Development and validation of a pretreatment nomogram to predict disease-specific mortality in gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 312-312
Author(s):  
Etsuro Bando ◽  
Xinge Ji ◽  
Michael W. Kattan ◽  
Maria Bencivenga ◽  
Giovanni De Manzoni ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Model ◽  
External Validation ◽  
Multivariable Analysis ◽  
Individual Risk ◽  
American Joint Committee ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
The University ◽  
Disease Specific

312 Background: The American Joint Committee on Cancer (AJCC) has increasingly recognized the need for individual risk prediction model. The AJCC has emphasized the attractiveness of disease-specific mortality (DSM), which can properly control for competing events. as an endpoint of risk model, as well as overall survival (OS) and disease-specific survival (DSS). For the era of tailored therapy, we aimed to develop a new pretreatment gastric cancer nomogram for prediction of DSM. Methods: The nomogram was developed using data of 5,231 patients with primary gastric cancer treated at Shizuoka Cancer Center (Shizuoka, Japan), and it was created with a Fine and Gray competing-risks proportional hazards regression model. Fifteen clinical variables, which were obtained at pretreatment, were collected and registered, to develop the nomogram. Data of independent cohort of patients from the University of Verona (Italy; 389 patients) formed the external validation cohort. The model was validated internally and externally using measures of discrimination (Harrell’s C-index), calibration and decision curve analysis. Results: In the development procedure, multivariable analysis for DSM selected 14 variables for constructing the nomogram. The developed nomogram showed good discrimination, with a C-index of 0.887 (95%CI; 0.881-0.894); that of the American Joint Committee on Cancer (AJCC) clinical stage was 0.794 (0.784-0.804). In the external validation procedure, the C-index was 0.713 (0.680-0.746) (AJCC, 0.582, 0.539-0.622) in the University of Verona cohort. The nomogram performed well in the calibration and decision curve analyses when applied to both the internal and external validation cohorts. Conclusions: This new pretreatment risk model accurately predicts DSM in gastric cancer and can be used for patient counseling in clinical practice and stratification in clinical trials.

scholarly journals Anatomic site as prognostic marker of pancreatic neuroendocrine tumors: a cohort study

2019 ◽  
Vol 181 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Muhamad Badarna ◽  
Ruth Percik ◽  
Genya Aharon-Hananel ◽  
Inbal Uri ◽  
Amit Tirosh
Keyword(s):  
Cohort Study ◽  
Multivariable Analysis ◽  
Rank Test ◽  
Pancreatic Neuroendocrine Tumors ◽  
Anatomic Site ◽  
Log Rank Test ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Objective Patients with pancreatic neuroendocrine tumors (PNET) have variable prognosis, even with comparable tumor grade and stage. In the current study we aimed to evaluate the prognostic utility of the intrapancreatic PNET anatomical site. Design Cohort study based on the Surveillance Epidemiology and End Results database. Methods Patients diagnosed with non-functioning PNET between 2004 and 2015 were compared by anatomic site for disease-specific mortality and all-cause mortality, using log-rank test and by multivariable cox regression analysis. Results Overall, 4171 patients (1839 women (44.1%), median age strata 60–64 years, range 10–14 to ≥85 years) were included in our analysis. Patients with PNETs located at the head vs body/tail of the pancreas had comparable tumor diameter, as well as ethnicity, gender and age distributions, but had higher rates of grade III and IV NET (13.2 vs 6.6% and 4.4 vs 1.9%, respectively, P < 0.001). NETs located at the head vs body/tail of pancreas were more likely to be locally advanced (32.2 vs 19.9%) with no difference in distant metastases (36.4 vs 33.5%, respectively, P < 0.001). Patients with NETs of the head vs. body/tail of the pancreas had higher disease-specific mortality risk in univariate (log-rank test, P < 0.001) and multivariable analysis (hazard ratio (HR): 1.34, 95% confidence interval: 1.10–1.65, P = 0.004). Multivariable analysis for all-cause mortality also showed increased risk for patients with pancreatic head vs. body/tail PNET (HR: 1.23, P = 0.013). Conclusions PNET anatomical location is associated with the mortality risk and should be considered as a prognostic factor, and as an additional consideration in directing patients management.

scholarly journals Increased neutrophil-to-lymphocyte ratio is associated with disease-specific mortality in patients with penile cancer

BMC Cancer ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Kasuga ◽  
Takashi Kawahara ◽  
Daiji Takamoto ◽  
Sachi Fukui ◽  
Takashi Tokita ◽  
...  
Keyword(s):  
Penile Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

scholarly journals Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during ‘watch and wait’ in rectal cancer

2019 ◽  
Vol 101 (7) ◽  
pp. 441-452 ◽  
Author(s):  
J On ◽  
J Shim ◽  
EH Aly
Keyword(s):  
Rectal Cancer ◽  
Relative Risk ◽  
Salvage Therapy ◽  
Meta Analysis ◽  
Salvage Treatment ◽  
Watch And Wait ◽  
Conventional Surgery ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Introduction The ‘watch and wait’ approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence. Materials and methods A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Study quality was assessed using the Newcastle–Ottawa assessment scale. The main outcome was relative risks for overall and disease specific mortality in salvage therapy. Results Nine eligible studies were included in the meta-analysis. Of 248 patients who followed the watch and wait strategy, 10.5% had salvage therapy for recurrent disease. No statistical heterogeneity was found in the results. The relative risk of overall mortality in the salvage therapy group was 2.42 (95% confidence interval 0.96–6.13) compared with the group who had conventional surgery, but this was not statistically significant (P > 0.05). The relative risk of disease specific mortality in salvage therapy was 2.63 (95% confidence interval 0.81–8.53). Conclusion Our findings demonstrated that there was no significant difference in overall and disease specific mortality in patients who had salvage treatment following recurrence of disease in the watch and wait group compared with the standard treatment group. However, future research into the oncological safety of salvage treatment is needed.

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