Olfactory function as an independent prognostic factor in glioblastoma

Neurology ◽  
2019 ◽  
Vol 94 (5) ◽  
pp. e529-e537
Author(s):  
Sied Kebir ◽  
Elke Hattingen ◽  
Michael Niessen ◽  
Laurèl Rauschenbach ◽  
Rolf Fimmers ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Independent Prognostic Factor ◽  
Control Cohort ◽  
Olfactory Pathway ◽  
Olfactory Pathways ◽  
Olfactory Testing

ObjectiveTo determine the role of olfactory function in patients with glioblastoma multiforme (GBM) as a prognostic clinical measure.MethodsIn a prospective case-control study, olfactory testing was performed in 73 patients with primary GBM at baseline during first-line treatment and at later follow-ups. An age-matched control cohort consisted of 49 patients with neurologic diseases, excluding those known to affect olfactory function per se. Depending on the olfactory testing score, patients were allotted to a hyposmia group (HG) or normosmia group (NG). MRI analysis was performed to assess whether tumor location affects olfactory pathways.ResultsPatients with GBM had olfactory dysfunction significantly more often compared to the control cohort (p = 0.003). Tumor location could not explain this finding since no relevant difference in MRI-based olfactory pathway involvement was found between HG and NG (p = 0.131). Patients with olfactory dysfunction had significantly worse overall survival (OS) and progression-free survival (PFS) compared to those without dysfunction (median OS 20.9 vs 40.6 months, p = 0.035; median PFS, 9 vs 19 months, p = 0.022). Multivariate analysis in patients without MRI-based involvement of olfactory pathways confirmed olfaction is an independent prognostic factor for OS (hazard ratio [HR] 0.43; p = 0.042) and PFS (HR 0.51; p = 0.049).ConclusionThis pilot study provides the first indication that olfactory dysfunction is frequently observed in GBM and may be associated with worse survival outcome in GBM. However, validation of these results in an independent cohort is needed.

scholarly journals Postinfectious Olfactory Dysfunction: Oral Steroids and Olfactory Training versus Olfactory Training Alone: Is There any Benefit from Steroids?

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Sotiria Genetzaki ◽  
Evangelia Tsakiropoulou ◽  
Vasilios Nikolaidis ◽  
Konstantinos Markou ◽  
Iordanis Konstantinidis
Keyword(s):  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Line Treatment ◽  
First Line ◽  
Olfactory Testing ◽  
Significant Difference ◽  
Oral Steroids ◽  
Group A ◽  
Olfactory Training ◽  
First Line Treatment

<b><i>Introduction:</i></b> There are limited treatment options for postinfectious olfactory dysfunction (PIOD). Olfactory training has recently been used in clinical practice, but no medical treatment is widely accepted. Although there is weak evidence for their value, some physicians use oral corticosteroids as first-line treatment. The aim of this study was to compare combined oral methylprednisolone and olfactory training with olfactory training alone in the management of PIOD. <b><i>Methods:</i></b> This prospective cohort study included 131 patients with PIOD over a 2-year period before the COVID-19 pandemic. Seventy-eight patients who were treated with oral methylprednisolone and olfactory training (group A) were compared with 53 patients who were treated with olfactory training only (group B). Olfactory function was evaluated with “Sniffin’ Sticks” at baseline and 2, 8, and 16 weeks after initial assessment. Patients who improved after steroid treatment underwent magnetic resonance imaging of the paranasal sinuses, skin prick tests, lung spirometry, and sputum eosinophil assessment. <b><i>Results:</i></b> Oral steroids improved 19.23% of patients (<i>n</i> = 15) of group A. History, clinical evaluation, imaging, and laboratory tests identified an inflammatory background in half of them (<i>n</i> = 8). The remaining 7 had no findings of nasal inflammation, and all had a short history of olfactory dysfunction. Both groups significantly improved in olfactory testing results at the end of the olfactory training scheme without significant difference between them. <b><i>Conclusions:</i></b> The percentage of improved patients after oral methylprednisolone was relatively low to suggest it as first-line treatment. Half of the improved patients had an underlying upper airway inflammatory condition not related to the infection that caused the acute loss of olfactory function.

Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer

2010 ◽  
Vol 89 (4) ◽  
pp. 1053-1059 ◽  
Author(s):  
Varun Puri ◽  
Nitin Garg ◽  
Erin E. Engelhardt ◽  
Daniel Kreisel ◽  
Traves D. Crabtree ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factor ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Tumor Location ◽  
Small Cell ◽  
Independent Prognostic Factor ◽  
Small Cell Lung

C-reactive protein as an independent prognostic factor for metastatic gastric cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 110-110 ◽  
Author(s):  
Mika Kitagawa ◽  
Takaya Shimura ◽  
Tomonori Yamada ◽  
Keisuke Itoh ◽  
Chihiro Hasegawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Progression Free Survival ◽  
Metastatic Gastric Cancer ◽  
Independent Prognostic Factor ◽  
C Reactive Protein ◽  
Antitumor Effects ◽  
Eligibility Criteria ◽  
Reactive Protein ◽  
Serum Crp

110 Background: S-1 plus cisplatin has been recognized as the standard chemotherapy for metastatic gastric cancer (MGC). Inflammation is considered to be a critical component of tumor progression. C-reactive protein (CRP) has been associated with the development of many cancers, but the significance of CRP remains unclear for MGC. The present study assessed the relationship between serum levels CRP and antitumor effects in MGC. Methods: Among 109 MGC patients who received S-1 plus cisplatin as first-line chemotherapy from January 2006 to December 2011 in 3 Japanese institutions, we retrospectively identified 70 patients who fulfilled eligibility criteria of this study. Patients were categorized into 2 groups depending on serum CRP level before chemotherapy: 43 patients with CRP <1.0 mg/dl (CRP <1.0 group) and 27 patients with CRP ≥1.0 mg/dl (CRP ≥1.0 group). Results: Median overall survival was significantly shorter in the CRP ≥1.0 group than in the CRP <1.0 group [267 days (95% CI, 208 to 326) versus 416 days (95% CI, 325 to 507); p = 0.0007]. Moreover, progression-free survival (PFS) was significantly shorter in the CRP ≥1.0 group than in the CRP <1.0 group (median PFS 126 days [95% CI, 63 to 189) versus 188 days (95% CI, 159 to 217); p = 0.0050]. Meanwhile, response rate was determined in 58 patients with target lesions. No significant differences were noted between the CRP <1.0 group and the CRP ≥1.0 group (10/33, 30.3% versus 7/25, 28.0%; p = 0.663). In a multivariate analysis, serum CRP level before chemotherapy was an only independent prognostic factor for MGC (hazard ratio 3.09 (95% CI, 1.46 to 6.54); p = 0.003). Conclusions: Serum CRP level before chemotherapy might be an independent and potential prognostic factor for MGC. Stringent follow-up during chemotherapy is expected for patients with MGC and a high CRP level.

scholarly journals High prevalence of long-term olfactory dysfunction confirmed by olfactory testing after a community COVID-19 outbreak

HNO ◽  
2021 ◽  
Author(s):  
Hilmar Gudziol ◽  
Timo Kirschstein ◽  
Mathias W. Pletz ◽  
Sebastian Weis ◽  
Orlando Guntinas-Lichius ◽  
...  
Keyword(s):  
Population Based ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Taste Disturbance ◽  
Gustatory Function ◽  
Psychophysical Testing ◽  
Olfactory Testing ◽  
High Prevalence ◽  
Normal Taste

Abstract Purpose The prevalence of long-term olfactory and gustatory dysfunction in participants suffering from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19) is unknown. Furthermore, evaluations of the reliability of participants’ self-reporting of olfactory function (SOF) and gustatory function (SGF) using extended objective psychophysical testing are missing. Methods In this population-based cohort study in a PCR-tested community in Thuringia, Germany, olfactory function was extensively examined 4 months after a COVID-19 outbreak using the “Sniffin Sticks” test battery to determine the TDIa score, i.e., the sum of results obtained for threshold, discrimination, and identification scores averaged for both nasal sides. Gustatory function was assessed using the three-drop test resulting in the gustatory composite score (CSg). The data were compared with SOF and SGF. Results Of 43 adult convalescents (median age: 68 years; 58% female) after SARS-CoV‑2 infection, 18 participants (42%) had olfactory complaints due to SOF, one participant (2%) complained of taste disturbance due to SGF. The TDIa was 22.0 ± 5.9. Normosmia, hyposmia, and anosmia were seen in 17, 18, and eight participants, respectively. TDIa correlated with SOF (rs = −0.434, p = 0.004); CSg was 23.5 ± 2.7. Normogeusia and hypogeusia were objectified in 39 and four participants, respectively. The prevalence of long-term olfactory dysfunction and gustatory dysfunction in the study group was 60.5 and 9.3%, respectively. Conclusion The SOF was reliable, especially for participants who felt a sudden chemosensory dysfunction during the outbreak. At 4 months after SARS-CoV‑2 infection, a high proportion of participants were dysosmic, whereas nearly all of them had normal taste function.

Methylated circulating tumor DNA (Met-DNA) as an independent prognostic factor in metastatic pancreatic adenocarcinoma (mPAC) patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4136-4136 ◽  
Author(s):  
Daniel Pietrasz ◽  
Shufang Wang-Renault ◽  
Laetitia Dahan ◽  
Julien Taieb ◽  
Karine Le Malicot ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Prognostic Factor ◽  
Prognostic Value ◽  
Progression Free Survival ◽  
Circulating Tumor Dna ◽  
Independent Prognostic Factor ◽  
Oncologic Outcomes ◽  
Phase Ii Trials ◽  
Training Cohort ◽  
Tumor Dna

4136 Background: Circulating tumor DNA has emerged as prognostic biomarker in oncology. Many different genes can be mutated within a tumor, complicating procedures, even with highly sensitive next-generation sequencing (NGS). DNA methylation in promotor of specific genes is an early key epigenetic change during oncogenesis. Specific methylated genes could be a potential relevant cancer biomarker that may substitute for NGS panels. The aim of this study was to assess the prognostic value of Met-DNA in mPAC. Methods: Prognostic value of Met-DNA was assessed in a prospective cohort (PLAPAN) of mPAC (training cohort), correlated with NGS, then in two prospective independent validation cohorts from two randomized phase II trials (PRODIGE 35 and 37). Plasma samples were collected before chemotherapy on EDTA-coated tubes. Met-DNA was quantified using two specific markers of pancreatic DNA methylation by digital droplet PCR and correlated with prospectively registered patient (pts) characteristics and oncologic outcomes (progression free survival (PFS) and overall survival (OS)). Results: 330 patients (pts) were enrolled. 60% (n = 58) of the 96 pts of the training cohort had at least one Met-DNA marker. The correlation with NGS assessment was R = 0.93 (Pearson; p < 0.001). 59.5% (n = 100/168) and 59% (n = 39/66) of pts had detectable Met-DNA in the 2 validation cohorts. In the training cohort, Met-DNA was correlated with poor OS (HR = 1.82; 95%CI 1.07-2.42; p = 0.026). In validation cohorts, Met-DNA was a prognostic factor of PFS (HR = 1.62; 95%CI 1.17-2.25, p = 004) and OS (HR = 1.79; 95%CI 1.28-2.49, p < 0.001) in PRODIGE 35, as in PRODIGE 37: PFS HR = 1.79 (95%CI 1.07-2.99; p = 0.026) and OS HR = 2.08 (95%CI [1.18-3.68], p = 0.01), respectively. In multivariate analysis adjusted on gender, age, CA19-9 > 40UI.mL, treatment arm, number of metastatic sites and stratified on center, Met-DNA was independently associated with poor OS in both trials: HR = 1.81 (95%CI 1.10-2.98; p = 0.02) and HR = 3.62 (95%CI: 1.32-9.93; p = 0.01). Conclusions: This study demonstrates that Met-DNA is a strong independent prognostic factor in mPAC. These results argue for patient’s stratification on ctDNA status for further randomized trials. Clinical trial information: NCT02827201 and NCT02352337.

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