Prognostic impact of radiology response and tumor volume among patients with locally advanced squamous cell carcinoma of the head and neck (LASCHNC) treated with concomitant chemoradiation

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17035-e17035
Author(s):  
D. Herchenhorn ◽  
A. L. Souza ◽  
A. M. Souza ◽  
E. T. Boasquevisque ◽  
E. M. Boasquevisque ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Disease Free Survival ◽  
Post Treatment ◽  
Volume Reduction ◽  
Base Line ◽  
Prognostic Impact ◽  
Free Survival ◽  
Treatment Changes ◽  
Tumor Volume Reduction ◽  
Disease Free

e17035 Background: There are no validated prognostic factors to predict response of chemo/RT in LASCHNC. Tumor volume as well as post-treatment CT radiology response have been studied in small retrospective series. An analysis of tumor volume and CT radiology response-score to endoscopic and pathologic responses as well as disease free survival was performed. Methods: In a single institution phase I-II study LASCHNC of oropharynx, hypopharynx and larynx were treated with concurrent radiation, cisplatin and erlotinib. 34 patients (pts) underwent a base line and post treatment CT (after 6 weeks), endoscopic evaluation and biopsy. Tumor volume was measured by multiplying the longest diameter by 0,523. (Cancer Res Clin Oncol. 2005), CT post-treatment changes score used as proposed by Pamejier et al., using a 3-point CT-score: 1 = expected post-treatment changes; 2 = focal mass with a maximal diameter of < 1 cm and/or asymmetric obliteration of laryngeal tissue planes; 3 = focal mass with a diameter of > 1 cm, or < 50% estimated tumor volume reduction. Results: Median tumor volume (mTV) was 21cm3 (0.3 to 178), median disease free survival (mDFS) in pts with tumor volume greater than mTV was 20.4 months and not reached in patients with tumor volume lower than mTV, log-rank 5.9, p = 0.015. The median tumor volume reduction by CT was 84% (-62 a 100%), 8pts were classified as score 1 (23.5%), 1pt score 2 (2.9%), 25pts score 3 (73%). There was a tendency for shorter DFS for those with a score 3, log-rank 3.05, p = 0.08. With a median follow-up of 24 months, 88% of score 1.2 are alive, versus 56% of score 3. Conclusions: There is a great variability in TV in LASCHNC, small tumor volumes were related to longer DFS and there is no correlation between tumor reduction and post-treatment CT score. No significant financial relationships to disclose.

scholarly journals Adaptive Radiotherapy for Head and Neck Cancer

2016 ◽  
Vol 16 (2) ◽  
pp. 218-223 ◽  
Author(s):  
Murat Surucu ◽  
Karan K. Shah ◽  
John C. Roeske ◽  
Mehee Choi ◽  
William Small ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Tumor Volume ◽  
Reduction Rate ◽  
Disease Free Survival ◽  
Volume Reduction ◽  
Free Survival ◽  
Original Plan ◽  
Tumor Volume Reduction

Objective: To investigate the effects of adaptive radiotherapy on dosimetric, clinical, and toxicity outcomes for patients with head and neck cancer undergoing chemoradiotherapy with intensity-modulated radiotherapy. Methods: Fifty-one patients with advanced head and neck cancer underwent definitive chemoradiotherapy with the original plan optimized to deliver 70.2 Gy. All patients were resimulated at a median dose of 37.8 Gy (range, 27.0-48.6 Gy) due to changes in tumor volume and/or patient weight loss (>15% from baseline). Thirty-four patients underwent adaptive replanning for their boost planning (21.6 Gy). The dosimetric effects of the adaptive plan were compared to the original plan and the original plan copied on rescan computed tomography. Acute and late toxicities and tumor local control were assessed. Gross tumor volume reduction rate was calculated. Results: With adaptive replanning, the maximum dose to the spinal cord, brain stem, mean ipsilateral, and contralateral parotid had a median reduction of −4.5%, −3.0%, −6.2%, and −2.5%, respectively (median of 34 patients). Median gross tumor volume and boost planning target volume coverage improved by 0.8% and 0.5%, respectively. With a median follow-up time of 17.6 months, median disease-free survival and overall survival was 14.8 and 21.1 months, respectively. Median tumor volume reduction rate was 35.2%. For patients with tumor volume reduction rate ≤35.2%, median disease-free survival was 8.7 months, whereas it was 16.9 months for tumor volume reduction rate >35.2%. Four patients had residual disease after chemoradiotherapy, whereas 64.7% (20 of 34) of patients achieved locoregional control. Conclusion: Implementation of adaptive radiotherapy in head and neck cancer offers benefits including improvement in tumor coverage and decrease in dose to organs at risk. The tumor volume reduction rate during treatment was significantly correlated with disease-free survival and overall survival.

scholarly journals The prognostic significance of pretreatment serum γ-glutamyltranspeptidase in primary liver cancer: a meta-analysis and systematic review

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Yang Ou ◽  
Junwei Huang ◽  
Liping Yang
Keyword(s):  
Liver Cancer ◽  
Primary Liver Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Prognostic Impact ◽  
Free Survival ◽  
Effect Measure ◽  
Pretreatment Serum ◽  
Disease Free

Aim: To assess the prognostic value of the pretreatment serum γ-glutamyltranspeptidase (GGT) level in patients with primary liver cancer (PLC). Methods: Relevant studies were systematically searched online on Web of Science, PubMed, and Embase databases published until 9 October 2018. The end points were overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS). Meta-analysis was conducted using hazard ratio (HR), and its 95% confidence interval (CI) as effect measure. Results: A total of 33 eligible studies with 9238 patients with PLC were included in this meta-analysis. The synthesized analysis showed that that higher serum GGT level was significantly related to poorer OS (HR: 1.79, 95% CI: 1.66–1.93, P<0.01), RFS (HR: 1.60, 95% CI: 1.46–1.77, P<0.01), and DFS (HR: 1.52, 95% CI: 1.33–1.73, P<0.01) of patients with PLC. Subgroup analyses demonstrated that the negative prognostic impact of higher serum GGT level on OS and RFS was still of significance regardless of ethnicity, pathological type, sample size, cut-off value, first-line treatment, and analysis type. Conclusion: The pretreatment serum GGT might be a predictive factor of poor prognosis for PLC patients.

scholarly journals Tumor Volume Change after Chemotheraphy as a Predictive Factor of Disease Free Survival for Osteosarcoma

2005 ◽  
Vol 46 (1) ◽  
pp. 119 ◽  
Author(s):  
Seong-Hwan Moon ◽  
Kyoo-Ho Shin ◽  
Jin-Suck Suh ◽  
Woo-Ick Yang ◽  
Jae-Keong Noh ◽  
...  
Keyword(s):  
Volume Change ◽  
Predictive Factor ◽  
Tumor Volume ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Increased Expression of Macrophage Migration Inhibitory Factor (MIF) Receptor CD74 Is Associated with Inferior Outcome in Younger Patients (Pts) with Cytogenetically Normal Acute Myeloid Leukemia (CN-AML): a Cancer and Leukemia Group B (CALGB) Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1616-1616 ◽  
Author(s):  
Eyal C. Attar ◽  
Kati Maharry ◽  
Krzysztof Mrózek ◽  
Michael D. Radmacher ◽  
Susan P. Whitman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cellular Proliferation ◽  
Conflicts Of Interest ◽  
Advanced Pancreatic Cancer ◽  
Disease Free Survival ◽  
Prognostic Impact ◽  
Free Survival ◽  
Expression Levels ◽  
The Impact ◽  
Disease Free

Abstract Abstract 1616 Poster Board I-642 CD74 is a type II integral membrane protein receptor that binds its ligand MIF to induce phosphorylation of the extracellular signal-regulated kinase-1/2 (ERK-1/2) and drive cellular proliferation via nuclear factor-kappa B (NF-kB) activation. CD74 expression has been identified in human solid tumors, and its expression is associated with adverse prognosis in advanced pancreatic cancer. As CD74 is expressed and NF-kB constitutively activated in myeloblasts, we hypothesized that CD74 expression might also be associated with adverse outcome in AML. To investigate the prognostic impact of CD74 expression in the context of other predictive molecular markers in CN-AML, we assessed CD74 expression levels by Affymetrix HG-U133 Plus 2.0 microarray in 102 younger [<60 years (y)] adults with primary CN-AML, treated on the front-line CALGB 19808 trial with an induction regimen containing daunorubicin, cytarabine, etoposide and, in some cases, the inhibitor of multidrug resistance valspodar, and consolidation with autologous stem cell transplantation. Microarray data were analyzed using the Robust Multichip Average method, making use of a GeneAnnot chip definition file, which resulted in a single probe-set measurement for CD74. At diagnosis, CD74 expression, when assessed as a continuous variable, was significantly associated only with extramedullary disease involvement (P=.006) among clinical features, and with none of the molecular prognostic variables tested, including NPM1, WT1, CEBPA, FLT3 (FLT3-ITD and FLT3-TKD) mutations, MLL partial tandem duplication, or differential BAALC and ERG expression levels. Although CD74 expression levels were not associated with achievement of complete remission (CR; 83% vs 81%), higher levels of CD74 were associated with shorter disease-free survival [DFS; P=.046, hazard ratio (HR) 1.85, 95% confidence interval (CI) 1.12-3.08] and with shorter overall survival (OS; P=.02, HR 1.32, CI 1.04-1.67). In multivariable analyses, higher CD74 expression was independently associated with shorter DFS (P=.045, HR 1.98, CI 1.16-3.40), after adjusting for WT1 mutations (P<.001) and FLT3-TKD (P=.04), and shorter OS (P=.01, HR 1.58, CI 1.11-2.25) after adjusting for FLT3-TKD (P=.02), WT1 mutations (P=.007), BAALC expression levels (P=.02), white blood counts (P=.007), and extramedullary involvement (P=.04). As quartiles 2-4 had similar expression levels distinct from the lowest quartile, to display the impact of CD74 expression levels on clinical outcome only, pts were dichotomized into low (the lowest quartile) and high (the top three quartiles) CD74 expressers. The Kaplan-Meier curves for DFS and OS (Figures 1 and 2) are shown below. In conclusion, our study identifies elevated CD74 expression as associated with adverse prognosis in younger CN-AML pts. Since we previously reported that higher CD74 expression was favorably associated with achievement of CR in AML patients receiving chemotherapy plus bortezomib, an inhibitor of the proteasome and NF-kB (Attar et al., Clin Cancer Res, 2008;14:1446-54), it is possible that in future studies elevated CD74 levels can be used not only for prognostication, but also to stratify CN-AML pts to study of bortezomib-containing chemotherapy regimens. Figure 1 Disease free survival Figure 1. Disease free survival Figure 2 Overall survival Figure 2. Overall survival Disclosures No relevant conflicts of interest to declare.

Adjuvant chemotherapy (ACT) in stage II colon cancer (CC) in patients with Lynch syndrome.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3550-3550
Author(s):  
Karsten Schulmann ◽  
Sven Koepnick ◽  
Christoph Engel ◽  
Christiane Bernhardt ◽  
Verena Steinke ◽  
...  
Keyword(s):  
Lynch Syndrome ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Prognostic Impact ◽  
Regression Analyses ◽  
Free Survival ◽  
Kaplan Meier ◽  
Stage Ii Colon Cancer ◽  
Disease Free

3550 Background: Previous studies showed conflicting results regarding the value of ACT in MSI-H CC. A recent study reported differential benefits from 5-FU-based ACT comparing suspected sporadic vs suspected hereditary MSI-H CC. We sought to evaluate the prognostic impact of ACT in a large cohort of Lynch syndrome (LS) patients (pts) with stage II CC. Methods: To minimize selection bias diagnoses >2 years prior to registration in the database of the German HNPCC consortium were excluded. 278 patients (61% male, mean age 42.9y, 13% stage IIB, 51% with MMR gene mutation) were eligible. Overall Survival (OS), CC-specific Survival (CSS), and Disease Free Survival (DFS) were analyzed using Kaplan-Meier and Cox Regression analyses. Results: 5y OS, CSS and DFS were 95%, 95% and 93% respectively. Right-sided CC was independently associated with lower DFS in stage II and IIA. Increasing age was associated with lower OS, CSS and DFS in stage IIA, however we observed only trends in the multivariate analysis. Surgery alone (without ACT) was associated with a slightly lower OS in stage IIA (univariate HR 3,659; 95% CI 0,81-16,5; P=0.092); but not with lower DFS and CSS. Prognosis was not different comparing FOLFOX vs. 5-FU-based ACT. Conclusions: Our data suggest that LS pts with stage II CC do not benefit from ACT. FOLFOX was not superior to 5-FU-based ACT. If our results are confirmed, LS pts with stage IIA CC should not receive ACT. The group of stage IIB CC was too small to make definite conclusions. [Table: see text]

scholarly journals Prognostic Impact of Hypoxia-InduciblemiRNA-210in Patients with Lung Adenocarcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Jun Osugi ◽  
Yuka Kimura ◽  
Yuki Owada ◽  
Takuya Inoue ◽  
Yuzuru Watanabe ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Disease Free Survival ◽  
Inverse Correlation ◽  
Prognostic Impact ◽  
Free Survival ◽  
Cox Analysis ◽  
Medical University ◽  
Disease Stages ◽  
The Relationship ◽  
Disease Free

Objective. The aim of this study was to investigate the prognostic value ofMicroRNA-210(miR-210) expression in patients with non-small-cell lung cancer (NSCLC).Methods. We examined themiR-210expression of samples of 80 patients, who underwent surgical resection at Fukushima Medical University from 2004 to 2007, by using quantitative RT-PCR. The relationship betweenmiR-210expression and clinicopathological factors as well as histological subtype was statistically analyzed.Results.miR-210expression showed an inverse correlation with disease-free and overall survival in patients with NSCLC. Significant correlations were found betweenmiR-210expression and lymph node metastasis, late disease stages, and poor prognosis in patients with adenocarcinoma. Multivariate Cox analysis indicated thatmiR-210expression was an independent prognostic factor for disease-free survival in patients with adenocarcinoma.Conclusions. We showed thatmiR-210may be a prognostic biomarker for patients with NSCLC, especially for those with lung adenocarcinoma.

scholarly journals Survival after Curative Resection for Stage I Colorectal Mucinous Adenocarcinoma

2020 ◽  
Author(s):  
Liang Huang ◽  
Shuangling Luo ◽  
Sicong Lai ◽  
Yonghua Cai ◽  
Zhanzhen Liu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Mucinous Adenocarcinoma ◽  
Disease Free Survival ◽  
Stage I ◽  
Prognostic Impact ◽  
Clinicopathologic Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival ◽  
Disease Free

Abstract Background : The prognostic value of the mucinous adenocarcinoma histotype on the early stages especially for stage I colorectal cancer (CRC) is still unclear. This study determined the clinicopathologic characteristics and long-term outcome of stage I colorectal mucinous adenocarcinomas (MAC).Methods : Among the total of 503 patients with stage I CRC (56 having MAC and 447 having non-MAC) who underwent radical resection, the correlation between clinicopathological factors and MAC was analyzed. Multivariate analysis was performed to determine whether mucinous histotype itself was an independent prognostic impact in stage I patients.Results : MACs were observed more frequently located in the colon than rectum ( p =0.046), more frequently displayed the microsatellite instability (MSI) phenotype ( p =0.023) and had a greater frequency of T2 stage ( p =0.001). The rate of recurrence was 13.5% and the cancer-specific mortality was 4.3% among all stage I CRC patients. There was no difference in disease-free survival and overall survival between MACs and non-MACs. On multivariate analysis, older age ( p =0.030), rectal cancer ( p =0.025), lymphovascular invasion (LVI) ( p <0.001), and microsatellite stability (MSS) phenotypes ( p =0.023) were independently associated to poor survival of stage I CRC. A high carcinoembryonic antigen (CEA) level ( p =0.031), LVI ( p =0.002) and MSS phenotypes ( p =0.012) were independently related to short disease-free survival of stage I CRC.Conclusions : Compared with non-MAC, MAC patients had more T2 patients and more MSI phenotypes in stage I CRC at presentation, but the mucinous histology is not a significant predictor of recurrence and prognosis in stage I CRC.

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