Prognostic Significance of Chromosome Aberrations in High-Grade Soft Tissue Sarcomas

Purpose To investigate whether previously observed correlations between tumor karyotype and risk of metastases could be reproduced in an independent set of high-grade soft tissue sarcomas (STSs). Patients and Methods In a previous study on high-grade STSs with clonal chromosome aberrations, we identified a number of cytogenetic variables, besides tumor grade and size, that were associated with significantly increased risk of metastases. In the present study, we have tested the predictive value of these cytogenetic variables in a new set of 156 high-grade STSs, all located in the extremities or trunk wall. Results Of the 10 cytogenetic variables that turned out to provide prognostic information in the previous series, encompassing 122 trunk wall or extremity STSs, three were significantly associated with metastases also in the new series. In a final Cox regression analysis including these three cytogenetic variables, as well as tumor grade and size, on the combined series of 278 high-grade STSs, four parameters were found to be significantly associated with metastasis risk: tumor grade 3, tumor size ≥ 5 cm, breakpoint in region 1p1, and gain of region 6p1. Conclusion Our findings suggest that independent prognostic information may be gained from cytogenetic analysis of high-grade STS.

Download Full-text

Prognostic significance of lymph node metastasis and bone, major vessel, or nerve involvement in adults with high-grade soft tissue sarcomas

Cancer ◽

10.1002/1097-0142(19880901)62:5<999::aid-cncr2820620527>3.0.co;2-n ◽

1988 ◽

Vol 62 (5) ◽

pp. 999-1006 ◽

Cited By ~ 37

Author(s):

Wlodzimierz Ruka ◽

Lawrence J. Emrich ◽

Deborah L. Driscoll ◽

Constantine P. Karakousis

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Lymph Node Metastasis ◽

Prognostic Significance ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Node Metastasis ◽

Nerve Involvement ◽

Major Vessel

Download Full-text

Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e23526 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e23526-e23526

Author(s):

Alan T. Blank ◽

Charles Gusho ◽

Steven Gitelis

Keyword(s):

Soft Tissue ◽

Cox Regression ◽

Prognostic Significance ◽

Multivariable Analysis ◽

Distant Metastases ◽

High Grade ◽

Seer Database ◽

Inclusion Criteria ◽

Rare Malignancy ◽

Primary Leiomyosarcoma

e23526 Background: Leiomyosarcoma is a rare malignancy that may occur in bone. This investigation described the characteristics and outcomes of primary leiomyosarcoma of bone (PLB) compared to soft tissue leiomyosarcoma (SLMS). Methods: This study was a retrospective review using the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2016. Continuous and categorial variables were described, and Cox regression were used to identify factors of prognostic significance. Results: Seven thousand five-hundred two patients met inclusion criteria. Seventy-four (1%) were PLB and 7428 (99%) were SLMS. On multivariable analysis for high-grade SLMS radiation (neoadjuvant: HR, 0.56; 95% CI, 0.4-0.8; p = 0.003, and adjuvant: HR, 0.75; 95% CI, 0.6-0.9; p = 0.008) and surgery (procedure specific) improved DSS, while age (HR, 1.013; 95% CI, 1.0-1.1; p < 0.001), tumor size greater than or equal to 5 cm (HR, 3.16; 95% CI, 2.3-4.2; p < 0.001), abdomen/pelvis/trunk/thorax tumors (HR, 1.31; 95% CI, 1.1-1.6; p = 0.006), and distant metastases at presentation (HR, 2.6; 95% CI, 2.1-3.3; p < 0.001) negatively influenced DSS. Conclusions: Radiation and surgery positively influence survival in high-grade SLMS while chemotherapy appears to have no benefit. Surgery alone appears to lower the mortality risk in PLB.

Download Full-text

Focus on the Tumour Periphery in MRI Evaluation of Soft Tissue Sarcoma: Infiltrative Growth Signifies Poor Prognosis

Sarcoma ◽

10.1155/srcm/2006/21251 ◽

2006 ◽

Vol 2006 ◽

pp. 1-5 ◽

Cited By ~ 20

Author(s):

Josefin Fernebro ◽

Marie Wiklund ◽

Kjell Jonsson ◽

Pär-Ola Bendahl ◽

Anders Rydholm ◽

...

Keyword(s):

Soft Tissue ◽

Growth Pattern ◽

Tumour Growth ◽

Neoadjuvant Treatment ◽

Soft Tissue Sarcomas ◽

Prognostic Information ◽

Diffuse Infiltration ◽

Increased Risk ◽

Tumour Periphery ◽

Mri Evaluation

Purpose. Infiltrative microscopical peripheral growth of soft tissue sarcomas (STS) has been shown to be of prognostic importance and preoperative risk stratification could individualize neoadjuvant treatment.Patients and methods. We assessed peripheral tumour growth pattern on preoperative MRI from 78 STS. The findings were correlated to histopathology and to outcome.Results. The MRI-based peripheral tumour growth pattern was classified as pushing in 34 tumours, focally infiltrative in 25, and diffusely infiltrative in 19. All tumours with diffuse infiltration on MRI also showed microscopical infiltration, whereas MRI failed to identify infiltration in two-thirds of the microscopically infiltrative tumours. Diffusely infiltrative growth on MRI gave a 2.5 times increased risk of metastases (P=.01) and a 3.7 times higher risk of local recurrence (P=.02).Discussion. Based on this observation we suggest that MRI evaluation of STS should focus on the peripheral tumour growth pattern since it adds prognostic information of value for decisions on neoadjuvant therapies.

Download Full-text

Antibiotic Allergy and Blood Eosinophils Percent Could Be Prognostic Indicators of Glioma

10.21203/rs.3.rs-148347/v1 ◽

2021 ◽

Author(s):

Liming Cao ◽

Zhanghua Lv ◽

Weiliang Wang ◽

Xue Li ◽

Jing Shi ◽

...

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Tumor Grade ◽

Blood Eosinophil ◽

Low Grade ◽

High Grade ◽

Cox Regression Analysis ◽

Low Grade Gliomas ◽

Antibiotic Allergy ◽

High Grade Gliomas

Abstract Background: Antibiotic allergy and blood eosinophil percentage (EOS%) may play an important role in the prognosis of gliomas, but few studies reported the relationship between antibiotic allergy and glioma as well as EOS% and glioma. The aim of our study was to estimate the relationships between antibiotic allergy, blood eosinophil percentage (EOS%) and glioma prognosis and to conduct a nomogram model for glioma patients. Estimating the effect of antibiotic allergy and EOS% on glioma prognosis may conduce to finding low-cost and safe prognostic indicators of glioma.Methods: We conducted a retrospective cohort study with 656 glioma patients to estimate the associations between antibiotic allergy, EOS% and glioma prognosis by Kaplan-Meier and Cox regression analysis. Stratified analyses were performed according to tumor grade. We constructed a nomogram with age at diagnosis, gender, tumor grade, antibiotic allergy, EOS% to predict the survival probabilities of glioma. Results: During 12 months follow-up, a total of 227 patients were alive and 318 patients died. Antibiotic allergy and EOS% >1.65 conferred a survival advantage on glioma patients. In the stratified analysis by tumor grade, antibiotic allergy was significantly associated with the prognosis of the prognosis of low-grade gliomas (HR = 0.36, 95%CI: 0.13-0.97) and high-grade gliomas (HR = 0.58, 95%CI: 0.36-0.93) in the univariate Cox regression analysis. However, after adjusting for confounding factors in the multivariate Cox regression analysis, antibiotic allergy was only significantly associated with high-grade gliomas (HRadj = 0.50, 95%CI: 0.30-0.82); the relationship between EOS% and glioma prognosis was restricted to low-grade gliomas (HRadj = 0.50, 95%CI: 0.30-0.82). The C-index of nomogram was 0.74.Conclusions: Antibiotic allergy was a protective prognosis factor of high-grade gliomas, EOS% >1.65 was a protective prognosis factor of low-grade gliomas. The nomogram with antibiotic allergy and EOS% could effectively predict the survival probability of glioma.

Download Full-text

The relevance of depressive symptoms for the outcome of patients receiving vitamin K antagonists: results from the thrombEVAL cohort study

European Heart Journal - Cardiovascular Pharmacotherapy ◽

10.1093/ehjcvp/pvz085 ◽

2020 ◽

Author(s):

Matthias Michal ◽

Lisa Eggebrecht ◽

Sebastian Göbel ◽

Marina Panova-Noeva ◽

Markus Nagler ◽

...

Keyword(s):

Cohort Study ◽

Depressive Symptoms ◽

Vitamin K ◽

Cox Regression ◽

Vitamin K Antagonists ◽

Independent Study ◽

Prognostic Information ◽

Cox Regression Analysis ◽

Increased Risk ◽

Patient Health

Abstract Aims Although depressive symptoms are highly prevalent in patients receiving oral anticoagulation (OAC), the relevance of depression for the outcome of anticoagulated individuals is unknown. Methods and results We analysed data from the multicentre cohort study thrombEVAL (NCT01809015) investigating the efficacy of OAC with vitamin K antagonists. There was an independent study monitoring, and an independent review panel assessed the endpoints. Out of n = 1558 participants, information about depressive symptoms, as measured by the two-item screener of the patient health questionnaire (PHQ-2), was available in n = 1405 individuals. The mean follow-up period was 28.04 months, with a standard deviation of 11.52 months. In multivariable Cox regression analysis, baseline PHQ-2 sum score was a strong and robust predictor of clinically relevant bleeding [hazard ratio (HR) 1.13, 95% confidence interval 1.03–1.24; P = 0.011] and all-cause mortality (HR 1.18, 1.08–1.28; P = 0.001) independent of age, sex, high school graduation, partnership, clinical profile, intake of serotonin reuptake inhibitors, and quality of OAC therapy. Individuals with clinically significant depressive symptoms (PHQ-2 ≥ 3) had a 57% increased risk for clinically relevant bleeding (fully adjusted HR 1.57, 1.08–2.28) and 54% greater risk for death (fully adjusted HR 1.54, 1.09–2.17). There was no association of depressive symptoms with thromboembolic events. For hospitalization, individuals with depressive symptoms (PHQ-2 ≥ 3) did not experience an elevated risk in the fully adjusted model (HR 1.08, 0.86–1.35; P = 0.52). Conclusion Assessment of depression by the PHQ-2 provided independent long-term prognostic information beyond common biomedical risk factors. These findings highlight the need for targeting depressive symptoms in the management of patients receiving OAC therapy.

Download Full-text

Prognostic Significance of Activated Akt Expression in Melanoma: A Clinicopathologic Study of 292 Cases

Journal of Clinical Oncology ◽

10.1200/jco.2005.07.168 ◽

2005 ◽

Vol 23 (7) ◽

pp. 1473-1482 ◽

Cited By ~ 186

Author(s):

Derek L. Dai ◽

Magdalena Martinka ◽

Gang Li

Keyword(s):

Cox Regression ◽

Patient Survival ◽

Prognostic Significance ◽

Primary Melanoma ◽

Low Risk ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Dysplastic Nevi ◽

Increased Risk ◽

Melanoma Metastases

Purpose Akt is a serine/threonine kinase that leads to stimulation of cell cycle progression, cell proliferation, and inhibition of apoptosis. To investigate the role of Akt in melanoma pathogenesis, we examined the expression of phospho-Akt (p-Akt; Ser-473) in melanocytic lesions at different stages and analyzed the correlations between the p-Akt expression level and clinicopathologic factors and patient survival. Patients and Methods We evaluated the p-Akt expression in 12 cases of normal nevi, 58 cases of dysplastic nevi, 170 cases of primary melanomas, and 52 cases of melanoma metastases using tissue microarray and immunohistochemistry. Results Strong p-Akt expression was observed in 17%, 43%, 49%, and 77% of the biopsies in normal nevi, dysplastic nevi, primary melanoma, and melanoma metastases, respectively. Significant differences for p-Akt staining pattern were observed between normal nevi and primary melanomas (P < .05), and between primary melanomas and melanoma metastases (P < .001). Furthermore, our Kaplan-Meier survival curves showed that strong p-Akt expression is inversely correlated with both overall and disease-specific 5-year survival of patients with primary melanoma (P < .05 for both). Strikingly, our multivariate Cox regression analysis revealed that p-Akt is an independent prognostic factor in low-risk melanomas (thickness ≤ 1.5 mm; relative risk, 6.44; 95% CI, 1.28 to 32.55; P = .018). Conclusion The expression of p-Akt increases dramatically with melanoma invasion and progression and is inversely correlated with patient survival. In addition, p-Akt may serve as an independent prognostic marker and help to identify those patients with low-risk melanomas who are at increased risk of death.

Download Full-text

Prognostic significance of histological invasion in high grade soft tissue sarcomas

SpringerPlus ◽

10.1186/2193-1801-3-544 ◽

2014 ◽

Vol 3 (1) ◽

Cited By ~ 12

Author(s):

Satoshi Tsukushi ◽

Yoshihiro Nishida ◽

Hiroshi Urakawa ◽

Eiji Kozawa ◽

Naoki Ishiguro

Keyword(s):

Soft Tissue ◽

Prognostic Significance ◽

Soft Tissue Sarcomas ◽

High Grade

Download Full-text

Do Radiation-Associated Soft Tissue Sarcomas Have the Same Prognosis As Sporadic Soft Tissue Sarcomas?

Journal of Clinical Oncology ◽

10.1200/jco.2009.25.1728 ◽

2010 ◽

Vol 28 (12) ◽

pp. 2064-2069 ◽

Cited By ~ 156

Author(s):

Rebecca A. Gladdy ◽

Li-Xuan Qin ◽

Nicole Moraco ◽

Mark A. Edgar ◽

Cristina R. Antonescu ◽

...

Keyword(s):

Multivariate Analysis ◽

Soft Tissue ◽

Cohort Analysis ◽

Prognostic Significance ◽

Soft Tissue Sarcomas ◽

High Grade ◽

Histologic Type ◽

Matched Cohort ◽

Peripheral Nerve Sheath Tumors ◽

Clinicopathologic Factors

Purpose To determine the prognostic significance of histologic type in radiation-associated soft tissue sarcomas (RASs) and determine whether RASs are associated with an inferior prognosis compared with sporadic soft tissue sarcomas (STSs). Patients and Methods One hundred thirty primary RASs were identified from 7,649 STS patients from 1982 to 2007. Multivariate analysis of clinicopathologic factors for disease-specific survival (DSS) was performed for RASs, and a multivariate analysis of radiation exposure was also performed for RASs and sporadic sarcomas. A matched-cohort analysis was performed for radiation-associated and sporadic malignant fibrous histiocytoma (MFH). Results Most RASs were high grade (83%), deep (87%), and truncal (61.5%). The median interval between radiation therapy and RAS development was 10 years (range, 1.3 to 74 years), which varied significantly by histologic type (P = .003). The 5-year DSS was 58%, and independent predictors were size > 5 cm, margin positivity, and histologic type. Multivariate analysis of histologic types of primary, high-grade radiation-associated and sporadic STSs showed that RAS was associated with a worse DSS (hazard ratio, 1.7; range, 1.1 to 2.4; P = .007). For pleomorphic MFH—the most common RAS type—the 5-year DSS was 44% versus 66% in a matched cohort of sporadic MFH patients (P = .07). DSS was significantly worse in primary RAS malignant peripheral nerve sheath tumors (MPNSTs) compared with unmatched sporadic MPNSTs (P = .001). Conclusion Histologic type, margin status, and tumor size are the most important independent predictors of DSS in patients with RASs. DSS in patients with primary RAS is significantly worse compared with sporadic STS independent of sarcoma histologic type.

Download Full-text

Tumor Grade Is Associated With Venous Thromboembolism in Patients With Cancer: Results From the Vienna Cancer and Thrombosis Study

Journal of Clinical Oncology ◽

10.1200/jco.2011.40.1810 ◽

2012 ◽

Vol 30 (31) ◽

pp. 3870-3875 ◽

Cited By ~ 65

Author(s):

Jonas Ahlbrecht ◽

Boris Dickmann ◽

Cihan Ay ◽

Daniela Dunkler ◽

Johannes Thaler ◽

...

Keyword(s):

Venous Thromboembolism ◽

Cox Regression ◽

Tumor Grade ◽

Individual Risk ◽

Rank Test ◽

Cumulative Probability ◽

Low Grade ◽

High Grade ◽

Cox Regression Analysis ◽

Patients With Cancer

Purpose Patients with cancer are at risk of venous thromboembolism (VTE). Tumor-related factors could help estimate patients' individual risk for VTE. Currently, only scarce information on the association between tumor grade and VTE is available. We thus evaluated the role of tumor grade and its association with VTE. Patients and Methods The Vienna Cancer and Thrombosis Study is a prospective, observational cohort study including patients with newly diagnosed cancer or progression of disease after remission. Study end point is the occurrence of symptomatic VTE. Results Seven hundred forty-seven patients with solid tumors received follow-up for a median of 526 days. VTE occurred in 52 patients (7.0%). At study inclusion, 468 patients had low-grade tumors (G1 and G2) and 279 had high-grade tumors (G3 and G4). In multivariable Cox regression analysis including tumor grade, tumor histology, tumor sites, stage, sex, and age, patients with high-grade tumors had a significantly higher risk of VTE compared with those with low-grade tumors (hazard ratio, 2.0; 95% CI, 1.1 to 3.5; P = .015). The cumulative probability of developing VTE after 6 months was higher in patients with high-grade tumors than in those with low-grade tumors (8.2% v 4.0%; log-rank test P = .037). Patients with high-grade tumors had higher D-dimer levels (P = .008) and leukocyte counts (P < .001), and lower hemoglobin levels (P = .008). Conclusion The tumor grade may help identify patients with cancer who are at high risk of VTE. The association of tumor grade with recently identified biomarkers indicates a link between tumor differentiation and pathogenesis of cancer-associated VTE.

Download Full-text