Real-world outcomes among patients (pts) treated with gemcitabine (GEM)-based therapy post-FOLFIRINOX (FFOX) failure in advanced pancreatic cancer (APC).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 303-303
Author(s):  
Erica S Tsang ◽  
Jennifer L. Spratlin ◽  
Winson Y. Cheung ◽  
Christina Kim ◽  
Shiying Kong ◽  
...  
Keyword(s):  
Cox Regression ◽  
Advanced Pancreatic Cancer ◽  
Population Based ◽  
Rank Test ◽  
Survival Outcomes ◽  
Test Results ◽  
Publicly Funded ◽  
Cox Regression Analysis ◽  
Treatment Regimens ◽  
Kaplan Meier

303 Background: Limited evidence exists for the selection of chemotherapy in APC after first-line (1stL) FFOX. Gemcitabine/nab-paclitaxel (GEMNAB) is publicly funded for second-line (2ndL) use in the provinces of Alberta (AB) and Manitoba (MB), but is not covered in British Columbia (BC). We compared population-based outcomes by region to examine the utility of 2ndL GEMNAB versus GEM alone. Methods: We identified pts treated with 1stL FFOX between 2013-2015 across BC, AB, and MB. Baseline characteristics and treatment regimens were compared between AB/MB and BC. Survival outcomes were assessed by the Kaplan-Meier, and compared with log-rank test. Results: 370 pts treated with 1stL FFOX were identified (145 AB/MB, 225 BC), with a median age of 61y, 42% female, and 68% with metastatic disease (similar in both groups). Receipt of 2ndL therapy was 49% AB/MB vs 44% BC ( p = 0.35), and time from diagnosis to 2ndL therapy measured 7.6 mos AB/MB versus 9.4 mos BC ( p = 0.1). The distribution of 2ndL gemcitabine use was: 72% GEMNAB, 23% GEM in AB/MB versus 27% GEMNAB, 66% GEM in BC ( p < 0.001). Median overall survival (OS) from diagnosis was similar: 12.4 mos in AB/MB versus 10.9 mos in BC ( p = 0.75). On Cox regression analysis, region was not significant. A secondary survival analysis by 2ndL regimen demonstrated a median OS of 18.0 mos with GEMNAB versus 14.3 mos GEM ( p < 0.01). Conclusions: In our population-based comparison of APC pts treated with 1stL FFOX, survival outcomes were comparable regardless of publicly funded access to 2ndL GEMNAB versus GEM. OS by regimen favored 2ndL GEMNAB, but patient selection may be largely responsible for this difference. Randomized trials are needed to demonstrate the benefit of GEMNAB post-FFOX in APC.

scholarly journals Development of predictive prognostic nomogram for NECs of rectum on population-based exploration

2018 ◽  
Vol 7 (11) ◽  
pp. 1178-1185 ◽  
Author(s):  
Yang Lv ◽  
Ning Pu ◽  
Wei-lin Mao ◽  
Wen-qi Chen ◽  
Huan-yu Wang ◽  
...  
Keyword(s):  
Cox Regression ◽  
Population Based ◽  
Prognostic Indicators ◽  
Rank Test ◽  
Chi Square ◽  
Related Factors ◽  
Ki 67 ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Chi Square Test

Aim We aim to investigate the clinical characteristics of the rectal NECs and the prognosis-related factors and construct a nomogram for prognosis prediction. Methods The data of 41 patients and 1028 patients with rectal NEC were retrieved respectively from our institution and SEER database. OS or PFS was defined as the major study outcome. Variables were compared by chi-square test and t-test when appropriate. Kaplan–Meier analysis with log-rank test was used for survival analysis and the Cox regression analysis was applied. The nomogram integrating risk factors for predicting OS was constructed by R to achieve superior discriminatory ability. Predictive utility of the nomogram was determined by concordance index (C-index) and calibration curve. Results In the univariate and multivariate analyses, tumor differentiation, N stage, M stage and resection of primary site were identified as independent prognostic indicators. The linear regression relationship was found between the value of Ki-67 index and the duration of OS (P < 0.05). Furthermore, the independent prognostic factors were added to formulate prognostic nomogram. The constructed nomogram showed good performance according to the C-index. Conclusions Contrary to WHO classification guideline, we found that the rectal NEC diseases are heterogeneous and should be divided as different categories according to the pathological differentiation. Besides, the nomogram formulated in this study showed excellent discriminative capability to predict OS for those patients. More advanced predictive model for this disease is required to assist risk stratification via the formulated nomogram.

Prognostic value of D-dimer/fibrinogen ratio in the adverse outcomes of patients hospitalized for heart failure

2020 ◽  
Vol 14 (18) ◽  
pp. 1733-1745
Author(s):  
Tian-Jun Zhao ◽  
Qian-Kun Yang ◽  
Chun-Yu Tan ◽  
Li-Dan Bi ◽  
Jie Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Cox Regression ◽  
Prognostic Indicator ◽  
Adverse Outcomes ◽  
Rank Test ◽  
Clinical Value ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
D Dimer

Aim: To evaluate the clinical value of plasma D-dimer/fibrinogen ratio (DFR) in patients hospitalized for heart failure (HF). Methods: Clinical data of 235 patients were retrospectively analyzed. Kaplan–Meier method and Cox regression analysis were used to identify significant prognosticators. Results: The Kaplan–Meier analysis showed that a higher DFR level was significantly associated with an increase in the end point outcomes, including HF readmission, thrombotic events and death (log-rank test: p < 0.001). The multivariate Cox regression analysis showed that the high tertile of DFR was significantly associated with the study end points (HR: 2.18; 95% CI: 1.31–3.62; p = 0.003), compared with the low tertile. Conclusion: DFR is a reliable prognostic indicator for patients hospitalized for HF.

The prognostic value of polymorphisms in the insulin-like growth factor receptor (IGFR) pathway in patients with locally advanced pancreatic cancer (LAPC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4500-4500
Author(s):  
R. T. Shroff ◽  
M. M. Javle ◽  
X. Dong ◽  
V. S. Kumar ◽  
S. Krishnan ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Induction Chemotherapy ◽  
Prognostic Value ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Rank Test ◽  
Cox Regression Analysis

4500 Background: The IGFR pathway is activated in pancreatic cancer and may result in aggressive disease course. The study of single nucleotide polymorphisms (SNPs) involved in this pathway may provide prognostic information and predict response to IGFR directed agents. We investigated IGFR pathway SNPs in patients with LAPC. Methods: We evaluated 39 SNPs from 7 candidate genes in the IGFR pathway (IGF1R, IGF2R, IGF1, IGF2, IRS1, IRS2, IGFBP3) in 105 LAPC patients. DNA extraction from whole blood was performed using the Qiagen Flexigene DNA and Promega Maxwell 16 kits. Genotyping was performed using the Sequenom method. Overall survival was measured from date of diagnosis to date of death or last follow-up. Kaplan-Meier plot, log-rank test, and Cox regression were used to compare survival of patients according to genotype corrected for previously identified prognostic factors, including induction chemotherapy, CA 19–9, albumin, LDH, hemoglobin and Karnofsky performance status (KPS). Results: Median survival time (MST) was 15 months (95% CI 13.3–16.7). Induction chemotherapy, LDH, CA 19–9 level, hemoglobin, and KPS were not significantly associated with survival. Serum albumin and three SNPs of the IGF pathway (IGF1R IVS20–3431A>G, IRS1 G971R, and IGF2 *4352A>G) were significantly associated with prognosis ( Table ). Two of the three genotypes remained as significant predictors for survival in Cox regression analysis when adjusted for clinical factors. A significant combined genotype effect was observed wherein patients with all three deleterious alleles had significantly worse survival than those with only two or one (10 vs. 16.3 vs. 21.3 months, p< 0.0001). Conclusions: These data suggest that SNPs in the IGFR pathway genes may have prognostic value for LAPC patients. This information may identify population subgroups that could benefit from IGFR-targeted agents. [Table: see text] No significant financial relationships to disclose.

Natural history and outcomes of synchronous and metachronous colorectal cancers (CRC): A population-based analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3593-3593
Author(s):  
Jackson Chu ◽  
Ozge Goktepe ◽  
Winson Y. Cheung
Keyword(s):  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Presenting Symptoms ◽  
Kaplan Meier ◽  
Index Cancer ◽  
Metachronous Tumors

3593 Background: Early data suggest that synchronous and metachronous CRC portend a worse prognosis when compared to solitary CRC. Our aims were to 1) characterize the clinical features and treatment patterns of synchronous and metachronous CRC and 2) compare their survival outcomes with those of solitary CRC. Methods: All patients diagnosed with non-metastatic CRC between 1999 and 2008 and referred to any 1 of 5 regional cancer centers in British Columbia, Canada were reviewed. Synchronous and metachronous CRC were defined as multiple (2 or more) distinct tumors that were diagnosed within and beyond 6 months of the date of index CRC diagnosis, respectively, during the study period. Patients with liver metastases at initial diagnosis were excluded. Kaplan-Meier and Cox regression analyses were used to estimate survival among the different CRC groups. Results: A total of 6360 patients were identified: 6147 (96%) solitary, 178 (3%) synchronous and 35 (1%) metachronous tumors; median age was 68 years (IQR 59-76); 57% were men; and 75% were ECOG 0/1 at the time of index cancer diagnosis. Baseline demographic characteristics were comparable across patients (all p>0.05). Compared with solitary CRC, synchronous and metachronous CRC more commonly affected the colon rather than the rectum (84 vs 85 vs 59%, respectively, p<0.001), but presenting symptoms, treatment approaches, and use of chemotherapy, radiation and surgery were similar among the different tumor groups (all p>0.05). In terms of survival, no differences were observed in 3-year relapse free survival (66 vs 66 vs 56%, p=0.20), 5-year cancer specific survival (69 vs 69 vs 53%, p=0.34) and 5-year overall survival (62 vs 59 vs 49%, p=0.74) for solitary, synchronous and metachronous CRC, respectively. These findings persisted after controlling for known prognostic factors, such as age and ECOG. Conclusions: In this large population-based cohort, there were no differences in survival outcomes among solitary, synchronous and metachronous CRC. Patients who present with multiple tumors in the colon or the rectum should be managed similarly to those who present with an isolated tumor.

Expression of MUM1/IRF4 correlates with clinical outcome in patients with B-cell chronic lymphocytic leukemia

Blood ◽  
2002 ◽  
Vol 100 (13) ◽  
pp. 4671-4675 ◽  
Author(s):  
Chung-Che Chang ◽  
Jennifer Lorek ◽  
Daniel E. Sabath ◽  
Ying Li ◽  
Christopher R. Chitambar ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Lymphocytic Leukemia ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Interferon Regulatory Factor 4 ◽  
Cell Chronic Lymphocytic Leukemia

In this study, we evaluated the prognostic significance of multiple myeloma-1/interferon regulatory factor-4 (MUM1/IRF4) expression in B-cell chronic lymphocytic leukemia (B-CLL). Our results demonstrated that the absence of MUM1/IRF4 expression showed the highest relative risk among the factors analyzed in determining the probability for death in patients with B-CLL using univariate and multivariate Cox regression analysis. Patients without MUM1/IRF4 expression had significantly worse overall survival than did those with MUM1/IRF4 expression (52% cumulative survival, 63 months vs not reached, Kaplan-Meier survival analysis; P < .03, log-rank test). Patients with MUM1/IRF4 expression were more likely to have disease at low Rai stage and interstitial/nodular marrow involvement. Furthermore, only 1 of 11 patients with MUM1/IRF4 expression and interstitial/nodular marrow involvement died during a 100-month follow-up. Our results suggest that B-CLL with expression of MUM1/IRF4, indicative of postgerminal center origin, has a more favorable clinical course and that MUM1/IRF4 is an important prognostic marker in B-CLL.

scholarly journals Effect of Health Care Provider Delays on Short-Term Outcomes in Patients With Colorectal Cancer: Multicenter Population-Based Observational Study

10.2196/15911 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e15911
Author(s):  
Ahmed Abdulaal ◽  
Chanpreet Arhi ◽  
Paul Ziprin
Keyword(s):  
Colorectal Cancer ◽  
Observational Study ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Diagnostic Delay ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Treatment Delays ◽  
Cox Regression Analysis ◽  
Kaplan Meier

Background The United Kingdom has lower survival figures for all types of cancers compared to many European countries despite similar national expenditures on health. This discrepancy may be linked to long diagnostic and treatment delays. Objective The aim of this study was to determine whether delays experienced by patients with colorectal cancer (CRC) affect their survival. Methods This observational study utilized the Somerset Cancer Register to identify patients with CRC who were diagnosed on the basis of positive histology findings. The effects of diagnostic and treatment delays and their subdivisions on outcomes were investigated using Cox proportional hazards regression. Kaplan-Meier plots were used to illustrate group differences. Results A total of 648 patients (375 males, 57.9% males) were included in this study. We found that neither diagnostic delay nor treatment delay had an effect on the overall survival in patients with CRC (χ23=1.5, P=.68; χ23=0.6, P=.90, respectively). Similarly, treatment delays did not affect the outcomes in patients with CRC (χ23=5.5, P=.14). The initial Cox regression analysis showed that patients with CRC who had short diagnostic delays were less likely to die than those experiencing long delays (hazard ratio 0.165, 95% CI 0.044-0.616; P=.007). However, this result was nonsignificant following sensitivity analysis. Conclusions Diagnostic and treatment delays had no effect on the survival of this cohort of patients with CRC. The utility of the 2-week wait referral system is therefore questioned. Timely screening with subsequent early referral and access to diagnostics may have a more beneficial effect.

scholarly journals NUCKS1 Acts As A Promising Novel Bio-Marker in The Prognosis of Patients with Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Xianfeng Zhang ◽  
Xianjun Zhang ◽  
Xinguo Li ◽  
Hongbing Bao ◽  
Guang Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mrna Expression ◽  
Prognostic Value ◽  
Cox Regression ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
Kinase Substrate ◽  
Normal Tissues ◽  
Kaplan Meier ◽  
Relative Mrna Expression

Abstract Background: Nuclear casein kinase and cyclin-dependent kinase substrate 1 (NUCKS1) was over-expressed in some tumors, including hepatocellular carcinoma (HCC). However, the clinical significance of NUCKS1 in HCC was still unclear. The aim of this study was to explore the expression and prognostic value of NUCKS1 in HCC. Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative mRNA expression of NUCKS1 in HCC tissues and corresponding adjacent normal tissues. The relationship between NUCKS1 expression and clinical characteristics of patients was analyzed by c2 test. Kaplan-Meier method and cox regression analysis were applied to estimate the prognostic value of NUCKS1 in HCC. Results: Compared with normal tissues, the relative mRNA expression level of NUCKS1 was significantly up-regulated in HCC tissues (P < 0.001). And high NUCKS1 expression was closely associated with tumor differentiation, TNM stage, vascular invasion and metastasis (P < 0.05). Kaplan-Meier analysis revealed that the overall survival of HCC patients with low expression of NUCKS1 was obviously longer than those with high NUCKS1 expression (log rank test, P = 0.001). NUCKS1 was an independent prognostic factor of HCC patients via univariate and multivariate cox regression analyses.Conclusions: NUCKS1 may be correlated with the progression of HCC and may serve as a potential factor for the prognosis of this disease.

scholarly journals Role of nicergoline in corneal wound healing in diabetic rats

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Lemos Barros Martins Portela ◽  
Rafael Neves Moreno ◽  
Maria Helena Madruga Lima Ribeiro ◽  
Fernanda Miguel de Andrade ◽  
Yale Viana Alves ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cox Regression ◽  
Survival Curve ◽  
Diabetic Rats ◽  
Rank Test ◽  
Control Group ◽  
Cox Regression Analysis ◽  
Corneal Epithelial Defect ◽  
Kaplan Meier ◽  
Diabetic Keratopathy

Abstract Background To investigate the effect of nicergoline on the rate of complete corneal ulcer reepithelialization (CCUR) in diabetic rats with diabetic keratopathy. Methods Forty-eight streptozotocin-induced diabetic rats were randomly divided into two groups. The experimental group (n = 24) received nicergoline (10 mg.kg− 1.day− 1), while the control group (n = 24) received a placebo. A corneal epithelial defect was induced using a corneal diamond burr, and defect area was compared at time points of 0, 12, 24, 48 and 72 h after the injury using image analysis software. The probability of CCUR within 72 h was assessed using the Kaplan–Meier survival analysis log-rank test. Results When compared, 4 of the 24 rats (17%) in the placebo group and 12 of the 24 rats (50%) in the nicergoline group were found to have CCUR within 72 h (log-rank = 0.027). Cox regression analysis found no effect of the covariates blood glucose (P = 0.601) or weight (P = 0.322) on the corneal reepithelialization (survival) curve. Conclusions Nicergoline increased wound healing rates relative to placebo and may therefore be investigated as a treatment option in diabetic keratopathy.

The clinical significance of simple endoscopic scoring of patients with rectal cancer after concurrent chemoradiotherapy.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 109-109
Author(s):  
Jae Hyun Kim ◽  
Seun Ja Park
Keyword(s):  
Rectal Cancer ◽  
Recurrence Rate ◽  
Concurrent Chemoradiotherapy ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Rank Test ◽  
Effective Treatment Option ◽  
Cox Regression Analysis ◽  
Kaplan Meier

109 Background: Neoadjuvant concurrent chemoradiotherapy (CCRT) is an effective treatment option for patients with rectal cancer. In this study, we investigated the clinical efficacy of simple endoscopic scoring of patients with rectal cancer after CCRT. Methods: Between July 2008 and October 2015, medical records including endoscopic imaging from 41 patients with rectal cancer who received CCRT were retrospectively reviewed. Two expert gastroenterologists reviewed the endoscopic images and assigned scores from 0–3 according to post-CCRT findings. The scoring criteria were as follows: 0 = scar without marginal elevation; 1 = clean-based ulcer without marginal elevation; 2 = clean-based ulcer with marginal elevation; 3 = non-clean-based ulcer. We evaluated image scores to predict long-term outcomes using Kaplan-Meier curves and Cox regression models. Results: The median follow-up duration was 55 months (interquartile range: 35–76). Patients with a low score (≤2) had a 17.2% recurrence rate, whereas patients with a high score (3) had a 50.0% recurrence rate. Patients with a low score had longer disease-free survival (DFS) than those with a high score in log-rank test (p = 0.026). In multivariate Cox regression analysis, a high score was a significant predictor of poor DFS in patients with rectal cancer after CCRT treatment (hazard ratio = 4.89, 95% confidence interval: 1.11–21.50, p = 0.036). Conclusions: This simple endoscopic scoring approach is helpful for predicting prognosis of patients with rectal cancer after treatment with CCRT.

Chemoradiation-related lymphopenia and its association with survival in patients with anal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 3-3
Author(s):  
Grace Lee ◽  
Daniel W. Kim ◽  
Vinayak Muralidhar ◽  
Devarati Mitra ◽  
Nora Horick ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Anal Cancer ◽  
Cox Regression ◽  
Cox Model ◽  
Rank Test ◽  
Anal Squamous Cell Carcinoma ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Increased Risk

3 Background: While treatment-related lymphopenia (TRL) is common and associated with poorer survival in multiple solid malignancies, little data exists for anal cancer. We evaluated TRL and its association with survival in anal cancer patients treated with chemoradiation (CRT). Methods: A retrospective analysis of 140 patients with non-metastatic anal squamous cell carcinoma (SCC) treated with definitive CRT was performed. Total lymphocyte counts (TLC) at baseline and monthly intervals up to 12 months after initiating CRT were analyzed. Multivariable Cox regression analysis was performed to evaluate the association between overall survival (OS) and TRL, dichotomized by G4 TRL ( < 0.2k/μl) two months after initiating CRT. Kaplan-Meier and log-rank tests were used to compare OS between patients with versus without G4 TRL. Results: Median time of follow-up was 55 months. Prior to CRT, 95% of patients had a normal TLC ( > 1k/μl). Two months after initiating CRT, there was a median of 71% reduction in TLC from baseline and 84% of patients had TRL: 11% G1, 31% G2, 34% G3, and 8% G4. On multivariable Cox model, G4 TRL at two months was associated with a 3.7-fold increased risk of death (p = 0.013). On log-rank test, the 5-year OS rate was shorter in the cohort with versus without G4 TRL at two months (32% vs. 86%, p < 0.001). Conclusions: TRL is common and may be another prognostic marker of OS in anal cancer patients treated with CRT. The association between TRL and OS supports the hypothesis that host immunity plays an important role in survival among patients with anal cancer. These results support ongoing efforts of randomized trials underway to evaluate the potential role of immunotherapy in localized anal cancer.

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