Association between postoperative pneumonia and prognosis of patients with esophageal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 370-370
Author(s):  
Yosuke Atsumi ◽  
Toru Aoyama ◽  
Ayako Tamagawa ◽  
Hiroshi Tamagawa ◽  
Mihwa Ju ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Risk Factor ◽  
Curative Resection ◽  
Independent Risk Factor ◽  
Postoperative Pneumonia ◽  
Recurrence Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Significant Independent Risk Factor

370 Background: We examined the association between postoperative pneumonia and prognosis of patients with esophageal cancer after curative surgery. Methods: We enrolled 122 patients who underwent curative resection for esophageal cancer between 2008 and 2018. The patients who had postoperative pneumonia were categorized into the pneumonia group, while those without postoperative pneumonia were classified into the non-pneumonia group. We identified the risk factors for the recurrence-free survival (RFS) and the overall survival (OS). Postoperative pneumonia was defined using the revised Uniform Pneumonia Score. Results: Thirty-four of the 122 patients (27.9%) had postoperative pneumonia. The 5-year OS rate after surgery in the pneumonia group was significantly lower than that in the non-pneumonia group (28.2% versus 55.1%, p = 0.006). Although not significant, the 5-year RFS rate after surgery in the pneumonia group tended to be lower than that in the non-pneumonia group (18.9% versus 49.2%, p = 0.061). A multivariate analysis identified postoperative pneumonia as a significant independent risk factor for the OS (hazard ratio = 2.15; 95% confidence interval, 1.25 to 3.68; P = 0.006). Conclusions: Our analysis showed postoperative pneumonia was an independent risk factor for worse overall survival in patients who underwent curative resection for esophageal cancer. This finding suggests that we should plan the surgical procedure, perioperative care and surgical strategy to prevent postoperative pneumonia.

scholarly journals Postoperative Imaging and Tumor Marker Surveillance in Resected Pancreatic Cancer

2019 ◽  
Vol 8 (8) ◽  
pp. 1115 ◽  
Author(s):  
Hsu Wu ◽  
Jhe-Cyuan Guo ◽  
Shih-Hung Yang ◽  
Yu-Wen Tien ◽  
Sung-Hsin Kuo
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Risk Factor ◽  
Tumor Marker ◽  
Independent Risk Factor ◽  
Multivariate Analyses ◽  
Curative Surgery ◽  
Primary Tumor Site ◽  
Symptom Group ◽  
Marker Group

Background: Pancreatic cancer is a catastrophic disease with high recurrence and death rates, even in early stages. Early detection and early treatment improve survival in many cancer types but have not yet been clearly documented to do so in pancreatic cancer. In this study, we assessed the benefit on survival resulting from different patterns of surveillance in daily practice after curative surgery of early pancreatic cancer. Methods: Patients with pancreatic ductal adenocarcinoma who had received curative surgery between January 2000 and December 2013 at our institute were retrospectively reviewed. Patients were classified into one of four groups, based on surveillance strategy: the symptom group, the imaging group, the marker group (carbohydrate antigen 19-9 and/or carcinoembryonic antigen), and the intense group (both imaging and tumor marker assessment). Overall survival (OS), relapse-free survival (RFS), and post-recurrence overall survival (PROS) were evaluated. Results: One hundred and eighty-one patients with documented recurrence or metastasis were included in our analysis. The median OS for patients in the symptom group, imaging group, marker group, and intense group were 21.4 months, 13.9 months, 20.5 months, and 16.5 months, respectively (p = 0.670). Surveillance with imaging, tumor markers, or both was not an independent risk factor for OS in univariate and multivariate analyses. There was no significant difference in median RFS (symptom group, 11.7 months; imaging group, 6.3 months; marker group, 9.3 months; intense group, 6.9 months; p = 0.259) or median PROS (symptom group, 6.9 months; imaging group, 7.5 months; marker group, 5.0 months; intense group, 7.8 months; p = 0.953) between the four groups. Multivariate analyses identified poor Eastern Cooperative Oncology Group Performance Status (ECOG PS) (≥1), primary tumor site (tail), and tumor grade (poor differentiation) were poor prognostic factors for OS. Conclusions: Surveillance with regular imaging, tumor marker, or both was not an independent risk factor for OS of pancreatic cancer patients who undergo curative tumor resection.

scholarly journals The Pre- and Postoperative FIB-4 Indexes Are Good Predictors to the Outcomes of HBV-Related HCC Patients after Resection

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Meng-Yun Tsai ◽  
Yi-Hao Yen ◽  
Pao-Yuan Huang ◽  
Fai-Meng Sou ◽  
Chih-Che Lin ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Fibrosis ◽  
Curative Resection ◽  
Independent Risk Factor ◽  
Adverse Outcome ◽  
Chang Gung Memorial Hospital ◽  
Clinical Markers ◽  
Free Survival ◽  
The Impact ◽  
Curative Hepatectomy

Background and Aim. Liver fibrosis is associated with the prognosis of patients with hepatocellular carcinoma (HCC) after resection. The fibrosis-4 (FIB-4) index is an accurate and noninvasive marker to determine the degree of liver fibrosis. Here, we evaluated the effect of pre- and postoperative FIB-4 index in predicting the outcomes after resection of HCC in patients who have chronic hepatitis B (CHB) infection. Methods. A total of 534 CHB patients with HCC who received curative hepatectomy between 2001 and 2016 at Kaohsiung Chang Gung Memorial Hospital, Taiwan, were enrolled in this study. The impact of the FIB-4 index (preoperative and the 1st year after operation) on overall survival (OS) and recurrence-free survival (RFS) was evaluated. Results. There was a significant association between the preoperative FIB-4 index and Metavir fibrosis stage (p<0.01). The multivariate analysis showed that preoperative FIB‐4>2 is an independent risk factor for RFS and OS after HCC curative resection [hazard ratio (HR), 1.902; 95% CI, 1.491–2.460; p<0.001, and HR, 2.207; 95% CI, 1.420–3.429; p<0.001, respectively]. Notably, preoperative FIB-4 is also an independent risk factor for RFS (HR, 1.219; p=0.035) in noncirrhotic patients. Furthermore, patients had deteriorated FIB-4 1 year after operation [definition: the value the 1st year FIB‐4 after operation minus preoperative FIB‐4>1] and had an adverse outcome in RFS and OS (p<0.001, both). Conclusion. The pre and postoperative FIB-4 indexes are useful clinical markers to predict the prognosis in HBV-HCC patients after curative hepatectomy.

scholarly journals Prognostic Value of Postoperative Neutrophil and Albumin: Reassessment One Month After Gastric Cancer Surgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Ali Guner ◽  
Minah Cho ◽  
Yoo-Min Kim ◽  
Jae-Ho Cheong ◽  
Woo Jin Hyung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Neutrophil Count ◽  
Prognostic Value ◽  
Risk Groups ◽  
Cancer Surgery ◽  
Recurrence Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Pathologic Stage

ObjectiveThe prognostic value of postoperative parameters reflecting the inflammatory and nutritional status of patients undergoing cancer surgery has been rarely studied. This study investigated the prognostic value of inflammatory and nutritional parameters measured preoperatively and 1 month after curative gastrectomy for gastric cancer.MethodsData from a prospectively maintained database of 1,194 patients with gastric cancer who underwent curative surgery in 2009–2018 were retrospectively reviewed. Demographics, clinicopathologic characteristics, operative data, survival data, and laboratory parameters were extracted. Neutrophil counts, lymphocyte counts, and albumin levels before surgery and 1 month postoperatively were analyzed.ResultsIn multivariable analysis adjusted for age, sex, and pathologic stage, high neutrophil count (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.01–1.17, p = 0.022) and low albumin (HR 0.45, 95% CI 0.27–0.74, p = 0.002) 1 month postoperatively were independent prognostic factors for overall survival. High neutrophil count (HR 1.09, 95% CI 1.02–1.16, p = 0.015) 1 month postoperatively was also an independent prognostic factor for recurrence-free survival after adjusting for age, sex, body mass index, extent of gastrectomy, and pathologic stage. Patients were classified into risk groups based on thresholds of 4.2 × 103 cells/mm3 and 4.1 g/dl for 1-month neutrophil count and albumin. High-risk groups had a significantly worse prognosis than low-risk groups for overall survival (HR 5.87, 95% CI 3.28–10.51, p &lt;0.001) and recurrence-free survival (HR 1.52, 95% CI 1.07–2.16, p = 0.021).ConclusionsNeutrophil count and albumin level 1 month after curative surgery reflect long-term prognosis better than preoperative values. These parameters can be used to stratify patients with the same stage into different prognostic groups.

scholarly journals Extrapolating Prognostic Factors of Primary Curative Resection to Postresection Recurrences Hepatocellular Carcinoma Treatable by Radiofrequency Ablation

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hui Ma ◽  
Zhongchen Li ◽  
Jia Yuan ◽  
Lan Zhang ◽  
Xiaoying Xie ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Radiofrequency Ablation ◽  
Curative Resection ◽  
Multivariate Analyses ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival

Objective. Recurrence after curative resection for hepatocellular carcinoma (HCC) is a major cause of death from this disease. Factors of primary curative resection are available and potential in the prognosis of follow-up treatment. Our aim was to assess the prognostic significance of primary curative resection factors in recurrent HCC patients undergoing radiofrequency ablation therapy (RFA). Methods. In this retrospective study, we assessed 235 patients who underwent limited RFA of HCC recurrences ( tumors ≤ 5   cm ; nodules ≤ 3 ) after primary curative resection. Factors of primary curative resection were collected, and overall survival and recurrence-free survival were evaluated by the Kaplan-Meier method. Univariate and multivariate analyses were used to identify significant prognostic factors. Results. After a median follow-up of 36 months, 54 patients died, and 128 patients had hepatic recurrence. On univariate analyses, patients whose primary tumors were less differentiated ( p = 0.032 and p = 0.048 ) and required less time to recur ( p = 0.013 and p = 0.001 ) after curative resection displayed poorer overall survival and higher recurrence rates following RFA. On multivariate analyses, the pathologic tumor grade ( p = 0.026 and p = 0.038 ) and recurrence-free survival after primary curative resection ( p = 0.028 and p < 0.001 ) emerged as independent risk factors of survival and HCC recurrence. Conclusions. Primary tumor differentiation and time to recurrence after curative resection are viable prognostic factors of overall survival and further recurrence risk in patients undergoing RFA of recurrent HCC.

scholarly journals Impact of an MT-RNR1 Gene Polymorphism on Hepatocellular Carcinoma Progression and Clinical Characteristics

2021 ◽  
Vol 22 (3) ◽  
pp. 1119
Author(s):  
Yang-Hsiang Lin ◽  
Yu-De Chu ◽  
Siew-Na Lim ◽  
Chun-Wei Chen ◽  
Chau-Ting Yeh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Risk Factor ◽  
Distant Metastasis ◽  
Tumor Metastasis ◽  
12S Rrna ◽  
Potential Candidate ◽  
Free Survival ◽  
Mtdna Mutations ◽  
Distant Metastasis Free Survival

Mitochondrial DNA (mtDNA) mutations are highly associated with cancer progression. The poor prognosis of hepatocellular carcinoma (HCC) is largely due to high rates of tumor metastasis. This emphasizes the urgency of identifying these patients in advance and developing new therapeutic targets for successful intervention. However, the issue of whether mtDNA influences tumor metastasis in hepatoma remains unclear. In the current study, multiple mutations in mtDNA were identified by sequencing HCC samples. Among these mutations, mitochondrially encoded 12S rRNA (MT-RNR1) G709A was identified as a novel potential candidate. The MT-RNR1 G709A polymorphism was an independent risk factor for overall survival and distant metastasis-free survival. Subgroup analysis showed that in patients with cirrhosis, HBV-related HCC, α-fetoprotein ≥ 400 ng/mL, aspartate transaminase ≥ 31 IU/L, tumor number > 1, tumor size ≥ 5 cm, and histology grade 3-4, MT-RNR1 G709A was associated with both shorter overall survival and distant metastasis-free survival. Mechanistically, MT-RNR1 G709A was clearly associated with hexokinase 2 (HK2) expression and unfavorable prognosis in HCC patients. Our data collectively highlight that novel associations among MT-RNR1 G709A and HK2 are an important risk factor in HCC patients.

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