Prognostic factors of mortality and recurrence of malignant pleural effusion in high-risk tumors according to the LENT Score.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21666-e21666
Author(s):  
Fernando Abrao ◽  
Mariana Campello de Oliveira ◽  
Igor Abreu ◽  
Geisa Garcia ◽  
Renata D'Alpino D'Alpino ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
First Line ◽  
Primary Tumors ◽  
Factors Affecting ◽  
Group I

e21666 Background: The aim of this study was to identify predictors of overall survival (OS) and recurrence after palliative pleural procedures in patients with malignant pleural effusion (MPE) and high-risk tumors according to the LENT Score. Methods: Data was collected from our database between January 2013 and December 2015 of patients with MPE and high-risk tumors according to the LENT Score. All patients were followed-up for at least 30 days after the pleural procedure. We evaluated radiological aspects, biochemical and hematologic parameters as well as clinical features. For OS analysis, patients were divided into two groups. Group I included OS < 30 days and group II included OS > 30 days. Prognostic factors for pleural recurrence and OS were identified by univariate analysis, using Fisher's exact and Student's t-test. Subsequently, significant variables were entered into a multivariate logistic regression analysis ( p < 0.05). Results: A total of 134 patients were included. Median follow-up time for surviving patients was 56 (range: 2-623) days. High-risk primary tumors included lung (66.4%), gastrointestinal (24.6%) , sarcoma (3.7%), urologic (3.7%) and others (1.5%). Forty-four patients in Group I had OS < 30 days while 22 patients had MPE recurrence. Factors affecting OS in univariate analysis were: type of procedure, ECOG, albumin, leukocytes, neutrophil to lymphocyte ratio( NRL) and hemoglobin. Factors affecting recurrence were: type of procedure, chemotherapy line (CT), albumin and platelets. In multivariate analysis for Group I, type of procedure (therapeutic pleural aspiration – TPA) ( p= 0.011), ECOG 3/4 ( p= 0.004), NLR > 5 ( p= 0.037) and leukocytes > 8000 ( p= 0.042) were identified as independent predictors of OS. In terms of recurrence, only CT beyond first line ( p = 0.042) was identified as an independent prognostic factor. Conclusions: Patients with MPE who underwent TPA, had ECOG 3/4, leukocytes > 8000, and NLR > 5 were significantly associated with shorter OS,. CT beyond first line was associated with recurrence. The identification of these prognostic factors may assist physicians in choosing the optimal palliative technique.

Prognostic factors for mortality in malignant pleural effusion: Is it possible to predict survival?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21638-e21638
Author(s):  
Fernando Abrao ◽  
Mariana Campello de Oliveira ◽  
Geisa Garcia ◽  
Igor Abreu ◽  
Renata D'Alpino D'Alpino ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Pulmonary Infiltrate ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Factors Affecting ◽  
Group I

e21638 Background: The aim of this study was to identify predictors of overall survival (OS) following palliative pleural procedures in patients with malignant pleural effusion (MPE). Methods: Data was collected from our database between January 2012 and December 2016 including all patients with MPE. All patients were followed-up for at least 30 days after the pleural procedure. We evaluated radiological aspects, biochemical and hematologic parameters as well as clinical features. For OS analysis, patients were divided into two groups. Group I included OS < 30 days and Group II included OS > 30 days. Prognostic factors for OS were identified by univariate analysis, using Fisher's exact for the categorical variables and Student's t-test for the quantitative ones. The cutoff points for any significant continuous variables were determined by the ROC curve. Subsequently, significant variables were entered into a multivariate logistic regression analysis ( p < 0.05). Results: A total of 238 patients were included in the analysis (37,6% males). Median age was 62 year-old (range 24-965) and median follow-up time for surviving patients was 127 days. Median OS was 83 days for therapeutic pleural aspiration (TPA), 353 days for pleurodesis, 135 days for VAT drainages without pleurodesis due to trapped lung and 39 days for indwelling pleural catheter. Regarding primary site, median OS was 170 days for lung (n = 91), 253 days for breast (n = 70), 90 days for gynecological (n = 18), 33 for gastrointestinal (n = 34) and 305 days for others (n = 26). Factors affecting OS in univariate analysis with p < 0.0001 were ECOG, procedure, protein, albumin, neutrophil to lymphocyte ratio(NLR) and hemoglobin, pulmonary infiltrate (p < 0.0438), hematocrit (p < 0.0002), and chemotherapy line (p < 0.0229). In multivariate analysis the following variables were identified as independent prognostic factor: ECOG 3/4 (p < 0.0095), pulmonary infiltrate (p < 0.0011), albumin < 2.5 (p < 0.0325), and hematocrit < 35 (p < 0.0055). Conclusions: Patients with MPE who presented with ECOG 3/4, pulmonary infiltrate, albumin < 2.5 and hematocrit < 35 had shorter OS. The identification of these prognostic factors may assist physicians in choosing the optimal palliative technique.

PROGNOSTIC FACTORS OF 30-DAY MORTALITY AND RECURRENCE OF MALIGNANT PLEURAL EFFUSION IN HIGH-RISK TUMORS ACCORDING TO THE LENT SCORE STUDY

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 623A
Author(s):  
MARIANA CAMPELLO DE OLIVEIRA ◽  
FERNANDO ABRAO ◽  
GEISA VIANA ◽  
IGOR RENATO LOURO BRUNO DE ABREU ◽  
ANTONIO FLÁVIO BINA BIAZZOTTO
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Score Study

scholarly journals Prediction of patients with a tumor proportion score >50% who do not respond to first-line monotherapy with pembrolizumab

2020 ◽  
Author(s):  
Mitsunori Morita ◽  
Motohiro Tamiya ◽  
Daichi Fujimoto ◽  
Akihiro Tamiya ◽  
Hidekazu Suzuki ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Group Performance ◽  
Performance Status ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
Smoking History ◽  
First Line ◽  
Status Score ◽  
Performance Status Score

Abstract Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the response of first-line monotherapy with pembrolizumab.

scholarly journals Prediction of patients with a tumor proportion score >50% who do not respond to first-line monotherapy with pembrolizumab

2019 ◽  
Author(s):  
Mitsunori Morita ◽  
Motohiro Tamiya ◽  
Daichi Fujimoto ◽  
Akihiro Tamiya ◽  
Hidekazu Suzuki ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Group Performance ◽  
Performance Status ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
Smoking History ◽  
First Line ◽  
Status Score ◽  
Performance Status Score

Abstract Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the effectiveness of first-line monotherapy with pembrolizumab.

scholarly journals Prediction of patients with a tumor proportion score >50% who do not respond to first-line monotherapy with pembrolizumab

2019 ◽  
Author(s):  
Mitsunori Morita ◽  
Motohiro Tamiya ◽  
Daichi Fujimoto ◽  
Akihiro Tamiya ◽  
Hidekazu Suzuki ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Group Performance ◽  
Performance Status ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
Smoking History ◽  
First Line ◽  
Status Score ◽  
Performance Status Score

Abstract Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the effectiveness of first-line monotherapy with pembrolizumab.

Deletions Affecting Codons 557-558 of the c-KIT Gene Indicate a Poor Prognosis in Patients With Completely Resected Gastrointestinal Stromal Tumors: A Study by the Spanish Group for Sarcoma Research (GEIS)

2005 ◽  
Vol 23 (25) ◽  
pp. 6190-6198 ◽  
Author(s):  
Javier Martín ◽  
Andrés Poveda ◽  
Antonio Llombart-Bosch ◽  
Rafael Ramos ◽  
José A. López-Guerrero ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Gastrointestinal Stromal Tumors ◽  
Risk Index ◽  
Univariate Analysis ◽  
Primary Tumors ◽  
Stromal Tumors ◽  
Clinicopathologic Factors ◽  
High Cellularity ◽  
Exon 11

Purpose To explore the prognostic value of mutations in c-KIT and PDGFR-α genes with respect to relapse-free survival (RFS) in patients with gastrointestinal stromal tumors (GIST). We have investigated the prognostic relevance of the type and position of the mutations, in addition to other clinicopathologic factors, in a large series of patients with GIST. Methods For this study, 162 patients were selected according to the following criteria: completely resected tumors with negative margins attended between 1994 and 2001; no metastasis at diagnosis; tumor larger than 2 cm, c-KIT–positive immunostaining; and no other primary tumors. Results The median follow-up was 42 months for patients free of recurrence. Mutations were detected in 96 tumors (60%): 82 cases involving c-KIT and 14 cases involving PDFGR-α. Univariate analysis demonstrated the following as poor prognostic factors for RFS: tumors larger than 10 cm (P < .0001); mitotic count higher than 10 mitoses per 50 high-power fields (P < .0001); high risk index (P < .0001); intestinal GIST location (P = .0041); high cellularity (P < .0001); tumor necrosis (P < .0001); deletions affecting exon 11 (P = .0007); and deletions affecting codons 557 to 558 (P < .0001). After the multivariate analysis, only the high risk index (relative risk [RR], 12.36), high cellularity (RR, 3.97), and deletions affecting codons 557 to 558 of c-KIT (RR, 2.57) corresponded to independent prognostic factors for RFS in GIST patients. Conclusion Deletions affecting codons 557 to 558 are relevant for the prognosis of RFS in GIST patients. This critical genetic alteration should be considered to be a new prognostic stratification variable for randomized trials exploring imatinib mesylate in the adjuvant setting in GIST patients.

scholarly journals Prediction of patients with a tumor proportion score >50% who do not respond to first-line monotherapy with pembrolizumab

2020 ◽  
Author(s):  
Mitsunori Morita ◽  
Motohiro Tamiya ◽  
Daichi Fujimoto ◽  
Akihiro Tamiya ◽  
Hidekazu Suzuki ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Group Performance ◽  
Performance Status ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
Smoking History ◽  
First Line ◽  
Status Score ◽  
Performance Status Score

Abstract Background: Pembrolizumab is effective as first-line therapy against advanced non-small cell lung cancer (NSCLC) in patients with programmed death ligand-1 (PD-L1) expression levels ≥50%. However, it is not effective in all patients, and the factors predicting responses among this population remain unknown. Methods: We retrospectively analyzed patients with NSCLC and a PD-L1 tumor proportion score (TPS) >50%, who received first-line monotherapy with pembrolizumab from February 1, 2017 to April 30, 2018. The study included 11 hospitals, which participated in the Hanshin Oncology clinical Problem Evaluation group (HOPE). We analyzed the differences between responders and non-responders in terms of age, sex, performance status score, degree of progression, histological type, smoking history, expression of PD-L1, use of steroids prior to treatment, metastasis site, and laboratory data. Results: A total of 205 patients were included in this study. Of those, 108 patients exhibiting complete or partial response were defined as responders. Those exhibiting progressive disease (N=52) were defined as non-responders. In the univariate analysis, Eastern Cooperative Oncology Group performance status score ≥2 (p=0.0832), stage IV disease or recurrence (p=0.0487), PD-L1 TPS 50–89% (p=0.0657), use of steroids prior to the administration of pembrolizumab (p=0.0243), malignant pleural effusion (p=0.0032), and baseline C-reactive protein (CRP) levels >1.0 mg/dL (p=0.0390) were significantly associated with non-response to treatment. In the multivariate analysis, use of steroids prior to the administration of pembrolizumab (odds ratio [OR]: 5.86; 95% confidence interval [CI]: 1.32–31.8; p=0.0200), malignant pleural effusion (OR: 2.68; 95% CI: 1.15–6.35; p=0.0228), and baseline CRP >1.0 mg/dL (OR: 2.17; 95% CI: 1.03–4.68; p=0.0402) were significantly associated with non-response to treatment. Conclusion: In real-world patients with NSCLC and a PD-L1 TPS ≥50%, use of steroids prior to treatment, malignant pleural effusion, and baseline CRP levels >1.0mg/dL reduced the response of first-line monotherapy with pembrolizumab.

Characteristics influencing high-risk sexual behaviours in elderly men

2018 ◽  
Vol 30 (4) ◽  
pp. 353-361 ◽  
Author(s):  
Gui-Yuan Xiao ◽  
Bin Peng ◽  
Ying Hu ◽  
Dou Qu ◽  
Min-Qing Lai ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Intercourse ◽  
Age Differences ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Sexual Partners ◽  
Elderly Men ◽  
Healthy Elderly ◽  
Sexual Behaviours ◽  
Age Related

With the objective of investigating the characteristics influencing high-risk sexual behaviours in elderly men (60–74 years of age) in Chongqing, China, a total of 1433 healthy elderly men with sexual intercourse frequencies of one to six times/month who were willing to participate in the questionnaires were studied at four hospitals. We measured serum testosterone levels and performed follow-ups every six months, with a total of 1128 elderly men followed up after two years. We also investigated socio-economic and demographic characteristics (age, education, income, location, marital status and number of marriages), types of sexual partners, age differences with fixed sexual partners, frequency of sexual intercourse, combined basic age-related diseases, sexually transmitted infections (STIs) education, elderly self-care ability and high-risk sexual behaviours (frequency of sexual intercourse and number of sexual partners) using questionnaires. We analysed the influencing factors of high-risk sexual behaviours in elderly men using a univariate analysis, multivariate logistic regression analysis, BP neural network prediction and cluster analysis. Finally, we found that serum total testosterone, age, types of sexual partners, age differences with fixed partners and frequency of sexual intercourse are five factors that influence high-risk sexual behaviours in elderly men.

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