several common cancers. We explore its clinical application value in the prognosis of patients with esophageal squamous cell carcinoma (ESCC) undergoing radical chemoradiotherapy (CRT) or radiotherapy. Methods: Overall, 193 patients with ESCC who received radiotherapy with or without chemotherapy at Sichuan Cancer Hospital from March 20, 2012 to December 25, 2017 were retrospectively analyzed. Based on serum measurements before treatment, PNI at ESCC recurrence was calculated as albumin (g/L) + 5 × total lymphocyte count. Kaplan-Meier method and Cox proportional regression model were used to analyze the relationship between PNI and overall survival (OS). Results: The PNI of 193 ESCC patients was 49.01 ± 4.68. The optimal cutoff value of PNI was calculated to be 47.975. The patients were divided into a low PNI group (<47.975) and a high PNI group (≥47.975). The median OS for the entire group was 22.37 months. The median OS of patients in the high PNI group (PNI ≥ 47.975) and low PNI group (PNI <47.975) were 32.63 months and 15.4 months, respectively. The 3-year overall survival rates were 47.5% and 32.2%, and 5-year overall survival rates were 37.7% and 16.8%, respectively, and the differences were statistically significant (P = 0.001). Multivariate analysis showed that tumor length (P = 0.019), synchronous chemotherapy (P = 0.009), and PNI (P = 0.003) were independent prognostic factors affecting the prognosis of patients in ESCC treated with radical CRT or radiotherapy. Conclusions: The calculation of PNI value is simple, reliable and repeatable, which can improve the accuracy of patients' prognosis. And it needs to be further confirmed by the prospective study of large sample size. Keywords: Esophageal squamous cell carcinoma, chemoradiotherapy, prognostic nutritional index, prognosis.

scholarly journals Preoperative lymphocyte to monocyte ratio and prognostic nutritional index were correlated with clinical outcomes in patients with operable colon cancer

2019 ◽  
Author(s):  
zhigui li ◽  
Tiangen Ni ◽  
Yong Zhou ◽  
Xiaoting Wu
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Univariate Analysis ◽  
Prognostic Nutritional Index ◽  
Radical Resection ◽  
Predictive Values ◽  
Lymphocyte To Monocyte Ratio ◽  
Nutritional Index

Abstract Background: Systemic inflammation plays an important part in tumorigenesis and progression. The predictive values of the preoperative lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) in colon cancer remained unclear. Methods: A total of 308 patients with colon cancer undergoing radical resection were enrolled and analyzed. The receiver operating curves were applied to identify the thresholds for these biomarkers. Kaplan-Meier method and multivariate analysis were used to identify independent prognostic factors. Results: The univariate analysis showed that elevated LMR and PNI were significantly correlated with better overall survival and progression-free survival. The multivariate analysis showed that LMR and PNI were the independent prognostic factors for overall survival. Conclusions: Preoperative LMR and PNI could serve as useful prognostic factor in patients with colon cancer undergoing radical resection.

scholarly journals Prognostic factors for elderly gastric cancer patients who underwent gastrectomy

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Shunji Endo ◽  
Tomoki Yamatsuji ◽  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Performance Status ◽  
Postoperative Mortality ◽  
Prognostic Nutritional Index ◽  
Pathological Stage ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Abstract Background Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed. Methods The medical records of 166 patients aged ≥ 80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival. Results In univariate analyses, age (≥ 90 vs. ≥ 80, < 85), performance status (3 vs. 0), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), Onodera’s prognostic nutritional index (< 40 vs. ≥ 45), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥ 40 vs. ≥ 20, ≤ 29), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥ D2), pathological stage (II–IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24–4.24], extent of gastrectomy (total vs. distal, HR 2.17, 95% CI 1.10–4.31) (proximal vs. distal, HR 4.05, 95% CI 1.45–11.3), extent of lymphadenectomy (D0 vs. ≥ D2, HR 12.4, 95% CI 1.58–97.7), and pathological stage were independent risk factors for mortality. Conclusions ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia is best avoided.

scholarly journals Clinical and therapeutic features and prognostic factors of metastatic colorectal cancer over age 80: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroyuki Hisada ◽  
Yu Takahashi ◽  
Manabu Kubota ◽  
Haruhisa Shimura ◽  
Ei Itobayashi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Carcinoembryonic Antigen ◽  
Prognostic Nutritional Index ◽  
Hazard Ratio ◽  
Elderly Group ◽  
Younger Patients ◽  
Nutritional Index

Abstract Background Colorectal cancer (CRC) is one of the most common cancers in the world. The number of elderly patients with CRC increases due to aging of the population. There are few studies that examined chemotherapy and prognostic factors in metastatic colorectal cancer (mCRC) patients aged ≥ 80 years. We assessed the efficacy of chemotherapy and prognostic factors among patients with mCRC aged ≥ 80 years. Methods We retrospectively analyzed clinical and laboratory findings of 987 patients newly diagnosed with CRC at Asahi General Hospital (Chiba, Japan) between January 2012 and December 2016. The Kaplan–Meier method was used for the overall survival (OS) and the log-rank test was used to identify difference between patients. A multivariate Cox proportional hazard regression analysis was performed to determine the hazard ratios and 95% confidence intervals (CIs) of prognostic factors among super-elderly patients. Results In total, 260 patients were diagnosed with mCRC (super-elderly group: n = 43, aged ≥ 80 years and younger group, n = 217, aged < 80 years). The performance status and nutritional status were worse in the super-elderly group than in the younger group. The OS of super-elderly patients who received chemotherapy was worse than that of younger patients (18.5 vs. 28.8 months; P = 0.052), although the difference was not significant. The OS of patients who received chemotherapy tended to be longer than that of those who did not; however, there were no significant differences in OS in the super-elderly group (18.5 vs. 8.4 months P = 0.33). Multivariate analysis revealed that carcinoembryonic antigen levels ≥ 5 ng/mL (hazard ratio: 2.27; 95% CI 1.09–4.74; P = 0.03) and prognostic nutritional index ≤ 35 (hazard ratio: 8.57; 95% CI 2.63–27.9; P = 0.0003) were independently associated with poor OS in the super-elderly group. Conclusions Patients with mCRC aged ≥ 80 years had lower OS than younger patients even though they received chemotherapy. Carcinoembryonic antigen and prognostic nutritional index were independent prognostic factors in super-elderly patients with mCRC, but chemotherapy was not. Trial registration: retrospectively registered.

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