Efficacy of the Gallbladder Cancer Predictive Risk Score Based on Pathological Findings: A Propensity Score-Matched Analysis

2018 ◽  
Vol 25 (6) ◽  
pp. 1699-1708 ◽  
Author(s):  
Tetsuya Mochizuki ◽  
Tomoyuki Abe ◽  
Hironobu Amano ◽  
Keiji Hanada ◽  
Minoru Hattori ◽  
...  
Keyword(s):  
Propensity Score ◽  
Gallbladder Cancer ◽  
Risk Score ◽  
Pathological Findings ◽  
Predictive Risk

A novel pathology-based preoperative risk score to predict distant and locoregional residual disease and survival for incidentally discovered gallbladder cancer: A 10-institution study from the US Extrahepatic Biliary Malignancy Consortium.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 202-202
Author(s):  
Cecilia Grace Ethun ◽  
Lauren McLendon Postlewait ◽  
Timothy M. Pawlik ◽  
Stefan Buettner ◽  
George A. Poultsides ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Risk Score ◽  
Residual Disease ◽  
Risk Groups ◽  
Term Survival ◽  
T Stage ◽  
Increased Risk ◽  
The Us ◽  
Pathologic Characteristic ◽  
Predictive Risk

202 Background: T-stage alone is currently used to guide treatment for incidentally discovered gallbladder cancer. We aimed to develop a more robust predictive model for discovering distant or locoregional residual disease at the time of re-resection. Methods: All patients with incidentally discovered gallbladder cancer who underwent re-resection at 10 institutions from 2000-2015 were included. We utilized routine pathology data from initial cholecystectomy to create a gallbladder cancer predictive risk score (GBRS) for finding distant or locoregional residual disease at re-resection and predicting overall survival (OS). Results: Of 449pts with gallbladder cancer, 262 (58%) were incidentally discovered and underwent attempted re-resection. Advanced T-stage, grade, and lymphovascular (LVI) and perineural (PNI) invasion were all associated with increased rates of distant and locoregional residual disease, and decreased OS. Each pathologic characteristic was assigned a value (T1a: 0, T1b: 1, T2: 2, T3/4: 3; well diff: 1, mod diff: 2, poor diff: 3; LVI neg: 1, LVI pos: 2; PNI neg: 1, PNI pos: 2), which were added for a total GBRS score ranging from 3-10. The scores were then separated into 3 risk groups (Low: 3-4; Intermediate: 5-7; High: 8-10). Each progressive GBRS group was associated with an increased risk of finding distant and isolated locoregional residual disease at the time of re-resection, and was associated with reduced median OS (Table). Conclusions: By accounting for pathologic variations within each T-stage, this novel predictive risk-score redistributes T1b, T2, and T3 disease across separate risk-groups and more accurately identifies patients with incidentally discovered gallbladder cancer at risk for distant and locoregional residual disease, and decreased long-term survival. This score may help to better optimize treatment strategy for patients with incidentally discovered gallbladder cancer. [Table: see text]

Predictive risk-score model for selection of patients with high-risk stage II colon cancer for adjuvant systemic therapy

Surgery ◽  
2021 ◽  
Author(s):  
Richard J. Straker ◽  
Danny H.J. Heo ◽  
Adrienne B. Shannon ◽  
Douglas L. Fraker ◽  
Skandan Shanmugan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Risk Score ◽  
Systemic Therapy ◽  
Stage Ii ◽  
Score Model ◽  
Stage Ii Colon Cancer ◽  
Predictive Risk ◽  
Selection Of Patients ◽  
Selection Of

scholarly journals Evaluating Community-Based Translational Interventions Using Historical Controls: Propensity Score vs. Disease Risk Score Approach

2019 ◽  
Vol 20 (4) ◽  
pp. 598-608
Author(s):  
Luohua Jiang ◽  
◽  
Shuai Chen ◽  
Janette Beals ◽  
Juned Siddique ◽  
...  
Keyword(s):  
Propensity Score ◽  
Risk Score ◽  
Disease Risk ◽  
Community Based ◽  
Disease Risk Score ◽  
Historical Controls

scholarly journals Risk of recurrent stroke and antiplatelet choice in breakthrough stroke while on aspirin

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Joon-Tae Kim ◽  
Beom Joon Kim ◽  
Jong-Moo Park ◽  
Soo Joo Lee ◽  
Jae-Kwan Cha ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Risk Score ◽  
Stroke Risk ◽  
Recurrent Stroke ◽  
Vascular Events ◽  
Factors Associated ◽  
Increased Risk ◽  
Potential Factors ◽  
Predictive Risk ◽  
Multicenter Registry

Abstract Uncertainty regarding an optimal antiplatelet regimen still exists in patients with breakthrough acute ischemic stroke (AIS) while on aspirin. This study provides an analysis of a prospective multicenter registry between April 2008 and April 2014. Eligible patients were on aspirin at the time of AIS and treated with antiplatelet regimens (aspirin, clopidogrel, or clopidogrel-aspirin). Potential factors associated with the choice of each antiplatelet regimen were explored and included a predictive risk score for future vascular events, the Essen Stroke Risk Score (ESRS). A total of 2348 patients (age, 69 ± 11 years; male, 57.7%) were analyzed, and 55.3%, 25.3% and 19.4% were treated with clopidogrel-aspirin, aspirin and clopidogrel, respectively. While the likelihood of choosing clopidogrel-aspirin increased as the ESRS increased, the likelihood of choosing aspirin decreased as the ESRS increased (Ptrend < 0.001). The ESRS category (0–1/2–3/ ≥ 4) modified the effect of antiplatelet regimens for 1-year vascular events (Pinteraction < 0.01). Among patients with ESRS ≥ 4, clopidogrel-aspirin (HR 0.47 [0.30–0.74]) and clopidogrel (HR 0.30 [0.15–0.60]) significantly reduced the risk of outcome events. Our study showed that more than half of the patients with aspirin failure were treated with clopidogrel-aspirin. In particular, a higher ESRS, which indicates an increased risk of recurrent stroke, was associated with the choice of clopidogrel-aspirin rather than aspirin.

A risk score model to predict incidental gallbladder cancer in patients scheduled for cholecystectomy

2020 ◽  
Vol 220 (3) ◽  
pp. 741-744 ◽  
Author(s):  
Carolina Muszynska ◽  
Johan Nilsson ◽  
Linda Lundgren ◽  
Gert Lindell ◽  
Roland Andersson ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Risk Score ◽  
Score Model ◽  
Incidental Gallbladder Cancer

A Predictive Risk Score for Cancer-Associated Thrombosis: Role of Screening In A Prospective Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3173-3173 ◽  
Author(s):  
Alok A. Khorana ◽  
Kimberly Herman ◽  
Deborah Rubens ◽  
Charles W. Francis
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Risk Score ◽  
Prospective Cohort ◽  
Risk Model ◽  
Conflicts Of Interest ◽  
Clinical Risk Score ◽  
Clinical Risk ◽  
Predictive Risk

Abstract Abstract 3173 Background: We evaluated the utility of screening for VTE using a previously developed clinical risk score (Khorana et al, Blood 2008) in a prospective cohort of cancer patients initiating outpatient chemotherapy but not receiving thromboprophylaxis. Methods: Cancer patients initiating a new chemotherapy regimen and deemed high-risk based on a predictive risk model (score ≥3) were enrolled on an ongoing prospective cohort study with informed consent. Patients were evaluated with baseline and Q4 (± 1) week serial ultrasonography for upto 16 weeks; additionally, computed tomography scans for restaging were also evaluated for VTE. Results: Of 30 patients enrolled on study, 8 (27%) developed a VTE. This included 5 patients with DVT alone (17%), 1 patient with PE alone (3%) and 2 (7%) with both. Twenty-seven patients underwent a baseline ultrasound. Of these, 3 asymptomatic DVTs were identified (11%). Subsequent ultrasounds were performed in 18 patients at week 4 (0 DVT), 17 patients at week 8 (0 DVT) and 15 patients at week 12 (1 DVT, 7%). An additional two patients developed symptomatic DVT between weeks 1 and 4. Restaging CT scans identified an asymptomatic PE in 1 patient at week 6 and asymptomatic PE in 1 patient at week 9 with subsequent symptomatic DVT at week 10. Conclusions: In a prospective observational study, 27% of cancer outpatients deemed high-risk using a clinical risk score developed VTE, a rate much higher than observed even in hospitalized acutely ill patients. Thus, this study confirms the validity of a previously described risk score. The role of thromboprophylaxis in this population is currently being tested. The value of screening ultrasonography should be considered in high-risk patients based on this risk score. Disclosures: No relevant conflicts of interest to declare.

Association of neoadjuvant chemotherapy on survival in locally advanced gallbladder cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16716-e16716
Author(s):  
Syed Mohammad Ali Kazmi ◽  
Suleyman Yasin Goksu ◽  
Muhammet Ozer ◽  
Nina Niu Sanford ◽  
Matthew R. Porembka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Gallbladder Cancer ◽  
Propensity Score Matching ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Node Positive

e16716 Background: Gallbladder cancer (GBC) is an uncommon but highly fatal malignancy. Surgery remains the only potentially curative treatment for GBC. The role of neoadjuvant chemotherapy in patients with locally advanced GBC undergoing surgery is unknown. We studied the association of neoadjuvant chemotherapy on survival in locally advanced GBC patients who underwent resection. Methods: We identified adult patients with locally advanced (stage III-IV) GBC who underwent definitive surgery between 2004 and 2016 using the National Cancer Database. Treatment was categorized as neoadjuvant chemotherapy plus surgery (NAT), surgery plus adjuvant therapy (AT), and surgery alone (SA). Categorical variables were compared using the chi-square test with Bonferroni correction. Kaplan-Meier and Cox regression were used for survival analyses. We used 1:3 nearest neighbor propensity score matching based on NAT for each group. Results: Out of a total of 5,962 patients, 122 (2.2%) received NAT, 2934 (53.6%) AT, and 2421 (44.2%) SA. NAT was associated with private insurance and treatment at an academic/research facility (all p < .001) while SA patients were older, Hispanic, had government insurance, and higher comorbidities (all p < .001). Although all groups had similar lymph node assessment (NAT: 45%, AT: 46%, SA: 37%, p < .001), NAT was associated with lymph node negative disease (NAT 23%, AT 13.2%, SA 13.2%, p < .001). Median overall survival was higher in NAT compared to AT or SA (21 vs. 14 vs. 6 months, p < .001) which persisted after propensity score matching (21 vs. 15 vs. 9 months, p < .001) and multivariable regression analysis (Table). In node positive GBC, NAT was associated with improved median overall survival (NAT 24, AT 18, SA 8 months, p < .001). Conclusions: NAT is infrequently used in patients with locally advanced GBC. NAT is associated with improved median overall survival compared to AT and SA, and appears to be most beneficial in node positive disease. Prospective studies are needed to evaluate the role of neoadjuvant chemotherapy in locally advanced GB. [Table: see text]

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