scholarly journals Prognostic factors for in-transit metastasis in patients with malignant melanoma

2021 ◽  
Author(s):  
Vlad Alexandru Gâta ◽  
Andrei Roman ◽  
Maximilian Muntean ◽  
Dragoș Ștefan Morariu ◽  
Cătălin Ioan Vlad ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Malignant Melanoma ◽  
Tumor Stage ◽  
Mitotic Rate ◽  
Clinicopathological Characteristics ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Recurrence Rates ◽  
In Transit

Background and aims. Malignant melanoma represents an aggressive and unpredictable malignancy, with high locoregional recurrence rates, regardless of tumor stage and therapeutic management. This study aims to identify the main histopathological prognostic factors involved in the development of in-transit metastasis in patients with malignant melanoma.  Methods. The study includes only patients that were diagnosed with malignant melanoma and with histologically confirmed in-transit metastasis who were treated in a comprehensive cancer center between 2010-2021. Histopathological parameters were investigated, univariate and multivariate analysis was performed. Results. A total of 26 patients were included in the analysis. On univariate and multivariate analysis, only primary cutaneous melanomas located on the thorax correlated with the risk of developing in-transit metastasis, whereas clinicopathological factors such as an increased Breslow thickness and Clark level, the presence of ulceration, positive lymph nodes, a non-brisk TIL density, a high mitotic rate, a nodular subtype, and age>50 years may represent risk factors, even though we could not find any correlations. Conclusions. Primary cutaneous melanomas that arise on the thorax present a high risk for the occurrence of locoregional disease, whereas other clinicopathological characteristics could not be used to predict local recurrence. However, prospective and more extensive cohort studies are needed in order to validate these important prognostic factors.

scholarly journals Clinicopathological Characteristics and Prognosis of Proximal and Distal Gastric Cancer during 1997–2017 in China National Cancer Center

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Lulu Zhao ◽  
Huang Huang ◽  
Dongbin Zhao ◽  
Chengfeng Wang ◽  
Yantao Tian ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Tumor Location ◽  
Clinicopathological Characteristics ◽  
Survival Outcome ◽  
Cancer Center ◽  
Poor Survival ◽  
Node Metastasis ◽  
Distal Gastric Cancer

Background. The prognostic relevance of gastric tumor location has been reported and debated. Our study was conducted to examine the differences in clinicopathological features, prognostic factors, and overall survival (OS) between patients with proximal gastric cancer (PGC) and distal gastric cancer (DGC). Patients and Methods. Patients with PGC or DGC were identified from the China National Cancer Center Gastric Cancer Database (NCCGCDB) during 1997–2017. Survival analysis was performed via Kaplan-Meier estimates and Cox proportional hazards models. Results. We reviewed 16,119 cases of gastric cancer patients, including 6,479 of PGC and 9,640 of DGC. PGC patients presented as older patients (61.5 versus 56.4 years, P<0.001) and more males (82.9% versus 68.2%, P<0.001). Compared with DGC, PGC was more likely to be in later pT stage (pT3 and pT4, 65.0% versus 52.8%, P<0.001) and lymph node metastasis (54.8% versus 50.9%, P<0.001). In univariate analysis, PGC patients had a worse survival outcome in stage I (Hazard ratio [HR] = 2.04, 95% CI: 1.42-2.94) but a better prognosis in stage IV (HR = 0.85, 95% CI: 0.73-0.98) when compared to DGC patients. However, multivariate analysis demonstrated that PGC was not an independent predictor for poor survival (HR = 1.07, 95% CI: 1.00-1.14). Results from multivariate analysis also revealed that pT4, lymph node metastasis, distant metastasis, no gastrectomy, and Borrmann IV were independent predictors associated with poor survival for both PGC and DGC patients. Additional prognostic factors for PGC patients included underweight (BMI < 18.5) (HR = 1.29, 95% CI: 1.06-1.58), linitis plastica (HR = 2.13, 95% CI: 1.25-3.65), and overweight (23 ≤ BMI <27.5) (HR = 0.80, 95% CI: 0.71-0.90). During the 20-year study period, the 5-year OS increased significantly for both PGC and DGC, with the increase rate of 91.7% and 67.7%, respectively. Conclusion. In China, PGC significantly differed from DGC in clinicopathological characteristics and prognostic factors. However, there was no significant relationship between survival outcome and gastric tumor location.

scholarly journals Clinicopathological Characteristics and Prognostic Factors in Axial Chondroblastomas: A Retrospective Analysis of 61 Cases and Comparison with Extra-Axial Chondroblastomas

2022 ◽  
Author(s):  
Bo-Wen Zheng ◽  
Bo-Yv Zheng ◽  
Hua-Qing Niu ◽  
Xiao-Bin Wang ◽  
Guo-Hua Lv ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Motor Dysfunction ◽  
Surrounding Tissue ◽  
Wide Resection ◽  
Tissue Specimens

Abstract Background The clinical characteristics and prognostic factors of axial chondroblastoma (ACB) are still poorly understood. Purpose To characterize clinicopathological characteristics in a large ACB cohort and investigate their correlation with survival. We also sought to compare these results with extra-axial CB (EACB). Methods Our institution's local database was retrospectively reviewed and included a total of 132 CB patients, including 61 ACB patients and 71 EACB patients. Immunohistochemistry was used to assess the expression levels of Vimentin (Vim), S100, and cytokeratin (CK) on tumor cells in 132 tissue specimens. Results Overall, ACB and EACB had similar characteristics, except for older age and tumor size, as well as higher Vim expression, incidence of surrounding tissue invasion and postoperative sensory or motor dysfunction. Whereas wide resection and absence of invasion of surrounding tissues were consistently associated with favorable survival in the ACB and EACB cohorts in univariate analysis, most parameters showed differential prognostic significance between the 2 groups. Significant prognostic factors for local recurrence-free survival in multivariate analysis included the type of resection and chicken-wire calcification in the ACB cohort. Multivariate analysis of overall survival demonstrated that the type of resection was a significant predictor in the ACB cohort, whereas the type of resection and postoperative sensory or motor dysfunction were predictive of overall survival in the EACB group. Conclusion These data suggest that there may be distinct biological behaviors between ACB and EACB and may provide useful information to better understand the prognostic characteristics of patients with ACB and to improve outcome prediction in patients with ACB.

Outcomes and prognostic factors in marginal zone lymphoma: Case comprehensive cancer center cumulative experience of 358 cases.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 8554-8554
Author(s):  
Adam Starr ◽  
PingFu Fu ◽  
Paolo Fabrizio Caimi ◽  
Erica Leigh Campagnaro ◽  
Brenda W. Cooper ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cumulative Experience

Frequency and factors predicting the risk for aberrant opioid use in patients receiving outpatient palliative care at a comprehensive cancer center.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 228-228
Author(s):  
Sriram Yennu ◽  
Tonya Edwards ◽  
Joseph Anthony Arthur ◽  
Zhanni Lu ◽  
John M Najera ◽  
...  
Keyword(s):  
At Risk ◽  
Multivariate Analysis ◽  
Drug Use ◽  
Supportive Care ◽  
Cancer Patients ◽  
Financial Distress ◽  
Male Gender ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale

228 Background: Opioid misuse is a growing crisis among patients with chronic pain. Cancer patients at risk of aberrant drug behaviors (ADB) are frequently underdiagnosed in routine cancer care. The aim of this study was to determine the frequency and factors predicting risk for Aberrant Opioid and Drug use among Patients receiving Outpatient Supportive Care Consultation at a Comprehensive Cancer Center Methods: In this retrospective study, 690 consecutive patients referred to a supportive care clinic were reviewed. Patients were eligible if they were ≥18 years, had a diagnosis of cancer, and were on opioids for pain for atleast a week. All patients were assessed with the Edmonton Symptom Assessment Scale (ESAS), SOAPP-14, and CAGE-AID. At risk patients with aberrant opioid behavior (+Risk) was defined as SOAPP-14 score ≥7. Descriptive statistics, spearman correlation coefficient, multivariate analysis were performed. Results: 690/752 consults were eligible. A total of 135(20%)were +risk. 69(11%) were CAGE-AID +.SOAPP-14 scores were positively associated with CAGE-AID p < 0.001; male gender p = 0.007; ESAS pain p = < 0.006; ESAS depression p < 0.001; ESAS anxiety, p < 0.001, and ESAS financial distress p = < 0.001. Multivariate analysis indicated that the odds ratio for +Risk was 2.47 in patients with CAGE-AID+ (p < 0.001), 1.95 for male gender (p = 0.005), 1.11 per point for ESAS anxiety (p = 0.019), and 1.1 per point. for ESAS financial distress (p = 0.02). Conclusions: 20% of cancer patients on opioids presenting to supportive care center are at risk of aberrant drug behavior. Male patients with anxiety, financial distress, and prior alcoholism/illicit drug use are significant predictors of +Risk. Further research to effectively manage these patients is needed.

Retrospective analysis of adjuvant treatment for localized, operable uterine leiomyosarcoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11072-11072
Author(s):  
Jomjit Chantharasamee ◽  
Karlton Wong ◽  
Pasathorn Potivongsajarn ◽  
Amir Aqorbani ◽  
Bartosz Chmielowski ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Mitotic Rate ◽  
Stage I ◽  
Uterine Leiomyosarcoma ◽  
Recurrence Rates ◽  
The Impact

11072 Background: Surgery is the standard of care for uterine leiomyosarcoma, but recurrence rates are high and outcomes are poor. Standard adjuvant treatment of localized uterine leiomyosarcoma(uLMS) has not yet been established as clinical trials to address this question have been small or hindered by slow accrual. Methods: We reviewed the medical records of patients with uLMS who underwent upfront surgery between 2000-2018. We evaluated the clinical characteristics and adjuvant therapy on outcomes. Patient characteristics and treatment outcomes were described using descriptive statistics. Kaplan-Meier survival analysis was used for DFS. Cox proportional hazard regression was used to compare difference between groups. Results: 59 patients with a median age of 52 years were analyzed and the median time from surgery to adjuvant treatment was 47 days. 48/59 (81.4%) underwent TAH-BSO. 64.4% were FIGO stage I, 16.9% were stage II and 6.7% were stage III. The median tumor size was 11 cm (range: 3-21cm) and the median mitotic rate was 13 mitoses/ 10 high-power fields (HPF), (range: 1-63). 34/59 (57.6%) of patients received adjuvant chemotherapy +/- radiation therapy and 25 patients (42.3%) did not receive adjuvant treatment. With a median follow-up time of 42.8 months, 42 patients (71.2%) had disease relapse and 15 (35.7%) had pulmonary metastases. The median disease-free survival (mDFS) for all patients was 23.1 months. Any adjuvant treatment (chemotherapy or radiation) had a trend toward longer mDFS than no adjuvant treatment (36.6 vs 13.6 months, p = 0.14). Patients who had adjuvant chemotherapy had a non-significant longer mDFS compared to who did not receive any adjuvant treatment (33.8 vs 13.6 months, p = 0.18). Patients with stage I disease had trend towards higher mDFS in the chemotherapy group, it was not statistically significant (29.7 vs 16.6 months, p = 0.59). Multivariate analysis found that the independent prognostic factors for worse DFS included tumor size larger than 10 cm, and mitotic rate over 10/ 10HPF. More morcellated specimens were found in non-adjuvant treatment arm (36%) compare to 8% in adjuvant arm. In the non-treatment arm, 14 patients had recurrences within 6 months. Conclusions: In a retrospective uLMS population, the mDFS was 23.1 months. Tumor size > 10cm and mitotic rate > 10/10 HPF were independent prognostic factors for lower DFS. The non-treatment group had a significantly higher number of patient with morcellization and relapsed within 6 months, confounding analyses of the impact of adjuvant chemotherapy.

scholarly journals Non-Hodgkin’s lymphomas of the large bowel - clinical characteristics, prognostic factors and survival

2008 ◽  
Vol 55 (3) ◽  
pp. 109-114 ◽  
Author(s):  
G.Z. Stanojevic ◽  
M.P. Stojanovic ◽  
M.M. Stojanovic ◽  
Z. Krivokapic ◽  
M.M. Jovanovic ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Large Bowel ◽  
Survival Function ◽  
Clinical Information ◽  
Tumor Stage ◽  
Rank Test ◽  
The Difference ◽  
Hodgkin's Lymphomas

The aims of this study were to review the clinical presentation of non-Hodgkin?s lymphomas of the large bowel, to analyze the prognostic factors using univariate and multivariate methods, as well as the overall survival. We identified 24 cases at our clinic between 1991 and 2005, based on pathohistological analysis and standard diagnostic criteria established by Dawson et al. They accounted for 1,2% of all cases of the large bowel malignancies (24/2021) during this period. The following clinical information such as age, gender, symptoms, tumor localization, operation performed, histology grade, stage of disease, and adjuvant chemotherapy was obtained. Survival function was expressed by Kaplan-Meier curve and Log-rank test was performed for the difference in survival between two patient groups. Multivariate analysis was carried out using the Cox proportional hazard model. Overall mean survival time was 41,91months. According to the univariete analysis, the factors influencing overall survival rate was operation type (elective and emergent). Tumor stage and operation type were independent prognostic factors for survival, as determined by multivariate analysis. Our results showed that tumor stage and operation type should be considered as the most important prognostic factors in patients with primary non-Hodgkin?s lymphomas of the large bowel.

scholarly journals Prognostic factors in patients with metastatic malignant melanoma: A multivariate analysis

Cancer ◽  
1993 ◽  
Vol 72 (10) ◽  
pp. 3091-3098 ◽  
Author(s):  
Matthew N. Sirott ◽  
Dean F. Bajorin ◽  
George Y. C. Wong ◽  
Yue Tao ◽  
Paul B. Chapman ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Malignant Melanoma ◽  
Metastatic Malignant Melanoma

Intermediate prognosis in metastatic germ cell tumors (IPGCT): Outcome and prognostic factors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4560-4560
Author(s):  
Christoph Alexander Seidel ◽  
Gedske Daugaard ◽  
Alexey Tryakin ◽  
Andrea Necchi ◽  
Marcus Hentrich ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Tumor Marker ◽  
Germ Cell Tumors ◽  
Current Treatment ◽  
Recurrence Rates ◽  
Response To Chemotherapy ◽  
Before And After ◽  
Group 2 ◽  
Group 1

4560 Background: The IGCCCG classification published in 1997 is based on data from the 1970-80s. Approximately 25% of metastatic GCT patients belong to the intermediate prognosis category, that was associated with a 5-year overall survival (OS) rate of 79%. However, more recent data suggest significant changes. We have thus performed an international registry of IPGCT patients to analyze current treatment, outcome, and potential prognostic factors. Methods: Data of IPGCT patients, diagnosed between 1979-2012, were retrospectively collected from 14 centers. Treatment and outcome before and after implementation of IGCCCG were analyzed. For patients diagnosed since 1997 prognostic factors were investigated by uni- and multivariate analysis to test whether current patients or subgroups may require less intensive treatment. Results: This registry includes 637 patients: group 1 diagnosed prior 1997 (n = 237), and group 2 since 1997 (n = 400). Mean follow-up duration was 128.4 months (IQR: 168.9). Patients in group 1 and 2 received first-line treatment with BEP (median 4 cycles; range 1 - 6) in 98% and 97%, respectively. Response to chemotherapy (CR and marker negative PR) was similar: 91% group 1; 94% group 2; (p = 0.233), but survival curves were significantly superior in group 2 associated with a 5-year OS rate of 87% (group 2) and 81% (group 1), respectively (p = 0.011; 95%CI 294-317). Recurrence rates were higher in group 1 (36% versus 24%; p = 0.001). Patients treated with 3 cycles BEP (n = 58) in both groups had a similar outcome concerning OS compared to patients treated with 4 cycles (n = 489) (p = 0.415). Uni- and multivariate analysis revealed LDH levels < 2.0 UNL prior chemotherapy (p = 0.018; HR 0.35) and an adequate tumor marker decline at days 18-21 (half-life) of first cycle (p = 0.025; HR 2.58) as independent prognosticators, both associated with 5-year OS rates of 94%, respectively. Conclusions: Outcome of intermediate patients seems improved after implementation of the IGCCCG classification and less intensive regimes may also be sufficient. Here, patients treated with 3xBEP had a non-inferior outcome. A baseline LDH < 2.0 UNL and an adequate tumor marker decline after first treatment cycle can be used for further stratification.

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