Prognostic significance of preoperative plasma fibrinogen and Albumin Score in esophageal cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 36-36
Author(s):  
Yusuke Maeda ◽  
Hiroya Takeuchi ◽  
Hirofumi Kawakubo ◽  
Koichi Suda ◽  
Rieko Nakamura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Clinical Utility ◽  
Prognostic Significance ◽  
Patient Characteristics ◽  
Preoperative Treatment ◽  
Free Survival ◽  
Favorable Prognosis ◽  
Patients With Poor Prognosis

36 Background: The clinical outcome of esophageal cancer has recently improved. However, the relapse rate in any stages is still high. Prognostic classification in patients with esophageal cancer has not yet established. If the patients with poor prognosis could be extracted before surgery, we can add more intensive preoperative treatment, which might lead more favorable prognosis. We have previously reported clinical utility of fibrinogen (FNG) and Albumin (Alb) Score (FA score) in esophageal cancer. The purpose of this study was to analyze the utility of FA score comparing at each stage as a prognostic factor in esophageal cancer. Methods: Patient characteristics, clinicopathological factors, and preoperative biochemical markers (FNG, Alb, and CRP) were investigated in esophageal cancer patients who underwent transthoracic esophagectomy between January 2004 and November 2013. Correlation between preoperative FNG, CRP, Alb, clnicopathological factors and survival were investigated. We evaluated between recurrence-free survival (RFS), overall survival (OS) and FA score comparing at each stage. The cut-off value was defined according to previous reports; fibrinogen 350mg/dl, albumin 3.8mg/dl. Results: 252 patients were recorded. High FA score were correlated to worse OS and RFS (p < 0.001). Especially in cStageI, high FA score showed remarkably worse 5-year RFS (score0/ score1/ score2, 5-year RFS 84%/ 64%/ 33%; p = 0.038). Conclusions: FA score was significantly associated with postoperative survival in esophageal cancer patients. If the patients with poor prognosis in cStageI could be extracted before surgery, we can add more intensive preoperative treatment, which might lead more favorable prognosis.

scholarly journals Endoprosthetic Reconstruction for a Displaced Atypical Femoral Fracture in a Cancer Patient with Poor Prognosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Hironari Tamiya ◽  
Hiroki Hagizawa ◽  
Takaaki Nakai ◽  
Yoshinori Imura ◽  
Takaaki Tanaka ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Activities Of Daily Living ◽  
Cancer Patients ◽  
Femoral Fracture ◽  
Daily Living ◽  
Poor Prognosis ◽  
Femoral Fractures ◽  
Endoprosthetic Reconstruction ◽  
Atypical Femoral Fractures ◽  
Patients With Poor Prognosis

Zoledronate or denosumab treatment is beneficial for cancer patients with bone metastasis. However, each agent may trigger atypical femoral fractures. Incomplete atypical femoral fractures can be successfully treated with prophylactic intramedullary nailing. On the other hand, intramedullary nailing for displaced atypical femoral fractures occasionally causes problems with regard to bone healing, resulting in long-term treatment. In cancer patients with poor prognosis who experience atypical femoral fractures, improvement in activities of daily living should be the priority. Thus, we performed endoprosthetic reconstruction for a displaced atypical femoral fracture in a breast cancer patient with poor prognosis to enable walking in the early stage after the operation. Two weeks after the operation, she could successfully walk. The postoperative Musculoskeletal Tumor Society score was 47%, and it had improved to almost the preoperative level before injury (50%). In conclusion, endoprosthetic reconstruction for displaced atypical femoral fractures may be a first-line treatment approach to acquire early postoperative walking ability for improving activities of daily living in cancer patients with poor prognosis.

scholarly journals Expression signature, prognosis value and immune characteristics of cathepsin F in non-small cell lung cancer identified by bioinformatics assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liyuan Song ◽  
Xianhui Wang ◽  
Wang Cheng ◽  
Yi Wu ◽  
Min Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Molecular Markers ◽  
Cancer Patients ◽  
Targeted Therapies ◽  
Poor Prognosis ◽  
Immune Cell ◽  
Clinicopathological Parameters ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients ◽  
Favorable Prognosis

Abstract Background In recent years, immunotherapies and targeted therapies contribute to population-level improvement in NSCLC cancer-specific survival, however, the two novel therapeutic options have mainly benefit patients containing mutated driven genes. Thus, to explore other potential genes related with immunity or targeted therapies may provide novel options to improve survival of lung cancer patients without mutated driven genes. CTSF is unique in human cysteine proteinases. Presently, CTSF has been detected in several cell lines of lung cancer, but its role in progression and prognosis of lung cancer remains unclear. Methods CTSF expression and clinical datasets of lung cancer patients were obtained from GTEx, TIMER, CCLE, THPA, and TCGA, respectively. Association of CTSF expression with clinicopathological parameters and prognosis of lung cancer patients was analyzed using UALCAN and Kaplan–Meier Plotter, respectively. LinkedOmics were used to analyze correlation between CTSF and CTSF co-expressed genes. Protein–protein interaction and gene–gene interaction were analyzed using STRING and GeneMANIA, respectively. Association of CTSF with molecular markers of immune cells and immunomodulators was analyzed with Immunedeconv and TISIDB, respectively. Results CTSF expression was currently only available for patients with NSCLC. Compared to normal tissues, CTSF was downregulated in NSCLC samples and high expressed CTSF was correlated with favorable prognosis of NSCLC. Additionally, CTSF expression was correlated with that of immune cell molecular markers and immunomodulators both in LUAD and LUSC. Noticeably, high expression of CTSF-related CTLA-4 was found to be associated with better OS of LUAD patients. Increased expression of CTSF-related LAG-3 was related with poor prognosis of LUAD patients while there was no association between CTSF-related PD-1/PD-L1 and prognosis of LUAD patients. Moreover, increased expression of CTSF-related CD27 was related with poor prognosis of LUAD patients while favorable prognosis of LUSC patients. Conclusions CTSF might play an anti-tumor effect via regulating immune response of NSCLC.

scholarly journals Effect of Diagnosis (Refractory Anemia With Excess Blasts, Refractory Anemia With Excess Blasts in Transformation, or Acute Myeloid Leukemia [AML]) on Outcome of AML-Type Chemotherapy

Blood ◽  
1997 ◽  
Vol 90 (8) ◽  
pp. 2969-2977 ◽  
Author(s):  
Elihu Estey ◽  
Peter Thall ◽  
Miloslav Beran ◽  
Hagop Kantarjian ◽  
Sherry Pierce ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Poor Prognosis ◽  
Multivariate Analyses ◽  
Patient Characteristics ◽  
Refractory Anemia ◽  
Event Free Survival ◽  
Free Survival ◽  
Current Medical Practice ◽  
Acute Myeloid

Abstract In current medical practice, patients with refractory anemia with excess blasts in transformation (RAEB-t), and especially patients with RAEB, receive chemotherapy regimens (AML Rx) administered to patients with acute myeloid leukemia (AML) less often than do patients with AML. These entities are distinguished primarily by marrow blast percentage (5% to 19% RAEB, 20% to 29% RAEB-t, and ≥30% AML). The poor prognosis of many RAEB or RAEB-t patients, if untreated, led us to give them AML Rx using the same plan as for AML. The purpose of this analysis was to see if diagnosis (RAEB, RAEB-t, or AML) affected outcome. We treated 372 patients with AML (acute promyelocytic leukemia [APL] excluded), 106 with RAEB-t, and 52 with RAEB. AML Rx produced a 62% complete remission (CR) rate in RAEB, essentially identical to the rates in RAEB-t and AML, but event-free survival (EFS) from CR and from start of treatment (start of Rx), as well as overall survival, were poorer in RAEB than in AML or RAEB-t, with AML and RAEB-t being identical. However, patients with RAEB or RAEB-t were more likely to have poor prognostic characteristics, in particular complex abnormalities involving chromosomes 5 and/or 7. Multivariate analyses indicated that, when considered together with cytogenetics and other patient characteristics, a diagnosis of RAEB rather than AML or RAEB-t had no effect on EFS from start of Rx, EFS from CR, survival, or achievement of CR. These analyses suggested a trend for patients with RAEB-t to have better EFS from start of Rx than patients with AML or RAEB (P = .08; relative risk, 0.80; 95% confidence interval, 0.62 to 1.03), but there were no differences with respect to the other outcomes. Our data suggest that the propriety of administering AML Rx to patients with RAEB or RAEB-t who have poor prognosis without treatment is identical to the propriety of treating AML in this fashion. Deterrents to standard AML Rx in these patients could justifiably include cytogenetics, age, etc, but not a diagnosis of RAEB or RAEB-t per se.

Dose-Dense Rituximab Improves Outcome of Elderly Patients with Poor-Prognosis Diffuse Large B-Cell Lymphoma (DLBCL): Results of the DENSE-R-CHOP-14 Trial of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 789-789 ◽  
Author(s):  
Michael Pfreundschuh ◽  
Samira Zeynalova ◽  
Viola Poeschel ◽  
Mathias Haenel ◽  
Norbert Schmitz ◽  
...  
Keyword(s):  
Complete Remission ◽  
Elderly Patients ◽  
Poor Prognosis ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Serum Levels ◽  
Event Free Survival ◽  
Free Survival ◽  
Dose Dense ◽  
Patients With Poor Prognosis

Abstract Background: While 6 to 8 cycles of CHOP in combination with rituximab are widely accepted as standard regimen of care for aggressive lymphomas, the optimal dose and number of rituximab application have not been determined to date. In a previous pharmacokinetic study we had shown that the concomitant application of CHOP and rituximab does not achieve a plateau of rituximab trough levels until cycle 5 (Reiser, Blood 108, 778a, 2006). In order to achieve high rituximab levels early, we increased the number of rituximab applications. Methods: 100 elderly patients with aggressive CD20+ B-cell lymphoma received 6 cycles of biweekly CHOP-14 combined with 12x rituximab (375 mg/m2) on days 0, 1, 4, 8, 15, 22, 29, 43, 57, 71, 85, and 99. Radiotherapy was planned to sites of initial bulk and/or extranodal involvement. The primary endpoint was event-free survival (EFS). 306 patients treated within the RICOVER-60 trial (Pfreundschuh et al., Blood 64a, 2006) with 6xCHOP-14 and 8 applications of rituximab served as control. Results: 97/100 patients are evaluable for response. Dose-dense rituximab resulted in plateau trough serum levels of rituximab as early as day 1 of the first chemotherapy cycle and higher rituximab levels were maintained throughout the treatment compared to 8 bi-weekly applications. Because 3 therapy-associated deaths were observed among the first 20 patients treated, prophylaxis with levofloxacin, acyclovir and cotrimoxazol became mandatory for the following patients. Despite a less favorable study population DENSE-R-CHOP-14 resulted in a somewhat higher complete remission (83% vs. 78%) and lower progression under therapy rate (5% vs. 7%) rate, but event free and overall survival were not different compared to 8 biweekly applications of rituximab. However, a subgroup analysis of patients according to IPI risk group showed that DENSER-R-CHOP-14 resulted in a higher complete response rate of patients with poor-prognosis (IPI:3–5) disease (81% vs. 68%). This advantage translated into a better 1-year event-free survival rate (74% vs. 65%) of these patients. Conclusion: In combination with 6 cycles of CHOP-14 densification of rituximab achieves higher rituximab serum levels and results in higher complete remission and event-free survival rates in elderly patients with poor-prognosis DLBCL. These observations from a phase-II trial must be confirmed in a randomized study.

Dose-Adjusted EPOCH Plus Rituximab in Untreated Patients with Poor Prognosis Large B-Cell, with Analysis of Germinal Center and Activated B-Cell Biomarkers. A Phase IV Study Conducted by the Spanish PETHEMA Group

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 593-593
Author(s):  
Noelia Purroy ◽  
Juan Bergua ◽  
Laura Gallur ◽  
Julio Prieto ◽  
Juan-Manuel Sancho ◽  
...  
Keyword(s):  
B Cell ◽  
Germinal Center ◽  
Poor Prognosis ◽  
Cellular Differentiation ◽  
Tumor Proliferation ◽  
Bulky Disease ◽  
Free Survival ◽  
Grade 3 ◽  
Large B Cell ◽  
Patients With Poor Prognosis

Abstract Abstract 593 Objectives . This prospective multi-institutional phase IV study was designed within the Spanish PETHEMA Group to assess the efficacy and safety of dose adjusted EPOCH plus Rituximab (DA-EPOCH-R) infusional therapy (as previously reported*) in untreated patients with poor prognosis large B-cell lymphomas. All cycles were supported with G-CSF. Additional analysis of the clinical outcome and the influence of biomarkers associated with tumor proliferation (Ki67) and cellular differentiation was performed. Patients and Methods. Eighty-one untreated patients diagnosed of DLBCL (68), PMLBL (6) and FL grade 3 (7), with an age-adjusted IPI higher than 1 (or equal to 1 plus bulky disease), were enrolled and evaluable. Radiation consolidation was permitted to patients with bulky disease at diagnosis. Histology was centrally reviewed. Fifty tumor tissue samples (61.7% of patients) were analyzed by immunohistochemistry for biomarkers of proliferation (Ki67) and cellular differentiation (CD10, Bcl6, GCET1, MUM1 and FOXP1). Results. The median age was 52 (range, 21–77) years, with 52% older than 60. 92.5% had intermediate-high or high risk score according to aaIPI criteria. The median number of cycles administered was 6 (range, 1–8). Treatment was discontinued in 7 patients: disease progression (2) and death (5: 2 unrelated and 3 for disease progression). Radiotherapy (30 Gy maximum) was given to 37 patients (45.7%). A median of 3 escalation level (range, 0–6) was achieved. Toxicity was assessed during 470 cycles administered. Grade 3–4 anaemia was reported in 240 cycles (51%) and in 84% of patients; and grade 3–4 thrombocytopenia in 176 cycles (37%) and in 71.6% of patients. There were 54 episodes of neutropenic fever (11.5% of cycles) in 37 patients (45.7%). On an intention-to-treat basis, 64 (79.1%) patients achieved a complete response (CR or uCR) and 8 (9.9%) a partial response (PR) with an overall response rate (ORR) of 89%. 19.8% (16) of patients who achieved CR (or uCR) relapsed between 6 to 12 months after the beginning of EPOCH-R therapy. With a median follow-up of 55 months (range, 23–100 months), overall survival (OS), progression-free survival (PFS), and event-free survival (EFS) were 63.1% (95% CI 50.1%–76.1%), 62.01% (95% CI 50.8%–73.2%), and 59.7% (95% CI 48.5%–70.9%) respectively; and disease-free survival for patients who achieved CR or uCR was 72.1% (95% CI 60.95%–83.3%). Neither aaIPI risk factors nor IPI were associated with poorer response, PFS (p=0.418 and p=0.099 respectively) or OS (p=0.458 and p=0.141 respectively). There was only a slight association between ß2 microglobulin levels (>3.5mg/L) and OS (p=0.015). High tumor proliferation (Ki67>75%) was not associated with neither poorer OS (p= 0.461) nor poorer PFS (p=0.769). After having ruled out other non-DLBCL histologies, 39 patients were analyzed for germinal center (GC) or activated B-cell (ABC) biomarkers using Hans and Choi algorithms. No differences were found neither in OS (p=0.972 and p=0.673, respectively) nor PFS (p=0.215 and p=0.433, respectively). Conclusion. DA-EPOCH-R shows a promising outcome in Intermediate-High and High risk aaIPI subgroups of large B-cell lymphoma patients with an acceptable toxicity profile. Further studies (some of them are now in process) are needed to verify its actual role in the ABC subtype of DLBCL. DA-EPOCH-R outcome was no affected by high tumor proliferation. * Wilson WH et al. JCO 2008: 26:2717-24. Disclosures: No relevant conflicts of interest to declare.

Involvement of NK cell molecular signatures in favorable prognosis of breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10565-10565
Author(s):  
Maria Libera Ascierto ◽  
Michael O Idowu ◽  
Yingdong Zhao ◽  
Davide Bedognetti ◽  
Paolo Antonio Ascierto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nk Cells ◽  
Cancer Patients ◽  
Adhesion Molecules ◽  
Nk Cell ◽  
Breast Cancer Patients ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Favorable Prognosis ◽  
Activating Receptors

10565 Background: Tumor cell recognition by NK cells is mediated by the interaction of activating and inhibitory NK cell receptors with their ligands expressed on tumor cells. In addition, NK cells express adhesion molecules that facilitate formation of the immunological synapse with the tumor targets. Here, we investigated whether the coordinate expression of NK activating receptors and adhesion molecules could provide a signature to segregate breast cancer patients into relapse and relapse-free outcomes. Methods: Gene expression profiling, RT-PCR screening and survival analysis were performed on RNA extracted from primary breast cancers. Tumors were obtained from patients experiencing either 5-8 years relapse-free survival or tumor relapse within 1-3 years following initial treatment. Results: Tumors from patients with a favorable prognosis were characterized by increased expression of genes involved in NK cell interaction with tumor cells and its activation signaling. In particular, up-regulation of Natural Cytotoxicity Receptors (NCRs), leukocyte function-associated antigen 1 (LFA-1), CD226 (DNAM-1) and CD96 was observed in relapse-free patients. Thus, the expression of the NK activating receptors and relevant adhesion molecules involved in NK cell:target interactions can predict relapse free survival in breast cancer patients. Conclusions: Results from the present study, highlighted the effector cooperation between the innate and adaptive immune components within the tumor microenvironment. The NK cells parameters identified in this study, together with the prognostic B and T cell signatures previously reported by us, represent a powerful tool for predicting breast cancer outcome which might be easily introduced in clinical practice.

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