Survival analysis following resection of AJCC stage III gallbladder carcinoma based on different combinations of T and N stages

6018 Background: Positron emission tomography (PET) is often used for the staging of head and neck cancer (HNC). The purpose of this study is to explore the association between the increased utilization of PET and stage/survival in the managed care environment. Methods: Adult patients diagnosed with HNC (n=958) between 2000-2008, at 4 integrated health systems (Group Health Cooperative, Seattle; Health Alliance Plan/Henry Ford Health System, Detroit; Kaiser Permanente Colorado and Northwest, Portland) were identified via tumor registries linked to claims data. We compared AJCC stage distribution, patient/treatment characteristics, and survival between pre-PET era (2000-2004) vs. PET era (2005-2008), and those with PET vs. those without, during the PET era. AJCC stage was grouped into stage I/II (localized), stage III/IVa/IVb (locally advanced), and stage IVc (metastatic). Ordered logistic regression estimated the effects of PET utilization on upstaging. Kaplan-Meier estimates described overall survival (OS) differences between PET users and nonusers in the PET era. Cox proportional hazards regression evaluated the effect of PET use on survival. Results: There was a non-significant increase in stage III/IVa/IVb (40% to 44%) with a decrease in stage I/II (58% to 52%) between pre-PET era and PET era (p=0.11). During the PET era, patients with PET were more likely stage III/IVa/IVb and less likely stage I/II compared to patients without PET (III/IVa/IVb: 62% vs. 29%, I/II: 35% vs. 68%). On multivariate analysis those who were staged with PET were twice as likely to have locally advanced disease (OR 2.091; p=0.006). There was no difference in stage IVc. Patients with PET scans were more likely to receive chemotherapy with radiation and less likely to receive no treatment. 3-year actuarial OS for patients (all stages) with and without PET was 81% vs. 77% (p=0.261). 3-year actuarial OS for patients staged III/IVa/IVb with and without PET was 58% vs. 41% (p= 0.001). Conclusions: HNC patients were more likely to be upstaged with the use of PET. There was an improvement in survival in stage III/IVa/IVb patients, but no difference in survival across all stages. This likely reflects selection bias and stage migration rather than improved outcomes among individual patients.

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Improved survival in stage III melanoma patients with GM2 antibodies: a randomized trial of adjuvant vaccination with GM2 ganglioside.

Journal of Clinical Oncology ◽

10.1200/jco.1994.12.5.1036 ◽

1994 ◽

Vol 12 (5) ◽

pp. 1036-1044 ◽

Cited By ~ 380

Author(s):

P O Livingston ◽

G Y Wong ◽

S Adluri ◽

Y Tao ◽

M Padavan ◽

...

Keyword(s):

Overall Survival ◽

Stage Iii ◽

Disease Free Interval ◽

Free Interval ◽

Ajcc Stage ◽

Melanoma Patients ◽

Stage Iii Melanoma ◽

Receive Treatment ◽

To Receive ◽

Disease Free

PURPOSE To perform a double-blind randomized trial with American Joint Commission on Cancer (AJCC) stage III melanoma patients for the following reasons: (1) to confirm our previous finding that patients with antibodies against the melanoma differentiation antigen GM2 have an improved prognosis, and (2) to demonstrate clinical benefit from GM2 antibody induction. PATIENTS AND METHODS One hundred twenty-two patients with AJCC stage III melanoma who were free of disease after surgery were randomized: 58 to receive treatment with the GM2/BCG vaccine, and 64 to receive treatment with bacille Calmette-Guèrin (BCG) alone. All patients were pretreated with low-dose cyclophosphamide (Cy). RESULTS GM2 antibody was detected in 50 of 58 patients treated with GM2/BCG and seven of 64 patients treated with BCG alone. With a minimum follow-up period of 51 months, there was a highly significant increase in the disease-free interval (P = .004) and a 17% increase in overall survival (P = .02) in these 57 antibody-positive patients, confirming our earlier experience. Exclusion of all patients with preexisting GM2 antibodies (one in the GM2/BCG group and five in the BCG group) from statistical analysis resulted in a 23% increase in disease-free interval (P = .02) and a 14% increase in overall survival (P = .15) at 51 months for patients treated with the GM2/BCG vaccine. However, when all patients in the two treatment groups were compared as randomized, these increases were 18% for disease-free interval and 11% for survival in the GM2/BCG treatment group, with neither result showing statistical significance. CONCLUSION (1) Vaccination with GM2/BCG induced immunoglobulin M (IgM) antibodies in most patients. (2) GM2 antibody production was associated with a prolonged disease-free interval and survival. (3) Comparison of the two arms of this trial as randomized fails to show a statistically significant improvement in disease-free interval or survival for patients treated with GM2/BCG vaccines.

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Protein signatures correspond to survival outcomes of AJCC stage III melanoma patients

Pigment Cell & Melanoma Research ◽

10.1111/pcmr.12290 ◽

2014 ◽

Vol 27 (6) ◽

pp. 1106-1116 ◽

Cited By ~ 10

Author(s):

Swetlana Mactier ◽

Kimberley L. Kaufman ◽

Penghao Wang ◽

Ben Crossett ◽

Gulietta M. Pupo ◽

...

Keyword(s):

Stage Iii ◽

Survival Outcomes ◽

Ajcc Stage ◽

Protein Signatures ◽

Melanoma Patients ◽

Stage Iii Melanoma

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Analysis of Variance Based Significance Analysis of Cartilage Tumor

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.3121 ◽

2020 ◽

Vol 10 (9) ◽

pp. 1985-1991

Author(s):

Yuan Li ◽

Zili Xu ◽

Xiangyang Liu ◽

Xiandong Peng ◽

Shu Cao ◽

...

Keyword(s):

Protein Expression ◽

Poor Prognosis ◽

Histological Grade ◽

Stage I ◽

Stage Iii ◽

Ajcc Stage ◽

Kaplan Meier ◽

First Choice ◽

Clinicopathological Significance ◽

Enneking Stage

Chondrosarcoma is a malignant bone tumor with poor prognosis. Surgical treatment is the first choice for chondrosarcomas. Chondrosarcoma is not sensitive to chemotherapy and radiotherapy. Identification of biological markers is important for the early diagnosis and targeted treatment of chondrosarcoma. This study aimed to investigate the protein expression and clinicopathological significance of APEX1 and Haptoglobin in 85 chondrosarcomas and 38 osteochondromas based on deep learning. The APEX1 and Haptoglobin protein expression in tissues was measured by immunohistochemistry. The percentage of positive APEX1 and Haptoglobin expression was significantly higher in patients with chondrosarcoma than in patients with osteochondroma (P < 0001). The percentage of positive APEX1 and Haptoglobin expression was significantly lower in patients with histological grade I, AJCC stage I, Enneking stage I and non-metastatic chondrosarcoma than patients with histological grade III, AJCC stage III+IV, Enneking stage III, and metastatic chondrosarcoma (P < 0005 or P < 0001). APEX1 expression was positively correlated with Haptoglobin expression in chondrosarcoma (P < 0001). Kaplan—Meier survival analysis demonstrated that histological grade, AJCC stage, Enneking stage, metastasis, invasion, and APEX1 and Haptoglobin expression significantly correlated with a short mean survival time of patients with chondrosarcoma (P < 0005 or P < 0001). Cox multivariate analysis showed that positive APEX1 and Haptoglobin expressions were independent prognostic factors that negatively correlated with postoperative survival and positively correlated with mortality. The AUC for APEX1 (AUC = 0.673, 95% CI: 0.573—0.772), or Haptoglobin (AUC = 0.649, 95% CI: 0.548—0.750), respectively. Positive APEX1 and Haptoglobin expression is associated with the carcinogenesis, progression and poor prognosis of chondrosarcoma.

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Racial disparities in the presentation of hepatocellular carcinoma in the population 65+ years in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.249 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 249-249

Author(s):

Michael Ross Kaufman ◽

David J. Delgado ◽

Stephanie Costa ◽

Brandon George ◽

Edith P. Mitchell

Keyword(s):

United States ◽

Hepatocellular Carcinoma ◽

Racial Disparities ◽

Late Stage ◽

The United States ◽

Pacific Islanders ◽

Stage Iii ◽

Ajcc Stage ◽

Asian Pacific Islanders ◽

Asian Pacific

249 Background: Insufficient evidence exists regarding the presentation and management of elderly patients with hepatocellular carcinoma (HCC). The purpose of this study was to describe racial differences in cancer staging of elderly (65+) patients with HCC diagnosed in the United States. Methods: A retrospective cohort study was conducted using the 1973-2014 Surveillance, Epidemiology and End Results Program (SEER) database of the National Cancer Institute. Patients with primary hepatocellular carcinoma, diagnosed between 2004 and 2014, and with complete information on race, gender, year of diagnosis, age, marital status, region and stage at diagnosis (Derived SEER Summary Stage 2000, and Derived American Joint Committee on Cancer (AJCC) Stage Group, 6th Edition) were included. Descriptive statistics were used to compare sociodemographic and clinical variables with race. Univariate and multivariate logistic regressions were preformed to describe the association of race with the diagnosis of late stage HCC (Regional/Distant vs Localized Stage for SEER Summary Stage, and Stage III/IV vs Stage I/II for AJCC Stage Group). Results: The sample consisted of 19,902 HCC patients: 69.7% White, 9.2% Black, 20.2% API, 1.0% AI; 69.1% male; 45.1% diagnosed in 2004-2009; 56.2% age 65-74, 35.6% 75-84, and 8.2% 85 and older; 58.3% married; 7.4% Midwest, 12.4% Northeast, 17.0% Southeast, 63.2% Pacific West; 44.9% Regional/Distant Stage (SEER Summary Stage) and 41.2% Stage III/IV (AJCC Stage Group). After controlling for confounding variables, Asian/Pacific Islanders had a decreased odds of presenting with late stage disease relative to whites in both the SEER Summary Stage (OR: 0.867, CI:0.805-0.934) and AJCC Stage Group (OR: 0.904, CI:0.838-0.975). Conclusions: Racial disparities exist at the presentation of HCC in the 65+ population. Asian/Pacific Islanders are less likely to be diagnosed with late stage HCC compared to whites. There is a need to study further these relationships in subpopulations.

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Immunohistochemical Expression of Phospho-mTOR Is Associated With Poor Prognosis in Patients With Gallbladder Adenocarcinoma

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0032-oa ◽

2013 ◽

Vol 137 (4) ◽

pp. 552-557 ◽

Cited By ~ 25

Author(s):

Pamela Leal ◽

Patricia García ◽

Alejandra Sandoval ◽

Pablo Letelier ◽

Priscilla Brebi ◽

...

Keyword(s):

Survival Analysis ◽

Gallbladder Carcinoma ◽

Poor Prognosis ◽

Mammalian Target Of Rapamycin ◽

Prognostic Significance ◽

Tissue Microarrays ◽

Chronic Cholecystitis ◽

Common Finding ◽

Immunohistochemical Expression ◽

Significance Level

Context.—Advanced gallbladder carcinoma (GBC) is a highly fatal disease with poor prognosis and few therapeutic alternatives. The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that plays a central role in cell growth and homeostasis. Its regulation is frequently altered in various tumors and is an attractive target for cancer therapy; however, its status in GBC remains unclear. Objective.—To characterize immunohistochemical expression and prognostic significance of phospho-mTOR in advanced gallbladder carcinoma. Design.—Phospho-mTOR expression was examined by immunohistochemistry in tissue microarrays containing 128 advanced GBCs and 99 cases of chronic cholecystitis, which were divided into 2 groups according to the presence or absence of metaplasia. To evaluate the association of the level of phospho-mTOR expression with clinical variables and patient survival, the advanced GBCs were classified as having low or high expression. Statistical analysis was performed by using a significance level of P < .05, and Kaplan-Meier curves were constructed for survival analysis. Results.—Immunostaining for phospho-mTOR was positive in 82 of 128 tumors (64.1%) and in 24% of chronic cholecystitis cases (16% nonmetaplasia and 32% with metaplasia) (P < .001). Survival analysis indicated that a high phospho-mTOR immunohistochemical expression was associated with poorer prognosis in patients with advanced GBC (P = .02). Conclusions.—Metaplasia is a common finding in chronic cholecystitis and is considered a precursor lesion of dysplasia. Our results suggest that the activation of mTOR occurs very early during the development of GBC, contributing to the carcinogenesis process. Phospho-mTOR expression is correlated with poor survival, supporting the potential of mTOR for targeted therapy.

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Randomized Phase II Trial of Carboplatin–Paclitaxel Compared with Carboplatin–Paclitaxel–Trastuzumab in Advanced (Stage III–IV) or Recurrent Uterine Serous Carcinomas that Overexpress Her2/Neu (NCT01367002): Updated Overall Survival Analysis

Clinical Cancer Research ◽

10.1158/1078-0432.ccr-20-0953 ◽

2020 ◽

Vol 26 (15) ◽

pp. 3928-3935 ◽

Cited By ~ 3

Author(s):

Amanda N. Fader ◽

Dana M. Roque ◽

Eric Siegel ◽

Natalia Buza ◽

Pei Hui ◽

...

Keyword(s):

Overall Survival ◽

Survival Analysis ◽

Phase Ii ◽

Phase Ii Trial ◽

Stage Iii ◽

Advanced Stage ◽

Randomized Phase Ii ◽

Overall Survival Analysis

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14-CpG-Based Signature Improves the Prognosis Prediction of Hepatocellular Carcinoma Patients

BioMed Research International ◽

10.1155/2020/9762067 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15

Author(s):

Hong-ye Jiang ◽

Gang Ning ◽

Yen-sheng Wang ◽

Wei-biao Lv

Keyword(s):

Hepatocellular Carcinoma ◽

Dna Methylation ◽

Survival Analysis ◽

Validation Cohort ◽

Univariate Analysis ◽

Prognosis Prediction ◽

Risk Of Death ◽

Ajcc Stage ◽

Patient Prognosis ◽

Robust Likelihood

Background. Epigenetic dysregulation via alteration of DNA methylation often occurs during the development and progression of cancer, including hepatocellular carcinoma (HCC). In the past, many patterns of single-gene DNA methylation have been extensively explored in the context of HCC prognosis prediction. However, the combined model of a mixture of CpGs has rarely been evaluated. In the present study, we aimed to develop and validate a CpG-based signature model for HCC patient prognosis. Methods. Data from methylation profiling of GSE73003, GSE37988, and GSE57958 from the Gene Expression Omnibus (GEO) database and 371 HCC patients from the Cancer Genome Atlas (TCGA) were downloaded. The 371 HCC patients were randomly divided into a development cohort (N = 263) and a validation cohort (N = 108). Two algorithms, least absolute shrinkage and selection operator (LASSO) and robust likelihood-based survival analysis, were used to select the most significant CpGs associated with overall survival (OS) time and were used to develop and validate a methylation-based signature (MSH) for HCC patient prognosis. In addition, the prognostic efficacy of the MSH was compared with that of AJCC TNM classification and other CpG-based MSHs from TCGA. Finally, a nomogram incorporating the MSH and clinicopathologic factors was also developed. Results. Fourteen differential CpGs associated with OS were identified in HCC patients. The MSH, based on these 14 differential CpGs, could effectively divide HCC patients into two distinct subgroups with high risk or low risk of death (P<0.0001) in the development cohort (26.35 vs 83.18 months, HR = 3.83, 95% CI: 2.56–5.90, P<0.0001) and in the validation cohort (40.37 vs 107.03 months, HR = 2.23, 95% CI: 1.22–4.17, P=0.01). Univariate analysis showed that the MSH was significantly associated with OS, and the multivariate analysis also showed that the MSH was an independent prognostic factor for the OS of HCC patients in the two cohorts. In addition, stratified survival analysis indicated that the MSH still exhibited good prognostic value in different subgroups classified by AFP, cirrhosis, Child-Pugh A, tumor histologic grade, and AJCC stage. Moreover, time-dependent ROC analysis showed better performance of the MSH in predicting 3-year and 5-year survival of HCC patients than of AJCC stage and other CpG-based signatures from TCGA. The MSH-based nomogram also performed well in predicting 1-year, 3-year, and 5-year OS (C-index: 0.709). Conclusion. The 14-CpG-based signature is significantly associated with OS and may be used as a novel prognostic biomarker for HCC patients.

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