scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

2020 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Jie Liu
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Bone Metastases ◽  
Cox Regression ◽  
Molecular Subtype ◽  
Stage Iv ◽  
Cox Proportional Hazards Model ◽  
Significant Prognostic Factor ◽  
Cancer Stage ◽  
Cox Regression Analysis

Abstract Background : Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer. Methods : Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square, overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model. Results : A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer stage IV patients are significant differences ( p <0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270 ), black race ( HR=1.317 ), grade in III or IV ( HR=1.960 ), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), live metastases (HR=2.085), brain metastases (HR=1.903) are independent risk factors of prognosis; married (HR=0.819 ), HR+/HER2+ (HR=0.631 ), HR-/HER2+ (HR=0.716), insurance (HR=0.587 ) and surgery (HR=0.504) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95%CI: 0.485-0.992）,but interaction between race and substype did not reach significance on prognosis. Conclusions : There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases) on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation. Keywords : Breast cancer, Bone metastases, Tumour subtype, Prognosis factor, Survival

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

2020 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Jie Liu
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Bone Metastases ◽  
Cox Regression ◽  
Molecular Subtype ◽  
Stage Iv ◽  
Cox Proportional Hazards Model ◽  
Significant Prognostic Factor ◽  
Cancer Stage ◽  
Cox Regression Analysis

Abstract Background: Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square. Overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model.Results: A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer stage IV patients are significant differences (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade in III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), live metastases (HR=2.085), brain metastases (HR=1.903) are independent risk factors of prognosis; married (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95%CI: 0.485-0.992), but interaction between race and substype did not reach significance on prognosis. Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases) on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation.

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

2020 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Jie Liu
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Bone Metastases ◽  
Cox Regression ◽  
Stage Iv ◽  
Cox Proportional Hazards Model ◽  
Significant Prognostic Factor ◽  
Cancer Stage ◽  
Cox Regression Analysis ◽  
Stage Iv Breast Cancer

Abstract Introduction : Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking.The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of stage IV breast cancer. Methods : Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square, overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model. Results : A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different subtype of breast cancer stage IV patients are significant differences ( p <0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270 ), black race (HR=1.317 ), grade in III/IV ( HR=1.960 ), HR-/HER2- (HR=2.808 ), lung metastases (HR=1.378 ), live metastases ( HR= 2.085 ), brain metastases (HR=1.903 ) are independent risk factors of prognosis; married ( HR=0.819 ), HR+/HER2+ (HR= 0.631 ), HR-/HER2+ (HR= 0.716 ), insurance ( HR=0.587 ) and surgery (HR=0.504 ) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases , HR=0.694 , 95%CI: 0.485 -0.992 on prognosis. Conclusions : There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases ）on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation.

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

2019 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Jie Liu
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Cox Regression ◽  
Molecular Subtype ◽  
Cox Proportional Hazards Model ◽  
Significant Prognostic Factor ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis

Abstract Background: Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer. Methods: Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate patients with bone metastases in breast cancer. Patients characteristic according subtypes were compared using chi-square, overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model. Results: A total of 3384 patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer patients are significant differences (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 ( HR=1.270 ), black race ( HR=1.320 ), grade in III or IV ( HR=1.952 ), HR-/HER2- ( HR=2.727), lung metastases (HR=1.249), live metastases (HR=1.840), brain metastases (HR=1.812) only bone metastases ( HR=1.237) are independent risk factors of prognosis; married ( HR=0.812 ), HR+/HER2+ ( HR=0.618 ), HR-/HER2+ (HR=1.237), insurance ( HR=0.597 ) and surgery (HR=0.512) are independent protection factors of prognosis. Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. Tumour subtype, as a significant prognostic factor, warrant further investigation. Keywords: Breast cancer, Bone metastases, Tumour subtype, Prognosis factor, Survival

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

2020 ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Shen Yin Zhong ◽  
Jie Liu
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Cox Regression ◽  
Stage Iv ◽  
Cox Proportional Hazards Model ◽  
Significant Prognostic Factor ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Stage Iv Breast Cancer

Abstract Background: Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively.Results: A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at five years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), liver metastases (HR=2.085), and brain metastases (HR=1.903) were independent risk factors for prognosis; married status (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95% CI: 0.485-0.992), but the interaction between race and subtype did not reach significance for prognosis.Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao Li ◽  
Xiaoli Zhang ◽  
Jie Liu ◽  
Yinzhong Shen
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Cox Regression ◽  
Stage Iv ◽  
Significant Prognostic Factor ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Stage Iv Breast Cancer

Abstract Background Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer. Methods Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively. Results A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR−/HER2-, and 7.39% were HR−/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at 5 years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p < 0.05). Multivariate Cox regression analysis showed that age of 55–59 (HR = 1.270), black race (HR = 1.317), grade III or IV (HR = 1.960), HR−/HER2- (HR = 2.808), lung metastases (HR = 1.378), liver metastases (HR = 2.085), and brain metastases (HR = 1.903) were independent risk factors for prognosis; married status (HR = 0.819), HR+/HER2+ (HR = 0.631), HR−/HER2+ (HR = 0.716), insurance (HR = 0.587) and surgery (HR = 0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR = 0.694, 95% CI: 0.485–0.992), but the interaction between race and subtype did not reach significance for prognosis. Conclusions There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

scholarly journals Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

2020 ◽  
Author(s):  
Xiao Li ◽  
XiaoLi Zhang ◽  
Jie Liu ◽  
Shen Yin Zhong
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Cox Regression ◽  
Stage Iv ◽  
Significant Prognostic Factor ◽  
Breast Cancer Patients ◽  
Cox Regression Analysis ◽  
Stage Iv Breast Cancer

Abstract Background: Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively.Results: A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at five years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), liver metastases (HR=2.085), and brain metastases (HR=1.903) were independent risk factors for prognosis; married status (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95% CI: 0.485-0.992), but the interaction between race and subtype did not reach significance for prognosis.Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

Breast cancer molecular subtypes association with clinical outcomes and race.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12575-e12575 ◽  
Author(s):  
Ramses F. Sadek ◽  
Li fang Zhang ◽  
Houssein Talal Abdul Sater
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Cancer Stage ◽  
Luminal A ◽  
Luminal B ◽  
Race Disparity

e12575 Background: Breast Cancer (BC) has been classified into four subtypes: Luminal A (LABC), Luminal B (LBBC), Triple negative (TNBC) and HER2-enriched (HER2e). BC mortality in Black women is significantly higher than in Whites and Asians. BC in Blacks has been characterized by higher grade and later stage. Causes of the Black-White BC survival disparity have been investigated, including differences in: diagnostic stage, socioeconomics, and comorbidities. These have led researchers to investigate the differences in tumor molecular subtype and their association with clinical outcomes and races. Methods: This study used the Surveillance, Epidemiology, and End Results – 18 (SEER-18) Registries research data between 2010 and 2013 that included over 212,000 patients. Descriptive statistics, Odds ratios (OR) and 95%Confidence intervals (CI) were used to study the association between BC stage, grade, and mortality and BC molecular subtypes across different races. We employed Cox regression models to explore the race disparity in BC mortality before and after controlling for BC molecular subtype and other clinical and social factors. Results: TNBC had more high grade cancer compared to HER2e subtype (OR, 1.5; CI, 1.3 - 1.8), LBBC (OR, 4.5; CI, 4.0 - 5.0) and LABC (OR, 12.2; CI, 11.2 – 13.3) for Black. BC mortality was higher in TNBC subtype compared to HER2e subtype (OR, 1.3; CI, 1.1 - 1.6), LBBC (OR, 2.4; CI, 2.0 - 2.9), and LABC (OR, 2.8; CI, 2.4 – 3.2) for Blacks. Results are consistent for all races. HER2e subtype had more late cancer stage compare to LBBC (OR, 1.2; CI, 1.0 - 1.4), TNBC (OR, 1.4; CI, 1.2 - 1.6) and LABC (OR, 2.1; CI, 1.8 - 2.4) in Blacks with similar results in all races. BC mortality in Blacks was higher compare with Whites (HR, 1.9; CI, 1.8 - 2.0) and Asian (HR, 2.7; CI, 2.5 - 3.0). After controlling for cancer subtype and other factors in the Cox regression model, the corresponding HRs ware significantly decreased to 1.2 (CI, 1.1 -1.3) and 1.6 (9CI, 1.5 -1.8). Blacks have heighst percent in stage IV and grade higer grade of disease. Conclusions: Molecular subtypes of BC contribute differently to risks of late cancer stage, high cancer grade and BC specific mortality. These differences are consistent in all races. The molecular subtypes and other social and clinical factors may explain part of the BC mortality race disparity.

Limited M1 Disease: A Significant Prognostic Factor for Stage IV Breast Cancer

2012 ◽  
Vol 19 (9) ◽  
pp. 3028-3034 ◽  
Author(s):  
David H. A. Nguyen ◽  
Pauline T. Truong ◽  
Caroline V. Walter ◽  
Emily Hayashi ◽  
Jennifer L. Christie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Stage Iv ◽  
Significant Prognostic Factor ◽  
Stage Iv Breast Cancer

scholarly journals The prognostic value of androgen receptor (AR) in HER2-enriched metastatic breast cancer

2020 ◽  
Vol 27 (4) ◽  
pp. 199-208 ◽  
Author(s):  
Xinyue Wang ◽  
Xiwen Bi ◽  
Zhangzan Huang ◽  
Jiajia Huang ◽  
Wen Xia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Metastatic Breast Cancer ◽  
Androgen Receptor ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Metastatic Breast ◽  
Independent Prognostic Factor ◽  
First Line ◽  
Cox Regression Analysis

The significance of androgen receptor (AR) in metastatic breast cancer (MBC) remains unclear, and it is still largely unknown how AR expression level influences HER2-positive tumors. This study aimed to investigate the prognostic and predictive value of AR in HER2-enriched MBC. Primary and/or paired metastatic tumors of 304 patients with pathologically confirmed HER2-enriched MBC were collected and immunohistochemically assessed for AR expression. The associations of AR and other clinicopathological characteristics were compared using the Chi-square test. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan–Meier method and log-rank test. Cox regression analysis was used to determine independent prognostic factors. AR-positivity with a cut-off value of 10% was observed in 237 (78.0%) cases and was associated with longer PFS, 13.2 months, as compared to that of 8.2 months (P = 0.004) in patients with AR-negativity. Moreover, a significant increase in the 5-year OS rate (65.3% vs 36.2%, P < 0.001) was also observed for patients with AR-positive tumors. Cox regression analysis identified AR-positivity as an independent prognostic factor of both PFS (hazard ratio = 0.71, P = 0.039) and OS (HR = 0.53, P = 0.013). Additionally, for those who received first-line Trastuzumab therapies, prolonged PFS (15.8 months vs 8.2 months, P = 0.005) and 5-year OS rate (66.2% vs 26.2%, P = 0.009) were observed in AR-positive tumors compared to AR-negative ones. In conclusion, AR was identified as an independent prognostic factor for favorable PFS and OS and could also predict the efficacy of first-line Trastuzumab treatment in patients with HER2-enriched MBC.

scholarly journals Clinical Significance of Pre-to-Postoperative Dynamics of Aspartate Transaminase/Alanine Transaminase Ratio in Predicting the Prognosis of Renal Cell Carcinoma after Surgical Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Minyong Kang ◽  
Seung Jea Shin ◽  
Hyun Hwan Sung ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Cox Regression ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Group 2

Background. This study is aimed at examining the prognostic role of pre-to-postoperative dynamics of De Ritis ratio (aspartate aminotransaminase (AST)/alanine aminotransaminase (ALT)) in patients with nonmetastatic renal cell carcinoma (RCC) following radical nephrectomy. Methods. We retrospectively reviewed the records of 670 patients who underwent radical nephrectomy for nonmetastatic RCC between 1996 and 2012 at our institution. The cutoff points for preoperative (=1.0) and postoperative AST/ALT ratios (=1.12) were assigned based on the median values. We categorized patients into four groups according to the dynamics of AST/ALT ratios: group 1 (lower (≤1.0) ⟶ lower (≤1.12)), group 2 (lower (≤1.0) ⟶ higher (>1.12)), group 3 (higher (>1.0) ⟶ lower (≤1.12)), and group 4 (higher (>1.0) → higher (>1.12)). Results. When grouped by a preoperative AST/ALT ratio alone, the groups were not statistically different in cancer-specific survival (CSS) or overall survival (OS). In contrast, in Kaplan-Meier analysis, CSS (P=0.0296) and OS (P=0.0324) were both significantly shorter with an increased postoperative AST/ALT ratio. According to the pre-to-postoperative dynamics of the AST/ALT ratio, group 2 (lower (≤1.0) ⟶ higher (>1.12)) had a significantly lower CSS (P=0.0028) and OS (P=0.0194) than the other groups. On multivariate Cox regression analysis, the pre-to-postoperative dynamics of the AST/ALT ratio were a significant prognostic factor for CSS (hazard ratio, HR=3.45) and OS (HR=2.18). Conclusion. This study is the first to suggest that the dynamics of the pre-to-postoperative De Ritis ratio represent an independent prognostic factor for RCC patients following nephrectomy.

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