Survival outcomes of left-sided versus right-sided colon cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 502-502 ◽  
Author(s):  
Jasmine Lizette Gowarty ◽  
Charis Durham ◽  
Lucas Wong ◽  
Wencong Chen
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Tumor Location ◽  
Independent Prognostic Factor ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Colon Cancers ◽  
Time To Recurrence ◽  
Significant Difference

502 Background: Right-sided colon cancers (RCC) are defined up to the splenic flexure where as left-sided colon cancers (LCC) involve the descending, sigmoid, and rectosigmoid regions. The landmark CALGB/SWOG 80405 study concluded that sidedness was an independent prognostic factor for survival in stage IV adenocarcinoma of the colon or rectum, with a poorer prognosis in RCC. This raises the question as to whether or not stage of malignancy plays a role. We performed a retrospective analysis on survival for stage I to IV colon cancer treated at our institution in order to assess if tumor location is an independent prognostic factor as described in previous studies. Methods: Primary site of cancer, sex, age at diagnosis, vital status, and year of diagnosis for stage I, II, III, and IV colon cancer was collected from our institution’s tumor registry from 2007 to 2017. The inclusion criteria included those diagnosed with stage I to IV colon cancer at 18 years of age and above. Exclusion criteria included a diagnosis of both RCC and LCC and patients under age 18. The median of overall survival and time to recurrence between LCC and RCC were compared using Wilcoxon Rank Sum Test with two-sided significance level at 0.05. Results: Time to overall survival and time to recurrence was shown to have no significant difference between RCC and LCC (p = 0.3398 and 0.9467, respectively). Cox proportional hazards model adjusted for age and sex also support the claim (p = 0.1725 and 0.0633). There was a statistically significant difference in age between the two groups with the older mean age seen in RCC (68 versus 62). The distribution of recurrence was statistically significant with a higher recurrence in RCC (p = 0.0105). Conclusions: Unlike CALGB/SWOG 80405, our analysis included the transverse colon as part of RCC and examined stage I to IV colon cancer to ultimately conclude that there was no significant difference in overall survival or time to recurrence. Our study suggests that tumor location is not an independent prognostic factor on survival for all stages of colon cancer. However, a higher suspicion for recurrence may be needed for those diagnosed with RCC. Future investigations involving molecular subtypes and mutations are needed to further clarify prognosis and tumor sidedness.

scholarly journals Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

2021 ◽  
Author(s):  
Claudius E. Degro ◽  
Richard Strozynski ◽  
Florian N. Loch ◽  
Christian Schineis ◽  
Fiona Speichinger ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Blood Level ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Cancer Stage ◽  
Single Center ◽  
Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

Plasma Epstein-Barr Viral Deoxyribonucleic Acid Quantitation Complements Tumor-Node-Metastasis Staging Prognostication in Nasopharyngeal Carcinoma

2006 ◽  
Vol 24 (34) ◽  
pp. 5414-5418 ◽  
Author(s):  
Sing-fai Leung ◽  
Benny Zee ◽  
Brigette B. Ma ◽  
Edwin P. Hui ◽  
Frankie Mo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Nasopharyngeal Carcinoma ◽  
Early Stage ◽  
Independent Prognostic Factor ◽  
Stage I ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Ebv Dna ◽  
Epstein Barr

Purpose To evaluate the effect of combining circulating Epstein-Barr viral (EBV) DNA load data with TNM staging data in pretherapy prognostication of nasopharyngeal carcinoma (NPC). Patients and Methods Three hundred seventy-six patients with all stages of NPC were studied. Pretreatment plasma/serum EBV DNA concentrations were quantified by a polymerase chain reaction assay. Determinants of overall survival were assessed by multivariate analysis. Survival probabilities of patient groups, segregated by clinical stage (I, II, III, or IV) alone and also according to EBV DNA load (low or high), were compared. Results Pretherapy circulating EBV DNA load is an independent prognostic factor for overall survival in NPC. Patients with early-stage disease were segregated by EBV DNA levels into a poor-risk subgroup with survival similar to that of stage III disease and a good-risk subgroup with survival similar to stage I disease. Conclusion Pretherapy circulating EBV DNA load is an independent prognostic factor to International Union Against Cancer (UICC) staging in NPC. Combined interpretation of EBV DNA data with UICC staging data leads to alteration of risk definition of patient subsets, with improved risk discrimination in early-stage disease. Validation studies are awaited.

Serum YKL-40 Predicts Relapse-Free and Overall Survival in Patients With American Joint Committee on Cancer Stage I and II Melanoma

2006 ◽  
Vol 24 (5) ◽  
pp. 798-804 ◽  
Author(s):  
Henrik Schmidt ◽  
Julia S. Johansen ◽  
Pia Sjoegren ◽  
Ib J. Christensen ◽  
Boe S. Sorensen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Serum Level ◽  
Independent Prognostic Factor ◽  
Stage I ◽  
Serum Samples ◽  
Primary Tumor Site ◽  
Ajcc Stage ◽  
American Joint Committee

PurposeTo evaluate the novel tumor biomarker YKL-40 in serial serum samples from patients with American Joint Committee on Cancer (AJCC) stage I and II melanoma from the time of diagnosis and during routine follow-up. Macrophages, neutrophils, and cancer cells secrete YKL-40, and a high serum level has been associated with poor prognosis in patients with several cancer types.Patients and MethodsSerum samples from 234 patients with stage I (n = 162) and II (n = 72) melanoma were analyzed for YKL-40 by enzyme-linked immunosorbent assay. Serial samples were obtained before definitive primary surgery and during follow-up.ResultsAfter a median follow-up period of 66 months (range, 1 to 97 months), 41 relapses (18%) and 39 deaths (17%) were observed. Serum YKL-40 treated as an updated continuous covariate were analyzed together with the covariates sex, age, primary tumor site, ulceration, thickness, Clark level and histologic subtype in a Cox proportional hazard model. Serum YKL-40 was an independent prognostic factor of relapse-free survival (hazard ratio [HR], 1.6; 95% CI, 1.1 to 2.5; P = .03) and overall survival (HR, 1.8; 95% CI, 1.2 to 2.6; P = .002) together with thickness and ulceration. The serum level of YKL-40 (dichotomized as normal or elevated) at the time of diagnosis was also an independent prognostic factor for overall survival (HR, 3.6, 95% CI, 1.7 to 7.7; P = .001).ConclusionSerum YKL-40 may be an early biomarker of relapse and survival in patients with AJCC stage I and II melanoma. Serum YKL-40 may also be useful for patient stratification and follow-up in clinical trials. Our results need confirmation in an independent study.

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.

scholarly journals Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

2019 ◽  
Vol 8 (11) ◽  
pp. 1812 ◽  
Author(s):  
Jung-Soo Pyo ◽  
Young-Min Shin ◽  
Dong-Wook Kang
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Metastatic Lymph Node ◽  
Tumor Location ◽  
Prognostic Implication ◽  
Colon Cancers ◽  
Significant Difference ◽  
Node Ratio ◽  
Rectal Cancers ◽  
Location Methods

Background: The proportion of the number of involved lymph nodes (LNs) to the number of examined LNs—defined as metastatic LN ratio (mLNR)—has been considered as a prognostic parameter. This study aims to elucidate the prognostic implication of the mLNR in colorectal cancer (CRC) according to the tumor location. Methods: We evaluated the correlation between prognoses and the involved and examined LNs as well as mLNR according to the tumor location in 266 surgically resected human CRCs. Besides, to evaluate the optimal cutoff for high and low mLNRs, we investigated the correlation between mLNR and survival according to the various cutoffs. Results: LN metastasis was found in 146 cases (54.9%), and colon and rectal cancers were found in 116 (79.5%) and 30 (20.5%) of the cases, respectively. The mean mLNRs were significantly higher in rectal cancer than in colon cancer (0.38 ± 0.28 vs. 0.21 ± 0.24, P = 0.003). Besides this, the number of involved LNs in rectal cancer was significantly high compared to colon cancer (11.83 ± 10.92 vs. 6.37 ± 7.78, P = 0.014). However, there was no significant difference in the examined LNs between the rectal and colon cancers (31.90 ± 12.28 vs. 36.60 ± 18.11, P = 0.181). In colon cancer, a high mLNR was significantly correlated with worse survival for all cutoffs (0.1, 0.2, 0.3, and 0.4). However, rectal cancer only showed a significant correlation between high mLNR and worse survival in the subgroup with a cutoff of 0.2. Conclusions: Our results showed that high mLNR was significantly correlated with worse survival. The number of involved LNs and mLNRs were significantly higher in rectal cancer than in colon cancer. The cutoff of 0.2 can be useful for the differentiation of prognostic groups, regardless of tumor location.

scholarly journals Deciphering Promoter Hypermethylation of Genes Encoding for RASSF/Hippo Pathway Reveals the Poor Prognostic Factor of RASSF2 Gene Silencing in Colon Cancers

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5957
Author(s):  
Marc Riffet ◽  
Yassine Eid ◽  
Maxime Faisant ◽  
Audrey Fohlen ◽  
Benjamin Menahem ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Hippo Pathway ◽  
Promoter Hypermethylation ◽  
Recurrence Free Survival ◽  
Poor Prognostic Factor ◽  
Free Survival ◽  
Colon Cancers ◽  
Genes Encoding

The aims of this study were to assess the frequency of promoter hypermethylation of the genes encoding the Ras associated domain family (RASSF)/Hippo pathway, as well as the impact on overall (OS) and progression-free survival (PFS) in a single-center retrospective cohort of 229 patients operated on for colon cancers. Hypermethylation status was investigated by methylation-specific PCR on the promoters of the RASSF1/2, STK4/3 (encoding Mammalian Ste20-like protein 1 and 2 (MST1 and 2), respectively), and LATS1/2 genes. Clinicopathological characteristics, recurrence-free survival, and overall survival were analysed. We found the RASSF/Hippo pathway to be highly silenced in colon cancer, and particularly RASSF2 (86%). The other promoters were hypermethylated with a lesser frequency of 16, 3, 1, 10 and 6%, respectively for RASSF1, STK4, STK3, LATS1, and LATS2 genes. As the hypermethylation of one RASSF/Hippo family member was by no means exclusive from the others, 27% of colon cancers displayed the hypermethylation of at least two RASSF/Hippo member promotors. The median overall survival of the cohort was 60.2 months, and the median recurrence-free survival was 46.9 months. Survival analyses showed a significantly poorer overall survival of patients when the RASSF2 promoter was hypermethylated (p = 0.03). The median OS was 53.5 months for patients with colon cancer with a hypermethylated RASSF2 promoter versus still not reached after 80 months follow-up for other patients, upon univariate analysis (HR = 1.86, [95% CI: 1.05–3.3], p < 0.03). Such difference was not significant for relapse-free survival as in multivariate analysis. A logistic regression model showed that RASSF2 hypermethylation was an independent factor. In conclusion, RASSF2 hypermethylation is a frequent event and an independent poor prognostic factor in colon cancer. This biomarker could be investigated in clinical practice.

Circulating Proteasome Level Is an Independent Prognostic Factor for Survival in Patients with Multiple Myeloma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1486-1486
Author(s):  
Christian Jakob ◽  
Karl Egerer ◽  
Eugen Feist ◽  
Ivana Zavrski ◽  
Jan Eucker ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Proportional Hazards ◽  
Therapy Response ◽  
Independent Prognostic Factor ◽  
Stage I ◽  
Enzyme Linked Immunosorbent Assay ◽  
20S Proteasome ◽  
Kaplan Meier

Abstract The proteasome is a nonlysosomal proteolytic complex which is essentially involved in intracellular degradation of ubiquitinated proteins. This process includes the turnover of proteins which are involved in cell cycle regulation and apoptosis. A constitutively increased proteasome activity has been found in multiple myeloma. Treatment with the proteasome inhibitor bortezomib resulted in induction of remission in a substantial portion of patients with relapsed or refractory multiple myeloma. The objective of the present study was to investigate the clinical significance of circulating levels of the 20S proteasome in patients with monoclonal gammopathy of undetermined significance (MGUS) or multiple myeloma (MM). To detect proteasome concentrations in peripheral blood samples, we developed a sandwich enzyme-linked immunosorbent assay (ELISA) using anti-20S proteasome antibodies. Serum proteasome levels were measured in 200 individuals, 85 normal donors and 115 patients with MGUS or multiple myeloma. Patients with multiple myeloma had significantly (P<0.001) higher serum proteasome values (median 624 ng/mL, range 108–5181) than healthy controls (209.9 ng/mL, range 68–392). The proteasome levels increased significantly (P<0.001) from Durie and Salmon stage I to stage III. Furthermore the proteasome concentrations were significantly elevated in MM versus MGUS (P=0.026) and in MM stages II/III versus stage I (P<0.001). In 55 patients with multiple myeloma in stages II and III, who received chemotherapy, there was a significant (P<0.001) decrease from pre- to post-treatment proteasome concentrations in those patients, who achieved a remission after chemotherapy, while no difference could be found in refractory patients (P=0.981). In a univariate Kaplan-Meier analysis myeloma patients in stages II and III with elevated circulating proteasome levels had a significantly (log-rank: P<0.001) shorter overall survival than patients with proteasome levels lower or equal to the median value. Furthermore, circulating proteasome concentration, b2-microglobulin (b 2-MG) and C-reactive protein (CRP) were included in a Cox’s proportional-hazards regression analysis. In the multivariate analysis, circulating proteasome concentration and b 2-MG were found to be powerful independent prognostic factors (hazard ratio 6.79 and 2.95, respectively). Our study shows that advanced disease stages in multiple myeloma are associated with increased circulating proteasome concentrations and that remission after chemotherapy is accompanied by a significant decrease. Furthermore we demonstrate for the first time, that the circulating proteasome concentration is an independent prognostic factor for overall survival. We conclude that assessment of the circulating proteasome could be a novel tool to monitor disease activity and to predict therapy response and survival in multiple myeloma.

scholarly journals Survival of glioblastoma in relation to tumor location: a statistical tumor atlas of a population-based cohort

2021 ◽  
Author(s):  
Even Hovig Fyllingen ◽  
Lars Eirik Bø ◽  
Ingerid Reinertsen ◽  
Asgeir Store Jakola ◽  
Lisa Millgård Sagberg ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Elderly Patients ◽  
Temporal Lobe ◽  
Third Ventricle ◽  
Tumor Location ◽  
Population Based ◽  
Independent Effect ◽  
Precentral Gyrus ◽  
The Third

Abstract Purpose Previous studies on the effect of tumor location on overall survival in glioblastoma have found conflicting results. Based on statistical maps, we sought to explore the effect of tumor location on overall survival in a population-based cohort of patients with glioblastoma and IDH wild-type astrocytoma WHO grade II–III with radiological necrosis. Methods Patients were divided into three groups based on overall survival: < 6 months, 6–24 months, and > 24 months. Statistical maps exploring differences in tumor location between these three groups were calculated from pre-treatment magnetic resonance imaging scans. Based on the results, multivariable Cox regression analyses were performed to explore the possible independent effect of centrally located tumors compared to known prognostic factors by use of distance from center of the third ventricle to contrast-enhancing tumor border in centimeters as a continuous variable. Results A total of 215 patients were included in the statistical maps. Central tumor location (corpus callosum, basal ganglia) was associated with overall survival < 6 months. There was also a reduced overall survival in patients with tumors in the left temporal lobe pole. Tumors in the dorsomedial right temporal lobe and the white matter region involving the left anterior paracentral gyrus/dorsal supplementary motor area/medial precentral gyrus were associated with overall survival > 24 months. Increased distance from center of the third ventricle to contrast-enhancing tumor border was a positive prognostic factor for survival in elderly patients, but less so in younger patients. Conclusions Central tumor location was associated with worse prognosis. Distance from center of the third ventricle to contrast-enhancing tumor border may be a pragmatic prognostic factor in elderly patients.

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