The effect of gender on outcomes in esophageal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 170-170
Author(s):  
Jordan McDonald ◽  
Sabrina Saeed ◽  
Sarah E. Hoffe ◽  
Rutika Mehta ◽  
Jessica M. Frakes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Surgical Complications ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Age At Diagnosis ◽  
Thoracic Esophagus ◽  
Female Patients ◽  
Upper Thoracic

170 Background: Few epidemiological studies address differences in outcomes by gender in locoregional esophageal cancer (LEC) for which the current standard of care is chemoradiation followed by surgical resection. Although male gender is associated with the majority of LEC cases, we sought to determine if gender could impact clinical presentation as well as surgical and oncologic outcomes in our single institution 20 year experience. Methods: A retrospective query of our institution’s IRB-approved database of patients that had surgical therapy between 2008 and 2019 for esophageal cancer (EC) was performed. Patients were stratified by gender and analyzed based on characteristics such as tumor histology, tumor location, clinical stage at presentation, age at diagnosis, receipt of neoadjuvant therapy, surgical intent, surgical complications, length of post-operative hospital stay, response to neoadjuvant therapy, final pathology, and recurrence. Chi-square, ANOVA and Kaplan Meier survival analysis were performed on the previously defined groups. Results: The cohort studied included 1180 patients with resection for EC. Of those, 1005 (85.2%) had adenocarcinoma, 145 (12.3%) had squamous cell cancer (SCC), 10 (0.8%) had adenosquamous carcinoma, and 20 (1.7%) had other histological variants. There were 985 (83.5%) male patients and 195 (16.5%) female patients. SCC was more common in females (29.2% in females vs. 8.9% in males, p = 0.000) and females tended to have tumor location in the upper thoracic esophagus more often (4.7% in females vs. 0.9% of males, p = 0.000). Additionally, females developed surgical complications more often than males (72.2% vs. 64.7%, p = 0.045). Staging at diagnosis (p = 0.508), receipt of neoadjuvant treatment (p = 0.676), and age at diagnosis (65.3 years in males vs. 66.3 years in females, p = 0.934) had no association with gender. Response to neoadjuvant therapy (p = 0.157) and cancer recurrence (p = 0.434) did not have significant associations with gender. The median overall survival was not statistically significantly different but trended to be longer for females (73.4 months in females [95% CI: 51.5-95.4] vs. 47.0 months in males [95% CI: 39.6-54.5], p = 0.160). Conclusions: Based on our high-volume cancer center study, female patients were more likely to have SCC, upper thoracic esophageal lesions, and surgical complications following resection. While univariate analysis did not demonstrate significant differences in overall survival between genders, there are plans to report additional data after controlling for other variables. Further studies are warranted to validate these findings, given the potential for higher prioritization of an organ preservation approach for this patient population.

563 VARIATION IN TREATMENT PATTERNS AND OUTCOMES FOR RESECTED ESOPHAGEAL CANCER AT DESIGNATED THORACIC SURGERY CENTERS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Vaibhav Gupta ◽  
Jordan Levy ◽  
Biniam Kidane ◽  
Alyson Mahar ◽  
Jolie Ringash ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Thoracic Surgery ◽  
Neoadjuvant Therapy ◽  
Surgical Outcomes ◽  
Postoperative Mortality ◽  
Positive Margin ◽  
Treatment Patterns ◽  
Case Mix

Abstract   Ontario defined designated thoracic surgery centres to provide high-volume care for patients undergoing esophageal cancer resection. The objective of this study was to compare thoracic centres’ performance to non-thoracic centres, and to assess variation in treatment patterns and outcomes across thoracic centres. Methods A retrospective cohort study (2002–2014) was conducted in Ontario, Canada (population 13.6 million), examining adults with resected esophageal cancer. Case mix, use of neoadjuvant therapy, surgical outcomes (lymph node yield and positive margin rates) and survival were described across the 15 thoracic centres. Multivariable regression was used to estimate the effect of having surgery at designated thoracic centres on postoperative (in-hospital & 90-day post-discharge) mortality and overall survival, adjusting for case mix. Results Of 3,880 patients meeting study criteria, 2,213 had pathology data available and were included in the analysis. Average age was 64 years, 85.7% had adenocarcinoma, 50.2% were pT3, and 38.4% were pN0. Patients at thoracic centres (82.6%) received more neoadjuvant therapy, but there was no difference in positive margin rates, lymph node harvest, postoperative mortality and overall survival between thoracic and non-thoracic centres. Across thoracic centres, rates of neoadjuvant therapy varied from 16.4–81.6%, positive margin rates varied from 8.2–29.6%, median lymph node harvest varied from 7–20 nodes, postoperative mortality varied from 0–18.7%, and median survival varied from 17–26 months. Conclusion There was significant variability in treatment patterns, surgical outcomes, and survival among patients treated at designated thoracic centres. Feedback of patient outcomes to surgeons and hospitals, and translating best practices from high-performing hospitals to other hospitals, is the next step in improving outcomes.

scholarly journals Clinical Relevance of Circulating Tumor Cells in Esophageal Cancer Detected by a Combined MACS Enrichment Method

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 718 ◽  
Author(s):  
Anna Woestemeier ◽  
Katharina Harms-Effenberger ◽  
Karl-F. Karstens ◽  
Leonie Konczalla ◽  
Tarik Ghadban ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Clinical Relevance ◽  
Univariate Analysis ◽  
Immunocytochemical Staining ◽  
Clinicopathological Parameters ◽  
Advanced Tumor

Introduction. Current modalities to predict tumor recurrence and survival in esophageal cancer are insufficient. Even in lymph node-negative patients, a locoregional and distant relapse is common. Hence, more precise staging methods are needed. So far, only the CellSearch system was used to detect circulating tumor cells (CTC) with clinical relevance in esophageal cancer patients. Studies analyzing different CTC detection assays using advanced enrichment techniques to potentially increase the sensitivity are missing. Methods. In this single-center, prospective study, peripheral blood samples from 90 esophageal cancer patients were obtained preoperatively and analyzed for the presence of CTCs by Magnetic Cell Separation (MACS) enrichment (combined anti-cytokeratin and anti-epithelial cell adhesion molecules (EpCAM)), with subsequent immunocytochemical staining. Data were correlated with clinicopathological parameters and patient outcomes. Results. CTCs were detected in 25.6% (23/90) of the patients by combined cytokeratin/EpCAM enrichment (0–150 CTCs/7.5 mL). No significant correlation between histopathological parameters and CTC detection was found. Survival analysis revealed that the presence of more than two CTCs correlated with significantly shorter overall survival (OS) and progression-free survival (PFS). Conclusion. With the use of cytokeratin as an additional enrichment target, the CTC detection rate in esophageal cancer patients can be elevated and displays the heterogeneity of cytokeratin (CK) and EpCAM expression. The presence of >2CTCs correlated with a shorter relapse-free and overall survival in a univariate analysis, but not in a multivariate setting. Moreover, our results suggest that the CK7/8+/EpCAM+ or CK7/8+/EpCAM− CTC subtype does not lead to an advanced tumor staging tool in non-metastatic esophageal cancer (EC) patients.

PS02.080: CLINICAL SIGNIFICANCE OF THE NUMBER OF PERITUMORAL LYMPHATIC VESSELS AFTER CHEMOTHERAPY IN ESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 143-143
Author(s):  
Takeo Hara ◽  
Tomoki Makino ◽  
Makoto Yamasaki ◽  
Koji Tanaka ◽  
Yasuyuki Miyazaki ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Primary Tumor ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
Lymphatic Vessels ◽  
Tumor Location ◽  
Resected Specimen ◽  
Long Term Outcome ◽  
Cutoff Value

Abstract Background Neoadjuvant chemotherapy (NAC), a standard treatment for locally-advanced esophageal cancer, often achieves significant antitumor effect as clinically or microscopically confirmed. However, how chemotherapy histologically impacts upon normal tissues, in particular lymphatic vessels, adjacent to a tumor remains unclear. Methods A total of 137 patients who underwent curative esophagectomy with (NAC group n = 62)/without (nonNAC group n = 75) NAC for thoracic esophageal cancer in our department from 2004 to 2012 were analyzed. The number of lymphatic vessels (NLV) adjacent to primary tumor (within 1000μm from the edge of tumor) in lamina propria mucosae layer was assessed by immunostaining of D2–40 and its association with clinico-pathological parameters was analyzed. Results The NLV was significantly lower in the NAC group as compared with the nonNAC group (NAC vs nonNAC; 19.1 ± 9.0 vs 22.8 ± 8.6, P = 0.014). In the nonNAC group, when classified into two (high vs low NLV) groups by using the cutoff value of the median NLV in nonNAC group, NLV did not correlated with any clinico-pathological factors including age, gender, tumor location, pT, pN, pM, ly, v, and overall survival. On the other hand, in the NAC group, high NLV (classified by the same cutoff value as noted above) was significantly associated with good histological response (grade1b-2) (high vs low NLV; 52 vs 26%, P = 0.026) and less development of lymph node recurrence (16 vs 40%, P = 0.029) but not with other parameters including age, gender, tumor location, pT, pN, pM, ly, and v. Notably, the high NLV group showed the more favorable 5-year overall survival compared to the low NLV group (61 vs 49%, P = 0.0041). Multivariate analysis of overall survival further identified low NLV (HR = 3.68, 95%CI 1.54–10.83, P = 0.0005) to be one of independent prognostic factors along with pT(HR = 2.87, 95%CI 1.37–6.35, P = 0.0050) and pN(HR = 4.04, 95%CI 1.53–13.89, P = 0.0034) in the NAC group. Conclusion NAC might decrease the number of lymphatic vessels adjacent to primary tumor in resected specimen, and this number was associated with tumor response to NAC and long-term outcome in patients who underwent NAC plus surgery. Disclosure All authors have declared no conflicts of interest.

Factors predictive of tumor recurrence and overall survival in patients with esophageal cancer who have pathologic complete response after neo-adjuvant therapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 170-170
Author(s):  
Alexandra Gangi ◽  
Sarah E. Hoffe ◽  
Jessica M. Frakes ◽  
Khaldoun Almhanna ◽  
Luis Pena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Neoadjuvant Therapy ◽  
Recurrent Disease ◽  
Systemic Disease ◽  
Cell Cancer ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Specific Information ◽  
Patient Demographics

170 Background: Pathologic complete response (pCR) to neoadjuvant therapy is presumably associated with favorable outcomes in patients (pts) with esophageal cancer, but reported survival rates vary. This study evaluates patterns of recurrence after curative esophagectomy and identifies factors predictive of recurrent disease and overall survival (OS) in patients with pCR. Methods: An IRB-approved, retrospective review of a prospective esophageal cancer database was conducted. Patient demographics, perioperative data, and outcomes were examined. Recurrences were classified as locoregional (LR) or systemic. Cox regression model and Kaplan–Meier (KM) plots were used for survival analysis. Results: 837 pts with invasive esophageal cancer treated at a single institution from 1994 to 2013 were identified. 176 pts underwent neoadjuvant therapy followed by surgery and had pCR. Of these, 93.7% had adenocarcinoma and 6.3% had squamous cell cancer. Mean age was 56.6 and most pts were white (96.6%) males (79.5%). Median follow up was 42.6 months. 95 pts were treated before 2007 and 81 after. Most pts (85%) underwent transthoracic esophagectomy. All 176 pts received chemotherapy and radiation; dose-specific information was available on 144 pts, of whom most received 50.4 Gy (45%). 170 pts had recurrence data available: 39 (22.9%) had recurrent disease at a mean of 18.3 months; 5 (2.9%) with LR and 34 (20%) with systemic disease. On multivariate analysis, when evaluating patient demographics, pretreatment stage, type of surgery, type of chemotherapy, and number of lymph nodes resected, only pretreatment stage was associated with recurrence (p = 0.04). Median time to recurrence was 26.3 months for LR disease and 10.9 months for systemic disease (p = 0.3). KM estimates determined that pre-treatment stage and time of treatment ( < 2007 or ≥ 2007) were predictive of improved OS (p < 0.01, = 0.03). Conclusions: The incidence of disease recurrence in pts who experience pCR is low. The pretreatment stage and time of treatment were independent predictors of improved OS. Enhancing treatment strategies to maximize pCR would improve outcomes in pts with esophageal cancer.

Influence of radiation field on safety and efficacy for stage II/III esophageal cancer treated with definitive chemoradiotherapy: An exploratory analysis of JCOG0909.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 104-104
Author(s):  
Azusa Komori ◽  
Shuichi Hironaka ◽  
Ryunosuke Machida ◽  
Yoshinori Ito ◽  
Hiroya Takeuchi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Progression Free Survival ◽  
Complete Response ◽  
Tumor Location ◽  
Efficacy And Safety ◽  
Definitive Chemoradiotherapy ◽  
Safety And Efficacy ◽  
Upper Thoracic

104 Background: JCOG0909, a single-arm confirmatory trial of definitive chemoradiotherapy (dCRT) including salvage treatment, demonstrated promising efficacy and safety for cStage II/III (UICC-TNM 6th) esophageal cancer (EC) (Ito Y, ASCO 2018). Radiation (RT) fields included the elective regional lymph node during initial 41.4 Gy, such as bilateral supraclavicular fossae and superior mediastinal lymph nodes for upper thoracic (Ut), and mediastinal and perigastric lymph nodes for middle thoracic (Mt)/lower thoracic (Lt) EC. It is unclear whether the safety and efficacy are associated with the tumor location in patients with cStage II/III EC treated with dCRT. Methods: Patients who were enrolled in JCOG0909 and underwent dCRT were analyzed. Patients were categorized into three groups according to primary tumor location (Ut/Mt/Lt). We compared adverse events during dCRT, complete response (CR) rate, progression-free survival (PFS) and overall survival (OS) among groups. Results: Ninety-four patients (Ut/Mt/Lt: 16/59/19) were analyzed. The proportions of cStage IIA/IIB/III were 31%/44%/25% in Ut group, 20%/42%/37% in Mt group, and 21%/32%/47% in Lt group, respectively. The summary of safety and efficacy was listed in Table 1. Grade 3-4 leukopenia, neutropenia and thrombocytopenia were more frequently observed in Mt and Lt groups than in Ut group. CR rate was 63% in Ut, 63% in Mt, and 42% in Lt, respectively. 3-year PFS in Ut/Mt/Lt was 60%/59%/47% and 3-year OS was 73%/78%/58%, respectively. Conclusions: The RT field by the tumor location might be associated with efficacy and safety of dCRT for cStage II/III esophageal cancer. [Table: see text]

Resection of brain metastases previously treated with stereotactic radiosurgery

2005 ◽  
Vol 102 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Giacomo G. Vecil ◽  
Dima Suki ◽  
Marcos V. C. Maldaun ◽  
Frederick F. Lang ◽  
Raymond SaWaya
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Surgical Complications ◽  
Univariate Analysis ◽  
Conventional Surgery ◽  
Recurrence Rates ◽  
Content Type ◽  
Previously Treated ◽  
Fine Print

Object. To date, no report has been published on outcomes of patients undergoing resection for brain metastases who were previously treated with stereotactic radiosurgery (SRS). Consequently, the authors reviewed their institutional experience with this clinical scenario to assess the efficacy of surgical intervention. Methods. Sixty-one patients (each harboring three or fewer brain lesions), who were treated at a single institution between June 1993 and August 2002 were identified. Patient charts and their neuroimaging and pathological reports were retrospectively reviewed to determine overall survival rates, surgical complications, and recurrence rates. A univariate analysis revealed that patient preoperative recursive partitioning analysis (RPA) classification, primary disease status, preoperative Karnofsky Performance Scale score, type of focal treatment undergone for nonindex lesions, and major postoperative surgical complications were factors that significantly affected survival (p ≤ 0.05). In contrast, only the RPA class and focal (conventional surgery or SRS) treatment of nonindex lesions significantly (or nearly significantly) affected survival in the multivariate analysis. Major neurological complications occurred in only 2% of patients. The median time to distant recurrence after resection was 8.4 months; that to local recurrence was not reached. The overall median survival time was 11.1 months, with 25% of patients surviving 2 or more years. Conventional surgery facilitated tapering of steroid administration. Conclusions. The complication, morbidity, survival, and recurrence rates are consistent with those seen after conventional surgery for recurrent brain metastases. Our results indicate that in selected patients with a favorable RPA class in whom nonindex lesions are treated with focal modalities, surgery can provide long-term control of SRS-treated lesions and positively affect overall survival.

scholarly journals EPID-18. GLIOBLASTOMA CHARACTERIZATION IN FEMALES WITHIN RURAL PENNSYLVANIA: A SINGLE INSTITUTIONAL RETROSPECTIVE REVIEW

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii82-ii82
Author(s):  
Maia Giombetti ◽  
Emilia Jakubek ◽  
Na Tosha Gatson ◽  
Shane Bross
Keyword(s):  
Overall Survival ◽  
Retrospective Review ◽  
Rural Population ◽  
Urban Areas ◽  
The United States ◽  
Tumor Location ◽  
Age At Diagnosis ◽  
Endocrine Disorders ◽  
Comorbid Disease ◽  
High Incidence

Abstract BACKGROUND Glioblastoma (GBM) is the most common malignant brain tumor in adults with a slightly higher incidence and shortened survival in males as compared to females in the United States. Recently, there has been a focus on specific health disparities between rural versus urban populations. There is growing interest in these disparities as it pertains to CNS tumors. Here, we characterize a rural population of females diagnosed with GBM as part of an ongoing investigation to drive research and further discussion around this important topic. METHODS We performed a single institutional retrospective review of patients with GBM in rural Pennsylvania between 2006 and 2019. We collected clinical, demographic, and tumor specific data including chronic comorbid disease, marital status, age at diagnosis, obstetric history, BMI, and tumor location. RESULTS Of the 611 patients diagnosed with GBM from 2006–2019, 41% (n= 249) were female with a median overall survival of 9.5 months compared to 10.7 months in males. At diagnoses, 69% (n=173) of females had chronic comorbid allergy/immunology disorders, 41% (n=101) had endocrine disorders, 53% (n=132) had hypertension, and 43% (n=106) had mood disorders. Tumor laterality was predominantly right-sided (58%, n=145) and frequently involved the frontal lobe (38%, n=94). The temporal lobe was the second most commonly involved (32%, n=80). The median age at diagnosis was 65-years-old [range, 21–92]. Fifty-six percent (n=140) of women were married with an average of 2.27 childbirths. The median body mass index (BMI) was 27.5 [range, 16.3–64.9] with 66% of females classified as overweight/obese at diagnosis. Greater than 95% of females were insured. CONCLUSION There is a high incidence of chronic comorbid disease and obesity amongst females in this rural population, and females demonstrated a poorer overall survival as compared to males. Further comparisons are needed to characterize rural female GBM populations versus those in urban areas.

PS01.170: IMPACT OF MUSCLE MASS, NUTRITIONAL STATUS AND MUSCLE STRENGTH ON OUTCOMES FOLLOWING SURGERY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 97-97
Author(s):  
Eliza Hagens ◽  
Minke Feenstra ◽  
Mark I Van Berge Henegouwen ◽  
Suzanne Gisbertz
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Esophageal Cancer ◽  
Muscle Strength ◽  
Nutritional Status ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Surface Area ◽  
Muscle Function ◽  
Skeletal Muscle Index

Abstract Background Muscle function loss and loss of skeletal muscle have been associated with worse outcomes following surgery for malignancies of gastrointestinal origin. The influence on post-operative outcomes and survival after esophageal surgery remains unclear. Primary objectives of this study were to evaluate the incidence of sarcopenia and malnutrition and to evaluate the influence of skeletal muscle surface area and muscle strength on postoperative outcomes and overall survival in esophageal cancer patients. Methods A retrospective cohort study from a prospective database was conducted in patients with resectable esophageal cancer who underwent curative-intent treatment between January 2011 and January 2016. Skeletal muscle surface area was calculated with CT scans at L3 level and corrected for height and weight before start of treatment and in the interval between neoadjuvant treatment and surgery. Muscle strength was evaluated with various tests on muscle functions and lung function tests. Nutritional status was evaluated using BMI. Results 273 Patients were included. There were 4 patients with sarcopenia before neoadjuvant therapy and only one patient with sarcopenia after completion of neoadjuvant therapy. Median skeletal muscle surface area was 78cm2/m2 for men and 61cm2/m2 for woman. Table 1 shows skeletal muscle surface area, muscle strength and BMI in relation to no, minor or major complications. Muscle strength and nutritional status did not have a significant influence on postoperative complications and overall survival. Conclusion Sarcopenia did not occur frequently in this cohort with potentially curable esophageal cancer patients. Muscle function, skeletal muscle index and BMI did not statistically influence post-operative complications or survival. Disclosure All authors have declared no conflicts of interest.

Use of DNA repair proteins translated from biomarker screening to predict overall survival in patients with esophageal cancer treated with oxaliplatin chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e13587-e13587
Author(s):  
Ricky A Sharma ◽  
Tom Macgregor ◽  
Richard Gillies ◽  
Stephanie Hatch ◽  
Lonnie Swift ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Dna Repair ◽  
Cho Cells ◽  
Univariate Analysis ◽  
S Phase ◽  
Mrna Levels ◽  
Oxaliplatin Treatment ◽  
Response To Chemotherapy ◽  
Dna Repair Proteins

e13587 Background: Oxaliplatin is first-line chemotherapy for colorectal, gastric, and esophageal cancers. Aim was to identify key determinants of oxaliplatin sensitivity and optimise these biomarkers to select patients for chemotherapy. Methods: High-throughput screening of oxaliplatin sensitivity was performed in a Schizosaccharomyces pombe deletion library of 229 DNA repair strains and Chinese Hamster Ovary (CHO) cell lines with mutations in specific proteins. Biopsies were taken from 50 patients with esophageal cancer, who then received two cycles of oxaliplatin and fluorouracil chemotherapy prior to surgery. Levels of DNA repair proteins were quantified by immunohistochemistry and by qRT-PCR. Results: Twelve lead biomarkers were identified from the preclinical models. In CHO cells, XPF and ERCC1 mutants were approximately 30 times more sensitive than the WT cells (p<0.01). In comparison to WT CHO cells, XPF-deficient cells had prolonged delay in mid-late S-phase after oxaliplatin treatment, and persistence of double strand breaks for at least 48 hours. Modified Comet assay confirmed persistence of inter-strand crosslinks created by oxaliplatin. Cells deficient in DNA polymerase eta (pol eta) also accumulated in S-phase and were 3-fold more sensitive (p<0.01) to oxaliplatin treatment than pol eta-complemented cells. Knockdown of XPF, ERCC1 or pol eta sensitised both oxaliplatin-resistant and oxaliplatin-sensitive HCT116 cells to oxaliplatin. In patients with esophageal cancer, low or absent XPF protein expression predicted complete pathological response to chemotherapy with a sensitivity of 58% and specificity of 72%. Cyclin A protein levels (univariate analysis, p<0.005) and pol eta mRNA levels (multivariate analysis, P<0.005) in pre-treatment esophageal biopsies correlated with overall survival. Conclusions: Results suggest that inter-strand DNA cross-links are the principal cytotoxic lesions created by oxaliplatin. Homologous recombination and damage checkpoint proteins are leading biomarkers for patient selection. In patients with esophageal cancer, XPF and pol eta predict response to oxaliplatin chemotherapy.

scholarly journals Perda de peso em pacientes oncológicos: prevalência e prognóstico relacionados a sexo, idade, localização do tumor e sintomas de impacto nutricional

2020 ◽  
Vol 35 (1) ◽  
pp. 84-92
Author(s):  
Dalton Luiz Schiessel ◽  
Amanda Kamitani Góis Orrutéa ◽  
Sabrina Eduarda da Silva ◽  
Mariana Abe Vicente Cavagnari ◽  
Caryna Eurich Mazur ◽  
...  
Keyword(s):  
Overall Survival ◽  
Weight Loss ◽  
Nutrient Intake ◽  
Primary Outcome ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Cancer Site ◽  
Grade Scheme ◽  
The City

ABSTRACT Introduction: Cancer causes an increase in nutritional demands and the presence of of nutritional impact symptoms (NIS) contributes to reduction of nutrient intake and absorption, leading to weight loss, malnutrition and predicting overall survival. Assess the prevalence and predict the weight loss related to cancer, the Grade Scheme and the NIS. Methods: Data were collected from 2012 to 2018 from the first nutritional consultation of cancer patients in a clinic linked to SUS in the city of Guarapuava-PR. The primary outcome was to determine the % of weight loss (% WL), NIS and by the Grade Scheme proposed by Martin et. al (2015) the prognosis was determined by univariate and multivariate Multinomial Logistic Regression (MLR) analysis (adjusted for age, sex and tumor location). Results: 1164 patients aged 56.9 years. In the first consultation, a 6.7 %WL was observed, and it was observed that 21.6% of the patients were underweight. The main sites and %WL were, respectively: Lung 140 (12.0%) and 9.4 %WL, Head and Neck 113 (9.7%) and 10.5 %WL, Colorectal 84 (7.2%) and 10.3 %WL, Stomach 90 (7.7%) and 13.7 %WL, Esophagus 85 (7.3%) and 14.0 %WL, Pancreas 24 (2.1%) and 16.1 %WL. The main NIS were: dry mouth (51.0%), abdominal pain (23.0%), constipation (21.7%), nausea (15.3%) and altered taste (10.5%). In the RML for univariate analysis, age, sex, cancer site and SIN and for multivariate analysis, all cancer locations showed significant OR to be classified in grades 3 and 4. Conclusion: Before chemotherapy, weight loss and malnutrition are present. The cancer site and SIN increase the chance of the patient being classified in grades 3 and 4, leading these patients to a worse nutritional status and contributing to adverse results.

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