Prognostic significance of the AJCC staging in patients with squamous cell carcinoma of the oropharynx.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5529-5529
Author(s):  
Carlos Rodrigo Acevedo-Gadea ◽  
Megan Ann Baumgart ◽  
Zuoheng Wang ◽  
Hari Anant Deshpande ◽  
Marianne Davies ◽  
...  
Keyword(s):  
Squamous Cell ◽  
Opposite Effect ◽  
Cox Model ◽  
Prognostic Significance ◽  
Prognostic Impact ◽  
Eligibility Criteria ◽  
Ajcc Stage ◽  
Kaplan Meier ◽  
Stage Ivb ◽  
Ajcc Staging

5529 Background: There have been significant changes in the epidemiology of head and neck squamous cell carcinomas (HNSCC), with an increase in the incidence of oropharyngeal (OP) cancer and opposite effect in other sites. Since the rise in OP cancer incidence is attributed to human papillomavirus (HPV), which is associated with a different biology and clinical behavior, we evaluated whether the current AJCC system retained its prognostic impact in this patient population. Methods: The Surveillance Epidemiology and End Results (SEER) registry was queried for patients with HNSCC diagnosed between 2004 and 2007. Overall survival (OS) was estimated by the Kaplan-Meier method and the Cox model was used to compare the survival curves for each AJCC stage. Patients were grouped into three anatomical locations: oral cavity (OC), larynx (L) and OP. Results: There were 26,520 patients meeting eligibility criteria, including 8622 OP, 7332 OC, and 10566 L. The AJCC staging retained its prognostic significance across all stages for patients with HNSCC of the OC and L. Patients with OP cancer, however, had similar 4-year survival for stages I through IVA, whereas stage IVB and IVC had a significantly decrease survival compared to IVA and IVB respectively (Table). Conclusions: The OS for stages III and IVA OP cancer is similar to those with stages I and II, in an effect that may be attributed to the increased frequency of HPV in this population, rendering the tumors more sensitive to chemotherapy and radiation. Therefore, the AJCC stage in OP cancer may be more useful in guiding the therapy than as a prognostic factor. [Table: see text]

scholarly journals Tumor Infiltration by OX40+ Cells Enhances the Prognostic Significance of CD16+ Cell Infiltration in Colorectal Cancer

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482090338
Author(s):  
Fabian Haak ◽  
Isabelle Obrecht ◽  
Nadia Tosti ◽  
Benjamin Weixler ◽  
Robert Mechera ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Immune Cell ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Tumor Necrosis Factor Receptor ◽  
Tissue Microarrays ◽  
Cell Infiltration ◽  
Prognostic Impact ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Objectives: Analysis of tumor immune infiltration has been suggested to outperform tumor, node, metastasis staging in predicting clinical course of colorectal cancer (CRC). Infiltration by cells expressing OX40, a member of the tumor necrosis factor receptor family, or CD16, expressed by natural killer cells, monocytes, and dendritic cells, has been associated with favorable prognosis in patients with CRC. We hypothesized that assessment of CRC infiltration by both OX40+ and CD16+ cells might result in enhanced prognostic significance. Methods: Colorectal cancer infiltration by OX40 and CD16 expressing cells was investigated in 441 primary CRCs using tissue microarrays and specific antibodies, by immunohistochemistry. Patients’ survival was evaluated by Kaplan-Meier and log-rank tests. Multivariate Cox regression analysis, hazard ratios, and 95% confidence intervals were also used to evaluate prognostic significance of OX40+ and CD16+ cell infiltration. Results: Colorectal cancer infiltration by OX40+ and CD16+ cells was subclassified into 4 groups with high or low infiltration levels in all possible combinations. High levels of infiltration by both OX40+ and CD16+ cells were associated with lower pT stage, absence of peritumoral lymphocytic (PTL) inflammation, and a positive prognostic impact. Patients bearing tumors with high infiltration by CD16+ and OX40+ cells were also characterized by significantly longer overall survival, as compared with the other groups. These results were confirmed by analyzing an independent validation cohort. Conclusions: Combined infiltration by OX40+ and CD16+ immune cells is an independent favorable prognostic marker in CRC. The prognostic value of CD16+ immune cell infiltration is significantly improved by the combined analysis with OX40+ cell infiltration.

Implications for the American Joint Committee on Cancer staging systems on esophageal squamous cell cancer patients receiving multimodality therapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 123-123
Author(s):  
Motoo Nomura ◽  
Tetsuya Abe ◽  
Azusa Komori ◽  
Yukiya Narita ◽  
Shiori Uegaki ◽  
...  
Keyword(s):  
Regression Model ◽  
Cancer Patients ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Staging System ◽  
Prognostic Impact ◽  
American Joint Committee ◽  
Staging Systems ◽  
Ajcc Staging System ◽  
Ajcc Staging

123 Background: The 7th edition of the American Joint Committee on Cancer (AJCC) staging system is based on pathologic data from esophageal cancers treated by surgery alone. The objective of this study was to evaluate the prognostic impact of the pretreatment clinical stage (cTNM) and posttreatment pathologic stage (ypTNM) on esophageal cancer patients undergoing neoadjuvant chemotherapy followed by surgery (NAC-S). Methods: Information on 245 consecutive esophageal squamous cell carcinoma patients undergoing NAC-S was reviewed. Data collected included demographics, cTNM, ypTNM, and survival. Statistical methods included the Cox regression model, Akaike information criterion (AIC) within the Cox proportional hazard regression model, and Kaplan-Meier analyses. Results: The overall three-year survival rate was 67.6%. There were significant differences between stages II and III in cTNM and ypTNM stage, respectively (P < 0.01, respectively). There were no significant survival differences between stages I and II, between stages III and IV in each TNM stage. For all patients, cN stage (cN0 vs. cN1-3), ypT stage (ypT0-2 vs. ypT3-4), ypN stage (N0 vs. N1-3), and ypM stage were independent prognostic factors by multivariate analysis (P< 0.05). Compared with cTNM stage, ypTNM stage has a smaller AIC value, which described the optimum prognostic stratification. Conclusions: Our study indicates that the ypTNM stage of the 7th edition of AJCC staging system has better performance than the cTNM stage in patients undergoing NAC-S.

Additive prognostic impact of elevated De Ritis ratio and renal score in predication of survival outcomes in localized renal cell carcinoma.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 532-532 ◽  
Author(s):  
Zachary Hamilton ◽  
Aaron Bloch ◽  
Charles Field ◽  
Katherine Elaine Fero ◽  
Sean Berquist ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Cox Model ◽  
Inflammatory Marker ◽  
Clinical Staging ◽  
Survival Outcomes ◽  
Prognostic Impact ◽  
Kaplan Meier ◽  
The Impact

532 Background: Renal Cell Carcinoma (RCC) is a metabolically driven neoplasm. Inflammatory markers and morphometric measures have been suggested to be predictive for prognosis. We investigated the impact of a novel combination of preoperative tumor morphology (RENAL score) and a laboratory based inflammatory marker (DeRitis Ratio, AST/ALT) on survival outcomes in localized RCC. Methods: Single center, retrospective analysis of 264 patients with RCC (112 PN, 152 RN, mean follow-up 45 months) from 2003−2015. A priori, we assigned a positive marker score of “1” if RENAL >8 or DeRitis >1.5. Patients were stratified by increasing positive markers (“0”=RENAL ≤8 and DeRitis ≤1.5, “1”=RENAL >8 or DeRitis >1.5, “2”=RENAL >8 and DeRitis>1.5). Primary outcome was overall survival (OS). Cox models and Kaplan−Meier curves were utilized. Results: 264 patients, 61.7% male, mean age 64.5 ± 12.8 years, mean BMI 28.5 ± 5.6, mean AST/ALT 1.1 ± 0.4. With regards to tumor characteristics, mean clinical tumor size 4.7 ± 3.2cm and median RENAL score 9 (IQR 7−10). For clinical staging, 75.7% were cT1, 17.4% were cT2, and 6.9% were >cT2. 32.6% had 0 positive markers, 60.2% had 1 marker, and 7.2% had 2 markers. Kaplan−Meier analysis for “0”, “1”, and “2”demonstrated significantly worsened OS (log−rank p=0.03). On Cox model for OS, RENAL >8 (HR 2.13, p=0.01) or AST/ALT >1.5 (HR 2.25, p=0.028) were significantly associated with worsened survival, as was combined RENAL >8 and DeRitis > 1.5 (HR 5.1, p<0.001). Conclusions: Novel combination of a morphological score (RENAL) and an inflammatory marker (DeRitis ratio) was associated with worsened OS in localized RCC. Our findings point toward development and validation of a prognostic index to assist in risk stratification for localized RCC.

Real world eligibility for cabozantinib (C), regorafenib (Reg), and ramucirumab (Ram) in hepatocellular carcinoma (HCC) patients after sorafenib (S).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 422-422 ◽  
Author(s):  
Andrea S. Fung ◽  
Vincent C. Tam ◽  
Daniel E. Meyers ◽  
Hao-Wen Sim ◽  
Jennifer J. Knox ◽  
...  
Keyword(s):  
Real World ◽  
Performance Status ◽  
Outcome Data ◽  
Prognostic Impact ◽  
Eligibility Criteria ◽  
Cancer Centre ◽  
Kaplan Meier ◽  
Real World Evidence ◽  
Receive Treatment ◽  
New Treatments

422 Background: The CELESTIAL, RESORCE, and REACH-2 trials showed survival benefit of C, Reg, and Ram, respectively, when given after S to HCC patients. However, strict eligibility criteria (SEC) may limit generalizability. In clinical practice, modified eligibility criteria (MEC) may be used to offer treatments to select patients with slightly worse performance status (ECOG 2) or limited liver dysfunction (Child-Pugh (CP) B7). This study evaluated which patients in the real world would be eligible for these new treatments using SEC and MEC, and their prognostic impact. Methods: HCC patients who received S between 01/2008-06/2017 in British Columbia, Alberta, Princess Margaret Cancer Centre, and Sunnybrook Cancer Centre in Canada were included. Clinical, pathologic, laboratory and outcome data were collected. Patients were classified as eligible or ineligible based on available CELESTIAL, RESORCE, REACH-2 clinical trial SEC or MEC. Median overall survival (mOS) for these groups was assessed using the Kaplan-Meier method. Results: A total of 730 patients were identified. Using SEC, only 13.1% of patients would be eligible for C, Reg, or Ram (table). Expanding eligibility to include patients who meet MEC increased the proportion of eligible patients to 31.7%. Patients who met SEC had longer mOS compared to those who were ineligible. The most common reasons for not meeting SEC across all 3 trials were ECOG ≥ 2 (61.7%) and CP ≥ B (63.9%). Higher ineligibility for Reg or Ram was likely driven by strict trial-specific criteria, with 28.0% of patients ineligible for Reg due to S intolerance and 58.9% ineligible for Ram due to AFP < 400. Conclusions: Only a small proportion of real-world HCC patients would be eligible for C, Reg, or Ram based on SEC. More than twice as many patients would likely receive treatment if MEC were applied. If MEC are adopted, ongoing real-world evidence generation will be important to evaluate outcomes in these unstudied patient groups. [Table: see text]

scholarly journals Overexpression of PVR and PD-L1 and its association with prognosis in surgically resected squamous cell lung carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jii Bum Lee ◽  
Min Hee Hong ◽  
Seong Yong Park ◽  
Sehyun Chae ◽  
Daehee Hwang ◽  
...  
Keyword(s):  
Squamous Cell ◽  
Lung Carcinoma ◽  
Prognostic Significance ◽  
Patient Characteristics ◽  
Cancer Center ◽  
Squamous Cell Lung Carcinoma ◽  
Cell Lung Carcinoma ◽  
Kaplan Meier ◽  
Poliovirus Receptor ◽  
Stage 1

AbstractTargeting T-Cell Immunoreceptor with Ig and ITIM domain-poliovirus receptor (PVR) pathway is a potential therapeutic strategy in lung cancer. We analyzed the expression of PVR and programmed death ligand-1 (PD-L1) in surgically resected squamous cell lung carcinoma (SQCC) and determined its prognostic significance. We collected archival surgical specimens and data of 259 patients with SQCC at Yonsei Cancer Center (1998–2020). Analysis of variance was used to analyze the correlations between PVR and PD-L1 expression and patient characteristics. Kaplan–Meier curves were used to estimate recurrence-free survival (RFS) and overall survival (OS). Most patients were male (93%); the majority were diagnosed with stage 1 (47%), followed by stage 2 (29%) and stage 3 (21%). Overexpression of PVR resulted in a significantly shorter median RFS and OS (P = 0.01). PD-L1 expression was not significant in terms of prognosis. Patients were subdivided into four groups based on low and high PVR and PD-L1 expression. Those expressing high levels of PVR and PD-L1 had the shortest RFS (P = 0.03). PVR overexpression is associated with a poor prognosis in surgically resected SQCC. Inhibition of PVR as well as PD-L1 may help overcome the lack of response to immune checkpoint monotherapy.

scholarly journals Survival Significance of Number of Positive Lymph Nodes in Oral Squamous Cell Carcinoma Stratified by p16

2021 ◽  
Vol 11 ◽  
Author(s):  
Peng Li ◽  
Qigen Fang ◽  
Yanjie Yang ◽  
Defeng Chen ◽  
Wei Du ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Model ◽  
Disease Free Survival ◽  
Kaplan Meier ◽  
The Difference ◽  
Positive Lymph Nodes

Objectives: To analyze the significance of the number of positive lymph nodes in oral squamous cell carcinoma (SCC) stratified by p16.Methods: A total of 674 patients were retrospectively enrolled and divided into 4 groups based on their number of positive lymph nodes (0 vs. 1–2 vs. 3–4 vs. ≥5). The Kaplan-Meier method was used to calculate the disease-free survival (DFS) and disease-specific survival (DSS) rates. Cox model was used to evaluate the independent risk factor.Results: p16 showed positivity in 85 patients with a rate of 12.6%. In patients with p16 negativity, the 5-year DFS rates were 52%, 39%, and 21% in patients with 0, 1–2, and 3–4 positive lymph nodes, respectively, in patients with ≥5 positive lymph nodes, all patients developed recurrence within 2 years after operation, the difference was significant; the 5-year DSS rates were 60, 38, and 18% in patients with 0, 1–2, and 3–4 positive lymph nodes, respectively, in patients with ≥5 positive lymph nodes, all patients died within 4-years after operation. The difference was significant. In p16 positivity patients, the 3-year DFS rates were 41% and 17% in patients with 0–2 and ≥3 positive lymph nodes, respectively, the difference was significant; the 3-year DSS rates were 84 and 46% in patients with 0–2 and ≥3 positive lymph nodes, the difference was significant.Conclusions: The number of positive lymph nodes is significantly associated with the survival in oral SCC, its survival effect is not affected by p16 status.

Prognostic significance of lymph node dissection on stage-specific survival for patients with primary small intestine tumor treated with enterectomy: A population-based study, 2004-2015

2020 ◽  
Author(s):  
Yifei Chen ◽  
Fei He ◽  
Dan Guo ◽  
Yarui Li ◽  
Ruhua Wang ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cox Regression ◽  
Cox Model ◽  
Prognostic Significance ◽  
Survival Curves ◽  
Small Bowel Tumors ◽  
Kaplan Meier ◽  
Better Than

Abstract Background: The positive rate of lymph node detection(LND) can be used as a predictor of prognosis for patients undergoing radical resection of small bowel tumors; thorough local LND may be crucial for the accurate staging and management of the disease.The purpose of our study was to determine the effect of the LND in specific stages. Methods: This study included 5413 patients with primary small intestine tumors after enterectomy within SEER database from 2004-2015. A multivariable COX model and Kaplan-Meier plots survival curves were used to analyze survival.Results: Of the 5413 patients, 4675(86.4%) underwent lymphadenectomy, and 3896(72.0%) were moved 4 or more than 4 lymph nodes. LND was performed in 67.8%, 83.3%, 87.9%, 89.3% in pT1/2/3/4 disease. In multivariable Cox regression analyses, LND was associated with OS and CSS, and the extended LND are better than limited LND (all P<0.05 except pT2). Kaplan-Meier plots survival curves showed that LND can benefit patients.Conclusions: The removal of LND with 4 or more lymph nodes in pT1/3/4 patients has relatively obvious benefits for survival. The effect of LND with more lymph nodes is significantly better than limited LND. For pT1, pT3 and pT4, LND can be considered.

scholarly journals 2488. Virologic Failure in ART Naïve Patients Initiating on a Dolutegravir or Elvitegravir-Based Regimen

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S862-S863
Author(s):  
Michael Wohlfeiler ◽  
Kathy Schulman ◽  
Jennifer S Fusco ◽  
Yogesh Punekar ◽  
Anthony Mills ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Proportional Hazards ◽  
Virologic Failure ◽  
Cox Model ◽  
Cox Proportional Hazards ◽  
People Living With Hiv ◽  
Eligibility Criteria ◽  
Kaplan Meier ◽  
Lower Baseline ◽  
Living With Hiv

Abstract Background Robust pharmacoeconomic modeling is dependent on high quality inputs, preferably from randomized clinical trials (RCT), but not all needed head to head comparisons occur in RCTs. We compared virologic outcomes in an antiretroviral (ART) naïve population initiating a dolutegravir (DTG) or elvitegravir (EVG)-based regimen using clinical trial-like criteria. Methods ART-naïve adults, initiating a DTG- or EVG-based regimen and meeting all study eligibility criteria (Figure 1) were identified in the OPERA® Observational Database, a collaboration of HIV caregivers following 100,000+ people living with HIV (PLWH) through electronic medical records. PLWH were followed from the date of first prescription until DTG- or EVG discontinuation, death, or study end (July 31, 2018). The primary outcome was verified (2 consecutive viral load (VL) ≥200 copies/mL or 1 VL ≥200 copies + discontinuation) virologic failure (VF), defined as either failure to achieve suppression (<50 copies/mL) prior to 36 weeks or failure to maintain suppression once achieved. Survival analyses were conducted with Kaplan–Meier methods and multivariate Cox Proportional Hazards modeling. Results A total of 1,688 (DTG) and 2,537 (EVG) met all eligibility criteria. Median (IQR) length of follow-up in the DTG users was 21 months (14–30), in the EVG users was 20 (14–32) months. Figure 2 characterizes baseline demographic/clinical characteristics. Figures 3 and 4 depict Kaplan–Meier curves and Cox model results, respectively. VF was experienced by 8.2% DTG and 10.9% EVG initiators at a rate (95% CI) per 1,000 person-years of 40.2 (33.8, 47.8) and 51.3 (45.3, 58.1), respectively. Younger age (18–25), being African American, having a baseline CD4 count ≤ 200, or having a government-based payer (ADAP, Ryan White, Medicaid, or Medicare) at baseline were associated with a significant (P < 0.05), increased hazard of VF. Initiating on DTG or initiating therapy with a lower baseline VL was associated with a significant, reduced hazard of VF. Compared with DTG, the adjusted hazard ratio for VF was 1.29 (95% CI: 1.02, 1.63) for EVG. Conclusion Among ART-naïve patients, DTG users were significantly less likely to experience virologic failure than EVG users after adjustment for important baseline covariates. Disclosures All authors: No reported disclosures.

scholarly journals The prognostic significance of primary tumor size in squamous cell carcinoma of the penis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kai Li ◽  
Guang Wu ◽  
Caibin Fan ◽  
Hexing Yuan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Size ◽  
Primary Tumor ◽  
Prognostic Significance ◽  
Independent Prognostic Factor ◽  
Primary Tumor Size ◽  
Kaplan Meier

Abstract Background To evaluate the association of primary tumor size with clinicopathologic characteristics and survival of patients with squamous cell carcinoma of the penis (SCCP). Methods This study analyzed the data of 1001 patients with SCCP, obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2014. The Kaplan–Meier method and the Cox proportional hazards regression model were used to analyze the effects of primary tumor size on overall survival (OS) and penile carcinoma-specific survival (PCSS). Results Advanced T stage (P < 0.001), lymph node metastasis (P < 0.001) and distant metastasis (P = 0.001) were more frequently associated with SCCP patients with tumor size ≥ 3 cm than those with tumor size  < 3 cm. In Kaplan–Meier analyses, the patients with large tumors (≥ 3 cm) exhibited an inferior OS and PCSS than those with small tumors (< 3 cm). Moreover, tumor size was identified to be an independent prognostic factor for OS [hazard ratio (HR) 1.665, P < 0.001] and PCSS (HR 2.076, P = 0.003) of patients with SCCP in multivariate analyses. Conclusions Large tumor size is associated with adverse clinicopathological characteristics of patients with SCCP. Besides, tumor size represents an independent prognostic factor for OS and PCSS. Therefore, clinical assessment of tumor size as a crucial prognostic factor might be highly beneficial for early intervention in patients with SCCP.

scholarly journals Hypoalbuminemia for the Prediction of Survival in Patients with Organ Metastatic Cervical Cancer

2021 ◽  
Author(s):  
Nobuhisa YOSHIKAWA ◽  
Masato YOSHIHARA ◽  
Satoshi TAMAUCHI ◽  
Yoshiki IKEDA ◽  
Akira YOKOI ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Serum Albumin ◽  
Characteristic Curve ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Primary Treatment ◽  
Clinicopathological Characteristics ◽  
Kaplan Meier ◽  
Stage Ivb

Abstract We evaluated the prognostic significance of malnutrition in patients with metastatic cervical cancer. In this study, we retrospectively analyzed the cases of 43 patients with stage IVB (FIGO2018) cervical cancer treated at our institute during December 2004–December 2017. We determined the correlation between clinicopathological characteristics and survival by performing univariate and multivariate analyses. The serum albumin value at diagnosis was used as an index of malnutrition. The median follow-up period was 16.4 months (range, 0.9—91.4 months). On Kaplan-Meier analysis, the 1- and 2-year overall survival (OS) rates for all patients were 61.6% and 48.6%, respectively. The optimal serum albumin for predicting 1-year survival was 3.3 g/dL, as determined by the receiver operating characteristic curve to maximize the area under the curve. The overall survival (OS) of the patients with albumin >3.3 g/dL (n=28) was significantly better than that of the patients with albumin ≤3.3 g/dL (n=15) (p=0.0041). The multivariate analysis revealed that albumin and mode of primary treatment were significantly associated with survival in patients with stage IVB cervical cancer. Hypoalbuminemia was an unfavorable prognostic factor for patients with metastatic cervical cancer..

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