Exploratory study of prognostic factors in mCRPC patients who administered enzalutamide focusing on early PSA decline and PSA kinetics at PSA progression: Results of retrospective multicenter study.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 292-292
Author(s):  
Yoshiyuki Miyazawa ◽  
Nobuaki Shimizu ◽  
Yutaka Takezawa ◽  
Toshiyuki Nakamura ◽  
Takeshi Miyao ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Acquired Resistance ◽  
Oncologic Outcomes ◽  
Cox Regression Analysis ◽  
Psa Kinetics ◽  
Psa Response ◽  
Psa Progression ◽  
Psa Velocity

292 Background: Recent studies have shown that an early PSA response to AR-targeting agents in mCRPC is associated with a better prognosis. We analyzed the early PSA response to enzalutamide (ENZ) by measuring the PSA doubling time (PSADT) and PSA Velocity while monitoring oncologic outcomes and survival in Japanese patients. Methods: A total of 241 patients with mCRPC treated with ENZ were analyzed. Patients’ median age is 75±7.9 (range 53-93). The patients pre-docetaxel settings were 171 cases (71 %), post-docetaxel settings were 70 cases (29 %). The PSA-PFS and OS were assessed according to PCWG2 criteria. This study was approved by the institutional review board of Gunma University Hospital (No.1595). Results: A case where PSA did not decline at all was defined as Primary Resistance (PR). A case in which PSA once declined after treatment but then progressed was defined as Acquired Resistance (AR). Those in which PSA remained low after treatment were defined as Good Response (GR). We observed 77 PR cases (31.9 %), 125 AR cases (51.9 %) and 39 GR cases (16.2 %).PSA-PFS and OS pre-docetaxel were significantly increased as compared to patients’ post-docetaxcel (PSA-PFS; 47.0 wks vs. 13.4 wks p < 0.001, OS; Not Yet Reached vs. 80.7 wks p < 0.001). Multivariate analysis of prognostic factors, including the PSA response at 4 weeks, was performed using a Cox regression analysis. The PS (0 or 1-2), Hb (≧11.4 or < 11.4), time to CRPC(≧12 m or < 12 m), docetaxel treatment history (none or done) and a PSA decrease of 50% at 4 weeks were all significant factors for the prediction of OS (all variables, p < 0.05). In cases of acquired resistance (n = 125), a multivariate analysis using PSA kinetics factors such as PSADT and PSA Velocity (ng/mL/month) at PSA progression, Hb, time to CRPC(≧12 m or < 12 m), PSADT (≧2 months or < 2 months) and PSA Velocity ( < 20 ng/mL/month or≧20 ng/mL/month), were all factors predicting OS following PSA progression (p < 0.05). Conclusions: Our study has demonstrated that PSA dynamics after ENZ administration may be a useful prognostication factor for mCRPC patients.

CARD: Overall survival (OS) analysis of patients with metastatic castration-resistant prostate cancer (mCRPC) receiving cabazitaxel versus abiraterone or enzalutamide.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 5569-5569
Author(s):  
Bertrand F. Tombal ◽  
Daniel Castellano ◽  
Gero Kramer ◽  
Jean-Christophe Eymard ◽  
Johann S. De Bono ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Metastatic Disease ◽  
Cox Regression ◽  
Castration Resistant Prostate Cancer ◽  
Cox Regression Analysis ◽  
Previously Treated ◽  
Alternative Art ◽  
Daily Prednisone ◽  
The Impact

5569 Background: The CARD trial (NCT02485691) compared cabazitaxel vs. an androgen receptor targeted agent (ART; abiraterone/enzalutamide) in mCRPC previously treated with docetaxel and the alternative ART (abiraterone/enzalutamide), in any order. These post hoc analyses assessed OS from various time points and the impact of prognostic factors. Methods: Patients with mCRPC previously treated with docetaxel and progressing ≤ 12 months on prior abiraterone/enzalutamide were randomized 1:1 to cabazitaxel (25 mg/m2 IV Q3W + daily prednisone + prophylactic G-CSF) vs. abiraterone (1000 mg PO + daily prednisone) or enzalutamide (160 mg PO). OS was calculated from date of diagnosis of metastatic disease, date of mCRPC, and start of 1st, 2nd or 3rd life-extending therapy (LET). A stratified multivariate Cox regression analysis assessed the impact of 14 prognostic factors on OS using a stepwise model selection approach with a significance level of 0.10 for entry into the model and 0.05 for removal. Results: In the CARD study (N = 255), median OS was longer with cabazitaxel vs. abiraterone/enzalutamide (13.6 vs 11.0 months; HR 0.64, 95% CI 0.46–0.89; p = 0.008). OS was numerically improved for cabazitaxel vs. abiraterone/enzalutamide when assessed from the time of diagnosis of metastatic disease or mCRPC, or from start of 1st or 2nd LET (Table). In the multivariate analysis, low hemoglobin, high baseline neutrophil to lymphocyte ratio, and high PSA values at baseline were associated with worse OS. In presence of these factors, the OS benefit observed with cabazitaxel versus abiraterone/enzalutamide remained significant (HR 0.63, 95% CI 0.42–0.94, p = 0.022). Conclusions: Cabazitaxel numerically improved OS vs. abiraterone/enzalutamide in patients with mCRPC previously treated with docetaxel and the alternative ART (abiraterone/enzalutamide), whatever the time point considered. The robustness of this OS benefit was confirmed by stratified multivariate analysis. Sanofi funded. Clinical trial information: NCT02485691 . [Table: see text]

Presence of CTCs and its prognostic potential compared to AR-V7 expression in mCRPC undergoing androgen-deprivation therapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17032-e17032
Author(s):  
Katrin Schlack ◽  
Konstantin Seitzer ◽  
Verena Humberg ◽  
Neele Wüstmann ◽  
Norbert Grundmann ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Regression Analysis ◽  
Regression Models ◽  
Cox Regression ◽  
Androgen Deprivation ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Psa Response ◽  
Visceral Metastases

e17032 Background: Biomarkers predicting response to mCRPC treatment are rare. CTCs and AR-V7 status have been discussed as potential prognosticators. Methods: We evaluated 64 patients (pts.) treated with abiraterone (n=47) or enzalutamide (n=17), determined CTCs and analyzed AR-V7 status in correlation with survival using Kaplan-Meier-estimates and Cox-regression-models. Results: For PSA response, CTC- vs. CTC+ were not different (p=0.25) whereas AR-V7 status was predictive (68.2% AR-V7- and 33.3% AR-V7+ pts. (p=0.01)). Median PSA PFS was 17 mo. (CI 9.5-24.5) for CTC- and 6 (CI 5.2-6.9) for CTC+ pts. (p<0.01) with 9 mo. (CI 4.2-13.8) for CTC+/AR-V7- and 5 (CI 3.0–7.0) for CTC+/AR-V7+ pts. (p=0.04). In univariate cox regression analysis (UV), prior abiraterone or enzalutamide (A/E) (p=0.01), bone metastases (p=0.03), CTC+ (p=0.01), AR-V7+ (p=0.01), Hb ≤12 g/dl (p=0.01) and PSA decline ≥50% (p<0.01) were significant prognosticators. Within the CTC+ subgroup, AR-V7+ (p=0.02) and PSA decline ≥50% (p=0.03) showed a relevant difference. In multivariate analysis (MV), for CTC+ pts, AR-V7+ (p=0.02), PSA decline ≥50% (p=0.02) and visceral metastases (p=0.02) remained independent prognosticators. The analysis for PFS resulted in 22 mo. (CI NA) for CTC- compared to 9 (CI 7.7-10.3) for CTC+ (p=0.01) and 10 mo. (CI 8.2-11.8) for CTC+/AR-V7- vs. 6 (CI 1.9-10.1) for CTC+/AR-V7+ (p=0.07). Performing UV, prior A/E (p<0.01), CTC+ (p=0.01), AR-V7+ (p=0.01), Hb ≤12 (p<0.01), PSA decline ≥50% (p<0.01) and ALP elevated at baseline (p=0.03) showed statistically significant differences. Within the CTC+ subgroup, prior A/E (p=0.01), visceral metastases (p=0.02), Hb ≤12 (p=0.01) and PSA decline ≥50% (p=0.03) were significant prognosticators, whereas AR-V7+ was not. In MV of CTC+ pts, visceral metastases (p=0.02), PSA decline ≥50% (p=0.02) and Hb ≤12 (p=0.05) remained independent prognosticators. Median OS was not reached for CTC- and 17 mo. (CI 9.8–24.2) for CTC+ (p<0.01) with 27 (CI 10.6-43.4) vs. 14 (CI 10.4-17.7) mo. for AR-V7- and AR-V7+, respectively (p=0.06). UV resulted in statistically relevant differences for prior docetaxel (p=0.01), prior A/E (p<0.01), visceral metastases (p=0.02), CTC+ (p=0.01), AR-V7+ (p<0.01) and Hb ≤12 (p< 0.01). Within CTC+, prior docetaxel (p<0.01), prior A/E (p=0.01), visceral metastases (p<0.01) and Hb ≤12 (p<0.01) were statistically relevant parameters. UV for AR-V7 status did not result in a significant difference for OS either. In MV, CTC status as well as Hb ≤12 remained independent prognosticators (p=0.04 and p<0.01, respectively). For MV of CTC+, visceral metastases (p=0.01), Hb ≤12 (p<0.01) and prior docetaxel (p=0.01) were independent prognosticators of OS. Conclusions: Presence of CTCs seems to prognosticate PFS and OS in mCRPC patients undergoing Androgen-deprivation while presence of AR-V7 does not despite its predictive potential.

The effect of change in PSA velocity on overall survival (OS) in men with biochemically recurrent prostate cancer (BRPC) treated with nonhormonal agents: Combined analysis of four phase 2 trials.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 121-121
Author(s):  
Daniel L. Suzman ◽  
Marianna Zahurak ◽  
Michael Anthony Carducci ◽  
Mario A. Eisenberger ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Overall Survival ◽  
Cox Regression ◽  
Phase 2 ◽  
Cox Regression Analysis ◽  
Psa Kinetics ◽  
Investigational Drugs ◽  
Psa Velocity ◽  
Prospective Trials ◽  
The Impact ◽  
Baseline Psa

121 Background: A number of phase 2 trials in men with BRPC have assessed the impact of non-hormonal agents on PSA kinetics. We have previously demonstrated that changes in PSA kinetics are correlated with metastasis-free survival; however, it is unknown whether these changes may also correlate with overall survival (OS). Methods: We performed a combined retrospective analysis of 146 men with BRPC treated on phase 2 trials using one of four investigational drugs: lenalidomide (n=60), marimastat (n=39), ATN-224 (n=22), and imatinib (n=25). We examined factors influencing OS, including within-subject changes in PSA kinetics (PSA slope, PSA doubling time, and PSA velocity) before and 6 months after treatment initiation. Results: After a median follow up of 77 months, 47 men had died. In univariate Cox regression analysis, four factors were associated with OS: prior androgen deprivation therapy (ADT), prior local radiotherapy, baseline PSA velocity, and change in PSA velocity after therapy. In a landmark multivariable model, stratified by study, which also controlled for age and Gleason score (<7 vs ≥7): prior radiotherapy, baseline PSA velocity, and increase in PSA velocity remained independent predictors of OS (Table). Median OS for men with an increase in PSA velocity on treatment was 9.1 years vs 12.3 years for men with a decrease in PSA velocity (HR 1.95; 95%CI 1.07–3.57; P=0.03). Conclusions: This hypothesis-generating study suggests that within-subject changes in PSA velocity after initiation of non-hormonal therapy may correlate with OS in men with BRPC. If validated in prospective trials using OS as the primary endpoint, change in PSA velocity may represent a reasonable intermediate endpoint for screening new agents in these patients. [Table: see text]

scholarly journals Prognosticki faktori resektabilnog primarnog nemikrocelularnog karcinoma bronha

2003 ◽  
Vol 50 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Dragan Subotic ◽  
Dragan Mandaric ◽  
Ljiljana Andric ◽  
Nikola Atanasijadis ◽  
Milan Gajic
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Tumor Diameter ◽  
Incomplete Resection ◽  
Cox Regression Analysis ◽  
Tumor Pathology

This study represents the univariate and multivariate analysis of prognostic factors of resectable non small cell lung cancer (NSCLC) that included 360 patients who underwent a surgical treatment because of primary (NSCLC) in the aforementioned institution in a period between 1985 and 1992. Patients with incomplete resection were rejected, perioperative deaths were not included in the analysis. In the analyzed group there were 293(81.38%) males and 67(18.62%) females - M:F ratio 4.37:1. Age of the operated patients was 36-75 years with the mean age of 55.15 years. Right-sided tumours existed in 197(54.72%) patients, left-sided tumors in 163(45.28%) patients. Based on pTNM, 157, 65, 114, 18 and 6 patients were classified into stages I, II, IIIA, IIIB and IV respectively. In the univariate analysis, survival curves were obtained using the life table method, with the statistical analysis of the obtained data using the Gehan-Wilcoxon method. In the multivariate analysis - Cox regression analysis was performed. Multivariate analysis found only T-stage, N-stage and the stage of the disease as significant independent prognostic factors. Mode of influence of factors that were found significant in the univariate analysis (age >60 years, tumor diameter > 60 mm, involvement of the visceral pleura, indirect tumor signs) is discussed and compared with literature data. Survival differences depending on other factors (tumor location, bronchoscopic aspect, extent of the resection), although without statistical significance, can be useful for the clinician, in the same time contributing to the better comprehension of information's obtained by basical investigations, especially of lymphatic spread of the disease and tumor pathology.

Predictors of mortality within the first year post-hepatectomy for hepatocellular carcinoma (Preprint)

2021 ◽  
Author(s):  
Sanaa Sheriff ◽  
Sudharsan Madhavan ◽  
Geraldine Lei ◽  
Yiong H. Chan ◽  
Sameer P Junnarkar ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Multivariate Analysis ◽  
Liver Failure ◽  
Cox Regression ◽  
Oncologic Outcomes ◽  
Cox Regression Analysis ◽  
Pugh Class ◽  
One Year

BACKGROUND Hepatic resection (HR) for hepatocellular carcinoma (HCC) is safe with good perioperative and long-term oncologic outcomes. There is a paucity of data with regards to intermediate-term outcomes, i.e. beyond 90-day and within one-year mortality. OBJECTIVE This paper studies the risk factors for within one-year mortality after elective HR with curative intent in patients with HCC. METHODS An audit of patients who underwent curative HR for HCC from January 2007 to April 2016 was conducted. Univariate and multivariate analysis were sequentially performed on perioperative variables using Cox-regression analysis to identify factors predicting intermediate-term outcomes defined as within one-year mortality. Kaplan-Meier survival curves and hazard ratios were obtained. RESULTS 348 patients underwent HR during the study period and 163 patients had curative hepatectomy for HCC. 15 patients (9.2%) died within one-year after HR. Multivariate analysis identified Child-Pugh class B/C [HR 5.5, p=0.035], multinodularity [HR 7.1, p=0.001], macrovascular invasion [HR 4.2, p=0.04] post-operative acute renal failure [HR 5.8, p=0.049] and post-hepatic liver failure [HR 9.6, p=0.009] as significant predictors of one-year mortality. CONCLUSIONS One-year mortality following HR for HCC remains high and can be predicted preoperatively by multinodularity, Child-Pugh class, and macrovascular invasion. Postoperative acute renal failure and liver failure are associated with one-year mortality.

scholarly journals Identification of Prognostic RBPs in Osteosarcoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Bei Li ◽  
Long Fang ◽  
Baolong Wang ◽  
Zengkun Yang ◽  
Tingbao Zhao
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Differential Expression ◽  
Ribosome Biogenesis ◽  
Rna Binding ◽  
Cox Regression ◽  
Rna Binding Proteins ◽  
Malignant Tumors ◽  
Differential Expression Analysis ◽  
Cox Regression Analysis

Osteosarcoma often occurs in children and adolescents and causes poor prognosis. The role of RNA-binding proteins (RBPs) in malignant tumors has been elucidated in recent years. Our study aims to identify key RBPs in osteosarcoma that could be prognostic factors and treatment targets. GSE33382 dataset was downloaded from Gene Expression Omnibus (GEO) database. RBPs extraction and differential expression analysis was performed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to explore the biological function of differential expression RBPs. Moreover, we constructed Protein-protein interaction (PPI) network and obtained key modules. Key RBPs were identified by univariate Cox regression analysis and multiple stepwise Cox regression analysis combined with the clinical information from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Risk score model was generated and validated by GSE16091 dataset. A total of 38 differential expression RBPs was identified. Go and KEGG results indicated these RBPs were significantly involved in ribosome biogenesis and mRNA surveillance pathway. COX regression analysis showed DDX24, DDX21, WARS and IGF2BP2 could be prognostic factors in osteosarcoma. Spearman’s correlation analysis suggested that WARS might be important in osteosarcoma immune infiltration. In conclusion, DDX24, DDX21, WARS and IGF2BP2 might play key role in osteosarcoma, which could be therapuetic targets for osteosarcoma treatment.

scholarly journals FRI0248 PROGNOSTIC FACTORS FOR STEROID-FREE REMISSION IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES: IMPORTANCE OF ANTHROPOMETRIC MEASUREMENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 708.1-708
Author(s):  
J. S. Lee ◽  
S. H. Nam ◽  
S. J. Choi ◽  
W. J. Seo ◽  
S. Hong ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cox Regression ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Immunosuppressant Therapy ◽  
Muscle Enzymes ◽  
Cox Regression Analysis ◽  
Factors Associated ◽  
Early Use

Background:Several studies have been conducted on factors associated with mortality in idiopathic inflammatory myopathies (IIM), but few studies have assessed prognostic factors for steroid-free remission in IIM.Objectives:We investigated the various clinical factors, including body measurements, that affect IIM treatment outcomes.Methods:Patients who were newly diagnosed with IIM between 2000 and 2018 were included. Steroid-free remission was defined as at least three months of normalisation of muscle enzymes and no detectable clinical disease activity. The factors associated with steroid-free remission were evaluated by a Cox regression analysis.Results:Of the 106 IIM patients, 35 displayed steroid-free remission during follow-up periods. In the multivariable Cox regression analyses, immunosuppressants’ early use within one month after diagnosis [hazard ratio (HR) 6.21, 95% confidence interval (CI) 2.61–14.74, p < 0.001] and sex-specific height quartiles (second and third quartiles versus first quartile, HR 3.65, 95% CI 1.40–9.51, p = 0.008 and HR 2.88, 95% CI 1.13–7.32, p = 0.027, respectively) were positively associated with steroid-free remission. Polymyositis versus dermatomyositis (HR 0.21, 95% CI 0.09–0.53, p = 0.001), presence of dysphagia (HR 0.15, CI 0.05–0.50, p = 0.002) and highest versus lowest quartile of waist circumference (WC) (HR 0.24, 95% CI 0.07–0.85, p = 0.027) were negatively associated with steroid-free remission.Conclusion:The early initiation of immunosuppressant therapy, type of myositis and presence of dysphagia are strong predictors of steroid-free remission in IIM; moreover, height and WC measurements at baseline may provide additional important prognostic value.Disclosure of Interests:None declared

scholarly journals A nomogram based on pretreatment levels of serum bilirubin and total bile acid levels predicts survival in colorectal cancer patients

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinghao Cao ◽  
Shenghe Deng ◽  
Lizhao Yan ◽  
Junnan Gu ◽  
Jia Yang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Bile Acid ◽  
Bile Acids ◽  
Cancer Patients ◽  
Serum Bilirubin ◽  
Cox Regression ◽  
Total Bile Acid ◽  
Cox Regression Analysis ◽  
Colorectal Cancer Patients

Abstract Background Serum bilirubin and total bile acid (TBA) levels have been reported to be strongly associated with the risk and prognosis of certain cancers. Here, we aimed to investigate the effects of pretreatment levels of serum bilirubin and bile acids on the prognosis of patients with colorectal cancer (CRC). Methods A retrospective cohort of 1474 patients with CRC who underwent surgical resection between January 2015 and December 2017 was included in the study. Survival analysis was used to evaluate the predictive value of pretreatment levels of bilirubin and bile acids. X-Tile software was used to identify optimal cut-off values for total bilirubin (TBIL), direct bilirubin (DBIL) and TBA in terms of overall survival (OS) and disease-free survival (DFS). Results DBIL, TBIL, and TBA were validated as significant prognostic factors by univariate Cox regression analysis for both 3-year OS and DFS. Multivariate Cox regression analyses confirmed that high DBIL, TBIL and TBA levels were independent prognostic factors for both OS (HR: 0.435, 95% CI: 0.299–0.637, P < 0.001; HR: 0.436, 95% CI: 0.329–0.578, P < 0.001; HR: 0.206, 95% CI: 0.124–0.341, P < 0.001, respectively) and DFS (HR: 0.583, 95% CI: 0.391–0.871, P = 0.008; HR:0.437,95% CI: 0.292–0.655, P <0.001; HR: 0.634, 95% CI: 0.465–0.865, P = 0.004, respectively). In addition, nomograms for OS and DFS were established according to all significant factors, and the c-indexes were 0.819 (95% CI: 0.806–0.832) and 0.835 (95% CI: 0.822–0.849), respectively. Conclusions TBIL, DBIL and TBA levels are independent prognostic factors in colorectal cancer patients. The nomograms based on OS and DFS can be used as a practical model for evaluating the prognosis of CRC patients.

Natural history definition and a suggested clinical approach to Buerger's disease: a case-control study with survival analysis

Vascular ◽  
2012 ◽  
Vol 20 (4) ◽  
pp. 198-202 ◽  
Author(s):  
Bahare Fazeli ◽  
Hassan Ravari ◽  
Reza Assadi
Keyword(s):  
Multivariate Analysis ◽  
Natural History ◽  
Cox Regression ◽  
Major Amputation ◽  
Clinical Approach ◽  
Buerger’S Disease ◽  
Buerger's Disease ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
History Of

The aim of this study was first to describe the natural history of Buerger's disease (BD) and then to discuss a clinical approach to this disease based on multivariate analysis. One hundred eight patients who corresponded with Shionoya's criteria were selected from 2000 to 2007 for this study. Major amputation was considered the ultimate adverse event. Survival analyses were performed by Kaplan–Meier curves. Independent variables including gender, duration of smoking, number of cigarettes smoked per day, minor amputation events and type of treatments, were determined by multivariate Cox regression analysis. The recorded data demonstrated that BD may present in four forms, including relapsing-remitting (75%), secondary progressive (4.6%), primary progressive (14.2%) and benign BD (6.2%). Most of the amputations occurred due to relapses within the six years after diagnosis of BD. In multivariate analysis, duration of smoking of more than 20 years had a significant relationship with further major amputation among patients with BD. Smoking cessation programs with experienced psychotherapists are strongly recommended for those areas in which Buerger's disease is common. Patients who have smoked for more than 20 years should be encouraged to quit smoking, but should also be recommended for more advanced treatment for limb salvage.

scholarly journals Prognostic Significance of PD-L1 and mTOR Expression in Oral Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Nattinee Charoen ◽  
Kitti Jantharapattana ◽  
Paramee Thongsuksai
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Prognostic Significance ◽  
P Value ◽  
Cox Regression Analysis

Objective: Programmed cell death ligand 1 (PD-L1) and mammalian target of rapamycin (mTOR) are key players in host immune evasion and oncogenic activation, respectively. Evidence of the prognostic role in oral squamous cell carcinoma (OSCC) is conflicting. This study examined the associations of PD-L1 and mTOR expression with 5-year overall survival in OSCC patients. Material and Methods: The expressions of PD-L1 and mTOR proteins were immunohistochemically evaluated on tissue microarrays of 191 patients with OSCC who were treated by surgery at Songklanagarind Hospital, Thailand from 2008 to 2011. Cox regression analysis was used to determine independent prognostic factors. Results: PD-L1 expression was observed in 14.1% of cases while mTOR expression was present in 74.3% of cases. Females were more likely to have tumors with PD-L1 (p-value=0.007) and mTOR expressions (p-value=0.003) than males. In addition, lower clinical stage and well differentiated tumor are more likely to have mTOR expression (p-value= 0.038 and p-value<0.001, respectively). Cox regression analysis showed that age, tumor stage, nodal stage, combined surgical treatment with radiation or chemoradiation therapy, surgical margin status, PD-L1 expression and mTOR expression are independent prognostic factors. High PD-L1 expression (hazard ratio (HR) 3.14, 95% confidence interval (CI), 1.26–7.79) and high mTOR expression (HR 1.69, 95% CI, 1.00–2.84) are strong predictors of poor outcome. Conclusion: A proportion of OSCC expressed PD-L1 and mTOR proteins. Expression of PD-L1 and mTOR proteins are strong prognostic factors of OSCC.

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