Colorectal treatment effectiveness in a population-based registry: A 1991-1994 and 2001-2005 comparison.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 647-647
Author(s):  
Ge Lin
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Early Stage ◽  
Multivariate Logistic Regression Analysis ◽  
Marked Change ◽  
Survival Advantage ◽  
Treatment Modalities ◽  
Outcome Variable ◽  
Important Prognostic Factor ◽  
Time Periods

647 Background: Providing state and regional cancer treatment prognoses, and comparing them over time are important for both local patients and physicians. The present study is the first in Nebraska, US to compare the change in prognostic factors for five-year survival of CC patients to those of RC patients from two time periods, 1991-1994 to 2001-2005. Methods: CC and RC Patients aged 19 years and older were selected from the Nebraska Cancer Registry the two time periods. The outcome variable was five-year survival (survived or not) from the date of diagnosis up to five years or more. Treatment was divided into five groups: surgery alone, surgery with chemotherapy and radiation therapy (S+CT+RT), surgery with chemotherapy (S+CT), other treatments, and no treatment. Multivariate logistic regression analysis was used to examine the effect of prognostic factors on five-year survival. Results: There was a 7% five-year survival improvement in RC patients from time 1 to time 2 but no survival improvement in CC patients. Younger age, female, being married, and early stage at diagnosis were associated with CC survival advantage in time 1 and time 2. In contrast, for RC patients, female had no survival advantage in time 2 while those in the 65-74 age group showed improved survival with time. With regard to treatment, surgery alone was the most consistent prognostic factor through time, while S+ CT+RT became the most important prognostic factor for survival in RC in time 2, and S+CT became the most important prognostic factor for survival in CC in time 2. Conclusions: There was marked change in treatment modalities for both CC and RC patients between the 1991-1995 and 2001-2005 periods, with a general trend toward better five-year survival prognosis. The most effective treatments for CC and RC patients in the most recent period are Surg+CT and S+CT+RT, respectively.

Prognostic Factors in Early-Stage Leiomyosarcoma of the Uterus

2009 ◽  
Vol 19 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Manuela Pelmus ◽  
Frédérique Penault-Llorca ◽  
Louis Guillou ◽  
Françoise Collin ◽  
Gérard Bertrand ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Vascular Invasion ◽  
Early Stage ◽  
Prognostic Significance ◽  
Figo Stage ◽  
Stage I ◽  
Free Interval ◽  
Important Prognostic Factor ◽  
Pathologic Features

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 × 10−15). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.

The Interaction of Response and FISH-Based Risk Stratification to Better Define Clinical Outcome in Myeloma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1823-1823
Author(s):  
Kevin D Boyd ◽  
Fiona M Ross ◽  
Mark T Drayson ◽  
Roger G Owen ◽  
Alex J Szubert ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
High Risk ◽  
Prognostic Factor ◽  
Induction Therapy ◽  
Response Rates ◽  
Phase Iii ◽  
Prognostic Impact ◽  
Cell Transplant ◽  
Important Prognostic Factor

Abstract Abstract 1823 Background: The achievement of a complete response (CR) is an important prognostic factor in myeloma. The international staging system (ISS) and tumor genetic lesions detected by FISH also impact survival. It is not known whether response rates are adversely affected by these factors, whether achieving CR overcomes the adverse prognosis associated with these factors, or if achievement of CR is more important in a specific biological subgroup. We have examined the importance of CR in the context of these other prognostic factors in the intensive arm of a phase III randomized trial, MRC Myeloma IX, in which all patients were planned to proceed to autologous stem cell transplant (ASCT) after induction. Patients and Methods: Patients were randomized to a conventional or thalidomide-based induction regimen followed by ASCT, with a second randomization to maintenance thalidomide versus no maintenance. Response was assessed after completion of induction therapy and 100 days post-ASCT. iFISH was performed on diagnostic bone marrow samples and genetic lesions associated with adverse progression free survival (PFS) were defined as t(4;14), t(14;16), t(14;20), +1q and 17p-. Results: To confirm that CR was prognostically important in the data set, patients with a CR at 100 days post-ASCT (N=355) were compared to non-CR (N=344) (comprising VGPR, PR and SD). CR was strongly associated with improved PFS (median 30.8 months vs 38.7 months, P<0.001) but was not associated with improved OS at median follow-up of 3.7 years. Response rates were assessed in the context of other prognostic factors. Interestingly, the presence of high risk FISH lesions was not associated with impaired CR rates following induction therapy (P=0.584) or following ASCT (P=0.314). Patients without adverse genetic lesions had a CR rate of 11.1% post-induction which improved to 48.3% post-ASCT. In comparison, patients with adverse FISH lesions had a 13.3% CR rate, rising to 44.9% post ASCT. Similarly, there was no correlation between ISS stage and response. The absence of adverse FISH lesions (hazard ratio (HR) 2.68 (1.94-3.70) P<0.001) and achievement of CR (HR 1.58 (1.15-2.17) P=0.005) were independently associated with improved PFS in multivariate analysis. The prognostic impact of achieving CR was assessed in various prognostic groups. CR was associated with improved PFS in patients with no adverse FISH lesions (N=179)(median PFS 58.4 vs 37.1 months, P=0.031), and in ISS I (N=182)(median PFS 51.2 vs 33.2 months, P=0.008). In patients with adverse FISH lesions, and in ISS II and III, there was a trend towards improved PFS with CR that was not significant. For patients achieving CR as their maximum response (N=398), in a multivariate analysis including the ISS, the presence of high risk FISH lesions was the most significant factor associated with impaired PFS and OS. Patients with more than 1 adverse FISH lesion were associated with an especially high risk of progression or death (PFS HR 6.63 (3.23-13.53) P<0.001; OS HR 5.35 (1.98-14.45) P=0.001). Conclusion: These data show that attainment of CR is an important prognostic factor associated with improved PFS in patients treated with ASCT, and this benefit was most significant in patients with favorable prognostic factors such as lack of adverse FISH lesions and ISS I. The presence of t(4;14), t(14;16), t(14;20), +1q or 17p- was also strongly associated with PFS, and the impaired outcome associated with these adverse genetic lesions was not overcome by achievement of CR, within the context of the therapies used in this trial. The presence of more than 1 adverse FISH lesion identified a patient group with an especially poor prognosis, despite achieving CR. However, CR rates within these high risk patients were similar to patients without adverse genetic features, showing that they were sensitive to chemotherapy, but progressed quickly after therapy was stopped. The implication of these data is that it may be possible to improve the poor outcome of this genetically-defined high risk group with an alternative treatment strategy aimed at maintaining these responses. Disclosures: Gregory: Celgene: Honoraria. Child:Celgene: Honoraria.

Chemotherapy treatment patterns for early-stage breast cancer (ESBC): Decreasing use of anthracycline-based regimens.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 141-141
Author(s):  
Katherine M. Serrurier ◽  
Jimmy Hwang ◽  
Joseph P. McGuire ◽  
Ann C. Griffin ◽  
Michelle E. Melisko ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Early Stage ◽  
Prospective Trial ◽  
Marked Change ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Stage Iii ◽  
Publication Date ◽  
Time Periods ◽  
The Impact

141 Background: Anthracyclines (A), given in sequence or combination with other agents, have been the mainstay of adjuvant chemotherapy (CTX) for ESBC for more than two decades. Recent molecular studies have questioned the value of A for lower risk disease. A single prospective trial presented in 2005 and published in 2006 (Jones et al) compared docetaxel and cyclophosphamide (TC) to doxorubicin and cyclophosphamide and reported improved disease free survival (2006) and overall survival (2009) with TC. We sought to understand the impact of this study on the type of CTX regimens used to treat ESBC. Methods: Using the UCSF Cancer Registry database and including patients who received at least one cycle of CTX at UCSF, we recorded use of A or non-anthracycline (NA) based CTX regimens in women with ESBC and correlated type of CTX with tumor stage, receptor status, and age. Based on the publication date of TC we looked at the use of A versus NA based CTX during two time periods, 2000-2005 and 2006-2010. Results: 1,116 patients met criteria for inclusion; 17 were excluded due to inadequate information. Patient characteristics were: median age 49 (range 21-78), stage I (24%), stage II (56%), and stage III (20%), 50% hormone receptor (HR) +, 25% HER2 +, 17% HR-/HER2-. From 2000-2010, 80% received A CTX. Overall use of A decreased from 95% to 65%, while use of NA based CTX increased from 5% to 35%. The table compares use of NA CTX during the two time periods by clinical variables. Conclusions: Use of NA CTX increased significantly over the 2nd half of the last decade in all cases except those patients with stage III disease. The timing of this marked change correlates with publication of TC, and emphasizes the impact of positive phase III trials on treatment practice. This study was supported by the UCSF Cancer Registry. [Table: see text]

scholarly journals Integrating Pathology, Chromosomal Instability and Mutations for Risk Stratification in Early-stage Endometrioid Endometrial Carcinoma

2020 ◽  
Author(s):  
Yuan Li ◽  
Jiaqi Li ◽  
Ensong Guo ◽  
Jia Huang ◽  
Guangguang Fang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Risk Stratification ◽  
Endometrial Carcinoma ◽  
Molecular Pathology ◽  
Chromosomal Instability ◽  
Risk Model ◽  
Early Stage ◽  
Molecular Characteristics ◽  
Molecular Stratification

Abstract Background: Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patient with specific pathological or molecular characteristics, and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosome resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology, which may be applicable to the risk stratification of EC.Results: By analysis of CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, POLE-mutant, as a favorable prognostic factor, had elevated CIN signatures, and CTNNB1-mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE / CTNNB1 mutation stratified stageⅠendometrioid EC into four groups with improved risk prognostication and treatment recommendations.Conclusions:We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves for further improvement and validation.

scholarly journals Evaluation of Depth of Invasion and Tumor Thickness as a Prognostic Factor for Early-Stage Oral Squamous Cell Carcinoma: A Retrospective Study

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 20
Author(s):  
You-Jung Lee ◽  
Tae-Geon Kwon ◽  
Jin-Wook Kim ◽  
Sung-Tak Lee ◽  
Su-Hyung Hong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Early Stage ◽  
Tumor Thickness ◽  
Depth Of Invasion ◽  
8Th Edition ◽  
T Category

The aim of this study was to compare the effect of using depth of invasion (DOI) versus tumor thickness (TT) as a prognostic factor for early-stage oral squamous cell carcinoma (OSCC). A total of 57 patients with early-stage OSCC treated surgically from 2009 to 2014 at our institution were reviewed retrospectively. Histopathological measurement of DOI and TT was performed. The validation of DOI and TT as prognostic factors was conducted using a Kaplan–Meier survival analysis. TT had no association with disease-specific survival (DSS) or progression-free survival (PFS) in this cohort; however, increased DOI was significantly associated with decreased DSS but not correlated to decreased PFS. The T category of the 7th edition of AJCC was statistically associated with both DSS and PFS; however, the T category of the 8th edition of the AJCC was only associated with DSS. In this study group, TT could not be used as a prognostic factor, and DOI was not by itself sufficient to predict prognosis for early-stage OSCC. The T category in AJCC 8th Edition cannot be considered the sole prognostic factor for early OSCC, so additional prognostic factors may need to be considered.

scholarly journals Integrating Pathology, Chromosomal Instability and Mutations for Risk Stratification in Early-stage Endometrioid Endometrial Carcinoma

2020 ◽  
Author(s):  
Yuan Li ◽  
Jiaqi Li ◽  
Ensong Guo ◽  
Jia Huang ◽  
Guangguang Fang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Risk Stratification ◽  
Endometrial Carcinoma ◽  
Molecular Pathology ◽  
Chromosomal Instability ◽  
Risk Model ◽  
Early Stage ◽  
Molecular Characteristics ◽  
Molecular Stratification

Abstract Background: Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patients with specific pathological or molecular characteristics and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosomes resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology and may be applicable to the risk stratification of EC.Results: By analyzing CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, the POLE mutant, as a favorable prognostic factor, had elevated CIN signatures, and the CTNNB1 mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE/CTNNB1 mutation stratified stageⅠendometrioid EC into four groups with improved risk prognostication and treatment recommendations. Conclusions: We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves further improvement and validation.

scholarly journals Integrating pathology, chromosomal instability and mutations for risk stratification in early-stage endometrioid endometrial carcinoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuan Li ◽  
Jiaqi Li ◽  
Ensong Guo ◽  
Jia Huang ◽  
Guangguang Fang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Risk Stratification ◽  
Endometrial Carcinoma ◽  
Molecular Pathology ◽  
Chromosomal Instability ◽  
Risk Model ◽  
Early Stage ◽  
Molecular Characteristics ◽  
Molecular Stratification

Abstract Background Risk stratifications for endometrial carcinoma (EC) depend on histopathology and molecular pathology. Histopathological risk stratification lacks reproducibility, neglects heterogeneity and contributes little to surgical procedures. Existing molecular stratification is useless in patients with specific pathological or molecular characteristics and cannot guide postoperative adjuvant radiotherapies. Chromosomal instability (CIN), the numerical and structural alterations of chromosomes resulting from ongoing errors of chromosome segregation, is an intrinsic biological mechanism for the evolution of different prognostic factors of histopathology and molecular pathology and may be applicable to the risk stratification of EC. Results By analyzing CIN25 and CIN70, two reliable gene expression signatures for CIN, we found that EC with unfavorable prognostic factors of histopathology or molecular pathology had serious CIN. However, the POLE mutant, as a favorable prognostic factor, had elevated CIN signatures, and the CTNNB1 mutant, as an unfavorable prognostic factor, had decreased CIN signatures. Only if these two mutations were excluded were CIN signatures strongly prognostic for outcomes in different adjuvant radiotherapy subgroups. Integrating pathology, CIN signatures and POLE/CTNNB1 mutation stratified stageIendometrioid EC into four groups with improved risk prognostication and treatment recommendations. Conclusions We revealed the possibility of integrating histopathology and molecular pathology by CIN for risk stratification in early-stage EC. Our integrated risk model deserves further improvement and validation.

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