Survival characteristics of patients with first progression of glioblastoma at Cleveland Clinic Foundation.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14526-e14526
Author(s):  
Yasmeen Rauf ◽  
Jimmy Yao ◽  
Addison Barnett ◽  
Yanwen Chen ◽  
Brian Hobbs ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Median Overall Survival ◽  
Methylation Status ◽  
Progression Free Survival ◽  
Free Survival ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

e14526 Background: Glioblastoma (GBM) is the most common primary central nervous system malignancy, with a median overall survival of 14 to 17 months. First progression refers to progressive disease after initial radiation with or without chemotherapy. The median overall survival of patients with the first progression of GBM is nine months. Currently, there is no standard treatment for progressive GBM. Common treatment options include clinical trials, surgical resection, re-irradiation, stereotactic radiosurgery, cytotoxic chemotherapies, bevacizumab, and tumor treating fields. Methods: This retrospective study reviewed 244 patients with the first progression of GBM who were treated at CCF between Jan 2012 to Jan 2020. Statistical analyses included patients who had biopsy-proven GBM, a known MGMT methylation status, a KPS of more than 70 and presented with the first progression on MRI brain. Four cohorts of patients were evaluated: Group 1 received cytotoxic chemotherapy, Group 2 received bevacizumab alone, Group 3 received surgical or radiation therapy alone, Group 4 received experimental treatments. Results: The median overall survival (OS) and progression-free survival (PFS) was 12.4 months (95% CI: 10.9 to 14.3) and 4.3 months (95% CI: 3.9 to 5.4), respectively. The cohorts demonstrate statistical significant differentiation for PFS (p = 0.021) but not OS (p = 0.19). Second progression was noted at a median interval of 5.6 months in Group 4, 4.3 months in Group 2, 3.8 months Group 3 and 3.2 months in Group 1. Conclusions: Patients with the first progression of GBM had a better progression-free survival on experimental clinical trials than those in other cohorts.

scholarly journals EPID-13. A RETROSPECTIVE ANALYSIS TO STUDY THE SURVIVAL CHARACTERISTICS OF PATIENTS WITH FIRST PROGRESSION OF GLIOBLASTOMA AT THE CLEVELAND CLINIC

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii81-ii81
Author(s):  
Yasmeen Rauf ◽  
Jimmy Yao ◽  
Addison Barnett ◽  
Yanwen Chen ◽  
Brian Hobbs ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Trials ◽  
Median Overall Survival ◽  
Cleveland Clinic ◽  
Progression Free Survival ◽  
Free Survival ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract BACKGROUND Glioblastoma (GBM) is the most aggressive primary central nervous system malignancy. The median overall survival is 15 to 18 months with treatment and decreases to nine months after first progression. METHODS This is a retrospective study. Data was collected from all patients with first progression of GBM treated at CCF between Jan 2012 to Jan 2020. Eight cohorts of patients were evaluated: Group 1 received cytotoxic chemotherapy, Group 2 received bevacizumab alone, Group 3 received surgical or reirradiation alone, Group 4 were enrolled in clinical trials. Each group was divided into methylated and unmethylated cohorts. RESULTS Median overall survival was 12.4 months for patients with first progression of GBM (n= 248). Among the methlylated patients, the median overall survival was 16.5 months for group 1, 13.4 for group 2, 23.7 for group 3, and 17.3 for group 4. Among the unmethylated patients, the Median overall survival was 8.6 months for group 1, 7.7 months for group 2, 11.7 months for group 3 and 10.7 months for group 4. (p= 0.00016). Progression free survival (PFS) was 4.3 months for all patients with first progression of GBM. Among the unmethlylated patients, the PFS was 3.6 months for group 1, 15.3 months for group 2, 4.8 months for group 3, and 6.1 months for group 4. Among the unmethylated patients, the PFS was 2.3 months for group 1, 3.9 months for group 2, 3.8 months for group 3, and 4.4 months for group 4. (p < 0.0001). CONCLUSION Patients with first progression of GBM had the best overall survival in the cohort that underwent a surgical or reirradiation. The best progression free survival was for patients who were treated with Bevacizumab if they were methylated and those enrolled in clinical trials if they were unmethylated. The study was statistically significant.

P1031The impact of the duration of atrial fibrillation persistence for arrhythmia free survival in patients undergoing catheter ablation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Furukawa ◽  
T Yamada ◽  
T Morita ◽  
S Tamaki ◽  
M Kawasaki ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Outcome Data ◽  
Free Survival ◽  
Group 4 ◽  
Kaplan Meier ◽  
Group 3 ◽  
Group 2 ◽  
Af Recurrence ◽  
Group 1

Abstract Background Catheter ablation (CA) for atrial fibrillation (AF) is a curable treatment option. However, AF recurrence after CA remains an important problem. Although the success rate has been improved after catheter ablation (CA) in patients with paroxysmal AF (PAF), outcome data after CA for persistent AF (PeAF) are highly variable. Previous studies showed the PeAF is one of independent predictors for AF recurrence in comparison to PAF. However, there are little information available on the prognostic significance of AF duration after CA for AF. The aim of this study is to evaluate the impact of AF duration on long-term outcomes of AF ablation in patients with PeAF compared with PAF. Methods We enrolled 778 consecutive patients, who were referred our institution between August 2015 and December 2017 for undergoing the first time CA for AF. We divided 5 groups (Group 1; PAF (n=442), Group 2; PeAF duration ≤6 months (n=198), Group 3; PeAF duration of 6 months to 2 years (n=87), Group 4; PeAF duration of 2–5 years (n=30) and Group 5; PeAF duration ≥5 years (n=21)). All patients followed up for at least 1 year. Outcome data on recurrence of AF after ablation were collected. Results There were no significant differences in baseline clinical characteristics before CA among 5 groups, except for the prevalence of congestive heart failure, left atrial diameter and left ventricular ejection fraction. During a mean follow-up period of 511±298 days, 217 patients had AF recurrence. Kaplan-Meier analysis revealed that AF recurrence was significantly higher in group 2 compared to group 1 (31% vs 20%, p=0.002) and in group 4 compared to group 3 (83% vs 30%, p<0.0001). However, AF recurrence was no significantly differences between groups 2 and 3 (31% vs 30%, p=0.76) and between groups 4 and 5 (83% vs 81%, p=0.45). Of 217 patients with AF recurrence, 154 patients had undergone multiple procedures. After last procedures, during a mean follow-up period of 546±279 days, 61 patients had AF recurrence. Kaplan-Meier analysis revealed that AF recurrence was significantly higher in group 2 compared to group 1 (10% vs 3%, P=0.0005) and in group 4 compared with group 3 (35% vs 10%, p=0.0001). However, AF recurrence was no significantly difference between groups 2 and 3 (10% vs 10%, p=0.91) and between groups 4 and 5 (47% vs 35%, p=0.47). AF Free Survival Curve Conclusion Although patients with PeAF within 2 years had significantly higher AF recurrence compared to PAF, AF ablation might still be a good contributor as the first line approach to improve outcomes in patient with PeAF within 2 years.

The association of PSA levels and survival outcomes in patients with chemotherapy-naïve, castration-resistant prostate cancer (CRPC) who were treated with androgen receptor signaling axis targeting agent (ARAT): A Japanese cohort study.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 315-315
Author(s):  
Tatsuya Shimomura ◽  
Keiichiro Mori ◽  
Toshihiro Yamamoto ◽  
Hajime Onuma ◽  
Hiroyuki Inaba ◽  
...  
Keyword(s):  
Survival Outcome ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Group 4 ◽  
Castration Resistant ◽  
Signaling Axis ◽  
Psa Response ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

315 Background: PSA decline is used as one of the treatment outcome of androgen receptor signaling axis targeting agent (ARAT) in general. However, correlation between PSA decline and survival outcome is not discussed enough. In this study we evaluated how PSA decline influence the survival outcome of ARAT against chemo-naive castration resistant prostate cancer (CRPC). Methods: A total of 200 chemo-naïve CRPC cases treated with ARAT (abiraterone acetate or enzalutamide) were included in this study. We investigated the relationship between PSA response rate and survival outcome (PSA progression free survival (PSA-PFS), Failure free survival (FFS) and overall survival (OS)). Results: PSA response rate correlated with PSA-PFA, TFS and OS significantly (p<0.0001, <0.0001, 0.0009, respectively). And we categorized PSA decline in four groups, group 1: no PSA decline, group 2: 0-50%, group 3: 50%-90%, group 4: over 90%. Median PSA-PFS were 2M (group 1), 4M (group 2), 10M (group 3) and 16M (group 4) (p<0.0001). Median FFS were 3M (group 1), 6M (group 2), 12M (group 3) and 27M (group 4) (p<0.0001). Median OS were 28M (group 1), 36M (group 2), not reached (group 3 and 4) (p=0.0056). In terms of OS, there is a big different between PSA decline <50% and ≥50% in survival curve. And we compare the factors influencing PSA decline ≥50%. PSA and age at initiating ARAT are significant factors predicting PSA decline 50%. Lower PSA and lower age correlated PSA decline ≥50%. Conclusions: PSA decline strongly correlated with PSA-PFS, FFS and OS in this study. It would be a surrogate marker predicting survival outcomes of chemo-naïve CRPC cases treated with ARAT. Further investigation is warranted to confirm these results.

Optimising prediction of early metastasis-free survival in uveal melanoma using a four-category model incorporating gene expression profile and tumour size

2021 ◽  
pp. bjophthalmol-2020-317714
Author(s):  
Kelsey Andrea Roelofs ◽  
Parampal Grewal ◽  
Steven Lapere ◽  
Matthew Larocque ◽  
Albert Murtha ◽  
...  
Keyword(s):  
Gene Expression ◽  
Gene Expression Profile ◽  
Information Criteria ◽  
Free Survival ◽  
Group 4 ◽  
Prognostic Groups ◽  
Class 1 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundLargest basal diameter (LBD) appears to have independent prognostic value in uveal melanoma (UM).MethodsAll patients undergoing plaque brachytherapy or enucleation for UM involving the choroid and/or ciliary body between 2012 and 2019.ResultsA total of 348 patients with a mean age of 60±14 years were included and followed for a mean of 40±26 months (3.3±2.2 years). On multivariate analysis, LBD >12 mm remained a significant independent predictor of metastasis for both class 1 (HR 21.90; 95% CI 2.69 to 178.02; p=0.004) and class 2 (HR 2.45; 95% CI, 1.03 to 5.83; p=0.04) tumours. Four prognostic groups were created: group 1 (class 1, LBD <12 mm), group 2 (class 1, LBD ≥12 mm), group 3 (class 2, LBD <12 mm) and group 4 (class 2, LBD ≥12 mm). Life tables were used to calculate the 3-year and 5-year metastasis-free survival: group 1 (98 and 98%), group 2 (86 and 86%), group 3 (81 and 62%) and group 4 (54 and 47%). Compared with the reference category (group 1), the Cox proportional hazard model demonstrated a significant worsening of survival for each progressive category (group 2 (HR 21.59; p=0.004), group 3 (HR 47.12, p<0.001), and group 4 (HR 114.24; p<0.001)). In our dataset, the four-category Cox model performed poorer compared with the American Joint Committee on Cancer (AJCC) and gene expression profile (AJCC+GEP) in the Akaike’s information criteria (AIC) (297 vs 291), fit better with the Bayesian information criteria (BIC) (309 vs 313) and performed similarly with the Harrel’s C (0.86 (95% CI 0.80 to 0.91) vs 0.89 (0.84 to 0.94), respectively).ConclusionsCombination of GEP and LBD allows separation of patients into four easy-to-use prognostic groups and was similar to a model combining AJCC stage with GEP.

Prognostic role of apolipoprotein and lactate dehydrogenase levels in resectable colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15541-e15541
Author(s):  
Yifei Ma ◽  
Ping Lu ◽  
Xinjun Liang ◽  
Shaozhong Wei
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Lactate Dehydrogenase ◽  
Cox Regression ◽  
Prognostic Role ◽  
Free Survival ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

e15541 Background: Apolipoprotein b (apob), apolipoprotein a1 (apoa1), and lactate dehydrogenase (LDH) levels are circulating biomarkers that relate to tumor inflammation. This study aimed to evaluate the prognostic role of apob/apoa1 and LDH in resectable colorectal cancer (CRC). Methods: 513 patients of colorectal cancer (CRC) from Hubei cancer hospital were included finally, and we collected the pre-operative laboratory results within a week before surgery. We combined the two indicators and divided them into three groups (group 1: apob/apoa1-LDH low; group 2: apob/apoa1 or LDH high; group 3: apob/apoa1-LDH high). Kaplan-Meier survival analysis, univariate COX regression and multivariate COX regression were used to assess the prognoses of colorectal cancer patients. Results: The median follow-up was 35 months. Our study found that the prognosis of group 1 was better than group 2 in both overall survival (88.2% vs. 75.4% vs. 61.9%) (P≤0.001) and diseases-free survival (77.4% vs. 64.7% vs. 42.8%) (P≤0.001), and group 3 was the worst. By multivariate analysis, the new predictive marker obtained by combining apob/apoa1 and LDH could independently predict outcomes in CRC [overall survival: (HR: 1.487; 95% CI, 1.074-2.061); diseases-free survival (HR: 1.381; 95% CI, 1.045-1.827)]. Conclusions: New marker based on apob/apoa1 and LDH is useful for predicting the prognosis of patients with CRC. However, more research is needed in the future.

Early Lymphocyte Recovery Predicts Superior Disease Free Survival and Overall Survival after High Dose Chemotherapy and Autologous Stem Cell Transplantation in Non-Hodgkin Lymphoma Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3992-3992
Author(s):  
Walter G Borelli ◽  
Cristina Otero ◽  
Ana Ines Landoni ◽  
Alicia Magariños ◽  
Mercedes Zamora ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Progression Free Survival ◽  
High Dose ◽  
Free Survival ◽  
Cell Dose ◽  
Non Hodgkin Lymphoma ◽  
Group 2 ◽  
Autologous Hsct ◽  
Group 1

Abstract Introduction. An early absolute lymphocyte count (ALC) recovery after high dose therapy (HDT) and autologous hematopoietic stem cell transplantation (HSCT) in non Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), multiple myeloma and acute leukemia patients has been related with an improved outcome due to a better immune restoration. In this retrospective study we analyze a population of NHL patients to evaluate ALC recovery after autologous HSCT and its relation with post-transplant survival. Patients and methods. Fifty-three consecutive adult NHL patients received HDT followed by autologous HSCT in a single center between 2000 and 2012. Only individuals with at least 6 months post-transplant follow up were included. All patients received the same conditioning regimen (BEAM: carmustine, etoposide, cytarabine and melphalan) followed by peripheral blood stem cells previously collected by leukapheresis. Median CD34+ cell dose was 4.13 x 106/kg (1.62 – 12.58). Patients were divided into two groups: ALC at day +15 inferior than 500/mm3 (group 1) and ALC at day +15 superior or equal than 500/mm3 (group 2). Differences between groups were analyzed using t-Student and Chi-Square tests, with statistical significance determined at p<0.05. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan Meier method. Differences in survival between the two groups were determined by log-rank test. Results. No differences were observed between groups regarding gender, histology, disease status at transplant and cell dose. Patients into group 1 were older and more heavily pre-treated. Neutrophil and platelet engraftment were significantly faster in group 2 (Table 1). After a median follow-up of 56 months, progression-free survival (PFS) and overall survival (OS) were superior in group 2 patients. Median PFS was 47 months and not reached (p=0.013) and OS was 51 months and not reached (p=0.016) in groups 1 and 2 respectively (figures 1 and 2). Discussion. An early ALC recovery after autologous HSCT is associated with a better PFS and OS in NHL patients. Patients with ALC major or equal than 500/mm3 had a shorter time to neutrophil and platelet recovery and a shorter stay at transplant unit. In this study, CD34+ cell dose does not appears as a determinant factor for lymphocyte recovery. The extent of pre-transplant chemotherapy may influence ALC recovery after transplant. These results confirm the association between lymphocyte recovery and outcome in NHL patients after autologous HSCT. Table 1.Patient characteristics and comparison between groups 1 and 2.Group 1Group 2pALC< 500 /mm3> 500/mm3N2528Age, median (range)57 (29 - 66)41 (15 - 65)0.008Female gender (n)1214NSHistology (n)DLBCL1316 NSFollicular lymphoma62Mantle cell lymphoma32Peripheral T cell lymphoma13Indolent lymphoma12Others13Individuals who received two or more lines of pre-transplant treatment (n)1180.01Disease status at transplant (n)Complete remission711 NSPartial remission1613Progressive disease21CD34+ cells dose, median (range) (10E6/kg)3.45 (1.62 - 9.12)4.40 (2.28 - 12.58)NSMononuclear cells dose, median (range) (10E8/kg)8,84 (3,55 - 18,74)6,7 (1,94 - 27)NSDays to achieve ANC > 500/mm3, median (range)11 (7 - 30)8 (3 - 16)0.034Days to achieve platelets > 20.000/mm3, median (range)9 (2 - 49)5 (1 - 10)0.003Length of stay in transplant unit, days, median (range)30 (20 - 59)24 (20 - 35)0.001 Figure 1. PFS and ALC on day +15. Group 1: patients with ALC < 500/mm3 (dotted line); group 2: patients with ALC > 500/mm3 (solid line). Figure 1. PFS and ALC on day +15. Group 1: patients with ALC < 500/mm3 (dotted line); group 2: patients with ALC > 500/mm3 (solid line). Figure 2. Figure 2. OS and ALC on day +15. Group 1: patients with ALC < 500/mm3 (dotted line); group 2: patients with ALC > 500/mm3 (solid line). Disclosures No relevant conflicts of interest to declare.

Peripheral Blood Absolute Lymphocyte/Monocyte Ratio At Diagnosis Is Independent of the Interim Positron-Emission Tomography in Predicting Progression-Free Survival and Time to Progression in Classical Hodgkin Lymphoma (HL)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1527-1527
Author(s):  
Luis F. Porrata ◽  
Kay M. Ristow ◽  
Thomas M. Habermann ◽  
Thomas E Witzig ◽  
Joseph P. Colgan ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Pet Scan ◽  
Emission Tomography ◽  
Time To Progression ◽  
Free Survival ◽  
Interim Pet ◽  
Group 4 ◽  
Positron Emission ◽  
Group 3 ◽  
Group 2

Abstract Abstract 1527 Interim Positron-Emission Tomography (PET-scan), as a functional imaging test for tumor activity, has been shown to be a predictor for progression-free survival (PFS) and time to progression (TTP) in classical Hodgkin lymphoma (HL). The peripheral blood absolute lymphocyte/monocyte ratio (ALC/AMC) at diagnosis, as a surrogate marker of host immunity (i.e., ALC) and tumor microenvironment (i.e., AMC), has been recently reported [Porrata et al, Hematologica 2012; 97(2): 262–9] and confirmed [Koh et al, Oncologist 2012; 17(6): 871–80] to be also a predictor for PFS and TTP in classical HL. Therefore, we evaluated the combination of ALC/AMC ratio at diagnosis and the interim PET-scan to further stratify the clinical outcomes of PFS and TTP in patients with classical HL. To participate in the studies, patients were required to be diagnosed, treated, and followed at Mayo Clinic, Rochester, Minnesota. The treatment consisted of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) with or without radiation therapy. Patients were required to have an interim PET-scan performed. An ALC/AMC ratio ≥1.1 cut-off was used in the study based on our previous publication [Porrata et al, Hematologica 2012; 97(2): 262–9]. From 2000 until 2008, 111 classical HL patients qualified for the study. The cohort included 54% males and 46% females. The median age at diagnosis was 37 years (range: 18–83 years). The median follow-up was 2.8 years (range: 0.3–10.4 years). Patients with a negative interim PET-scan (N=98) presented with a higher ALC/AMC ratio at diagnosis (median of 2.32, range: 0.26–37.5) compared with patients with a positive interim PET-scan (N = 13) (median of 0.9, range: 0.29–3.10), p < 0.004. By univariate analysis, the ALC/AMC ratio at diagnosis and the interim PET-scan were predictors for PFS [ ALC/AMC ratio, R =0.13, 95% CI (0.05–0.35), p < 0.0002; and interim PET-scan, HR = 0.13, 95% CI (0.05–0.37), p < 0.0003] and TTP [ALC/AMC ratio, R =0.07, 95% CI (0.02–0.24), p < 0.0001; and interim PET-scan, HR = 0.05, 95% CI (0.01–0.18), p < 0.0003]. By multivariate analysis, ALC/AMC ratio at diagnosis and the interim PET-scan were independent predictors for PFS [ ALC/AMC ratio, R =0.13, 95% CI (0.07–0.63), p < 0.006; and interim PET-scan, HR = 0.11, 95%CI (0.02–0.47), p < 0.003] and TTP [ALC/AMC ratio, R =0.11, 95% CI (0.02–0.71), p < 0.02; and interim PET-scan, HR = 0.10, 95% CI (0.02–0.46), p < 0.003] when compared to the International Prognostic Score, limited versus advanced stage, and radiation. Patients were stratified into four groups: group 1 included patients with a negative interim PET-scan and ALC/AMC ratio at diagnosis ≥1.1 (N = 88); group 2 included positive interim PET-scan and ALC/AMC ratio at diagnosis ≥1.1 (N = 5); group 3 included negative PET-scan and ALC/AMC ratio at diagnosis < 1.1 (N = 10); and group 4 included positive PET-scan and ALC/AMC ratio at diagnosis <1.1 (N = 8). The three year PFS rates for each group were for goup1 95% (Events = 6); group 2 40% (Events = 3); group 3 56% (Events = 4); and group 4 50% (events = 4), p < 0.0001. The three year TTP rates for each group were: for group1 was 100% (Events = 0); for group 2 of 40% (Events = 3); for group 3 of 65% (Events = 3); and group 4 of 50% (events = 4), p < 0.0001. In conclusion, the ALC/AMC ratio at diagnosis is independent of the interim PET-scan to predict PFS and TTP in classical HL. Further studies are warranted to confirm our findings and to assess if the combination of the ALC/AMC ratio at diagnosis and interim PET can be use for planning of risk-adapted treatment. Disclosures: Ansell: Seattle Genetics, Inc.: Research Funding.

Goblet Cell Carcinoid Tumor, Mixed Goblet Cell Carcinoid-Adenocarcinoma, and Adenocarcinoma of the Appendix: Comparison of Clinicopathologic Features and Prognosis

2015 ◽  
Vol 139 (6) ◽  
pp. 782-790 ◽  
Author(s):  
Melissa W. Taggart ◽  
Susan C. Abraham ◽  
Michael J. Overman ◽  
Paul F. Mansfield ◽  
Asif Rashid
Keyword(s):  
Overall Survival ◽  
Goblet Cell ◽  
Carcinoid Tumors ◽  
Disease Stage ◽  
Clinicopathologic Features ◽  
Goblet Cell Carcinoid ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Context The prognosis of appendiceal goblet cell carcinoid tumors (GCTs) is believed to be intermediate between appendiceal adenocarcinomas and conventional carcinoid tumors. However, GCTs can have mixed morphologic patterns, with variable amount of adenocarcinoma. Objective To evaluate the behavior of GCTs and related entities with variable components of adenocarcinoma. Design We classified 74 cases of appendiceal tumors into 3 groups: group 1, GCTs or GCTs with less than 25% adenocarcinoma; group 2, GCTs with 25% to 50% adenocarcinoma; group 3, GCTs with more than 50% adenocarcinoma; and a comparison group of 68 adenocarcinomas without a GCT component (group 4). Well-differentiated mucinous adenocarcinomas were excluded. Clinicopathologic features and follow-up were obtained from computerized medical records and the US Social Security Death Index. Results Of the 142 tumors studied, 23 tumors (16%) were classified as group 1; 27 (19%) as group 2; 24 (17%) as group 3; and 68 (48%) as group 4. Staging and survival differed significantly among these groups. Among 140 patients (99%) with available staging data, stages II, III, and IV were present in 87%, 4%, and 4% of patients in group 1 patients; 67%, 7%, and 22% of patients in group 2; 29%, 4%, and 67% of patients in group 3; and 19%, 6%, and 75% of patients in group 4, respectively (P = .01). Mean (SD) overall survival was 83.8 (34.6), 60.6 (30.3), 45.6 (39.7), and 33.6 (27.6) months for groups 1, 2, 3, and 4, respectively (P = .01). By multivariate analysis, only stage and tumor category were independent predictors of overall survival. Conclusion Our data highlight the importance of subclassifying the proportion of adenocarcinoma in appendiceal tumors with GCT morphology because that finding reflects disease stage and affects survival.

Paclitaxel and Carboplatin, Alone or With Irradiation, in Advanced or Recurrent Endometrial Cancer: A Phase II Study

2001 ◽  
Vol 19 (20) ◽  
pp. 4048-4053 ◽  
Author(s):  
Paul J. Hoskins ◽  
Kenneth D. Swenerton ◽  
Judith A. Pike ◽  
Frances Wong ◽  
Peter Lim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Survival Time ◽  
Area Under The Curve ◽  
Overall Survival Rate ◽  
Free Survival ◽  
Group 3 ◽  
Endometrial Cancers ◽  
Group 2 ◽  
Group 1

PURPOSE: To evaluate the efficacy of carboplatin plus paclitaxel in primarily advanced or recurrent endometrial cancers. PATIENTS AND METHODS: Four distinct patient groups received carboplatin (area under the curve, 5 to 7) plus paclitaxel 175 mg/m2 for 3 hours at 4-week intervals: group 1 (n = 21), patients with primarily advanced, nonpapillary serous cancers; group 2 (n = 20), the same as group 1 but with papillary serous cancers; group 3 (n = 18), recurrent, nonpapillary serous cancers; and group 4 (n = 4), recurrent, papillary serous cancers. Involved-field irradiation was used in groups 1 and 2 for those with radioencompassable disease. RESULTS: Sixty-three patients were treated. Response rates to chemotherapy in the assessable patients in the four groups were 78% (95% confidence interval [CI], 51% to 100%); 60% (95% CI, 35% to 85%), 56% (95% CI, 34% to 78%), and 50%, respectively. Nineteen patients (90%) in group 1 also were irradiated, and the median failure-free survival time for all 21 patients was 23 months, with a 62% 3-year overall survival rate. Eleven patients (55%) in group 2 were irradiated, and the median failure-free survival time for all 18 patients was 18 months, with a 39% 3-year overall survival rate. The median failure-free interval in the patients in group 3 was 6 months, with a 15-month median overall survival time. Toxicity was manageable, reversible, and predominantly hematologic. Two patients developed neutropenic fever, and three patients, including these two, were hospitalized for complications. CONCLUSION: Carboplatin-paclitaxel is an efficacious, low-toxicity regimen for managing primarily advanced or recurrent endometrial cancers.

scholarly journals Outcomes in Patients With Pancreatic Adenocarcinoma With Genetic Mutations in DNA Damage Response Pathways: Results From the Know Your Tumor Program

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Michael J. Pishvaian ◽  
Edik M. Blais ◽  
Jonathan R. Brody ◽  
Lola Rahib ◽  
Emily Lyons ◽  
...  
Keyword(s):  
Dna Damage ◽  
Overall Survival ◽  
Dna Damage Response ◽  
Median Overall Survival ◽  
Advanced Disease ◽  
Genetic Mutations ◽  
Damage Response ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PURPOSE Up to 25% of pancreatic adenocarcinomas (PDACs) harbor mutations in the homologous recombination DNA damage response (HR-DDR) pathway. Although known to affect responsiveness to DNA-damaging chemotherapy, the prognostic relevance of these mutations is unclear and outcomes in patients with PDAC who harbor HR-DDR mutations beyond BRCA1/2 remain unexplored. METHODS We evaluated 820 patients with PDAC enrolled in the Know Your Tumor program for whom we had collected comprehensive genomic testing results and longitudinal clinical outcomes. Patients were categorized as having resected versus advanced disease, and as having received platinum-based therapy versus being platinum naïve. Tumor genomic profiles were categorized as HR-DDR mutated (HR-DDRmut) or proficient (pHR-DDR) on the basis of the presence of pathogenic mutations of somatic or germline origin in BRCA1/2 or PALB2 (group 1); ATM/ATR/ATRX (group 2); or BAP1, BARD1, BRIP1, CHEK1/2, RAD50/51/51B, or FANCA/C/D2/E/F/G/L (group 3). Overall survival was measured from the date of diagnosis until death. RESULTS Median overall survival (mOS) was similar in all resected patients irrespective of exposure to platinum-based therapy, whereas for platinum-treated patients with advanced disease, mOS was significantly longer for HR-DDRmut versus pHR-DDR (2.37 years v 1.45 years, respectively). Of importance, no difference was identified in platinum-naïve patients. mOS in patients with mutations in all three HR-DDRmut groups was greater than that for pHR-DDR patients, but this difference was lost in platinum-naïve patients. CONCLUSION Patients with advanced HR-DDRmut have improved mOS when treated with platinum-based therapy compared with pHR-DDR patients. In platinum-naïve patients, there is no mOS difference, which suggests that HR-DDR status has no pure prognostic value. These findings support the need to test all patients with advanced PDAC to ensure that HR-DDRmut patients receive the benefit of treatment with platinum-based therapy.

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