Comparing clinicopathologic feature and treatment outcome of patients who underwent surgical resection or liver transplant for nonalcoholic fatty liver disease (NAFLD)-related and non-NAFLD related hepatocellular carcinoma (HCC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16675-e16675
Author(s):  
Surendra Pal Chaudhary ◽  
Lipika Goyal ◽  
Matthew L Chase ◽  
Andrew X. Zhu ◽  
Nikroo Hashemi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Liver Transplant ◽  
Tumor Size ◽  
Massachusetts General Hospital ◽  
Disease Recurrence ◽  
Large Tumor ◽  
Nonalcoholic Fatty Liver ◽  
Risk Of Death ◽  
Clinicopathologic Feature ◽  
Significant Difference

e16675 Background: NAFLD associated HCC is rapidly increasing in frequency worldwide. In this study, we evaluated potential differences in clinical characteristics and outcomes of patients who underwent surgery or liver transplant for NAFLD-associated HCC compared to HCC from other etiologies. Methods: Demographic, clinicopathological features and outcomes of patients with HCC who underwent liver resection or liver transplant at Massachusetts General Hospital and Brigham and Women’s Hospital were collected (January 2004 - April 2018). Of 713 patients screened, 481were eligible: 260 underwent resection [NAFLD (n = 61), viral (n = 150), cryptogenic (CC) (n = 49)]. 221 underwent transplant [(NAFLD (n = 14), viral (n = 201), CC (n = 6)]. Results: In the Resected cohort, NAFLD patients presented with median age of (71.5 years) compared with Viral (63.4) and Cryptogenic (68.4). NAFLD patients had significantly higher Body Mass Index (BMI) > 28.8 39(66%) p = < 0.001, while patients with cryptogenic HCC presented with large tumor size (>5cm) 37(75%) p = 0.001. In multivariate analysis, tumor size 5cm (HR1.78,p = 0.002), R1 or R2 resection (HR 2.48, p = < 0.001and 2.8,p = 0.007), low platelet count (HR 2.8,p = 0.002) and diabetes (HR 1.5,p = 0.025) were poor prognostic factors in resection cohort. Median overall survival (OS) was not significantly different between NAFLD, Cryptogenic and Viral (47.2, 69.7 and 69.0 months, p = 0.18) etiologies, respectively. In the Transplant cohort, NAFLD patients had a median age of 65.5 and cryptogenic, viral (61.3 and 58.5 years) respectively. NAFLD and Cryptogenic HCC patients compared with viral HCC patients had low AFP median 3.7, 3.9 and 7.5 ng/mL(p = 0.012) respectively. In multivariate analysis patients with perineural invasion (HR 20.7,p = 0.009), disease recurrence (HR 2.5,p = 0.001) and high AFP (HR 2.1,p = 0.001) were at higher risk of death among transplant patients. No significant difference in median OS was seen between NAFLD, cryptogenic and viral (69.1,92.3 and 88.0 months, p = 0.38). Conclusions: NAFLD patients had higher BMI and had a lower AFP than viral and CC. NAFLD had similar median OS following resection and transplant when compared to those with Viral and CC.

scholarly journals Comparison of Lobectomy and Sublobar Resection for Stage IA Elderly NSCLC Patients (≥70 Years): A Population-Based Propensity Score Matching’s Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Bo Zhang ◽  
Renwang Liu ◽  
Dian Ren ◽  
Xiongfei Li ◽  
Yanye Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Tumor Size ◽  
Cox Regression ◽  
Large Tumor ◽  
Cox Regression Analysis ◽  
Large Tumor Size ◽  
Significant Difference ◽  
Stage Ia ◽  
Nsclc Patients

BackgroundTo investigate the differences in survival between lobectomy and sub-lobar resection for elderly stage I non-small-cell lung cancer (NSCLC) patients using the Surveillance, Epidemiology, and End Results (SEER) registry.MethodThe data of stage IA elderly NSCLC patients (≥ 70 years) with tumors less than or equal to 3 cm in diameter were extracted. Propensity-matched analysis was used. Lung cancer-specific survival (LCSS) was compared among the patients after lobectomy and sub-lobar resection. The proportional hazards model was applied to identify multiple prognostic factors.ResultsA total of 3,504 patients met criteria after propensity score matching (PSM). Although the LCSS was better for lobectomy than for sub-lobar resection in patients with tumors ≤ 3 cm before PSM (p &lt; 0.001), no significant difference in the LCSS was identified between the two treatment groups after PSM (p = 0.191). Multivariate Cox regression showed the elder age, male gender, squamous cell carcinoma (SQC) histology type, poor/undifferentiated grade and a large tumor size were associated with poor LCSS. The subgroup analysis of tumor sizes, histologic types and lymph nodes (LNs) dissection, there were also no significant difference for LCSS between lobectomy and sub-lobar resection. The sub-lobar resection was further divided into segmentectomy or wedge resection, and it demonstrated that no significant differences in LCSS were identified among the treatment subgroups either. Multivariate Cox regression analysis showed that the elder age, poor/undifferentiated grade and a large tumor size were a statistically significant independent factor associated with survival.ConclusionIn terms of LCSS, lobectomy has no significant advantage over sub-lobar resection in elderly patients with stage IA NSCLC if lymph node assessment is performed adequately. The present data may contribute to develop a more suitable surgical treatment strategy for the stage IA elderly NSCLC patients.

Impact of margin status on survival after radical nephrectomy for renal cell carcinoma (RCC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16084-e16084
Author(s):  
Lindsay Kaye Morris ◽  
Alaa Altahan ◽  
John Mays ◽  
Upama Giri ◽  
Eric Wiedower ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Tumor Size ◽  
Radical Nephrectomy ◽  
Margin Status ◽  
Significant Determinant ◽  
Positive Margins ◽  
Neoadjuvant Systemic Therapy ◽  
Significant Difference ◽  
Time To Relapse ◽  
The Impact

e16084 Background: Data is limited regarding outcomes in patients with RCC with positive surgical margins. We sought to evaluate the impact of margin status after radical nephrectomy (RN) on relapse free survival (RFS) and overall survival (OS). Methods: A retrospective study was conducted evaluating patients with RCC having undergone RN at Methodist University Hospital in Memphis, Tennessee, between January 2009 and December 2013. Patients were identified from the tumor registry at this institution, and IRB approval obtained. Patient and tumor characteristics and survival were analyzed by GraphPad Prism, Microsoft Excel and IBM SPSS. Results: 156 patients that underwent RN for RCC were identified; 12 patients (7.7%) had positive margins and 144 had negative margins. Mediation duration of follow-up was 3.4 years. 5 of 12 patients with positive margins relapsed, versus 20 of 144 with negative margins (41.7% v. 13.9%, p = 0.022) with a RR of 3.10 (95% CI 1.417-6.799). Among those who relapsed, there was a statistically significant difference in time to relapse between patients with positive and negative margins (mean number of days to relapse 275 versus 621, respectively, with p = 0.038). On multivariate analysis of age, gender, ethnicity, laterality, tumor histology, margin status, and tumor size, margin status was not a statistically significant determinant of OS at 1, 3, and 5 years (p = 0.051, 0.124 and 0.185 respectively) or RFS at 1, 3, and 5 years (p = 0.372, 0.271 and 0.242 respectively). Pearson correlation analysis showed significant correlation between tumor size and margin status, R = 0.478, p < 0.001. Conclusions: Positive margins were associated with earlier time to relapse among patients following RN. However, in multivariate analysis, margin status was not a statistically significant determinant of OS or RFS. In the current era of multiple available agents in RCC capable of cytoreduction, the risk factors that are predictive of a positive surgical margin at RN should be considered in the design of neoadjuvant systemic therapy trials, with the goal of improving long-term outcomes.

scholarly journals Preoperative Tumor Abnormal Protein as a Promising Biomarker to Predict Oncological Outcome of Hepatocellular Carcinoma After Curative Resection

2021 ◽  
Author(s):  
Huayong Cai ◽  
Wenxin Li ◽  
Yu Zhang ◽  
Xiangdong Hua
Keyword(s):  
Multivariate Analysis ◽  
Tumor Size ◽  
Curative Resection ◽  
Tumor Diameter ◽  
Tumor Differentiation ◽  
Prognostic Variables ◽  
High Group ◽  
Large Tumor ◽  
Important Indicator ◽  
Abnormal Protein

Abstract Background: TAP (tumor abnormal protein) has been used as an important indicator in the early diagnosis of cancers, and some literatures showed that TAP can act as a prognostic factor in different kinds of cancer. The objective of this study was to explore the potential relationship between TAP and the prognosis of HCC after radical hepatectomy, and attempted to construct a robustly predictive nomogram on the strength of TAP and other prognostic variables of HCC patients.Methods: This retrospective study included 168 HCC patients (tumor recurrence occurred in 78 patients) who had undergone curative resection during January 2018 to June 2020 at the Department of Hepatopancreatobiliary Surgery of Liaoning Cancer Hospital & Institute. Serum TAP was detected by Abnormal Sugar Chain Structure of Glycoproteins, and according to the area of condensation particle, the whole population was categorized into the TAP high group (TAP≥225μm2) and TAP low group (TAP<225μm2).Results: There was no correlation between maximum tumor size and TAP. In the whole population or subgroups stratified by maximum tumor size, the recurrence-free survival (RFS) rate of the TAP low group was distinctly higher than TAP high group (P<0.05 for all). The multivariate analysis revealed that TAP (hazard ratio [HR], 3.47; 95% CI, 2.18-5.51; P<0.001), large tumor size (HR, 2.18; 95% CI, 1.36-3.49; P<0.001), poor tumor differentiation (HR, 0.53; 95% CI, 0.33-0.84; P=0.007) and presence of microvascular invasion (MVI) (HR, 2.03; 95% CI, 1.28-3.22; P=0.003) were independently associated with RFS. The prognostic implication of nomogram incorporating TAP, maximun tumor diameter, tumor differentiation and MVI was stronger than the model that integrated maximun tumor diameter, degree of tumor differentiation and MVI only.Conclusion: The present study suggested that higher preoperative TAP was correlated with undesirable prognosis in HCC patients who had undergone radical hepatectomy,and on the strength of prognostic variables identified by multivariate analysis, we constructed a robust nomogram for RFS of postoperative HCC patients.

scholarly journals Radical Nephrectomy Provides a Worse Prognosis Than Partial Nephrectomy in T3aN0M0 Renal Cancer of Small (≤4 cm) Size and No Invasion of Perisinus Fat

2020 ◽  
Author(s):  
Shiliang Liu ◽  
Zhixian Wang ◽  
Chang Liu
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Partial Nephrectomy ◽  
Tumor Size ◽  
Radical Nephrectomy ◽  
Risk Of Death ◽  
Recommended Treatment ◽  
Risk Of Mortality ◽  
Significant Difference

Abstract Background: Radical nephrectomy (RN) is the recommended treatment for T3aN0M0 renal cell carcinoma (RCC). However, it is not necessarily the best treatment for small T3aN0M0 RCCs. We evaluated the effect of tumor size combined with consideration of anatomic types of extrarenal-fat invasion on the surgical decision-making between partial nephrectomy (PN) vs. RN in T3aN0M0 RCC.Methods: Data were obtained from the Surveillance, Epidemiology, and End Results database (2004 to 2015) with 6125 patients suffering from T3aN0M0 RCC. Cox and Fine and Gray models were used for survival analyses. Propensity-score matching was used for PN vs. RN.Results: A larger T3aN0M0 RCC was associated with higher risk of mortality (hazard ratio (HR)all-cause mortality: 1.07, 95% confidence interval (CI): 1.02–1.13, P = 0.011; HRRCC-cause mortality: 1.13, 95%CI: 1.06–1.21, P < 0.001) compared with a small T3aN0M0 RCC. After propensity-score matching, in T3aN0M0 ≤4 cm, RN compared with PN significantly increased the risk of death (HR: 1.77; 95%CI: 1.14–2.74, P = 0.011) and offered no significant difference in RCC-specific survival (HR: 1.57, 95%CI: 0.74–3.36, P = 0.240). However, RN and PN showed no significant difference in overall survival in T3aN0M0 RCC >4 cm (HR: 0.98; 95%CI: 0.59–1.62, P= 0.929) or in T3aN0M0 RCC with sinus/perisinus-fat invasion (HR: 1.18; 95%CI: 0.61–2.27, P = 0.631).Conclusion: PN provided better overall survival compared with RN for small (≤4 cm) T3aN0M0 RCCs without sinus/perisinus-fat invasion. Focusing only on anatomic-invasion characteristics rather than type and tumor size is not sufficient for treatment decisions in T3aN0M0 RCC.

scholarly journals Clinical, Pathological, Laboratory Characteristics, and Treatment Regimens of Kimura Disease and Their Relationships With Tumor Size and Recurrence

2021 ◽  
Vol 8 ◽  
Author(s):  
Lina Fan ◽  
Shiyan Mo ◽  
Yanyan Wang ◽  
Jian Zhu
Keyword(s):  
Surgical Treatment ◽  
Combination Therapy ◽  
Tumor Size ◽  
Clinical Symptoms ◽  
Disease Recurrence ◽  
Tumor Diameter ◽  
Kimura Disease ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Maximum Tumor Diameter

Objective: As of date, Kimura disease (KD) has an unclear etiology, no accepted diagnostic standard, and no definite treatment regimen. In this study, clinical and pathological laboratory characteristics and treatment regimens of patients with KD with different tumor sizes and status of tumor recurrence were analyzed. This was performed to identify the factors, which determine tumor size and recurrence, and to identify effective treatment methods for patients with KD.Methods: A total of 33 hospitalized patients with a definite diagnosis of KD were enrolled in this study.Results: There were 15 patients (45.5%) with a maximum tumor diameter of &lt;3 cm. There were no statistically significant differences in age, gender, clinical symptoms, lesion sites, laboratory indicators, and treatment regimens among patients with a maximum tumor diameter &lt;3 cm or ≥3 cm (P &gt; 0.05). Among the 25 patients who completed the follow-up, there were 18 patients (72%) who had a recurrence of KD. There were no statistically significant differences in age, gender, clinical symptoms, the maximum tumor diameter, lesion sites, laboratory indicators, and initial treatment regimens between patients with or without the recurrence of KD (P &gt; 0.05). There was a statistically significant difference in systolic blood pressure (SBP) between patients with or without the recurrence of KD (P &lt; 0.05). All patients who received only surgical treatment had disease recurrence, 33.3% of patients who received prednisone therapy had no disease recurrence, and 37.5% of patients who received combination therapy showed recurrence.Conclusion: The current study summarized clinical manifestations, pathological features, laboratory indicators, and treatment regimens of patients with KD. There were no significant differences in these aspects among patients with different tumor sizes, and there was no significant difference in these aspects except in the SBP between patients with or without the recurrence of KD, indicating that SBP is a significant clinical factor affecting disease recurrence in patients. Combination therapy with prednisone was found to be superior to surgical treatment.

Risk Factors and Outcome of Chronic GVHD: Analysis of 5,660 Patients Undergoing Unrelated Bone Marrow Transplantation through the Japan Marrow Donor Program.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 139-139
Author(s):  
Chiaki Nakaseko ◽  
Miki Nishimura ◽  
Shinnichi Ozawa ◽  
Ryuko Cho ◽  
Chikako Ohwada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Cumulative Incidence ◽  
Hematological Malignancies ◽  
Chronic Gvhd ◽  
Post Transplant ◽  
Risk Of Death ◽  
Significant Difference ◽  
Late Morbidity

Abstract Background: Chronic GVHD (cGVHD) remains the major cause of late morbidity and mortality after allogeneic stem cell transplantation. However, there are limited data available on cGVHD after unrelated BMT (UR-BMT). We retrospectively analyzed the data of 5,660 patients who underwent UR-BMT through the Japan Marrow Donor Program (JMDP) between January 1993 and June 2004. Methods: Data were collected by the JMDP using a standard report form. Follow-up reports were submitted at 100 days, 1 year, and then annually after transplantation. Overall survival (OS) was estimated by the Kaplan-Meier method and patients surviving beyond day 100 after transplant were analyzed for the development of cGVHD. The log-rank test was used for univariate analysis and time-dependent Cox proportional hazards modeling was used for multivariate analysis. The cumulative incidence of cGVHD and of relapse was calculated using the Gray method considering death without cGVHD and death without relapse as respective competing risks. Results: The median age of all patients was 28 years and the median follow-up was 433.5 days after transplant. Estimated 5-year OS of all patients and those with hematological malignancies was 47.4% and 45.5%, respectively. A total of 3,974 patients survived beyond day 100 after transplant and their cumulative incidence of cGVHD was 43.2% at day 500 and 44.9% at day 2,000 post-transplant. The cumulative incidence of extensive cGVHD was 28.8% at day 2,000 post-transplant. In multivariate analysis, variables predicting cGVHD were recipient age (p=0.000), donor age (p=0.002), diagnosis of hematological malignancy (HR=1.99, p=0.000), HLA class I mismatch by either serology or DNA typing (HR=1.24, p=0.020), acute GVHD (I: HR=1.50, p=0.000; II: HR=2.07, p=0.000; III and IV: HR=2.25, p=0.000) and no platelet recovery over 50,000/mm3 before day 100 (HR=1.36, P=0.002). There was a significant difference between patients &lt;20 and ≥20 years old (HR=1.27, p=0.000). However, there were no significant differences between any adults grouped by age decade (p=0.894). OS at 5 years in patients surviving &gt;100 days post-transplant was 62.4% without cGVHD, 68.0% with limited cGVHD, and 55.4% with extensive cGVHD (p=0.000). In the patients with hematological malignancies, OS at 5 years was 58.8%, 67.3% and 55.8%, respectively (p=0.000). Cumulative incidence of relapse of hematological malignancies at day 2,000 in patients surviving &gt;100 days post-transplant was 17.6% with limited cGVHD, 18.4% with extensive cGVHD and 27.1% without cGVHD (P=0.000). Conclusions: This study provides strong evidence of risk factors for developing cGVHD after UR-BMT and suggests that limited cGVHD provides a survival benefit to patients with hematological malignancies by reducing the risk of relapse without increasing the risk of death from cGVHD. There was a significant difference in occurrence of cGVHD between patients &lt;20 and ≥20 years old but no differences comparing any age ≥20 years.

Outcomes with Autologous (Auto) and Allogeneic (Allo) Stem Cell Transplantation (SCT) for Relapsed/Refractory Follicular Lymphoma (FL) in the Post-Rituximab Era: A Comparative Analysis From the National Comprehensive Cancer Network (NCCN) Non-Hodgkin's Lymphoma (NHL) Outcomes Database Project,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4112-4112 ◽  
Author(s):  
Andrew M. Evens ◽  
Ann Vanderplas ◽  
Ann LaCasce ◽  
Allison Crosby ◽  
Auayporn Nademanee ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Disease Status ◽  
Risk Of Death ◽  
Resistant Disease ◽  
Increased Risk ◽  
Significant Difference

Abstract Abstract 4112 Background: AutoSCT and AlloSCT have both been shown to be effective for the treatment of relapsed/refractory FL. However, outcomes with either modality are not well defined in the post-rituximab era, especially regarding autoSCT. The NCCN NHL Outcomes Database was utilized to examine survival for FL patients (pts) refractory or relapsed after rituximab-based therapy who underwent subsequent autoSCT or alloSCT. Further, prognostic factors were investigated. Methods: The NCCN NHL Outcomes Database is a prospective cohort study collecting comprehensive clinical, treatment, and outcomes data for NHL pts at 7 participating NCCN centers. Among all NHL pts in the database (n=5,395), 1,670 had FL, of whom 240 had SCT during the study observation period of 1/1/00 to 12/31/09 (follow-up through May 2011). Pts were excluded if they 1) did not have relapsed/refractory FL (n=13) or 2) had not received prior rituximab (n=11). In total, 216 pts (autoSCT n=158, alloSCT n=58) were included for analysis. Median follow-up was 2.9 years. Univariate Cox proportional hazards regression was used to assess associations of prognostic factors within each type of SCT for overall survival (OS) and failure free survival (FFS). OS was defined as years from SCT to death; FFS was defined as relapse, transformation, disease progression, or death. Variables with a p <0.20 were entered into a multivariate Cox model within each type of SCT. In a similar fashion, Cox regression was used to assess OS and FFS between type of SCT. Results: There were several notable differences in pt and disease characteristics between SCT modalities. Pts who received autoSCT were significantly older at initial FL diagnosis compared with alloSCT (median 51 vs 46 years, p=0.002) and older at time of SCT (median 55 vs 51 years, p=0.005). However, median time from initial FL diagnosis to SCT was shorter for alloSCT vs autoSCT (3.3 vs 4.1 years, p=0.02). AlloSCT pts received a median of 4 prior therapies vs 3 for the autoSCT cohort (p<0.001). Further, pts who had alloSCT had a higher proportion of resistant disease at time of SCT than autoSCT pts (19% vs 7%, p=0.01), while autoSCT pts were more likely to have grade 3 FL compared with alloSCT (36% vs 9%, p=0.001). There were no comparative differences among gender, race, stage at SCT or performance status. 59% of alloSCT pts had a matched-sibling donor, while 42% had an unrelated donor. The most common conditioning regimens for autoSCT were CBV 50%, BEAM 30%, and TBI-based 16%, while for alloSCT were Flu/Mel 31%, TBI-based 28% (Flu-TBI or Cy-TBI), and Bu/Flu 24%. The cumulative rate of relapse, progression, and/or transformation was 33% for autoSCT pts compared with 16% for alloSCT (p=0.01), while the overall non-relapse mortality (NRM) rate for alloSCT was 33% vs 10% for autoSCT (p<0.0001). There was no difference in FFS between type of SCT (p=0.30) with 3-year FFS of 55% (95%CI 46%-63%) for autoSCT vs 56% (95%CI 42%-70%) for alloSCT (Figure 1). However, OS was significantly different between type of SCT (p<0.001); the 3-year OS was 85% (95%CI 79%-91%) for autoSCT compared with 64% (95%CI 50%-77%) for alloSCT (Figure 2). Factors that predicted survival on univariate analysis for pts who had autoSCT were increasing age (continuous variable, years) and >3 prior therapies, while age > 50 years and resistant disease status at SCT predicted survival for alloSCT. Further, these factors remained significant on Cox regression multivariate analysis (Table 1). Additionally, multivariate analysis including all SCT pts (n=216) was performed to compare survival between autoSCT and alloSCT. After adjusting for age, number of prior therapies, and disease status, alloSCT still showed increased risk of death compared with autoSCT (HR 2.2, 95%CI 1.2–4.1, p=0.01); no significant difference was noted for FFS (p=0.72). Conclusion: To our knowledge, this represents the largest analysis of autoSCT and alloSCT among FL pts relapsed/refractory s/p prior rituximab. Within this multicenter prospective cohort analysis, we identified prognostic factors that predicted survival within autoSCT and alloSCT cohorts. Furthermore, autoSCT and alloSCT were associated with comparable FFS, however including adjustment for competing prognostic factors, OS was improved among pts who had autoSCT. Based on these data, we conclude that autoSCT remains a viable therapy for relapsed/refractory FL in the post-rituximab era. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Clinicopathologic and Prognostic Significance of Body Mass Index (BMI) among Breast Cancer Patients in Western China: A Retrospective Multicenter Cohort Based on Western China Clinical Cooperation Group (WCCCG)

2019 ◽  
Vol 2019 ◽  
pp. 1-14
Author(s):  
Kang Wang ◽  
Yu-Tuan Wu ◽  
Xiang Zhang ◽  
Li Chen ◽  
Wen-Ming Zhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Tumor Size ◽  
Prognostic Significance ◽  
Western China ◽  
Large Tumor ◽  
Large Tumor Size ◽  
Significant Difference ◽  
The Impact

Introduction. Clinicopathologic and prognostic significance of body mass index (BMI) in breast cancer (BC) patients remained conflicting. We aimed to investigate and modify the impact of BMI on clinicopathological significance and survival in western Chinese BC patients.Materials and Methods. 8,394 female BC patients from Western China Clinical Cooperation Group (WCCCG) between 2005 and 2015 were identified. Multivariable logistic regression and Cox proportion hazard regressions were used to examine the difference of clinicopathologic and survival characteristics between BMI categories.Results. For the premenopausal, overweight and obese (OW) patients tended to have large tumor size (>5cm) (odds ratio [OR], 1.30, P<0.01) and triple-negative BC (OR, 1.31; P=0.01) compared with normal weight (NW) patients. Premenopausal underweight (UW) patients had a significantly higher risk of HER2 positive (OR, 1.71; P=0.02) and distant metastasis (OR, 2.59; P=0.01). For postmenopausal patients, OW patients showed higher risks of large tumor size (>5cm) (OR, 1.46; P=0.01), nuclear grade III (OR, 1.24; P=0.04), and lymphovascular invasion (OR, 1.46; P=0.01) compared with NW patients. An “U” shaped relationship between BMI and DFS was found (UW versus NW, adjusted hazard ratio (HR), 2.80, P<0.001; OW versus NW, adjusted HR, 1.40, P=0.02), whereas no significant difference of disease-free survival (DFS) between OW and NW premenopausal patients (adjusted HR=1.34, P=0.18) was revealed.Conclusion. We concluded that UW and OW were associated with aggressively clinicopathological characteristics, regardless of menopausal status. An “U” shaped association of BMI and DFS was revealed, and no significant difference of DFS between OW and NW in postmenopausal subgroup was revealed.

Effect of pregnancy, in the year prior and after treatment for breast carcinoma, on survival and recurrence in women with breast cancer younger than 35 years. GETNA GROUP

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 553-553 ◽  
Author(s):  
R. Largillier ◽  
A. Savignoni ◽  
J. Gligorov ◽  
P. Chollet ◽  
M. Guillaume ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Breast Carcinoma ◽  
Local Recurrence ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Axillary Node ◽  
Diagnosis And Treatment ◽  
Risk Of Death ◽  
Node Positive ◽  
Annual Risk

553 Background: The goal of this study was to assess the effect of pregnancy on the subsequent risk of recurrences after treatment for breast carcinoma, adjusted on established prognostic factors Methods: Between 1990 and 1999, 908 patients aged under 35 years old were treated for a non metastatic and unilateral invasive breast carcinoma in eight french hospitals, members of the GETNA association. The median follow-up period was 87 months. Mean age was 31.4 years old. Estrogen receptor (ER) status, lymph node involvement, tumor size, histological grade and pregnancy were evaluated as potential risk factors for recurrence and death in a multivariate analysis. A modified model was constructed using the four independent variables derived from the previous multivariate Cox model and the annual risk of death and recurrences were studied. Results: Women who gave birth within one year prior to diagnosis (n=105, 11, 8%) were more likely to have axillary node positive (> N1:48%, vs 35%, p=0.009) important tumor size (>T2:75% vs 55%, p=0.0002), and ER negative (54%, vs 42%, p=0.031). In univariate analysis, pregnancy the year before carcinoma diagnosis increased the risk of death, HR=1.5 [1.05–2.20] (p=0.028) and local recurrence, HR=1.71 [1.06–2.76] (p=0.027). In multivariate analysis, only influence on local recurrence is confirmed, HR=1.75 [1.08–2.84] (p=0.006). Patients who experienced a pregnancy after diagnosis and treatment (n=118, 13.4%) did not tend to have better prognosis regarding axillary node positive (> N1:71%, vs 61%, p=0.051), tumour size (> T2:53.4% vs 59.2%, p=0.49), ER negative (ER:44.2% vs 43.6%, p=0.92) and were significantly younger (<30 years old 52.5% vs 28%, p<10−4). The overall survival after five years was 97% for women who experienced a pregnancy and only 80% for those who did not (p< 0.0001). Conclusions: In this large study population, pregnancy was not associated with poorer survival and the healthy mother effect was studied. For the purpose of advising women on the decision to go forward with pregnancy, was studied after the diagnosis and treatment of breast carcinoma, the annual risk of recurrences. Study granted by Sanofi-Aventis. Acknoledgements to OSMO for its operational support. No significant financial relationships to disclose.

scholarly journals Accuracy of the fluorescence-aided identification technique (FIT) for detecting tooth-colored restorations utilizing different fluorescence-inducing devices: an ex vivo comparative study

2021 ◽  
Author(s):  
W. Leontiev ◽  
E. Magni ◽  
C. Dettwiler ◽  
C. Meller ◽  
R. Weiger ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Ex Vivo ◽  
Predictive Values ◽  
Composite Restorations ◽  
Significant Difference ◽  
Identification Technique ◽  
Illumination Method ◽  
Sensitivity Specificity ◽  
Entire Procedure ◽  
Higher Sensitivity

Abstract Objectives The aim of the present study was to compare the accuracy of the conventional illumination method (CONV) and the fluorescence-aided identification technique (FIT) for distinguishing between composite restorations and intact teeth using different fluorescence-inducing devices commonly used for FIT. Materials and methods Six groups of six dentists equipped with one of six different FIT systems each independently attempted to identify composite restorations and intact teeth on a full-mouth model with 22 composite restorations using CONV and, 1 h later, FIT. The entire procedure was repeated 1 week later. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, including 95% confidence intervals (CI), were calculated for CONV and FIT overall and for each device. The influence of examiner age, method, and device on each parameter was assessed by multivariate analysis of variance. Results The sensitivity (84%, CI 81–86%), specificity (94%, CI 93–96%), PPV (92%, CI 90–94%), and NPV (90%, CI 88–91%) of FIT was significantly higher than that of CONV (47%, CI 44–50%; 82%, CI 79–84%; 66%, CI 62–69%, and 69%, CI 68–71%, respectively; p<0.001). The differences between CONV and FIT were significant for all parameters and FIT systems except VistaCam, which achieved no significant difference in specificity. Examiners younger than 40 years attained significantly higher sensitivity and negative predictive values than older examiners. Conclusions FIT is more reliable for detecting composite restorations than the conventional illumination method. Clinical relevance FIT can be considered an additional or alternative tool for improving the detection of composite restorations.

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