PROGNOSTIC SIGNIFICANCE OF TRANSDURAL INVASION OF CRANIAL BASE MALIGNANCIES IN PATIENTS UNDERGOING CRANIOFACIAL RESECTION

Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. 1178-1185 ◽  
Author(s):  
Iman Feiz-Erfan ◽  
Dima Suki ◽  
Ehab Hanna ◽  
Franco DeMonte
Keyword(s):  
Prognostic Significance ◽  
Progression Free Survival ◽  
Cranial Base ◽  
Cancer Center ◽  
Primary Malignancy ◽  
Craniofacial Resection ◽  
Brain Invasion ◽  
University Of Texas ◽  
Negative Prognostic Factor ◽  
Alive With Disease

Abstract OBJECTIVE Invasion of the brain and/or dura is a known negative prognostic factor for patients undergoing craniofacial resection for cranial base malignancy. However, an evaluation of factors that may affect prognosis in this patient subgroup has not been undertaken. METHODS Between 1993 and 2003, 212 patients underwent craniofacial resection for primary malignancy of the cranial base at the University of Texas M.D. Anderson Cancer Center. Twenty-eight patients (eight women, 20 men; median age, 52 yr; age range, 26–76 yr) had evidence of transdural spread (subdural tumor or brain invasion) of malignancy. These patients were identified and a retrospective review of prospectively collected data was undertaken. RESULTS Subdural tumors were found in 16 of these patients, and brain invasion was detected in 12. Gross total resections were achieved in 22 patients: 13 with microscopically negative margins, eight with positive margins, and one with unspecified margins. Surgical complications occurred in six patients. There was no surgical mortality. The 5-year actuarial overall survival (OS) was 58%. Eleven patients had no evidence of disease, 11 died of disease, and six were alive with disease at the end of the follow-up period. The median actuarial progression-free survival (PFS) was 38 months (95% confidence interval, 4–72 mo). Gross total resection with negative margins was the key positive predictor of OS and PFS. Brain invasion was a negative predictor of survival (significant for PFS; trend only for OS). There was a trend for shorter OS and PFS in patients with high-grade tumors. CONCLUSION Overall OS and PFS in highly selected patients with transdural invasion of cranial base malignancy is similar to what has been historically reported for patients without such invasion. The most important variables positively affecting OS and PFS seem to be the ability to achieve a microscopically margins-negative resection followed by absence of brain invasion. Performing this resection in a piecemeal fashion does not seem to affect survival outcomes.

Surgical Management of Cranial Base Metastases

Neurosurgery ◽  
2011 ◽  
Vol 70 (4) ◽  
pp. 802-810 ◽  
Author(s):  
Roukoz B. Chamoun ◽  
Dima Suki ◽  
Franco DeMonte
Keyword(s):  
Neurological Deficit ◽  
Symptom Relief ◽  
Progression Free Survival ◽  
Cranial Base ◽  
Cancer Center ◽  
Limited Attention ◽  
Karnofsky Performance Scale ◽  
Consecutive Series ◽  
Brain Invasion

Abstract BACKGROUND: Cranial base metastases (CBM) are rare and have received limited attention in the medical literature. Questions remain regarding the role of surgery, if any, in the management of these tumors. OBJECTIVE: To report surgical outcomes in a consecutive series of patients with CBM and to better define the role of surgery in their management. METHODS: Twenty-seven patients with CBM underwent surgery between 1996 and 2009 at MD Anderson Cancer Center. A retrospective review of their prospectively collected data was performed after obtaining institutional review board approval. The median patient age was 52 years. The most common pathology was renal cell carcinoma (6 patients). Surgical indications were worsening neurological deficit, disfiguring mass, and the need for a diagnosis. RESULTS: Gross total resection was achieved in 59% of the cases. The median survival was 11.4 months. The median progression-free survival was 5.8 months. A Karnofsky Performance Scale score less than 90, dural invasion, and brain invasion were associated with a shorter survival. Seven patients were neurologically intact preoperatively; all of them remained intact after surgery. Among all patients with preoperative neurological deficit, 11 remained stable, 7 improved, and 2 had worsening of their deficit postoperatively. CONCLUSION: The goal of surgery for CBM is to provide symptom relief and to preserve functional status in well-selected cases. Patient selection is critical because the surgery is usually palliative, and only a minority of patients are surgical candidates. Radiation therapy remains the management option of choice for the majority of patients.

MET status and treatment outcomes in papillary renal cell carcinoma (PRCC): Pooled analysis of historical data.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19321-e19321
Author(s):  
Laurence Albiges ◽  
Daniel Yick Chin Heng ◽  
Jae-Lyun Lee ◽  
Stephen Walker ◽  
Anders Mellemgaard ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Progression Free Survival ◽  
Papillary Renal Cell Carcinoma ◽  
Kinase Domain ◽  
Pooled Analysis ◽  
Chromosome 7 ◽  
Cancer Center ◽  
Negative Prognostic Factor ◽  
Previously Treated ◽  
Kinase Domain Mutations

e19321 Background: PRCC accounts for 10–15% of RCCs, but there are limited biomarker-based data to inform targeted treatment. Treatments for patients (pts) with advanced/metastatic PRCC include those approved for clear cell RCC such as sunitinib or everolimus, however their activity in PRCC can be limited. A subset of PRCCs are MET-driven, and it has been suggested that this may be a negative prognostic factor, although the role of MET activation in advanced/metastatic disease is unclear. We explored the prevalance of MET status in pts with advanced/metastatic PRCC treated with targeted therapies and impact on clinical outcomes. Methods: This large, international, retrospective, observational study included pts with previously treated, locally advanced/metastatic PRCC. MET status was determined retrospectively by NGS of archival tissue. MET-driven disease was defined as MET and/or HGF amplification, chromosome 7 gain (requiring > 30% tumor content) and/or MET kinase domain mutations. Study objectives included progression-free survival (PFS), time to treatment failure (TTF) and overall survival (OS) by MET status. Results: 305/308 pts (International Metastatic RCC Database Consortium, n = 72; The Asan Genito-Urinary Cancer Center, n = 40; Groupe Français d’Etude des Tumeurs Uro-Génitales, n = 196) received first-line (1L) treatment; sunitinib was most common (68%). 214 (69%) pts received 2L therapy; everolimus was most common (20%). Of 179 pts with valid NGS results, 38%, 49% and 13% had MET-driven, MET-independent (ind) tumors and chromosome 7 ploidy unevaluable, respectively. Baseline demographics were mostly balanced among groups. In sunitinib-treated pts, PFS and TTF were numerically longer in pts with MET-driven tumors vs pts with MET-ind tumors, but OS was similar (Table). In everolimus-treated pts, PFS and TTF were similar for both MET groups; however the sample size was small. Conclusions: MET alterations are frequent in advanced/metastatic PRCC and have potential to impact PFS and TTF, although our results show limited effect on OS. These data show that MET-driven tumours may not predict for poorer outcome vs MET-ind tumours and there is a need for suitable therapies for MET-driven PRCC. [Table: see text]

Massively parallel sequencing (MPS) of circulating DNA in patients with metastatic colorectal cancer (mCRC): Prognostic significance and early changes during chemotherapy (CT).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 11015-11015 ◽  
Author(s):  
Jeanne Tie ◽  
Isaac Kinde ◽  
Hui-Li Wong ◽  
Joseph James McKendrick ◽  
Peter Gibbs ◽  
...  
Keyword(s):  
Massively Parallel Sequencing ◽  
Prognostic Significance ◽  
Predictive Biomarkers ◽  
Progression Free Survival ◽  
Circulating Tumor Dna ◽  
Rank Test ◽  
Cancer Center ◽  
Circulating Dna ◽  
Plasma Samples ◽  
Mutational Status

11015 Background: Prognostic and predictive biomarkers in mCRC are urgently needed. Circulating tumor cells are a promising blood biomarker, but are detectable in only a minority of pts. Recently, analysis of circulating tumor DNA (ctDNA) has shown promise as a liquid biopsy, reflecting the evolving mutational status of the tumor. Here we explored baseline ctDNA as a prognostic marker, and early changes in ctDNA as a marker of CT response. Methods: Serial plasma samples and CEA were collected at baseline (D1), day 3 (D3) and cycle 2 day 1 (C2D1) from 40 mCRC pts receiving standard combination CT. Restaging scans performed at 8 weeks were centrally assessed using RECIST criteria. Samples were analyzed at Johns Hopkins Kimmel Cancer Center. Initially tumor tissue was analyzed for hotspot mutations in TP53, APC, KRAS, BRAF, PIK3CA and FBXW7. The same mutation was queried and quantified in plasma using a MPS platform (Safe-SeqS). Log-rank test was used to compare survival curves and Wilcoxon matched pairs test was used to compare paired plasma samples. Results: Preliminary data is available on 19 pts in this ongoing study. Using our initial panel at least 1 mutation was found in 16 of 19 (84.2%) tumors (7 KRAS, 3 TP53, 3 BRAF, 2 APC and 1 PIK3CA), with matching ctDNA found for each pt. For the remaining 3 cases a further panel of mutations is being analyzed. Median D1 cell free DNA (cfDNA) and ctDNA levels were 1.98 ng/ul (0.15 – 57.18) and 523 mutant fragments (frag)/ml (0.4 – 109,876), respectively. Pts with D1 cfDNA of ≥ 2.5 compared with < 2.5 had shorter median overall survival (OS; 6.9 v 12.2 months, p = 0.0086), with a trend for shorter progression-free survival (PFS; 3.6 v 8.2 months, p = 0.3477). A surge of ctDNA level from D1 to D3 was typically observed (median increase: 91.2 frag/ml, p = 0.0313), followed by a drop (median decrease from D1 to C2D1: 208.8 frag/ml, p = 0.0098). All pts with a decrease in ctDNA at C2D1 had a reduction in tumor size at 8 weeks. Conclusions: In all cases of mCRC where tumor mutation was identified, matching ctDNA was detected in plasma. Circulating DNA is a promising marker of prognosis. Early changes in DNA levels may be a useful marker of tumor response.

scholarly journals Craniofacial Resection for Cranial Base Malignancies Involving the Infratemporal Fossa

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-339-ONS-347 ◽  
Author(s):  
Mark H. Bilsky ◽  
Brandon Bentz ◽  
Todd Vitaz ◽  
Jatin Shah ◽  
Dennis Kraus
Keyword(s):  
Malignant Tumors ◽  
Infratemporal Fossa ◽  
Survival Rates ◽  
Tumor Resection ◽  
Cranial Base ◽  
Outcome Analysis ◽  
Cancer Center ◽  
En Bloc ◽  
Craniofacial Resection ◽  
Anterior Cranial Base

Abstract OBJECTIVE: Cranial base malignancies involving the infratemporal fossa have been considered unresectable. Advanced operative techniques have made tumor resection feasible in an en bloc fashion with negative histological margins, but there are limited data regarding outcome analysis in patients who have undergone resection of malignant tumors in this area. METHODS: At Memorial Sloan-Kettering Cancer Center, 25 patients underwent anterolateral cranial base resections for tumors that involved the infratemporal fossa during a 7-year period. The most common tumors were sarcoma (n = 9), squamous cell carcinoma (n = 6), and adenoid cystic carcinoma (n = 3). The median size of the tumors was 6 cm, and 12 tumors involved the anterior cranial base and/or orbit. Tumor resections were divided into three types. Twelve patients underwent Type 1 dissection for tumors involving only the infratemporal fossa and maxillary sinus; 2 patients underwent Type 2 dissections involving the infratemporal fossa and anterior cranial base; and 11 patients underwent Type 3 dissection, which included the infratemporal fossa, anterior cranial base, and orbit. All patients required free flap reconstruction, 22 of which were rectus abdominis free flaps. RESULTS: Complications occurred in seven patients, including a single mortality resulting from a myocardial infarction. The 2-, 3-, and 5-year survival rates were 69, 63, and 56%, respectively. The relapse-free survival rates were 47% at 2 and 3 years and 41% at 5 years. Recurrences were local in nine patients and distant in four patients. CONCLUSION: Despite the extensive nature of many infratemporal fossa tumors, they can be resected with acceptable morbidity. Survival rates approach those of anterior cranial base malignancies without infratemporal fossa involvement.

scholarly journals Acute Erythroid Leukemia

2010 ◽  
Vol 134 (9) ◽  
pp. 1261-1270 ◽  
Author(s):  
Zhuang Zuo ◽  
Jacek M. Polski ◽  
Armen Kasyan ◽  
L. Jeffrey Medeiros
Keyword(s):  
Myeloid Leukemia ◽  
Prognostic Significance ◽  
Molecular Data ◽  
World Health ◽  
Cancer Center ◽  
Who Criteria ◽  
University Of Texas ◽  
Molecular Information ◽  
Health Organization ◽  
The University

Abstract Context.—Acute erythroid leukemia (AEL) is an uncommon type of acute myeloid leukemia (AML), representing less than 5% of all cases. Acute erythroid leukemia is characterized by a predominant erythroid proliferation, and in the current World Health Organization (WHO) classification scheme there are 2 subtypes: erythroleukemia (erythroid/myeloid leukemia) and pure erythroid leukemia. Morphologic findings are most important for establishing the diagnosis. The erythroleukemia subtype, which is most common, is defined as the presence of 50% or more erythroid precursors and 20% or more blasts in the nonerythroid component. The pure erythroid leukemia subtype is composed of 80% or more immature erythroblasts. Although these morphologic criteria appear straightforward, AEL overlaps with other types of AML and myelodysplastic syndrome that are erythroid rich. Objective.—To provide an update of AEL, including clinical presentation, morphologic features, immunophenotype, and cytogenetic and molecular data. As the erythroleukemia subtype is most common, the literature and this review are biased towards this subtype of AEL. Data Sources.—Clinicopathologic, cytogenetic, and molecular information were extracted from our review of pertinent literature and a subset of AEL cases in the files of The University of Texas M. D. Anderson Cancer Center (Houston) and University of South Alabama (Mobile). Conclusions.—The current WHO criteria for establishing the diagnosis of AEL reduce the frequency of this entity, as cases once classified as the erythroleukemia subtype are now reclassified as other types of AML, particularly AML with myelodysplasia-related changes and therapy-related AML. This reclassification also may have prognostic significance for patients with the erythroleukemia subtype of AEL. In contrast, the current WHO criteria appear to have little impact on the frequency and poor prognosis of patients with the pure erythroid leukemia subtype of AEL. Molecular studies, preferably using high-throughput methods, are needed for a better understanding of the pathogenesis of AEL, and for developing diagnostic and prognostic markers.

Comparison of Risk Models for Patients with Lower Risk Myelodysplastic Syndromes

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1919-1919
Author(s):  
Hye Ryoun Kim ◽  
Guillermo Garcia-Manero ◽  
Carlos E. Bueso-Ramos ◽  
Hagop M. Kantarjian ◽  
Sourindra Maiti ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Risk Stratification ◽  
Myelodysplastic Syndromes ◽  
Lower Risk ◽  
Prognostic Significance ◽  
Gene Mutations ◽  
International Prognostic Scoring System ◽  
Cancer Center ◽  
Study Cohort ◽  
University Of Texas

Abstract Accurate prognostication is essential for patients with myelodysplastic syndromes (MDS) to facilitate optimal patient management. Several systems for predicting the outcome of patients with MDS are commonly used in clinics, including the International Prognostic Scoring System (IPSS), revised IPSS, and a low risk MDS model developed by The University of Texas MD Anderson Cancer Center (MDA). We designed this study to evaluate and compare these three models in lower risk MDS patients in order to accurately identify patients with a poor prognosis who may need early therapeutic intervention. A total of 733 adult patients, median age 69 years (range, 24-91), who were diagnosed as lower risk MDS (IPSS low or intermediate-1) with complete cytogenetic evaluations at MDA were included in this study. Both IPSS and revised IPSS systems stratified the study cohort into groups with significantly different overall survival (OS) (P<0.001 in both). The MDA model further stratified patients into significantly different OS groups (P<0.001), and further stratified the revised IPSS low group (N=248, P<0.001) by OS, but not the very low or intermediate (INT) groups. Because both IPSS models are heavily weighted toward cytogenetic features, but over half of MDS patients present with normal (diploid) cytogenetics, we compared the effectiveness of these models in risk stratification among diploid MDS patients. Without the effects of cytogenetics, all 3 models still stratified OS significantly (P<0.001 for all). Revised IPSS further stratified IPSS low (N=171, P<0.001) and INT-1 (N=184, P=0.005) into significant different OS groups. The MDA model further stratified IPSS low (P=0.041) and INT-1 (p<0.001) into significant different OS groups. Multivariate analyses showed that age, bone marrow blast count, and hemoglobin and platelet levels were independent factors for survival in all MDS patients and in diploid MDS patients, whereas absolute neutrophil count was not significant for either group. Molecular markers hold promise for further risk stratification in diploid MDS patients. We assessed the prognostic significance of common gene mutations, such as NPM1, FLT3, DNMT3A, NRAS and KIT. We also identified a signature of plasma microRNAs of which expression levels can predict survival of diploid MDS patients more accurately than all three models. In summary, the revised IPSS system has improved the stratification of patients in the IPSS low and INT-1 categories. The MDA model improves the OS stratification in IPSS low and INT-1 groups, as well as the revised IPSS low group. All three systems effectively predict survivals in diploid MDS patients. Development of novel molecular markers will enable further risk stratification of MDS patients, especially in the diploid MDS group. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Kantarjian: ARIAD, Pfizer, Amgen: Research Funding. Cooper:InCellerate: Equity Ownership; Sangamo: Patents & Royalties; Targazyme: Consultancy; GE Healthcare: Consultancy; Ferring Pharmaceuticals: Consultancy; Fate Therapeutics: Consultancy; Janssen Pharma: Consultancy; BMS: Consultancy; Miltenyi: Honoraria.

scholarly journals Pituitary carcinoma: The University of Texas MD Anderson Cancer Center experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 2068-2068
Author(s):  
Fernando Santos Pinheiro ◽  
Marta Penas-Prado ◽  
Ian E. McCutcheon ◽  
Anita Mahajan ◽  
Paul D. Brown ◽  
...  
Keyword(s):  
Single Agent ◽  
Survival Rates ◽  
Pituitary Tumors ◽  
Progression Free Survival ◽  
Pituitary Carcinoma ◽  
Cancer Center ◽  
Ki 67 ◽  
University Of Texas ◽  
Md Anderson

2068 Background: Pituitary carcinoma (PC) is a rare and aggressive neuroendocrine tumor diagnosed once a pituitary adenoma (PA) becomes metastatic. Although no standard treatment currently exists, surgery, radiation (XRT) and/or chemotherapy are most commonly used. Recently, treatment with temozolomide (TMZ) has shown promising results, although the lack of prospective trials limits accurate outcome assessment. Methods: We describe a single-center multidisciplinary team experience in managing PC patients over a 13-year period (Oct, 2003 to Jan, 2017). Results: A total of 17 patients (9 males) were seen. Median age at diagnosis of PC was 44 years (range 16-82 years) and the median time from PA to PC conversion was 6 years (range 1-29 years). Median follow-up time: 28 months (range 8-158 months) with 7 reported deaths. The majority of PC was hormone-secreting (HS) subtype (n = 12): ACTH (n = 5), PRL (n = 4), FSH/LH (n = 2), GH (n = 1). After PC diagnosis, all pituitary tumors were locally invasive, all underwent at least one resection (mean 2.3) and all received at least one course of XRT alone (IMRT = 76%, SRS = 29%, IMPT = 12%) or concurrent with chemotherapy (18%). Immunohistochemistry showed high Ki-67 labeling index ( > 3%) in 9 (53%) cases. Most cases (n = 14) had metastases to the CNS, 35% of those had combined CNS and systemic foci. Ten (59%) cases underwent focal treatment of metastases, 90% of which underwent XRT. The most common chemotherapy used was TMZ [n = 14 (82%): single agent (n = 10); TMZ+capecitabine (n = 5); concurrent TMZ+XRT (n = 3); concurrent TMZ+XRT with adjuvant TMZ (n = 1)]. The median longest progression-free survival (LPFS) was 18 months (range 4-45 months). TMZ was associated with the chemotherapy-related LPFS in 9 (75%) cases. The 2, 3 and 5 year survival rate was 65%, 53% and 35%, respectively. All patients surviving > 5 years were treated with TMZ (n = 5, 2 survived > 10 years). Two refractory cases are currently on PD-1 inhibitor agent. Eighty percent of non-functioning PC were alive at last follow-up (HS-PC, 58%). Recurrence occurred in 11 (65%) cases. Conclusions: Treatment of PC requires a multidisciplinary approach. Multimodality therapy with surgery, radiation and TMZ was associated with higher survival rates and longer PFS.

scholarly journals Establishment and Validation of a Nomogram for Nasopharyngeal Carcinoma Patients Concerning the Prognostic Effect of Parotid Lymph Node Metastases

2020 ◽  
Vol 52 (3) ◽  
pp. 855-866 ◽  
Author(s):  
Chao Lin ◽  
Xue-Song Sun ◽  
Sai-Lan Liu ◽  
Xiao-Yun Li ◽  
Nian Lu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Nasopharyngeal Carcinoma ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Free Survival ◽  
Prognostic Effect ◽  
Calibration Curves ◽  
Negative Prognostic Factor

Purpose The prognosis of nasopharyngeal carcinoma (NPC) patients with parotid lymph node (PLN) metastasis remains unclear. This study was performed to investigate the prognostic significance and optimal staging category of PLN metastasis and develop a nomogram for estimating individual risk.Materials and MethodsClinical data of 7,084 non-metastatic NPC patients were retrospectively reviewed. Overall survival (OS) was the primary endpoint. A nomogram was established based on the Cox proportional hazards regression model. The accuracy and calibration ability of this nomogram was evaluated by C-index and calibration curves with bootstrap validation.ResultTotally, 164/7,084 NPC patients (2.3%) presented with PLNs. Multivariate analyses showed that PLN metastasis was a negative prognostic factor for OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS). Patients with PLN metastasis had a worse prognosis than N3 disease. Five independent prognostic factors were included in the nomogram, which showed a C-index of 0.743. The calibration curves for probability of 3- and 5-year OS indicated satisfactory agreement between nomogram-based prediction and actual observation. All results were confirmed in the validation cohort.ConclusionNPC patient with PLN metastasis had poorer survival outcome (OS, PFS, DMFS, and LRFS) than N3 disease. We developed a nomogram to provide individual prediction of OS for patients with PLN metastasis.

scholarly journals Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Patients With Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuki Kuranari ◽  
Ryota Tamura ◽  
Noboru Tsuda ◽  
Kenzo Kosugi ◽  
Yukina Morimoto ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Laboratory Data ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Tumor Location ◽  
Neutrophil To Lymphocyte Ratio ◽  
Ki 67 ◽  
Who Grade ◽  
Lymphocyte Ratio ◽  
Subtotal Removal

BackgroundMeningiomas are the most common benign intracranial tumors. However, even WHO grade I meningiomas occasionally show local tumor recurrence. Prognostic factors for meningiomas have not been fully established. Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic factor for several solid tumors. The prognostic value of NLR in meningiomas has been analyzed in few studies.Materials and MethodsThis retrospective study included 160 patients who underwent surgery for meningiomas between October 2010 and September 2017. We analyzed the associations between patients’ clinical data (sex, age, primary/recurrent, WHO grade, extent of removal, tumor location, peritumoral brain edema, and preoperative laboratory data) and clinical outcomes, including recurrence and progression-free survival (PFS).ResultsForty-four meningiomas recurred within the follow-up period of 3.8 years. WHO grade II, III, subtotal removal, history of recurrence, Ki-67 labeling index ≥3.0, and preoperative NLR value ≥2.6 were significantly associated with shorter PFS (P &lt; 0.001, &lt; 0.001, 0.002, &lt; 0.001, and 0.015, respectively). Furthermore, NLR ≥ 2.6 was also significantly associated with shorter PFS in a subgroup analysis of WHO grade I meningiomas (P = 0.003). In univariate and multivariate analyses, NLR ≥2.6 remained as a significant predictive factor for shorter PFS in patients with meningioma (P = 0.014).ConclusionsNLR may be a cost-effective and novel preoperatively usable biomarker in patients with meningiomas.

scholarly journals The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Rongqiang Liu ◽  
Shiyang Zheng ◽  
Qing Yuan ◽  
Peiwen Zhu ◽  
Biao Li ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Regression Analyses ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Meta Regression

Purpose. The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods. An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results. Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS ( HR = 1.77 ; 95% CI, 1.51–2.08) and poor DFS/PFS ( HR = 1.63 ; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions. Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

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