Identification of prognostic value of lymphocyte-to-monocyte ratio in patients with advanced HBV-associated hepatocellular carcinoma.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 206-206
Author(s):  
Zhan-Hong Chen ◽  
Yingfen Hong ◽  
Xiao-kun Ma ◽  
Xing Li ◽  
Dong-hao Wu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Prognostic Value ◽  
Proportional Hazards Model ◽  
Multivariate Analyses ◽  
Independent Prognostic Factor ◽  
Cox Proportional Hazards Model ◽  
Clinicopathological Parameters ◽  
Advanced Hcc

206 Background: Inflammatory microenvironment plays an important role in the progression of HCC. Peripheral blood LMR, as a novel inflammatory biomarker combining an estimate of host immune homeostasis and tumor microenvironment, has been found to be a predictor for clinical outcomes in various malignancies. There have been no reports regarding the prognostic value of LMR in advanced HCC until now. We want to investigate the prognostic value of LMR in patients with advanced HBV-associated hepatocellular carcinoma. Methods: From September 2008 to June 2010, a total of 174 patients with HBV-associated advanced HCC without fever or signs of infections were analyzed. Clinicopathological parameters, including LMR, were evaluated to identify predictors of overall survival. Univariate and multivariate analyses were performed, using the Cox proportional hazards model. The best cutoff was determined with time-dependent receiver operating characteristic curve. Results: Univariate and multivariate analyses showed that LMR was an independent prognostic factor in overall survival in patients with advanced HCC(P < 0.01 ). The best cutoff point of LMR was 4.52. All patients were dichotomized into either a low LMR group( ≤ 4.52) or a high LMR group( > 4.52). Overall survival(OS) of high LMR group was significantly longer than that of low LMR group(P < 0.01 ). High LMR group patients had significantly higher 6-month OS rate(50% vs 23%, P < 0.01) than that of low LMR group patients. Higher LMR level was significantly correlated with the presence of metastasis and larger tumor size(P < 0.05). Conclusions: LMR is an independent prognostic factor of advanced HCC patients. Higher Baseline LMR levels indicates better prognosis.

Survival and prognosticators of gastric cancer patients with only positive peritoneal lavage cytology.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 16-16
Author(s):  
Kazuki Kano ◽  
Tsutomu Sato ◽  
Yukio Maezawa ◽  
Kenki Segami ◽  
Tetsushi Nakajima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Proportional Hazards Model ◽  
Peritoneal Lavage ◽  
Multivariate Analyses ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Peritoneal Cytology ◽  
Peritoneal Lavage Cytology ◽  
Lavage Cytology

16 Background: Treatment strategies for only positive peritoneal lavage cytology findings have not yet been established. The objective of this retrospective study was to clarify the survival and prognosticators in these patients. Methods: Overall survival (OS) rates were examined in 39 patients with gastric cancer who underwent a curative resection and had positive peritoneal cytology in the absence of overt peritoneal metastases between January 2000 and June 2015. Univariate and multivariate analyses were performed to identify risk factors using a Cox proportional hazards model. Results: A total of 39 patients were evaluated. The median overall survival was significantly longer in the 34 patients who received chemotherapy after surgery than that in the 5 who did not (19.1 vs 5.9 months, p < 0.01). Among the patients who received chemotherapy after surgery, univariate and multivariate analyses showed that pN3b was an independent significant prognosticator (hazard ratio of 4.169 with 95% CI: 1.108-15.684, p = 0.035). The median OS was 15.8 months when the patients diagnosed with N3b was 33.1 months when the patients diagnosed with N3a or lower. Conclusions: The prognosis of gastric carcinoma with positive peritoneal lavage cytology without peritoneal metastasis is still poor and need more aggressive treatment. The lymph node metastasis was a significant prognosticator in these patients.

Evaluation of Smad2/3 and Smad4 as inhibitors of estrogens and Ski protein as a predictive factor in T1, T2 N0 breast carcinomas

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1543-1543
Author(s):  
D. S. Koumoundourou ◽  
T. I. Kassimatis ◽  
E. Tzorakoleftherakis
Keyword(s):  
Prognostic Factor ◽  
Prognostic Value ◽  
Independent Prognostic Factor ◽  
Negative Regulator ◽  
Clinicopathological Parameters ◽  
Breast Carcinomas ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Smad Proteins ◽  
Ski Protein

1543 Background: Smad proteins are TGF-β intracellular substrates, and Ski protein is a negative regulator of TGF-pathway. Tamoxifen's inhibition in breast cancer cells is mediated through TGF-β and Smad proteins. The purpose of our study was to investigate the activation of Smad2/3, Smad4, and Ski proteins in breast carcinomas and correlate their expression with each other and with hormonal receptors, as well as with other clinicopathological parameters such as the tumor size and grade, and the Distant Disease Free and the Overall Survival. Methods: One hundred forty-seven paraffin-embedded specimens from 22 in situ and 125 invasive ductal node-negative carcinomas were used, for which we had a mean follow-up time of 96 months. ER and PR status, as well as the expression of Smad2/3, Smad4, and Ski proteins were evaluated using immunohistochemistry. Staining of 5% of the tumor cells was adopted as a threshold. SPSS13 for windows was used for the statistical analysis of the results. Results: Smad2/3 and Smad4 were strongly correlated with each other (p < 0,001) and inversely correlated with patients’ DDFS (Kaplan-Meier plots, p = 0,004 for Smad2/3 and p = 0,026 for Smad4) and OS (Kaplan-Meier plots, p = 0,034 for Smad2/3 and p = 0,017 for Smad4). Smad2/3 was proved to be an independent prognostic factor in grade 1 tumors, while Smad4 was inversely correlated with PR expression (p = 0,028) and had a strong prognostic value in ER+ tumors (p = 0,02). Ski protein had a strong association with tumor grade (p < 0.001) and was found to be an independent prognostic factor in Cox regression analysis (p = 0,006, exp(B) = 4,98). Conclusions: Smad 2/3 and Smad 4 not only are tumor suppressor molecules, but also inhibit ER dependent gene expression. This inhibition is lost when Smad's expression is reduced, and that is a potent explanation for Smad 4 prognostic value in ER positive tumors. Moreover the correlation with PR expression, may be due to the fact that PR is an indicator of ER pathway's integrity and also to PR's enallaktiki activation by ER-β. From the other hand, Ski protein acts as an oncogene in breast carcinogenesis and contributes to the development of a more aggressive tumor phenotype. No significant financial relationships to disclose.

Pretreatment neutrophil/lymphocyte ratio (NLR) prior to steroids as a prognostic factor in metastatic castrate refractory prostate cancer (mCRPC) patients treated with taxanes.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 273-273
Author(s):  
David Chan ◽  
Jennifer Mary McLachlan ◽  
Megan Crumbaker ◽  
Gavin M. Marx
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Sensitivity Analyses ◽  
Rank Test ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

273 Background: The neutrophil/lymphocyte ratio (NLR) has been demonstrated to be a prognostic factor in multiple malignancies. Prior analyses have demonstrated conflicting results in correlation between NLR and overall survival (OS) in mCRPC. Prednisone and dexamethasone, commonly used in chemotherapy regimens for prostate cancer, have been demonstrated to affect neutrophils and hence NLR. We investigated the correlation between pre-dexamethasone NLR and OS in patients with mCRPC. Methods: We performed a retrospective single-center study of patients with mCRPC who received taxane-based chemotherapy (docetaxel or cabazitaxel) between 9/2005 and 12/2012. Patients were included if blood test results were available between 3 and 28 days prior to commencement of chemotherapy. Baseline demographics and NLR were correlated with OS using a Cox proportional hazards model. Results: 42 patients were included, 9 of whom were still alive, with median age 70 and median follow-up 23.1 months. Median OS was 24.1 months. 36 were commenced on docetaxel-based chemotherapy and 6 on cabazitaxel-based chemotherapy. Considering NLR as a categorical variable, OS was significantly better in patients with NLR<5 (n=28) compared to those with NLR>5 (n=14), with median OS 32mo vs 15.4mo and HR 2.155 (95% CI 1.072-4.332, p=0.0007 by log-rank test). In multivariate analyses, NLR (p=0.008) and age (p=0.048) were independent predictors of overall survival. In sensitivity analyses, when including NLRs within 48 hours of chemotherapy initiation, the correlation between NLR and OS was only marginally significant (p=0.048). Conclusions: HighNLR is an adverse prognostic marker for decreased overall survival in mCRPC patients undergoing taxane-based chemotherapy. Previous conflicting results regarding its value may be related to the effect of steroids on NLR.

scholarly journals Systemic Immune-Inflammation Index (SII) is Useful to Predict Survival Outcomes in Patients After Liver Transplantation for Hepatocellular Carcinoma within Hangzhou Criteria

2018 ◽  
Vol 47 (1) ◽  
pp. 293-301 ◽  
Author(s):  
Hongyuan Fu ◽  
Jun Zheng ◽  
Jianye Cai ◽  
Kaining Zeng ◽  
Jia Yao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Roc Curve ◽  
Prognostic Value ◽  
Proportional Hazards Model ◽  
Prognostic Biomarker ◽  
Cox Proportional Hazards Model ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio ◽  
Immune Inflammation

Background: There is growing evidence that the systemic immune-inflammation index (SII), a novel prognostic biomarker based on peripheral lymphocyte, neutrophil, and platelet counts, is associated with poor prognosis for several tumors. However, the prognostic value of SII in patients with hepatocellular carcinoma (HCC) who undergo liver transplantation (LT) remains unclear. The aim of this study was to determine the correlation between SII and prognosis in these patients. Methods: This retrospective study involved 150 patients with HCC who underwent LT within the Hangzhou criteria. The optimal cut-off value was determined by receiver-operating characteristic (ROC) curve analysis to stratify the patients into those with a high SII and those with low SII. The Kaplan-Meier method and the Cox proportional hazards model were used to evaluate the prognostic value of SII. Finally, we calculated the area under the ROC curve to compare the prognostic power of SII, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR). Results: Patients were divided into high SII (≥ 226) and low SII (< 226) groups. Five-year overall survival (OS) was lower in the high SII group than in the low SII group (56.1% vs. 82.4%, p = 0.002). SII ≥ 226 × 109/L, maximum tumor size> 5 cm, microvascular invasion, and poor differentiation were independent prognostic factors for OS. However, SII did not predict 5-year recurrence-free survival (high vs. low SII: 64.1% vs. 78.4%, p = 0.073). The area under the ROC curve was greater for SII than for PLR, NLR, and MLR. Conclusions: Preoperative SII may be a powerful prognostic biomarker in patients with HCC who undergo LT within the Hangzhou criteria. SII is superior to PLR, NLR, and MLR for prediction of OS in these patients.

scholarly journals Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038172
Author(s):  
Linbin Lu ◽  
Zhimin Su ◽  
Peichan Zheng ◽  
Zhixian Wu ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Platelet Count ◽  
Missing Data ◽  
Linear Relationship ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Cancer Center ◽  
Risk Increase ◽  
Non Linear

ObjectivesTo explore the non-linear relationship between platelet count (PLT) and hepatocellular carcinoma (HCC) overall survival (OS).SettingThe study was done in Sun Yat-sen University Cancer Center (SYSUCC) from January 2007 to May 2012, a total of 5005 consecutive participants at SYSUCC were retrospectively reviewed, and 979 patients with Barcelona clinic liver cancer (BCLC) stage B were selected for the final analysis.ParticipantsA total of 979 newly diagnosed patients with HCC with BCLC stage B were identified for the secondary analysis. Eight cases were excluded for missing data of PLT.Main outcome measuresCox proportional hazard regression models were used to calculate multivariable-adjusted HRs and 95% CIs for HCC. The non-linear relationship was estimated through a restricted cubic spline regression, and a two-piecewise Cox proportional hazards model was further performed to calculate the threshold effect. We used multiple imputation to deal with the missing data.ResultsIn the multivariate analysis, Log PLT was associated with a 91% risk increase in death (HR 1.91; 1.28 to 2.85) with adjustment for gender, Child-Pugh class, age × diameter of main tumour, both lobe with lesions × number of the intrahepatic lesions, alpha-fetoprotein (<25, ≥25) and lactic dehydrogenase (<245, ≥245). We also found a U-shape relationship between PLT and HCC OS at the inflexion point of 67.6×109/L. The HR was 0.12 (95% CI 0.03 to 0.52) for Log PLT≤10.83 and 3.07 (CI 1.91 to 4.92) for Log PLT>10.83 after adjusting for potential confounders. The core results were consistent with those from the sensitivity analysis. Besides, a significantly higher hazard risk was found in the patients with age <55, both lobes with lesions, tumour diameter >50, haemoglobin ≥120 and C reactive protein >10.ConclusionPLT was nonlinearly associated with HCC OS.

scholarly journals Objective Response by mRECIST Is an Independent Prognostic Factor for Overall Survival in Hepatocellular Carcinoma Treated with Sorafenib in the SILIUS Trial

Liver Cancer ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. 505-519 ◽  
Author(s):  
Masatoshi Kudo ◽  
Kazuomi Ueshima ◽  
Yasutaka Chiba ◽  
Sadahisa Ogasawara ◽  
Shuntaro Obi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Objective Response ◽  
Independent Prognostic Factor

scholarly journals Objective Response by mRECIST is an Independent Prognostic Factor for overall Survival in Hepatocellular Carcinoma in SILIUS Trial

2019 ◽  
Author(s):  
Masatoshi Kudo ◽  
Kazuomi Ueshima ◽  
Yasutaka Chiba ◽  
Sadahisa Ogasawara ◽  
Shuntaro Obi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Objective Response ◽  
Independent Prognostic Factor ◽  
Combination Group ◽  
Advanced Hepatocellular Carcinoma ◽  
Sorafenib Group ◽  
Landmark Analyses

Background In SILIUS (NCT01214343), combination of sorafenib and hepatic arterial infusion chemotherapy did not significantly improve overall survival in patients with advanced hepatocellular carcinoma (HCC) compared with sorafenib alone. In this study, we explored the relationship between objective response by mRECIST and overall survival (OS) in the sorafenib group, in the combination group and in all patients in the SILIUS trial. Methods Association between objective response and OS in patients treated with sorafenib (n=103), combination (n=102) and all patients (n=205) were analyzed. The median OS of responders was compared with that of non-responders. Landmark analyses were performed according to objective response at several fixed time points, as sensitivity analyses, and the effect on OS was evaluated by Cox regression analysis with objective response as a time-dependent covariate, with other prognostic factors was performed. Results In the sorafenib group, OS of responders (n = 18) was significantly better than that of non-responders (n = 78) (p &lt; 0.0001), where median OS was 27.2 (95% CI, 16.0&ndash;not reached) months for responders and 8.9 (95% CI, 6.5&ndash;12.6) months for non-responders. HRs from landmark analyses at 4, 6, and 8 months were 0.45 (p=0.0330), 0.37 (p=0.0053), and 0.36 (p=0.0083), respectively. Objective response was an independent predictor of OS based on unstratified Cox regression analyses. In the all patients and the combination group, similar results were obtained. Conclusion In the SILIUS trial, objective response was an independent prognostic factor for OS in patients with HCC.

Impact of HCV treatment in patients with advanced hepatocellular carcinoma on sorafenib.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15645-e15645
Author(s):  
Michael Herman ◽  
Yuhua Zhang ◽  
Lisa Wang ◽  
Hao-Wen Sim ◽  
Jennifer J. Knox
Keyword(s):  
Hepatocellular Carcinoma ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Early Stage ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Advanced Hepatocellular Carcinoma ◽  
Sorafenib Treatment ◽  
Advanced Hcc ◽  
Significant Difference

e15645 Background: Hepatocellular carcinoma (HCC) is the 4th leading cause of global cancer deaths. In North America, HCC is most commonly caused by Hepatitis C virus (HCV). Direct acting antivirals (DAAs) have dramatically increased sustained virologic response (SVR) rates for HCV. Studies of DAAs in early stage HCC have had conflicting results on HCC outcomes. A small Asian study of 58 advanced HCC patients treated with sorafenib demonstrated SVR improved survival, but whether the same effect occurs in North American patients is unknown. Methods: Inclusion criteria for this retrospective study were: biopsy or clinically proven advanced incurable HCC, sorafenib treatment at Princess Margaret Cancer Centre between January 1 2008-June 30 2018 and a history of HCV. Survival was analyzed using the Kaplan Meier method and a cox proportional hazards model was fit to determine the effect of SVR on OS. Results: 93 patients were included with a median duration of sorafenib therapy of 3 months. 89% were ECOG 0-1 and 96% were BCLC-C (See table 1). Of those receiving antivirals, 95% were given before sorafenib. Overall, SVR was achieved in 23 (50%) patients. Median OS of patients achieving SVR vs not in SVR was 10.3 vs 8.9 months respectively (HR 0.67, 95% CI 0.36-1.24, p = 0.20). Median PFS was 6.4 vs 5.0 months in patients with or without SVR (HR 0.66, 95% CI 0.39-1.13, p = 0.13). There was no significant difference between mean dose of sorafenib or discontinuation due to toxicity in patients by SVR status. Conclusions: Antiviral therapy with SVR lead to a non-statistically significant improvement in OS in patients with Child-Pugh A-B liver disease, advanced HCC treated with sorafenib and HCV. These results should be validated in larger data-sets. [Table: see text]

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