Association of leukocyte count (neutrophilia and lymphopenia) with poor prognosis in patients with high-grade gliomas in a Guatemalan cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14500-e14500
Author(s):  
Rixci Ramirez ◽  
Daniel Estuardo Rosales Lopez ◽  
Jennifer Dominguez ◽  
Marisol Gramajo ◽  
Carolina Camey
Keyword(s):  
Overall Survival ◽  
Neutrophil Count ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Rank Test ◽  
Significant Prognostic Factor ◽  
High Grade ◽  
Initial Surgery ◽  
High Grade Gliomas ◽  
Clinical Records

e14500 Background: In previous studies separately, it has already been determined how the inflammatory response measured by it neutrophilia and also lymphopenia s with temozolamide have determined that they are important at the time of initiation of treatment and have a prognostic value in patients with high-grade gliomas, the objective This study was the prognostic value of leukocyte disorders, absolute neutrophil count and absolute lymphocyte count in a retrospective cohort of patients with high-grade glioma who receive concomitant temozolomide and radiation plus maintenance. Methods: Clinical records of patients treated at the Guatemalan Social Security Institute were registered in the Oncology service within the period from January 1, 2013 to December 2018, the treatment consisted of temozolomide (75 mg / m2 per day) and concomitant radiation and subsequent maintenance with temozolomide (150 mg / m2 D1-5) every 28 days for 6 cycles. The prognostic value of neutrophilia and lymphopenia, prior to treatment in survival, was defined as a neutrophil count greater than 7x10 3 / uL and lymphopenia less than 2 x10 3 / uL. The analysis was performed using Kapplan Mayer curves, log rank test and Cox analysis. Results: We identified 64 high-grade patients (grades III and IV according to WHO), all treatments with concomitant chemoradiotherapy based on temozolomide and subsequent maintenance with temozolamide. The initial surgery was lost in the majority (75%), with resection > 90% in 25 patients (34%). 79.4% were treated with radiotherapy plus concomitant chemotherapy followed by adjuvant chemotherapy with temozolamide of these, 69% completed the treatment, thirty-two patients (50%) with pre-treatment neutrophilia. The overall survival at 2 years was 55%. In the univariate analysis, neutrophilia is associated with a worse overall survival (p = 0.019), as well as lymphopenia (p = 0.003), in addition to the age ≥65 years (p = 0.0001), surgical resection < 90% (p = 0.045) and prednisolone consumption ≥50mg / day (p = 0.045). In the multivariate analysis, neutrophilia (p = 0.017), age ≥65 (p = 0.001), lymphopenia (p = 0.0056) were associated with a worse prognosis with reduced survival. Conclusions: In high-grade gliomas treated with temozolomide and concomitant radiation followed by maintenance with temozolamide, neutrophilia and lymphopenia can be a significant prognostic factor for overall survival, with the advantage that it is not an expensive test and is accessible at all times of patient follow-up.

scholarly journals TAMI-54. THE PRESENCE OF IMMUNE CELL INFILTRATES IN THE TISSUE MICROENVIRONMENT OF HIGH-GRADE GLIOMAS AND THEIR ASSOCIATION WITH OVERALL SURVIVAL

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii225-ii225
Author(s):  
Anupam Rishi ◽  
Homan Mohammadi ◽  
Daniela Martir ◽  
Eric Welsh ◽  
Timothy Robinson ◽  
...  
Keyword(s):  
Gene Expression ◽  
Overall Survival ◽  
Surgical Resection ◽  
Immune Cell ◽  
Cox Regression ◽  
Tumor Biology ◽  
Rank Test ◽  
High Grade ◽  
High Grade Gliomas ◽  
Grade 3

Abstract OBJECTIVE Tumor-associated microglia and macrophages (TAMs) influence brain tumor biology and promote tumor-proliferating phenotype. Studies have shown these cell types predict outcomes in various tumor sites with limited evidence in high-grade gliomas (HGG). In this study, we assessed the presence of immune cell infiltrate (ICI) and overall survival (OS) in HGGs. METHODS A total of 97 consecutively treated patients with primary HGG with complete gene expression profiling were identified from our IRB-approved institutional tissue biorepository. Patients underwent primary surgical resection between 02/2004 and 03/2011. Gene expression levels were assessed by Affymetrix Hu-RSTA assays (Affymetrix; Santa Clara, CA). CIBERSORT estimated the presence of ICI via gene expression deconvolution. Tumor characteristics and the presence of 22 individual ICI subtypes were assessed with respect to OS. Time-to-event analyses were performed with Kaplan-Meier estimates and compared via log-rank test. Associations between the ICI and outcomes were explored using Cox-regression. P&lt; 0.05 (two-tailed) was considered statistically significant. RESULTS Median follow-up from primary surgical resection was 12.8 months (range: 0.1-162.8), and median age was 58 years (20-85). Most patients were male (n=63; 65%) and had grade 4 tumors (n=71; 73%). OS differed by grade with 24-month actuarial OS rates of 81% and 34% (P&lt; 0.0001) for grade 3 and 4 gliomas, respectively. The presence of M0 (HR 2.2; 95% CI 1.4-3.6; P=0.001), M1 (HR 1.8; 95%CI 1.1-2.9; P=0.01), and M2 macrophages (HR 1.9; 95%CI 1.2-3.2; P=0.007) predicted OS. No other ICI subtypes were predictive of OS. The presence of M0- and M2-polarized macrophages were more common in grade 4 compared to grade 3 gliomas 46% vs. 11% (P=0.002) and 69% vs. 31% (P=0.0007), respectively. CONCLUSION The increased presence of non-polarized or M2 TAMs within the glioma microenvironment was significantly associated with OS in HGG. Their presence may serve as unique stratification and a potential therapeutic target.

scholarly journals Prognostic value of 18F-FDG PET/MRI in patients with advanced oropharyngeal and hypopharyngeal squamous cell carcinoma

2021 ◽  
Vol 35 (4) ◽  
pp. 479-484
Author(s):  
Leonardo Pace ◽  
Emanuele Nicolai ◽  
Carlo Cavaliere ◽  
Luca Basso ◽  
Nunzia Garbino ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Standardized Uptake Value ◽  
Rank Test ◽  
Post Contrast ◽  
Kaplan Meier

Abstract Objective The aim of this study was to evaluate the prognostic value of combined positron emission tomography (PET)/magnetic resonance imaging (MRI) parameters provided by simultaneous 18F-fluorodeoxyglucose (FDG) PET/MRI in patients with locally advanced oropharyngeal and hypopharyngeal squamous cell carcinomas (OHSCC). Methods Forty-five patients with locally advanced OHSCC who underwent simultaneous FDG PET/MRI before (chemo)radiotherapy were retrospectively enrolled. Peak standardized uptake value (SULpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion were obtained on PET data. On MRI scans, primary tumor size, diffusion and perfusion parameters were assessed using pre-contrast and high-resolution post-contrast images. Ratios between metabolic/metabolo-volumetric parameters and ADC were calculated. Comparisons between groups were performed by Student’s t test. Survival analysis was performed by univariate Cox proportional hazard regression analysis. Overall survival curves were obtained by the Kaplan–Meier method and compared with the log-rank test. Survivors were censored at the time of the last clinical control. p < 0.05 was considered statistically significant Results During follow-up (mean 31.4 ± 21 months), there were 15 deaths. Univariate analysis shows that SULpeak and SULpeak/ADCmean were significant predictors of overall survival (OS). At multivariate analysis, only SULpeak remained a significant predictor of OS. Kaplan–Meier survival analyses showed that patients with higher SULpeak had poorer outcome compared to those with lower values (HR: 3.7, p = 0.007). Conclusion Pre-therapy SULpeak of the primary site was predictive of overall survival in patients with oropharyngeal or hypopharyngeal cancer treated with (chemo)radiotherapy.

scholarly journals Surgery for recurrent high-grade gliomas: the dilemma of debate

2018 ◽  
Vol 32 (2) ◽  
pp. 272-282
Author(s):  
Wael Musa ◽  
Ahmed N. Taha
Keyword(s):  
Overall Survival ◽  
Tumor Resection ◽  
High Grade Glioma ◽  
Mass Effect ◽  
High Grade ◽  
Initial Surgery ◽  
High Grade Gliomas ◽  
Outcome Of Surgery ◽  
Significant Mass Effect ◽  
Significant Mass

Abstract Background: Treating recurrent gliomas is a big dilemma in the literature and no uniform protocol is approved to treat such disappointing problem. Although improvement in the RT techniques, new CTX techniques and new techniques including targeted therapy and gene therapy; all fail to dramatically improve the outcome and solve the problem of significant mass effect when the recurrent tumor is big So resurgery play a role in treating such challenging problem. The aim of the study: to assess the goal and outcome of surgery in treatment of recurrent malignant glioma. Methods: We retrospectively analyzed the data of 56 patients who were operated upon for recurrent or progressed high grade gliomas in the Mansoura neurosurgery department allover 2007 to 2016. We have excluded patients with recurrent thalamic gliomas and patients with Kps score less than 70. Results: 12 patient underwent sterotactic biopsy for their tumor and were sent for adjuvant radiotherapy, 29 patients underwent partial tumor resection and gross total resection was done in 15 patients. The median time to progression was 5 months. All patients were sent after surgery for poster radiotherapy and chemotherapy. The median overall survival was 4 months. Conclusion: Recurrent high grade glioma is one of unsolved problem and optimal management is no longer available. Redo surgery is quiet challenging with higher minorities and no add to overall survival. Surgery is indicated to relieve significant mass effect. Outcome of surgery is better for those who did aggressive surgical resection at initial surgery than those who did only partial resection.

Prognostic value of genomic alterations (GA) on overall survival in appendiceal adenocarcinoma (AA).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 554-554
Author(s):  
Alexandre A Jacome ◽  
Kanwal Pratap Singh Raghav ◽  
Kenna Rael Shaw ◽  
Keith F. Fournier ◽  
Richard Eldon Royal ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Prognostic Value ◽  
Cox Model ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Tumor Grade ◽  
Rank Test ◽  
Cancer Center ◽  
Rare Tumors

554 Background: AA are extremely rare tumors, with potentially aggressive clinical behavior. The characterization of the molecular alterations of the disease is poorly described, as well as its association with clinical outcomes. The present study aims to evaluate the prognostic influence of GA on overall survival (OS) of AA patients (pts). Methods: We performed a retrospective study involving AA pts at MD Anderson Cancer Center between October 2012 and April 2017 who underwent next-generation sequencing (NGS) (at least 45 genes), using either tumor tissue specimens or peripheral blood for cell-free DNA (cfDNA). GA identified by NGS and clinicopathological variables were correlated with OS. Survival curves were performed by the Kaplan-Meier method and compared with log-rank test. Multivariate analysis of prognostic factors was performed by the Cox model. Results: A total of 78 pts were identified, of which 35 had died (45%) in a median follow-up time of 4.8 y. The majority of pts presented with stage IV disease (72%); 46% underwent cytoreductive surgery (CRS) + HIPEC. Tissue-based and cfDNA-based sequencing were performed on 73% and 23% of the pts, respectively, and 4% had both. The most frequent GA were KRAS (62%), TP53 (36%), GNAS (28%), SMAD4 (18%), PIK3CA (16%), and APC (15%). By univariate analysis, stage, tumor grade, and CRS + HIPEC demonstrated prognostic value (p < 0.05). Multivariate subset analysis of stage IV pts adjusting for age, tumor grade (TG), CRS + HIPEC, KRAS, GNAS, and p53, demonstrated that poorly differentiated tumors and a KRAS mutated tumor resulted in worse OS (HR: 12.1 and HR: 3.9, respectively, both with p < 0.05) and CRS + HIPEC resulted in an improved OS (HR: 0.32, p < 0.05). Conclusions: Our analysis indicates that TG and the presence of the KRAS mutation are poor prognostic factors in the OS of pts with AA. CRS + HIPEC offers survival advantage . Molecular characterization and prognostication of these rare tumors may help guide therapy. These findings need validation, thereby continued evaluation in a larger population and utilizing a wider molecular platform is ongoing.

scholarly journals Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrés Moreno Roca ◽  
Luciana Armijos Acurio ◽  
Ruth Jimbo Sotomayor ◽  
Carlos Céspedes Rivadeneira ◽  
Carlos Rosero Reyes ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Survival Time ◽  
Univariate Analysis ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Icd 10 ◽  
The Difference ◽  
Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

miR-181 Expression is Associated With The Prognosis in Lung Cancer.

2020 ◽  
Author(s):  
Yue Zhao ◽  
Xiangjun Kong ◽  
Hongbing Wang
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Value ◽  
Cox Regression ◽  
Suppressor Gene ◽  
Rank Test ◽  
High Morbidity ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Cancer Tissues

Abstract Background: Lung cancer is one of the most common cancers, with high morbidity and mortality. MiRNAs are proved to play important roles in various human cancers. In our study, we aimed to explore the prognostic value of miR-181 in lung cancerMethods: Quantitative real-time polymerase chain reaction (QRT-PCR) was used to detect the expression level of miR-181 in lung cancer tissues and the paired non-cancerous tissues. The relationship between miR-181 expression and clinicopathologic parameters were analyzed by chi-square test. Kaplan-Meier method with log rank test was applied for overall survival analysis. Furthermore, the Cox regression analyses were performed to evaluate the prognostic value of miR-181 in lung cancer.Results: Down-regulated miR-181 expression was observed in lung cancer tissues (P<0.001), moreover, its expression was significantly correlated with TNM stage (P=0.015) and metastasis (P=0.000). In addition, lung cancer patients with lower miR-181 expression level had poorer overall survival than those with higher expression (log rank test, P=0.011). Cox regression analysis suggested that miR-181 was an independent prognostic factor for lung cancer (HR=1.961, 95%CI=1.135-3.388, P=0.016).Conclusion: MiR-181 may be a tumor suppressor gene in lung cancer, which can predict outcomes for the patients.

Combined Immunoscore of CD103 and CD3 Identifies Long-Term Survivors in High-Grade Serous Ovarian Cancer

2016 ◽  
Vol 26 (4) ◽  
pp. 671-679 ◽  
Author(s):  
Hans-Christian Bösmüller ◽  
Philipp Wagner ◽  
Janet Kerstin Peper ◽  
Heiko Schuster ◽  
Deborah Lam Pham ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Clinical Outcome ◽  
Prognostic Value ◽  
Intraepithelial Lymphocytes ◽  
High Grade ◽  
Serous Ovarian Cancer ◽  
Term Survival ◽  
Cell Counts

ObjectiveIncreased numbers of tumor-infiltrating lymphocytes (TILs) in high-grade serous ovarian cancer (HGSC) are associated with improved clinical outcome. Intraepithelial localization of TILs might be regulated by specific homing receptors, such as CD103, which is widely expressed by intraepithelial lymphocytes. Given the emerging role of CD103+ TILs, we aimed to assess their contribution to the prognostic value of immunoscoring in HGSC.MethodsThe density of intratumoral CD3+ and CD103+ lymphocytes was examined by immunohistochemistry on a tissue microarray of a series of 135 patients with advanced HGSC and correlated with CD4+, CD8+, CD56+, FoxP3+, and TCRγ+ T-cell counts, as well as E-cadherin staining and conventional prognostic parameters and clinical outcome.ResultsBoth the presence of CD103+ cells, as well as high numbers of intraepithelial CD3+ lymphocytes (CD3E), showed a significant correlation with overall survival, in the complete series, as well as in patients with optimal debulking and/or platinum sensitivity. Combining CD3 and CD103 counts improved prognostication and identified 3 major subgroups with respect to overall survival. The most pronounced effect was demonstrated for patients with optimally resected and platinum-sensitive tumors. Patients with CD3high/CD103high tumors showed a 5-year survival rate at 90%, CD3low/CD103high at 63%, and CD3low/CD103low at 0% (P < 0.001).ConclusionsThese results suggest that combined assessment of CD103 and CD3 counts improves the prognostic value of TIL counts in HGSC and might identify patients with early relapse or long-term survival based on the type and extent of the immune response.

scholarly journals Effect of valproic acid on overall survival in patients with high-grade gliomas undergoing temozolomide

Medicine ◽  
2020 ◽  
Vol 99 (28) ◽  
pp. e21147
Author(s):  
Yu-Jen Kuo ◽  
Yao-Hsu Yang ◽  
I-Yun Lee ◽  
Pau-Chung Chen ◽  
Jen-Tsung Yang ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Overall Survival ◽  
High Grade ◽  
High Grade Gliomas

Creatinine Clearance Is More Important Prognostic Factor Than ß2 Microglobulin in Multiple Myeloma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4864-4864
Author(s):  
Jae-Pil Yun ◽  
Cheolwon Suh ◽  
Eunkyoung Lee ◽  
Jai Won Chang ◽  
Won Seok Yang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Factor ◽  
Creatinine Clearance ◽  
Survival Time ◽  
Univariate Analysis ◽  
Staging System ◽  
Rank Test ◽  
Significant Prognostic Factor ◽  
Important Prognostic Factor ◽  
Stage 1

Abstract In the new staging system of multiple myeloma (MM) by South West Oncology Group (SWOG), the concentration of serum β2 microglobulin (β2m) and serum albumin were focused as the most important prognostic factors for survival. However, serum concentration of β2m has been known as an indicator of glomerular filtration rate. The aim of this study was to compare the prognostic value of the level of β2m with that of creatinine clearance (Ccr) in patients with multiple myeloma. Retrospectively, from January 1, 1996 to November 30, 2003, we reviewed 176 MM patients (M: F 110:66 mean age: 58.5±11.0) whose 24-hour urinary creatinine clearance was available at the time of diagnosis. We collected clinical data such as hemoglobin, serum creatinine, calcium, albumin, β2m, creatinine clearance before chemotherapies, and patients’ survival time. Pretreatment β2m was inversely related to Ccr (Spearman’s correlation coefficient = −0.781, P <0.01). In univariate analysis, relative risk (RR) of death was 1.047 (p< 0.001) for β2m and 0.985 (p< 0.001) for Ccr. But multivariate analysis using Cox’s proportional hazard model showed β2m was not significant prognostic factor in patients’ survival after adjustment for Ccr (RR 1.025, p=0.054) but Ccr was an independent risk factor of death after adjustment for β2m (RR 0.990, p=0.013). And univariate analysis identified that RR for β2m is not significant in 88 MM patients (66 patients with β2m ≥ 2.5mg/l) with relatively normal renal function (Ccr ≥ 50 ml/min) (RR = 1.110, p=0.306) We could propose another new staging system with β2m replaced by Ccr in SWOG staging system. The stages were defined as: stage 1, Ccr ≥ 80ml/min; stage 2, 50< Ccr <80; stage 3, Ccr < 50 and albumin ≥ 3.0g/dl; and stage 4 Ccr < 50 ml/min and albumin< 3.0 g/dl. According to this proposed staging system, median survival time of each stage from 1 to 4 is 1475, 887, 513, and 196 days, respectively. (Log Rank test < 0.0001) In conclusion, Ccr could be more important prognostic factor than the level of β2m in patients of MM and we propose that Ccr should be reassessed as the component of staging system of MM.

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