AIDS-Related Kaposi’s Sarcoma: Evaluation of Potential New Prognostic Factors and Assessment of the AIDS Clinical Trial Group Staging System in the Haart Era—the Italian Cooperative Group on AIDS and Tumors and the Italian Cohort of Patients Naïve From Antiretrovirals

2003 ◽  
Vol 21 (15) ◽  
pp. 2876-2882 ◽  
Author(s):  
Guglielmo Nasti ◽  
Renato Talamini ◽  
Andrea Antinori ◽  
Ferdinando Martellotta ◽  
Gaia Jacchetti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Survival Data ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Kaposi’S Sarcoma ◽  
Staging System ◽  
Clinical Staging

Purpose: To assess potential new prognostic factors and to validate the AIDS Clinical Trials Group (ACTG) for AIDS-related Kaposi’s sarcoma (AIDS-KS) staging system in the highly active antiretroviral therapy (HAART) era. Patients and Methods: We collected epidemiologic, clinical, staging, and survival data from 211 patients with AIDS-KS enrolled in two prospective Italian human immunodeficiency virus (HIV) cohort studies. We included in the analysis all patients with the diagnosis of KS made from January 1996, the time at which HAART became available in Italy. Results: In the univariate analysis, survival was not influenced by sex, age, level of HIV viremia at KS diagnosis, HAART at KS diagnosis (HAART-naïve v HAART-experienced), or type of HAART combination. Regarding ACTG classification, the 3-year survival rate was 85% for T0 patients and 69% for T1 patients (P = .007), 83% for S0 patients and 63% for S1 patients (P = .003), and 83% for I0 patients and 71% for I1 patients (P = .06). In the multivariate analysis, only the combination of poor tumor stage (T1) and poor systemic disease (S1) risk identified patients with unfavorable prognosis. The 3-year survival rate of patients with T1S1 was 53%, which was significantly lower compared with the 3-year survival rates of patients with T0S0, T1S0, and T0S1, which were 88%, 80%, and 81%, respectively (P = .0001). Conclusion: In the era of HAART, a refinement of the original ACTG staging system is needed. CD4 level does not seem to provide prognostic information. Two different risk categories are identified: a good risk (T0S0, T1S0, T0S1) and a poor risk (T1S1).

scholarly journals Chronic myeloid leukemia (CML): prognostic factors and survival analysis

1996 ◽  
Vol 114 (1) ◽  
pp. 1083-1090 ◽  
Author(s):  
Gisele Wally Braga ◽  
Maria de Lourdes Lopes Ferrari Chauffaille ◽  
José Eduardo Cajado Moncau ◽  
Elizabeth Xisto Souto ◽  
Maria Regina Regis Silva ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Survival Analysis ◽  
Prognostic Factors ◽  
Univariate Analysis ◽  
Staging System ◽  
Clinical Staging ◽  
Five Factors ◽  
Blood Eosinophils ◽  
Predictive Relationship ◽  
Bone Marrow Blasts

The prognostic value of different factors upon diagnosis of CML was analysed in 45 Philadelphia (Ph1)-positive patients. The median survival was 48 months. Univariate analysis showed 5 poor prognostic factors (male sex, under 45 years-old, bone marrow blasts greater than or equal to 10 percent, blood basophils greater than or equal to 6 percent and blood eosinophils greater than or equal to 6 percent) which provided for the development of a clinical staging system: Stage I with none or one factor and a two-year survival rate of 100 percent; Stage II with two or three factors and two-year survival of 72.2 percent; and Stage III with four or five factors and two-year survival of 0 percent (p = 0.00016). Multivariate survival analysis showed that combination of blood basophilia and bone marrow blasts had the strongest predictive relationship to survival time. We conclude that a combination of pretreatment factors identifies different risk subcategories in CML patients and is helpful in assessing the overall prognosis and the treatment approach.

scholarly journals Risk classification as the basis for clinical staging of diffuse large- cell lymphoma derived from 10-year survival data

Blood ◽  
1989 ◽  
Vol 74 (2) ◽  
pp. 551-557 ◽  
Author(s):  
WS Velasquez ◽  
S Jagannath ◽  
SL Tucker ◽  
LM Fuller ◽  
LB North ◽  
...  
Keyword(s):  
Survival Data ◽  
Risk Model ◽  
Survival Rates ◽  
Staging System ◽  
Large Cell ◽  
Risk Groups ◽  
Lactic Dehydrogenase ◽  
Tumor Burden ◽  
Clinical Staging ◽  
Ann Arbor

Two hundred and fifty previously untreated adult patients with diffuse large-cell lymphomas were treated with a chemotherapy combination of cyclophosphamide, adriamycin, vincristine, prednisone, and low-dose bleomycin (CHOP-Bleo) with or without radiotherapy between 1974 and 1984. The 10-year survival rates for patients with Ann Arbor stages II, III, or IV disease of 55%, 42%, and 40%, respectively, were not significantly different. However, the survival rate of 76% for patients with stage I disease was clearly better. Factors more indicative of prognosis than stage, as found by univariant analysis, were tumor burden, serum lactic dehydrogenase level (LDH), age, and constitutional symptoms. From these, a multivariant analysis selected tumor burden, LDH level, and age as major independent factors for predicting survival (P less than .001). A prognostic risk model constructed on the basis of tumor burden and LDH levels identified four distinct risk groups (A, B, C, D) with 10-year survival rates of 85%, 66%, and 43% for A, B, and C. No patient in group D survived 10 years. These risk groups also had a strong correlation with complete remission rates and with relapse rates. Thus this model proved more effective for identifying patient populations according to their expected responses, durations of remission, and survivals than the Ann Arbor staging system. Detailed information supporting the use of this system for predicting prognosis and for treatment selection for patients with diffuse large-cell lymphomas is provided.

507 NEOADJUVANT AND ADJUVANT CHEMOTHERAPIES FOR PATIENTS WHO UNDERWENT RESECTION FOR SQUAMOUS CELL CARCINOMA CF THE THORACIC ESOPHAGUS

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
J Liu ◽  
Y Wang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Univariate Analysis ◽  
Entire Group ◽  
Thoracic Esophagus ◽  
Term Survival

Abstract   The efficacy of neo-adjuvant chenmotherapy (NCT) and adjuvant chemotherapy (ACT) for squamous cell carcinoma (SCC) of the esophagus has not been fully expounded. This study analyzed the prognostic factors of patients who underwent esophagectomy for SCC of the thoracic esophagus, specially focused on NCT and ACT. Methods From January 2008 to January 2016, 1075 consecutive patients underwent esophgagectomy for stage T3-T4 SCC of the thoracic esophagus. Propensity-score matching (PSM) analyses were conducted in patients who underwent NCT, surgery alone (SA) and ACT. After PSM, there were 83 patients in NCT, 249 patients in SA and 249 patients in ACT group. Postoperative outcomes and prognostic factors of patients in the three groups were analyzed. Univariate analysis was performed using the Kaplan–Meier method and multivariate analysis using the Cox proportional hazard model. Differences were considered to be statistically significant when P < 0.05. Results The incidence of main postoperative complications was 9.6% (8/83) in NCT group compared to 6.8% (34/498) in SA and ACT groups (P = 0.834). In NCT group, 20 patients (24.1%) were downstaged by NCT and 63 patients (75.9%) remained stable. The 3-year survival rate of the entire group was 51.0%, and the 5-year survival rate was 33.4%. The 5-year survival rate was 32.2% in NCT group, 50.9% in ACT, and 19.5% in SA patients. In univariate analysis, both NCT and ACT were associated with long-term survival. In multivariate analysis, however, ACT rather than NCT was independent prognostic factor. Conclusion This study supports the use of postoperative ACT for patients with stage T3 or T4 SCC of the thoracic esophagus, but the effect of NCT needs further study.

Kaposi's sarcoma associated with highly active antiretroviral therapy

2005 ◽  
Vol 16 (8) ◽  
pp. 583-583
Author(s):  
Heidi M Crane ◽  
Heike Deubner ◽  
Jane C Huang ◽  
Paul E Swanson ◽  
Robert D Harrington
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Highly Active

Prognostic factors and validation of prognostic nomograms in patients (pts) treated with three targeted therapies (TTs) for metastatic renal cell carcinoma (mRCC): Results from an Italian survey.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 470-470
Author(s):  
Roberto Iacovelli ◽  
Michele Milella ◽  
Matteo Santoni ◽  
Giuseppe Di Lorenzo ◽  
Cinzia Ortega ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Data ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Cleveland Clinic ◽  
Relative Survival ◽  
Prognostic Role ◽  
Third Line ◽  
Metastatic Sites ◽  
Ecog Ps

470 Background: Outcomes of pts treated with three TTs for mRCC have not been well characterized. Survival data as well as existing prognostic criteria in this population were evaluated. Methods: Pts with clear-cell mRCC who received 3 TTs were included. A questionnaire was send to main Italian centers involved in the treatment of mRCC. Demographic data, history of RCC, type, and length of first-, second-, and third-lines were collected. Values of serum Hb, PLT, neutrophils, LDH and Ca, ECOG-PS, previous RT and number of metastatic sites >2 before the start of third-line were evaluated. Cleveland Clinic, French, Heng, and MSKCC scores and relative survival were calculated. Results: Following the screening of 1,905 pts, 252 (13%) with 3 TTs were identified. The median age was 60 yrs (range 52-68), 73% were male, 96% had nephrectomy and 38% were metastatic at diagnosis. At first-line, the Motzer class was good, intermediate, and poor in 48%, 47%, and 5% of pts, respectively. The median OS from the start of third-line was 14.3 mos (95%CI, 10.1–18.6). Rate and survival by prognostic group according to each classification are reported in table below. When prognostic factors were considered separately, at the univariate analysis ECOG-PS≥2, Hb<LLN, LDH>1.5ULN, Ca>ULN; PLT>ULN; Neu>ULN, and sites of disease >2 had negative prognostic role. Multivariate analysis shows an independent prognostic role only for ECOG-PS≥2 (HR: 1.8; 95%CI: 1.1–2.8), Hb<LLN (HR: 1.8; 95%CI: 1.2–2.6) and neu>ULN (HR: 2.1; 95%CI: 1.2–3.8). Pts were stratified in 3 groups according to the presence of none, 1 or ≥2 prognostic factors. The median OS was 20.3, 13.6 and 7.8 months, respectively (p<0.001). Conclusions: Current nomograms are able to predict survival in patients with mRCC before the third-line with TT. Neutrophils, hemoglobin and ECOG-PS were the most important prognostic factors. [Table: see text]

Prognostic factors in duodenal adenocarcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15797-e15797
Author(s):  
Brandon M Huffman ◽  
Zhaohui Jin ◽  
Cristobal T. Sanhueza ◽  
Mindy L. Hartgers ◽  
Benny Johnson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Tumor Invasion ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Clinical Staging ◽  
Lymph Node Status ◽  
Duodenal Adenocarcinoma

e15797 Background: Duodenal adenocarcinoma is a rare tumor representing approximately 0.3% of all gastrointestinal tract cancers. Prognostic factors in relation to survival outcomes for these patients are sporadically reported in the medical literature. We aimed to evaluate outcomes of patients with duodenal adenocarcinoma who underwent pancreaticojejunostomy treated at Mayo Clinic Rochester from January 1, 2006 to December 31, 2016. Methods: Clinicopathological data of 52 duodenal cancer patients were collected. JMP software was used for statistical analysis. Kaplan-Meier method and log-rank tests were used for survival analysis, and multivariate cox proportional hazards model was used to evaluate the prognostic effect of pertinent clinical variables. All tests were two sided and a P value of < 0.05 was considered significant. Results: The median age at diagnosis was 65.9 years (range 39-81). The median overall survival was 51 months (95% CI 31.3-105.4) and the median progression free survival was 30.4 months with median follow up of 73.4 months. There were 3, 9, 21, and 19 patients with stage I, II, III, and IV disease, respectively. Depth of tumor invasion (p = 0.0156) and lymph node metastasis (p = 0.0441) were associated with overall survival on multivariate analysis. Advanced clinical staging influenced overall survival in univariate analysis, but lost prognostic significance in multivariate analysis. Age, gender, surgical technique, presence of metastases, tumor size, number of lymph nodes removed, location of duodenal segment involvement, and adjuvant treatment had no significant impact on overall survival. Laparoscopic approach did not influence survival but was associated with less hospital days (p = 0.0437). Conclusions: Depth of tumor invasion and lymph node status were associated with improved overall survival in patients with duodenal adenocarcinoma. Laparoscopic procedure decreased the hospital stay without affecting outcomes.

Overview of the Management of AIDS-Related Kaposi's Sarcoma

1996 ◽  
Vol 30 (10) ◽  
pp. 1150-1163 ◽  
Author(s):  
Ashley K. Morris ◽  
Amy Wells Valley
Keyword(s):  
Prognostic Factors ◽  
Combination Chemotherapy ◽  
Kaposi's Sarcoma ◽  
Single Agent ◽  
Prognostic Significance ◽  
Local Therapy ◽  
Kaposi’S Sarcoma ◽  
Interferon Alfa ◽  
Patient Specific ◽  
Disseminated Disease

OBJECTIVE: To review the epidemiology, pathogenesis, clinical presentation, diagnosis, and staging of Kaposi's sarcoma (KS), as well as the current role of local and systemic therapies in the management of AIDS-related KS (AIDS–KS). DATA SOURCES AND STUDY SELECTION: MEDLINE and CANCERLIT searches of the English-language medical literature were conducted. Emphasis was placed on studies published since the onset of the AIDS epidemic in the early 1980s. A manual review of selected bibliographies was also completed. DATA SYNTHESIS: AIDS–KS is a disease with a heterogeneous presentation that affects approximately 20% of patients with AIDS. Although the proportion of AIDS patients developing this disease during the course of their illness is declining, the actual number of AIDS–KS cases is increasing. The etiology of AIDS–KS is not clear, but a sexually transmitted cofactor has been implicated. Recent reports demonstrate that a herpes-like virus may be responsible for the development of KS in patients with and without AIDS. Furthermore, the cellular origin of KS has not been identified and questions remain about whether KS represents a true malignancy. The system used in staging patients with AIDS–KS has changed dramatically since initial therapeutic trials were conducted; this may account for observed differences in outcome among trials. The immunologic status of patients is now included as part of the staging system, since it has prognostic significance. Since specific therapy for AIDS–KS is not curative and does not prolong survival, it should be directed at improving patient cosmesis and palliation of disease-related symptoms. Local therapy, such as radiation, cryotherapy, and intralesional chemotherapy, is recommended for the management of limited disease. Systemic interferon alfa or chemotherapy is indicated for disseminated disease. Interferon alfa is useful in patients with predominantly mucocutaneous disease and is most effective in patients with good prognostic factors, such as absence of B symptoms, no history of opportunistic infections, and a CD4 count of more than 200 cells/mm3. Interferon alfa alone or in combination with zidovudine produces responses in approximately 30% of AIDS–KS patients with good prognostic factors. Single-agent or combination chemotherapy is indicated for rapidly progressive or advanced AIDS–KS. Commonly used agents include doxorubicin, daunorubicin, bleomycin, vincristine, and vinblastine. Responses can be expected in at least 50% of patients treated with single-agent or combination chemotherapy. However, many patients are unable to tolerate the toxicity associated with systemic AIDS–KS therapy. Future research will focus on therapies that target the underlying pathogenesis of this disease. CONCLUSIONS: The optimal therapy for patients with AIDS–KS has not been determined. Treatment is appropriately directed at palliation of disease-related symptoms as no therapy has been unequivocally proven to impact survival. Local therapies should be used in the management of localized disease, while systemic therapy is appropriate for disseminated disease. Interferon alfa is useful in patients with primarily mucocutaneous disease or asymptomatic visceral involvement. Chemotherapy is indicated in patients who have rapidly progressive or advanced disease. Therapy must be individualized according to the patient's disease course and other patient-specific factors.

scholarly journals Phase II Study of Bevacizumab in Patients With HIV-Associated Kaposi's Sarcoma Receiving Antiretroviral Therapy

2012 ◽  
Vol 30 (13) ◽  
pp. 1476-1483 ◽  
Author(s):  
Thomas S. Uldrick ◽  
Kathleen M. Wyvill ◽  
Pallavi Kumar ◽  
Deirdre O'Mahony ◽  
Wendy Bernstein ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Complete Response ◽  
Median Number ◽  
Primary Objective ◽  
Cytotoxic Agents ◽  
Prior Chemotherapy ◽  
Highly Active

Purpose Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti–VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS. Patients and Methods Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfected patients were also eligible and observed separately. Results Seventeen HIV-infected patients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T1), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2). Conclusion Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients.

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