Prognostic value of Ki-67 and ENSAT stage on recurrence-free survival and overall survival in patients with adrenocortical carcinoma

2020 ◽  
Author(s):  
Ivana Kraljevic ◽  
Nikola Knezevic ◽  
Luka Kakrigi ◽  
Marko Kakarigi ◽  
Tina Dusek ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Prognostic Value ◽  
Recurrence Free Survival ◽  
Ki 67 ◽  
Free Survival

scholarly journals Adjuvant Radiation Improves Recurrence-Free Survival and Overall Survival in Adrenocortical Carcinoma

2019 ◽  
Vol 104 (9) ◽  
pp. 3743-3750 ◽  
Author(s):  
Laila A Gharzai ◽  
Michael D Green ◽  
Kent A Griffith ◽  
Tobias Else ◽  
Charles S Mayo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Adjuvant Radiation ◽  
Recurrence Free Survival ◽  
University Of Michigan ◽  
Free Survival ◽  
Tumor Bed ◽  
Distant Failure ◽  
Rare Malignancy ◽  
The University

Abstract Context Adrenocortical carcinoma (ACC) is a rare malignancy with high rates of recurrence and poor prognosis. The role of radiotherapy (RT) in localized ACC has been controversial, and RT is not routinely offered. Objective To evaluate the benefit of adjuvant RT on outcomes in ACC. Design This is a retrospective propensity-matched analysis. Setting All patients were seen through the University of Michigan’s Endocrine Oncology program, and all those who underwent RT were treated at the University of Michigan. Participants Of 424 patients with ACC, 78 were selected; 39 patients underwent adjuvant radiation. Intervention Adjuvant RT to the tumor bed and adjacent lymph nodes. Main Outcomes Measures Time to local failure, distant failure, or death. Results Median follow-up time was 4.21 years (95% CI, 2.79 to 4.94). The median radiation dose was 55 Gy (range, 45 to 60). The 3-year overall survival estimate for patients improved from 48.6% for patients without RT (95% CI, 29.7 to 65.2) to 77.7% (95% CI, 56.3 to 89.5) with RT, with a hazard ratio (HR) of 3.59 (95% CI, 1.60 to 8.09; P = 0.002). RT improved local recurrence-free survival (RFS) from 34.2% (95% CI, 18.8 to 50.3) to 59.5% (95% CI, 39.0 to 75.0), with an HR of 2.67 (95% CI, 1.38 to 5.19; P = 0.0035). RT improved all RFS from 18.3% (95% CI, 6.7 to 34.3) to 46.7% (95% CI, 26.9 to 64.3), with an HR 2.59 (95% CI, 1.40 to 4.79; P = 0.0024). Conclusions In the largest single institution study to date, adjuvant RT after gross resection of ACC improved local RFS, all RFS, and overall survival in this propensity-matched analysis. Adjuvant RT should be considered a part of multidisciplinary management for patients with ACC.

External validation of preoperative AST/ALT (De-Ritis) ratio as a prognostic indicator in localized and metastatic renal cell carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 589-589
Author(s):  
Dattatraya H Patil ◽  
Rishi Robert Sekar ◽  
Jeff Pearl ◽  
Yoram Baum ◽  
Mehrdad Alemozaffar ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Value ◽  
External Validation ◽  
Prognostic Indicator ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Metastatic Rcc

589 Background: Recently, the De-Ritis ratio, defined as the ratio of preoperative aspartate aminotransferase (AST) to alanine aminotransferase (ALT), was shown to be an independent predictor of overall and recurrence-free survival in a European cohort with localized renal cell carcinoma (RCC). In this study, we perform an external validation of the De-Ritis ratio as a prognostic indicator in a distinct cohort of patients with localized and metastatic RCC. Methods: Patients that underwent nephrectomy for localized and metastatic RCC between 2001 and 2014 with available laboratory values within one week of surgery were queried from the Emory Nephrectomy Database. De-Ritis ratio of 1.2 was used to divide subjects into high and low subgroups. Using clinical follow-up data, prognostic value of the De-Ritis ratio was analyzed using the Kaplan-Meier method and Cox proportional regression models. Results: In a cohort of 451 patients, an elevated De-Ritis ratio (AST/ALT ≥ 1.2) was associated with significantly decreased overall survival (log-rank, p=0.0023) and recurrence-free survival (Log-rank, p=0.0395). On multivariate analysis, De-Ritis ratio was shown to be an independent and significant predictor of overall survival (HR=0.52, p=0.002) and recurrence-free survival (HR=0.47, p=0.014) as seen in Table. Conclusions: Elevated De-Ritis ratio (AST/ALT ≥ 1.2) is an independent and significant predictor of overall and recurrence-free survival and is capable of differentiating high-risk disease in patients with localized and metastatic RCC. These findings are consistent with a previous study investigating the prognostic value of the De-Ritis ratio in a European cohort, and further validates its prognostic ability in a geographically distinct cohort including patients who presented with metastatic disease [Table: see text]

scholarly journals Prognostic Value of Inflammasomes in Head and Neck Carcinoma: A Meta-analysis

2020 ◽  
Author(s):  
Yi-Qun Jia ◽  
Xiao-Chuan Chen ◽  
Yi-Ming Chen ◽  
Yu-Yan Zheng ◽  
Bo Yang
Keyword(s):  
Overall Survival ◽  
Head And Neck ◽  
Prognostic Value ◽  
Web Of Science ◽  
Meta Analysis ◽  
Head And Neck Carcinoma ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Pyrin Domain ◽  
Neck Carcinoma

Abstract Background: Inflammasomes play important roles in responding to insults, triggering inflammation. Nonetheless, their correlation with the prognosis of the head and neck carcinoma (HNC) patients remains controversial. Methods: In this meta-analysis, we searched 5 inflammasomes in PubMed, Embase and Web of Science databases and included 14 prospective studies with 677 patients. There were two molecules, pyrin domain containing 3 (NLRP3) and Absent In Melanoma 2 (AIM2) satisfied the criteria for further analysis. Results: Higher expression of both NLRP3 and AIM2 was correlated with longer recurrence-free survival of HNC patients (P < 0.001). And higher level of AIM2 expression was associated with better overall survival in HNC patients (P < 0.001). Conclusions: Although publication bias potentially existed, NLRP3 and AIM2 are possible prognostic predictors in HNC patients.

Adjuvant radiotherapy after primary surgical resection in patients with adrenocortical carcinoma: Retrospective cohort analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4641-4641
Author(s):  
Mouhammed Amir Habra ◽  
Shamim Ejaz ◽  
Lei Feng ◽  
Prajnan Das ◽  
Ferhat Deniz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Adrenocortical Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Distant Recurrence ◽  
Hazard Ratio ◽  
Control Group ◽  
Recurrence Free Survival ◽  
Free Survival

4641 Background: Adrenocortical carcinoma (ACC) is a rare malignancy with high recurrence and mortality rates. The role of adjuvant radiotherapy (RT) to improve outcome remains unclear. Considering the rarity of ACC, we conducted a historical cohort study to ascertain the effect of adjuvant RT on overall survival and recurrence rates. Methods: Patients were selected from the MD Anderson Cancer Center (MDACC) ACC registry (1998- 2011) who had primary tumor resection with no evidence of distant metastasis at the time of initial diagnosis and a minimum follow-up of 6-months. The adjuvant RT group included patients who received adjuvant RT within 3 months of diagnosis. Control group included patients who did not receive RT and matched based on resection margin status and stage at diagnosis. Results: There were no significant differences between the adjuvant RT group (n=15) and comparison group (n =45) in gender distribution, age, tumor size, functional status, and use of adjuvant mitotane therapy. On multivariate Cox proportional hazard model for overall survival, the adjuvant RT group had hazard ratio of 1.981(95% confidence interval [CI] 0.894-4.391, p=0.0922) compared to the control group. The differences in median time to local recurrence, distant recurrence and of recurrence free survival were not significant between the two groups. In subgroup analysis including only the patients whose initial treatments were from outside of MDACC, RT group (n=15) had hazard ratio of overall survival of 1.604 (95% CI 0.712- 3.613, p=0.2543) compared to group without adjuvant RT (n= 32). Median times to local recurrence, distant recurrence, or of recurrence free survival were also not significantly different between the two groups. Conclusions: To our knowledge, this is the largest single institution report about adjuvant RT use in ACC. In our study, RT did not appear to cause a significant difference in overall survival, recurrence rate, or time to recurrence. However, it is still possible that patients offered adjuvant RT and control groups may have been inherently different. Hence, a prospective study is needed to clarify the role of adjuvant RT in patients with resectable ACC.

scholarly journals Prognostic value of PIVKA-II in hepatocellular carcinoma patients receiving curative ablation: A systematic review and meta-analysis

2018 ◽  
Vol 33 (3) ◽  
pp. 266-274 ◽  
Author(s):  
Dongjing Zhang ◽  
Zhihong Liu ◽  
Xueru Yin ◽  
Xiaolong Qi ◽  
Bingyun Lu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Value ◽  
Clinical Utility ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Hazard Ratios

Background: Several studies have been conducted to evaluate the prognostic value of prothrombin induced by vitamin K absence-II (PIVKA-II) overexpression in hepatocellular carcinoma patients treated with curative ablation. However, the results remain controversial. The purpose of this meta-analysis was to explore the correlation between PIVKA-II expression and survival outcomes in these patients. Methods: We performed a systematic literature search in PubMed, EMBASE, Medline, Cochrane Library, and Web of Science to identify the relevant articles investigating the prognostic value of PIVKA-II in patients with hepatocellular carcinoma. Combined hazard ratios (HR) and their 95% confidence intervals (CI) for overall survival and recurrence-free survival were calculated as the analysis endpoints. Results: A total of 15 cohorts encompassing 5647 patients were included. The results indicated that elevated PIVKA-II was significantly associated with poorer overall survival (HR 1.59; 95% CI 1.40, 1.82; P < 0.001) and recurrence-free survival (HR 1.76; 95% CI 1.42, 2.17; P < 0.001). Similar results were observed in the subgroup analysis based on sample size, analytical method, treatment modality, and cut-off value. Conclusions: This meta-analysis suggests that elevated PIVKA-II is a predictor of unfavorable overall survival and recurrence-free survival in hepatocellular carcinoma patients receiving curative ablation. More rigorous studies are warranted to confirm the clinical utility of PIVKA-II in determining hepatocellular carcinoma prognosis.

Prognostic impact of immunohistochemical expression of Ki-67 in patients with advanced gastric cancer who underwent curative resection.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 19-19 ◽  
Author(s):  
S. Sym ◽  
J. Hong ◽  
E. Cho ◽  
W. Lee ◽  
M. Chung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Prognostic Value ◽  
Curative Resection ◽  
Lymphatic Vessel ◽  
Histologic Grade ◽  
The Other ◽  
Recurrence Free Survival ◽  
Ki 67 ◽  
Free Survival

19 Background: Ki-67, tumor proliferation marker, is an important prognostic factor in a variety of cancers. In the present study, we investigated the prognostic value of immunoexpression of Ki-67 in patient with gastric cancer who underwent curative resection. Methods: We retrospectively analyzed 241 patients who had undergone curative gastrectomy at Gachon University Gil Hospital between January 2008 and July 2009. Ki-67 proliferation index (PI) by immunohistochemistry on formalin-fixed, paraffin-embedded material and the other clinicopathologic variables were evaluated by univariate and mulvariate analysis. Results: The median follow-up from surgery was 12 months (range, 0.5-26.7 months) and mean recurrence-free survival was 23 months (95% confidence interval, 21.8-24.1 months). The mean Ki-67 PI was 40% (range, 5-90%). No significant correlation was found between Ki-67 PI and other clinicopathologic variables including histologic grade and pathologic TNM (pTNM) stage. Univariate analysis revealed that significant prognostic factors of recurrence-free survival included age, preoperative serum albumin, pre-operative hemoglobin, surgery type, pTNM, histologic grade, lymphatic vessel invasion, peri-neural invasion, and Ki-67 PI. In the multivariate analysis besides pTNM (p=0.046), lymphatic vessel invasion (p=0.024), and surgery type (p=0.047), Ki-67 PI (p=0.005) also remained as an independent prognostic factor of recurrence, whereas the other factors lost its prognostic value. Conclusions: Our results suggest that high Ki-67 PI is independent, poor prognostic factor of recurrence in patient with gastric cancer who underwent curative resection. No significant financial relationships to disclose.

scholarly journals Prognostic Value of Postoperative Neutrophil and Albumin: Reassessment One Month After Gastric Cancer Surgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Ali Guner ◽  
Minah Cho ◽  
Yoo-Min Kim ◽  
Jae-Ho Cheong ◽  
Woo Jin Hyung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Neutrophil Count ◽  
Prognostic Value ◽  
Risk Groups ◽  
Cancer Surgery ◽  
Recurrence Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Pathologic Stage

ObjectiveThe prognostic value of postoperative parameters reflecting the inflammatory and nutritional status of patients undergoing cancer surgery has been rarely studied. This study investigated the prognostic value of inflammatory and nutritional parameters measured preoperatively and 1 month after curative gastrectomy for gastric cancer.MethodsData from a prospectively maintained database of 1,194 patients with gastric cancer who underwent curative surgery in 2009–2018 were retrospectively reviewed. Demographics, clinicopathologic characteristics, operative data, survival data, and laboratory parameters were extracted. Neutrophil counts, lymphocyte counts, and albumin levels before surgery and 1 month postoperatively were analyzed.ResultsIn multivariable analysis adjusted for age, sex, and pathologic stage, high neutrophil count (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.01–1.17, p = 0.022) and low albumin (HR 0.45, 95% CI 0.27–0.74, p = 0.002) 1 month postoperatively were independent prognostic factors for overall survival. High neutrophil count (HR 1.09, 95% CI 1.02–1.16, p = 0.015) 1 month postoperatively was also an independent prognostic factor for recurrence-free survival after adjusting for age, sex, body mass index, extent of gastrectomy, and pathologic stage. Patients were classified into risk groups based on thresholds of 4.2 × 103 cells/mm3 and 4.1 g/dl for 1-month neutrophil count and albumin. High-risk groups had a significantly worse prognosis than low-risk groups for overall survival (HR 5.87, 95% CI 3.28–10.51, p &lt;0.001) and recurrence-free survival (HR 1.52, 95% CI 1.07–2.16, p = 0.021).ConclusionsNeutrophil count and albumin level 1 month after curative surgery reflect long-term prognosis better than preoperative values. These parameters can be used to stratify patients with the same stage into different prognostic groups.

scholarly journals Epigenetic Alterations Associated with the Overall Survival and Recurrence Free Survival among Oral Squamous Cell Carcinoma Patients

2020 ◽  
Vol 9 (4) ◽  
pp. 1035 ◽  
Author(s):  
Yasmen Ghantous ◽  
Aysar Nashef ◽  
Imad Abu-Elnaaj
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Features ◽  
Squamous Cell ◽  
Methylation Status ◽  
Recurrence Free Survival ◽  
Epigenetic Alterations ◽  
Free Survival

Oral squamous cell carcinoma (OSCC) is a fatal disease caused by complex interactions between environmental, genomic, and epigenetic alterations. In the current study, we aimed to identify clusters of genes whose promoter methylation status correlated with various tested clinical features. Molecular datasets of genetic and methylation analysis based on whole-genome sequencing of 159 OSCC patients were obtained from the The Cancer Genome Atlas (TCGA) data portal. Genes were clustered based on their methylation status and were tested for their association with demographic, pathological, and clinical features of the patients. Overall, seven clusters of genes were revealed that showed a significant association with the overall survival/recurrence free survival of patients. The top ranked genes within cluster 4, which showed the worst prognosis, primarily acted as paraneoplastic genes, while the genes within cluster 6 primarily acted as anti-tumor genes. A significant difference was found regarding the mean age in the different clusters. No significant correlation was found between the tumor staging and the different clusters. In conclusion, our result provided a proof-of-principle for the existence of phenotypic diversity among the epigenetic clusters of OSCC and demonstrated the utility of the use epigenetics alterations in devolving new prognostic and therapeutics tools for OSCC patients.

scholarly journals The role of neutrophil-lymphocyte ratio as a prognostic indicator in patients undergoing nephrectomy for renal cell carcinoma

2018 ◽  
Vol 12 (7) ◽  
pp. E348-8 ◽  
Author(s):  
Nathan Grimes ◽  
Cathal Hannan ◽  
Matthew Tyson ◽  
Ali Thwaini
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Primary Tumour ◽  
Preoperative Staging ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Introduction: Prognosis in patients with cancer is influenced by underlying tumour biology and also the host inflammatory response to the disease. There is limited evidence to suggest that an elevated neutrophil-lymphocyte ratio (NLR) predicts a poorer prognosis in patients undergoing nephrectomy for renal cell carcinoma (RCC). The aim of this paper is to investigate if patients undergoing nephrectomy for RCC with NLR ≤4 have a better overall and recurrence-free survival than patients with NLR >4.Methods: All patients who underwent nephrectomy at a single centre between January 1, 2011 and December 31, 2014 were identified. Patients were included if postoperative histology demonstrated RCC and if preoperative NLR was available. Patients were excluded if nephrectomy was not curative intent (i.e., cytoreductive nephrectomy), if primary tumour was graded to be T3b‒4 disease, if there was presence of nodal or metastatic disease on preoperative staging, or if adequate followup notes were not available. Primary and secondary outcomes were overall survival and recurrence-free survival, respectively.Results: A total of 154 patients were included in analysis of overall survival; 146 patients were included in analysis of recurrence-free survival. Patients with NLR ≤4 had a much better overall survival than patients with NLR >4 (95% vs. 78%; p=0.0219). Patients with NLR >4 also had higher rates of recurrence (p=0.0218).Conclusions: NLR may be a useful tool in identifying patients who may benefit from more frequent surveillance in the early postoperative period and may allow clinicians to offer surveillance schemes tailored to the individual patient.

Prognostic value of peripheral naive CD8+ T cells in oligometastatic non-small-cell lung cancer

2021 ◽  
Author(s):  
Xin Zhao ◽  
Yan Zhang ◽  
Zhenlin Gao ◽  
Yaguang Han
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
T Cells ◽  
Small Cell Lung Cancer ◽  
Immune Cells ◽  
Prognostic Value ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival

Aim: This study aimed to investigate the prognostic value of peripheral naive and memory CD8+ and CD4+ T cells and other immune cells in patients with oligometastatic non-small-cell lung cancer (NSCLC) undergoing radiotherapy (RT). Methods: A total of 142 patients with oligometastatic NSCLC treated with RT were enrolled, and their blood samples were collected within 3 days before RT. Immune cells were identified by flow cytometry. Results: Patients with high levels of naive CD8+ T cells had longer overall survival (p = 0.004) and progression-free survival (p = 0.001) than those with low levels of naive CD8+ T cells. Multivariate analyses revealed that naive CD8+ T cells were independently correlated with overall survival (p = 0.019) and progression-free survival (p = 0.024). Conclusion: The results suggest that peripheral naive CD8+ T cells may be an independent prognostic indicator for patients with oligometastatic NSCLC undergoing RT.

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