Surgical outcome and graded prognostic assessment of patients with brain metastasis from adult sarcoma: Multi-institutional retrospective study in Japan

Abstract Background: Little information is available about the feasibility and prognostic assessment of surgical resection of brain metastasis (BM) from sarcomas. We aimed to analyze functional and survival outcomes, and develop a preoperative graded prognostic assessment (GPA) for patients with BM from sarcomas to predict survival time after local resection surgery. Methods: This study involved a multi-institutional retrospective analysis of 22 patients with BM from sarcomas who underwent resection at six institutes in Japan between September 2002 and September 2018.Overall survival (OS) after resection of BM was calculated by the Kaplan–Meier method. Prognostic factors were analyzed to develop a GPA using the log-rank test and Cox regression analysis. P < 0.05 was considered to indicate statistical significance. For GPA validation, we collected data on 100 patients from 48 published reports. Results: Postoperative Karnofsky Performance Status (KPS) was improved in 50% (11/22) of patients. Median OS was 21 months. Univariate analysis of OS showed that age (≥ 30 years old), gross total resection, and alveolar soft part sarcoma (ASPS) were significant positive prognostic factors (P<0.05). Multivariate analysis of OS showed age and ASPS were significant preoperative prognostic factors (P<0.05). RTOG-RPA classification had no significant prognostic value. We developed a GPA system for survival time after resection of BM in our patients. A score of 0 was assigned to patients aged 18–29 years with non-ASPS, a score of 2 to patients aged 18–29 years with ASPS or those aged 30–76 years with non-ASPS, and a score of 4 to patients aged 30–76 years with ASPS. Median OS for patients with GPA scores of 0, 2, and 4 were 6.5, 16.0, and 44.0 months, respectively (P=0.002). The results were validated by the survival data of 100 patients compiled from the literature (P<0.001). Conclusion: Patients with BM from sarcomas surgically treated showed median survival comparable to that of patients with BM from carcinomas,and showed improvement in postoperative KPS.We developed a new GPA of patients with BM from sarcomas. These results may help patients and clinicians to select resection as a feasible option for treating BM from sarcomas.

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Prognosticki faktori resektabilnog primarnog nemikrocelularnog karcinoma bronha

Acta chirurgica iugoslavica ◽

10.2298/aci0302061s ◽

2003 ◽

Vol 50 (2) ◽

pp. 61-70 ◽

Cited By ~ 1

Author(s):

Dragan Subotic ◽

Dragan Mandaric ◽

Ljiljana Andric ◽

Nikola Atanasijadis ◽

Milan Gajic

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Cox Regression ◽

Statistical Significance ◽

Univariate Analysis ◽

Tumor Location ◽

Tumor Diameter ◽

Incomplete Resection ◽

Cox Regression Analysis ◽

Tumor Pathology

This study represents the univariate and multivariate analysis of prognostic factors of resectable non small cell lung cancer (NSCLC) that included 360 patients who underwent a surgical treatment because of primary (NSCLC) in the aforementioned institution in a period between 1985 and 1992. Patients with incomplete resection were rejected, perioperative deaths were not included in the analysis. In the analyzed group there were 293(81.38%) males and 67(18.62%) females - M:F ratio 4.37:1. Age of the operated patients was 36-75 years with the mean age of 55.15 years. Right-sided tumours existed in 197(54.72%) patients, left-sided tumors in 163(45.28%) patients. Based on pTNM, 157, 65, 114, 18 and 6 patients were classified into stages I, II, IIIA, IIIB and IV respectively. In the univariate analysis, survival curves were obtained using the life table method, with the statistical analysis of the obtained data using the Gehan-Wilcoxon method. In the multivariate analysis - Cox regression analysis was performed. Multivariate analysis found only T-stage, N-stage and the stage of the disease as significant independent prognostic factors. Mode of influence of factors that were found significant in the univariate analysis (age >60 years, tumor diameter > 60 mm, involvement of the visceral pleura, indirect tumor signs) is discussed and compared with literature data. Survival differences depending on other factors (tumor location, bronchoscopic aspect, extent of the resection), although without statistical significance, can be useful for the clinician, in the same time contributing to the better comprehension of information's obtained by basical investigations, especially of lymphatic spread of the disease and tumor pathology.

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Can we identify a group of breast cancer patients with a good prognosis despite four or more positive (4+) axillary nodes using a tissue microarray (TMA)?

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.10582 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 10582-10582

Author(s):

S. J. Crabb ◽

C. D. Bajdik ◽

C. H. Speers ◽

D. G. Huntsman ◽

K. A. Gelmon

Keyword(s):

Breast Cancer ◽

Estrogen Receptor ◽

Prognostic Factors ◽

Statistical Significance ◽

Univariate Analysis ◽

Good Prognosis ◽

Axillary Lymph ◽

Long Term Outcome ◽

Cox Regression Analysis ◽

Axillary Nodes

10582 Background: Although breast cancer with 4+ axillary lymph nodes generally carries a poor prognosis, we hypothesized that a good prognostic subgroup of such patients would be identifiable by immunohistochemical (IHC) biomarkers. Methods: Patients with primary breast cancer with 4+ axillary nodes and no metastatic disease at diagnosis were identified from a large clinically annotated TMA of formalin-fixed paraffin-embedded archival breast cancers and analyzed for eight IHC based biomarkers: estrogen receptor, HER2, carbonic anhydrase IX, EGFR, CK 5/6, progesterone receptor, p53 and Ki67. Expression of each biomarker was scored 0 or 1 to indicate good or bad prognosis based on univariate analysis of relapse free survival (RFS). Patients were banded as having a total score of 0 (i.e. each biomarker predicted a good outcome), 1–4 or 5–8. Kaplan Meier and Cox regression analysis of RFS outcomes was performed. 10 year RFS for each band was compared to the mean of predicted outcomes based on the prognostic tool Adjuvant! ( www.adjuvantonline.com ). Results: 313 eligible patients were identified and complete data were available for 228. The subset of 228 was similar to the larger group of 313 with respect to RFS and conventional prognostic factors. 10 year RFS for the 228 patients was 39.5% (standard error, SE 3.4%). The subgroup of 37 (16%) scoring zero for all 8 biomarkers had a mean 10 year RFS of 77.6% (SE 7.0). Mean 10 year RFS for the bands scoring 1–4 (154 patients, 68%) and 5–8 (37 patients, 16%) were 34.9% (SE 4.1) and 19.0% (SE 6.9) respectively. Mean 10 year RFS predictions by Adjuvant! were 35.9% (SE 2.6), 34.5% (SE 1.2) and 34.3% (SE 2.3) respectively. In multivariate analysis with conventional prognostic factors, the banded biomarker score retained statistical significance for predicting RFS (p=0.0007) along with estrogen receptor status (p=0.03) and tumour size (p=0.01). Conclusions: This TMA biomarker panel identified a breast cancer subgroup with good prognosis despite extensive axillary node involvement. Long term outcome was markedly better than that predicted by conventional prognostic factors. If validated, treatment decisions and clinical trial stratification might be modified using this new score. No significant financial relationships to disclose.

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Multimodality treatment of pediatric and adult patients with Ewing sarcoma: A single-institution experience.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.10082 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 10082-10082

Author(s):

David Lorente ◽

Robert Diaz ◽

Barbara Torres ◽

Adela Cañete ◽

Jorge Aparicio ◽

...

Keyword(s):

Prognostic Factors ◽

Ewing Sarcoma ◽

Cox Regression ◽

Pulmonary Metastases ◽

Univariate Analysis ◽

Local Treatment ◽

High Dose ◽

Cox Regression Analysis ◽

Increased Risk ◽

Treatment Surgery

10082 Background: Treatment of Ewing sarcoma pts. usually follows pediatric protocols, both in children and in adults. However, older patients fare poorly in most series. We analyze our experience with the 2001 protocol of the Spanish Society of Pediatric Oncology. Methods: Retrospective analysis. Schema: 6 cycles (cy) of VIDE chemotherapy (CT: vincristine, ifosfamide, etoposide, doxorrubicin). If no progression, local treatment (surgery or RT) and consolidation adjusted to risk: VACx8 (vincristine, dactinomycin, ciclophosphamyde) in standard-risk pts; if increased risk (axial, complete response in lung metastases or non-pulmonary metastases) VACx1, high-dose CT (busulphan-melphalan) and autologous transplant (ATSP). Analysis: induction CT toxicity, pathological response rates, consolidation treatment, disease-free (DFS) and overall survival (OS) (Kaplan- Meier). Log-rank and Cox regression analysis of prognostic factors in OS. Results: 35 patients (01.2003-05.2011). 60% male. Median age 16 y (r 7-57). Axial (43%), extremities (34%), extra-osseous (18%) and ribs (9%). Metastases: 54% (lung 58%, bone 26%, others 12%). > 1 location: 29%. Induction CT: 83% received 6 cy. 6% early progressions and 3% toxic deaths. 196 cycles of CT. Dose reduction (etoposide) in 60%. Grade 3-4 toxicity: neutropenia 13%, anemia 14%, neutropenic fever 13%, diarrhoea-stomatitis 7%.Local treatment: surgery (49%), radiotherapy (29%), none (22%). In 17 resections, > 90% necrosis in 53%. Consolidation: VACx8 29%; VACx1-ATSP in 34%; 37% other treatments (progression). No ATSP-related mortality. Median follow-up: 36 m ( 5-101 m). Median DFS 25 m (16-34 m). Median OS 28 m (15-41 m), 3-year OS 40%. Median time to progression 7 m (0.4-15 m). Median OS from progression 7 m (0.4-15 m). Age < 15 years, a non-axial primary and no extra-pulmonary metastases were favourable prognostic factors in the univariate analysis. Conclusions: Induction CT with the VIDE regimen is feasible in most patients, with a low risk of early progression. Hematological toxicity is substantial but manageable. Adults patients have a worse prognosis compared to pediatric patients. Unfortunately, survival after progression is dismal.

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Cetuximab (CTX) in first-line treatment of elderly patients with metastatic colorectal cancer (mCRC), KRAS wild type: French multicentre prospective community-based registry and results.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.760 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 760-760

Author(s):

Laurent Mineur ◽

Eric François ◽

Jean Marc Phelip ◽

Rosine Guimbaud ◽

Carine Plassot ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Cox Regression ◽

Univariate Analysis ◽

Rank Test ◽

Wild Type ◽

Community Based ◽

Cox Models ◽

Cox Regression Analysis ◽

Effective Age

760 Background: Pts included in clinical trials represent the unusual population in mCRC. This study aims to provide oncologist with a better understanding of the potential benefit of CT with CTX in older patients with mCRC KRAS wild type and evaluate prognostic variables on the PFS including the age. Methods: Premium cancer study is a French multicentre prospective community-based registry. 493 pts enrolled and 487 included between September 2009 to March 2012 from 94 French centers and physicians. Pts had to provide written informed consent and protocol submitted to regulatory authorities. Predefined efficacy endpoints was PFS. CTX was administrated at 250 mg/m2 weekly (n=100; 20.3%) or 500 mg/m2 every 2 weeks (n=380;77,2%), other n=13; 2.5%) CT regimen choice was at physician’s discretion.. The main analysis is PFS as well as analysis of prognostic factors of this PFS (29 items including age (< 65 years n=229; 65-74 years n= 165.; ≥75years n=93). Univariate analysis was performed for each covariate, PFS was estimated by Kaplan-Meier curves and compared by log-rank test. univariable Cox regression analysis was used to assess the association between each variable and outcome. Multivariable stepwise Cox models were then fitted for final variable selection of prognostic factors on PFS. Results: Univariate significant prognostic factors for PFS are OMS (0-1 vs 2-3), Tobacco, Site of tumor (right vs other), Number of metastatic organ (1 vs 2-3), Resecability of metastatic disease defined before CT (definitively non resectable metastases vs possible resectable), Surgery of mCRC, folliculitis or xerosis or paronychia grade 0-1 vs 2-4. Age was unidentified as a prognostic factor in univariate analysis. Four factors were independently associated with a better PFS: xerosis [hazard ratio (HR0,651); 95% confidence interval (CI) 0,494-0,857], (WHO PS) 0–1 (HR0,519 ; 95% CI 0,371–0,726) and folliculitis (HR 0,711; 95% CI0,558–0,956) metastases surgery 0,287(CI 0,205-0,403). Conclusions: CTX in combination with standard CT is effective, age is not identified as a prognostic factor for the PFS. Both groups of pts based on age benefit from CTX.

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Incidence and Survival Trends of Bladder Rhabdomyosarcoma:A SEER-based Analysis of 125 Cases

10.21203/rs.3.rs-19828/v1 ◽

2020 ◽

Author(s):

Pin Li ◽

Huixia Zhou ◽

Hualin Cao ◽

Tao Guo ◽

Weiwei Zhu ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Time ◽

Clinical Outcomes ◽

Cox Regression ◽

Survival Curve ◽

Clinicopathological Characteristics ◽

Chi Square ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Significant Factors

Abstract Background To elucidate the bladder rhabdomyosarcoma clinicopathological characteristics and reveal the prognostic factors. Methods We screened data from SEER database (1975-2016) stratified by age group, evaluated the differences between groups with Chi-square and Fisher’s test, conducted the Kaplan-Meier survival analysis and plotted the survival curve. The significant factors were brought into Cox regression analysis and calculated the HR(95%CI). Results About half of the patients who develop bladder RMS will be younger than 2 years of age. Embryonal RMS account for 76% of all histopathology types. Age at diagnosis more than 16-y (HR=6.595,95%CI:3.62-12.01, p=7.04e-10), NOT embryonal rhabdomyosarcoma (HR=3.61, 95%CI:1.99-6.549, p =4.1e-06), without radiotherapy combined or surgery alone (HR=4.382, 95%CI:1.99-6.549, p =2.4e-05) and not performed the surgery (HR=2.982,95%CI:1.263-7.039, p =0.0126) were negatively correlated with 5-year survival time, while race( p =0.341), whether performed the lymphadenectomy( p =0.722) showed no influence on survival time. Cox regression results show that age, histology, SEER stage, treatment combined or alone influence the clinical outcomes. Conclusions We demonstrated the demographic and characteristic of bladder rhabdomyosarcoma, identified and excluded the prognostic factors for the 5-year overall survival and clinical outcomes.

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The effect of tumor subtype on survival and the graded prognostic assessment (GPA) for patients with breast cancer and brain metastases.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.238 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 238-238 ◽

Cited By ~ 1

Author(s):

P. W. Sperduto ◽

N. Kased ◽

D. Roberge ◽

R. Shanley ◽

S. T. Chao ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Brain Metastases ◽

Predictive Power ◽

Clinical Decision Making ◽

Cox Regression ◽

Rank Statistic ◽

Tumor Subtype ◽

Prognostic Assessment ◽

Graded Prognostic Assessment

238 Background: The Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast GPA by analyzing a larger cohort and tumor subtype. Methods: A multi-institutional retrospective database of 400 breast cancer patients treated for newly-diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression (MCR) and recursive partitioning analysis (RPA). Factors were weighted by magnitude of their regression coefficients to define the GPA index. A GPA score of 4.0 represents the best prognosis, 0.0, the worst. Results: Significant prognostic factors by MCR and RPA were Karnofsky Performance Status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60-80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0 was 3.4 (n=23), 7.7 (n=104), 15.1 (n=140) and 25.3 (n=133) months, respectively (p < 0.0001). See table. Among HER2-negative patients, being ER/PR-positive improved MST from 6.4 to 9.7 months whereas in HER2-positive patients, being ER/PR-positive improved MST from 17.9 to 20.7 months. The log-rank statistic (predictive power) was 110 for the Breast-GPA versus 55 for tumor subtype. Conclusions: The Breast-GPA documents wide variation in prognosis and shows clear separation between subgroups of patients with breast cancer and brain metastases. This tool will aid clinical decision-making and stratification of clinical trials. These data confirm the effect of tumor subtype on survival and show the Breast-GPA offers significantly more predictive power than the tumor subtype alone. [Table: see text]

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Prognostic Impact Of Comorbidity In Multiple Myeloma

Blood ◽

10.1182/blood.v122.21.5340.5340 ◽

2013 ◽

Vol 122 (21) ◽

pp. 5340-5340 ◽

Cited By ~ 1

Author(s):

Rafael Ríos Tamayo ◽

Joaquín Martínez López ◽

Manuel Jurado ◽

María Esther Clavero Sánchez ◽

Fátima López Jiménez ◽

...

Keyword(s):

Multiple Myeloma ◽

Prognostic Factors ◽

Liver Disease ◽

Plasma Cell ◽

Cox Regression ◽

Conflicts Of Interest ◽

Statistical Significance ◽

Univariate Analysis ◽

Prognostic Impact ◽

Alcoholic Fatty Liver

Abstract Multiple myeloma (MM) is a heterogeneous disease. Evaluation of prognostic factors and risk stratification at diagnosis is necessary to compare outcome. Attempts have been made to apply a comorbidity score in the clinical sitting, but a standardized general approach is still lacking. We hypothesized that a comprehensive examination of every associated disease in a large cohort of patients could better highlight the prognostic impact of comorbidity in MM. All consecutive patients diagnosed in our institution, from 1993 to 2013, with symptomatic MM according to IMWG criteria were included in our population-based MM registry. Patients with plasma cell leukemia or with palliative management were excluded. Clinical variables analyzed were: age, sex, Durie-Salmon, International Scoring System (ISS), percentage of plasma cell in bone marrow by morphology (PC), serum creatinine (Cr) and estimated glomerular filtration rate according with Modification of Diet in Renal Disease (eGFR-MDRD). The following comorbodities were analysed: hypertension (HTA), diabetes (DM), obesity (OB) (body mass index > 30 Kg/m2), hyperlipaemia (HL), prior malignancy (PM), hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), peptic ulcer (PU), thromboembolism (TE), renal transplant (RT), splenectomy (S), cutaneous disease (CD), amyloidosis (AM), heart disease (HD) (arrhythmia, congestive heart failure, coronary artery disease, other), lung disease (LD) (chronic obstructive pulmonary disease, asthma, other), liver disease (HE) (cirrhosis, non-alcoholic fatty liver disease, other), neurological disorder (ND), psychiatric disorder (PD) and rheumatologic disorder (RD). Kaplan-Meier method was used to estimate OS curves. Cox regression was used to determine the prognostic impact of each comorbidity in a univariate and multivariate model. 311 patients were eligible. Median age was 66 years (12-91), 148 men (47.6 %) and 163 women. Percentage of comorbidities was: HTA 45; OB 32.5; DM 20.4; HD 20.4; LD 15.2; PU 10; HL 9.7; ND 8; PM 7.8; PD 6.5; HBV 3.9; HE 3.9; TE 3.6; RD 3,5; AM 2.3; HCV 1.9; CD 1.6; S 1; RT 0.6; HIV 0.3. 63 patients (20.4 %) showed no comorbidities. Univariate analysis (table 1) demonstrated that AM (P=0.022), HCV (0.038), HIV (0.022), PD (0.015) and ND (0.05) were significantly associated with shorter OS. The variables associated with mortality in the multivariate analysis were age (p=0.002), ISS (III vs I: p=0.01), PC (p=0.05) and Cr (p=0.02). Results will be validated in another MM series and presented during the meeting. The overall prognosis of MM depends on a variety of host and disease-related characteristics. We confirm age, ISS, PC and Cr as robust and independent prognostic factors. Adjusting for these factors, no isolated comorbidity reach statistical significance; however, comorbidity seems to have a role in MM prognosis. More studies are warranted to define the prognostic impact of comorbidities in MM. Disclosures: No relevant conflicts of interest to declare.

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Treatment of cancer of the anal canal. The Hamburg experience

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14062 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14062-14062

Author(s):

V. Rudat ◽

S. Streller ◽

D. Rades

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Anal Canal ◽

Survival Data ◽

Cox Regression ◽

Haemoglobin Concentration ◽

International Standards ◽

Surgical Approaches ◽

Rank Test ◽

Cox Regression Analysis

14062 Background: To compare surgical and non-surgical treatment approaches for anal cancer and to identify prognostic factors. Methods: Survival data of 214 patients with cancer of the anal canal were reviewed who were referred for radiotherapy to the Department of Radiation Oncology of the University of Hamburg, Germany between 1/88 and 3/05. 75 patients received a definitive radiochemotherapy (RCT) with 5-FU and MMC according to international standards, 43 an operation followed by RCT (OP+RCT), 37 an operation followed by irradiation (OP+RT), 25 an irradiation alone (RT) and 34 an operation alone because they refused a planned adjuvant RCT or RT. The operations had been performed by different referring hospitals in and around Hamburg. Results: The median follow-up time of the living patients was 67 months (1–200 months). The 10 year overall survival rate for RCT was 0.62 (95%CI 0.46–0.77), for OP+RCT 0.65 (95%CI 0.47–0.83), for OP+RT 0.55 (95%CI 0.37–0.74), for OP alone 0.51 (95%CI 0.26–0.75) and for RT alone 0.27 (95%CI 0.05–0.48). There was no statistical difference between the overall survival of patients who received RCT, OP+RCT and OP+RT according to Kaplan Meier analysis (log rank test, p = 0.71). Cox regression analysis was used to examine the simultaneous influence of the prognostic factors T, N, age, haemoglobin concentration before radiotherapy, gender, and grading on the survival of patients who were treated with RCT. The model (p = 0.015) revealed T and N to be the only statistically significant prognostic factors. Conclusions: The different surgical and non-surgical approaches to treat cancer of the anal canal in Hamburg obviously reflect the individual preferences of the different physicians. Statistical analysis did not show a benefit of an OP added to RCT. Prognostic factors for survival after RCT were the T- and N-stage. No significant financial relationships to disclose.

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Prognostic factors for survival in patients with mucosal and ocular melanoma treated with ipilimumab: Turkish Oncology Group study

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219840796 ◽

2019 ◽

Vol 26 (2) ◽

pp. 267-272 ◽

Cited By ~ 1

Author(s):

H Arzu Yaşar ◽

Hande Turna ◽

Ece Esin ◽

A Murat Sedef ◽

Ali Alkan ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Lactate Dehydrogenase ◽

Treatment Response ◽

Uveal Melanoma ◽

Survival Data ◽

Univariate Analysis ◽

Mucosal Melanoma ◽

Kit Mutation ◽

Cox Regression Analysis

Objective To evaluate prognostic factors associated with the use of ipilimumab in patients with mucosal and uveal melanoma. Methods In this multicenter, retrospective study, 31 patients with uveal and mucosal melanoma diagnosed between 2010 and 2017 were enrolled. Patients’ characteristics, metastatic disease sites, treatment before ipilimumab therapy, performance status, hemoglobin, lactate dehydrogenase levels, B-RAF and c-kit mutation status, toxicity, and survival data were assessed for patients with mucosal and uveal melanoma. SPSS version 17 was used for statistical analysis. Kaplan–Meier method was used for survival analysis. The log-rank test was used for univariate analyses. The Cox regression analysis was used to test the association between multivariate variables and survival. The p-value of less than 0.05 was considered statistically significant. Results Twenty patients had uveal and eleven patients had mucosal melanoma. The median overall survival was seven months (95% confidence interval: 1.1–12.7). In univariate analysis, while bone metastasis, anemia, high lactate dehydrogenase level, and more metastatic sites were associated with lower overall survival, better treatment response and administration of ipilimumab in first or second lines were associated with favorable overall survival. In multivariate analysis, only treatment response status and administration of ipilimumab in first or second lines were found to be significant as independent prognostic factors for survival. Conclusion Ipilimumab therapy may be associated with increased survival, but this retrospective small N study makes that hard to definitely conclude.

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Prognostic Significance of Clusterin Expression in Advanced-Stage Cervical Cancer Treated With Curative Intended Radiotherapy

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31821a03d9 ◽

2012 ◽

Vol 22 (3) ◽

pp. 465-470 ◽

Cited By ~ 3

Author(s):

Hidemichi Watari ◽

Rumiko Kinoshita ◽

Yimin Han ◽

Lei Wang ◽

Masayoshi Hosaka ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Cox Regression ◽

Univariate Analysis ◽

Prognostic Significance ◽

Advanced Stage ◽

Histologic Type ◽

Clinicopathological Factors ◽

Cox Regression Analysis

ObjectiveOverexpression of clusterin (CLU), an antiapoptotic molecule, has been reported to induce resistance to radiotherapy (RT) in a variety of cancer cell types. The aim of this study was to evaluate the significance of CLU expression to predict survival of patients with advanced-stage cervical cancer who received curative intended RT.MethodsBiopsy tissue specimens of advanced-stage cervical cancer before curative intended RT were obtained from 34 patients who were treated at Hokkaido University Hospital between 1998 and 2008 and whose complete medical records were available. The expression of CLU protein was analyzed by immunohistochemistry. Findings were evaluated in relation to several clinicopathological factors. Survival analyses were performed using the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis.ResultsClusterin protein was mainly present in the cytoplasm of cervical cancer cells. The expression of CLU protein in cervical cancer tissues before curative intended RT was not significantly related to any clinicopathological factors analyzed, including age, clinical stage, histologic type, and response to RT. Univariate analysis on prognostic factors showed that histologic type (P= 0.001), and CLU expression (P= 0.02) were related to survival. Multivariate analysis revealed that both histologic type (P= 0.002), and CLU expression (P= 0.02) were independent prognostic factors for overall survival.ConclusionWe conclude that CLU could be a new molecular marker to predict overall survival of patients with advanced-stage cervical cancer treated with curative intended RT.

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