scholarly journals The effect of cytoreductive partial nephrectomy in elderly patients with metastatic renal cell carcinoma：a systematic review

2019 ◽  
Author(s):  
Wei Zhuang ◽  
Jiabi Chen ◽  
Yining Li ◽  
Xiaoping Su
Keyword(s):  
Partial Nephrectomy ◽  
Tumor Size ◽  
Renal Cell ◽  
Term Survival ◽  
Factors Affecting ◽  
Kaplan Meier ◽  
N Stage ◽  
Independent Risk Factors ◽  
Male Patients ◽  
Cox Analysis

Abstract Background To explore the survival value of cytoreductive partial nephrectomy (cPN) in elderly metastatic renal cell carcinoma (EmRCC).Methods RCC patients aged ≥65 years from 2010 to 2015 in The Surveillance, Epidemiology and End Result database (SEER) were analyzed using Kaplan-Meier (K-M) method and multivariate COX analysis. Propensity score matching (PSM) was performed to balance effects of confounding factors such as general features and pathological features. We were committed to study the long-term survival advantages of cPN patients, explore the appropriate population of cPN, and try to establish a Nomogram model to predict individual survival.Results In EmRCC patients, especially in male patients with tumors size ≦7cm, N0 stage, or isolated metastases, cPN brought a better survival than cytoreductive radical nephrectomy (cRN). Tumor size and N stage were independent risk factors affecting the survival of cPN patients, cPN in patients with tumor size >7cm or N1 stage may present a higher risk of death.Conclusions The implementation of cPN in EmRCC patients who meet specific clinical characteristics like tumors size ≦7cm, N0 stage, or isolated metastases seems to help improve the tumor outcomes.

scholarly journals Predictors of outcome in pleomorphic xanthoastrocytoma

2020 ◽  
Author(s):  
Antonio Dono ◽  
Victor Lopez-Rivera ◽  
Ankush Chandra ◽  
Cole T Lewis ◽  
Rania Abdelkhaleq ◽  
...  
Keyword(s):  
Tumor Size ◽  
Postoperative Radiotherapy ◽  
Treatment Strategies ◽  
Pleomorphic Xanthoastrocytoma ◽  
Survival Outcomes ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Male Patients

Abstract Background Pleomorphic xanthoastrocytomas (PXA) are circumscribed gliomas that typically have a favorable prognosis. Limited studies have revealed factors affecting survival outcomes in PXA. Here, we analyzed the largest PXA dataset in the literature and identify factors associated with outcomes. Methods Using the Surveillance, Epidemiology, and End Results (SEER) 18 Registries database, we identified histologically confirmed PXA patients between 1994 and 2016. Overall survival (OS) was analyzed using Kaplan-Meier survival and multivariable Cox proportional hazard models. Results In total, 470 patients were diagnosed with PXA (males = 53%; median age = 23 years [14-39 years]), the majority were Caucasian (n = 367; 78%). The estimated mean OS was 193 months [95% CI: 179-206]. Multivariate analysis revealed that greater age at diagnosis (≥39 years) (3.78 [2.16-6.59], P < .0001), larger tumor size (≥30 mm) (1.97 [1.05-3.71], P = .034), and postoperative radiotherapy (RT) (2.20 [1.31-3.69], P = .003) were independent predictors of poor OS. Pediatric PXA patients had improved survival outcomes compared to their adult counterparts, in which chemotherapy (CT) was associated with worse OS. Meanwhile, in adults, females and patients with temporal lobe tumors had an improved survival; conversely, tumor size ≥30 mm and postoperative RT were associated with poor OS. Conclusions In PXA, older age and larger tumor size at diagnosis are risk factors for poor OS, while pediatric patients have remarkably improved survival. Postoperative RT and CT appear to be ineffective treatment strategies while achieving GTR confer an improved survival in male patients and remains the cornerstone of treatment. These findings can help optimize PXA treatment while minimizing side effects. However, further studies of PXAs with molecular characterization are needed.

Does pathologic upstaging to PT3A portend a worsened prognosis when compared to non-upstaged PT3A renal cell carcinoma: Analysis of the National Cancer Database.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 624-624
Author(s):  
Devin Patel ◽  
Fady Ghali ◽  
Margaret Meagher ◽  
Aaron Bradshaw ◽  
Sunil Patel ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
National Cancer Database ◽  
Kaplan Meier ◽  
Incident Cases ◽  
The Impact

624 Background: Pathological T3a (pT3a) renal cell carcinoma (RCC) is often diagnosed at the time of final pathological analysis, though impact of lack pre-treatment detection on surgical outcomes is unclear. We sought to compare outcomes of pathologically upstaged pT3a RCC with pT3a RCC recognized clinically. Methods: We queried the National Cancer Database for incident cases of pT3a pN0/x pM0/x renal cell carcinoma (RCC) treated with radical (RN) or partial nephrectomy (PN) between 2009-2015. Tumors were staged using the AJCC staging system, 7th edition. Pathologically upstaged tumors were defined as those that had a clinical stage of T1 or T2. Non-upstaged tumors had a clinical stage of T3a. Multivariable Cox proportional hazards and Kaplan-Meier survival analysis were performed to study the impact of clinical to pathological upstaging in pT3a tumors on overall survival (OS) in patients treated with RN and PN. Results: A total of 19,538 pT3a tumors were identified of which 7,231 (37%) had concordant clinical stage (non-upstaged) and 12,307 (63%) had lower clinical stage (upstaged). Patients with upstaged tumors had longer time from diagnosis to surgery (31.5 vs. 23.8 days; p<0.001), smaller tumor size (6.7 vs. 7.4 cm; p<0.001), higher rates of treatment with partial nephrectomy (18% vs. 11%; p<0.001), and higher rates of negative margins (92% vs. 89%; p<0.001). On multivariate analysis, age (HR 1.06; p<0.001), Charlson Comorbidity Index (HR 1.51; p=0.006) and positive margin status (HR 1.55; p<0.001) were associated with worse OS. Pathological upstaging was an independent predictor of improved OS following both PN (HR 0.74; 95% CI 0.59-0.91; p=0.006) and RN (HR 0.87; 95% CI 0.82-0.93; p<0.001). Kaplan-Meier analysis showed higher OS for tumors that were upstaged following both PN (5-year OS 73 vs. 70%; p=0.0083) and RN (5-year OS 67 vs. 64%; p<0.001). Conclusions: Most pT3a RCC are pathologically upstaged. Pathological pT3a tumors that were correctly detected clinically were associated with worsened outcomes. While our findings require further confirmation, they call for consideration and refinement of risk stratification protocols in pT3a RCC.

Impact of tumor size on the long-term survival of patients with early stage renal cell cancer

2005 ◽  
Vol 23 (1) ◽  
pp. 50-54 ◽  
Author(s):  
M. Kuczyk ◽  
G. Wegener ◽  
A. S. Merseburger ◽  
A. Anastasiadis ◽  
S. Machtens ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Tumor Size ◽  
Renal Cell ◽  
Early Stage ◽  
Cell Cancer ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Overexpression of KIAA1199 is an independent prognostic marker in laryngeal squamous cell carcinoma

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9637
Author(s):  
Meixiang Huang ◽  
Feifei Liao ◽  
Yexun Song ◽  
Gang Zuo ◽  
Guolin Tan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Protein Expression ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Clinical Stage ◽  
Rt Pcr ◽  
Independent Prognostic Marker ◽  
Kaplan Meier ◽  
Tumor Tissues ◽  
N Stage ◽  
Cox Analysis

Background KIAA1199 is a recently identified novel gene that is upregulated in various human cancers with poor survival, but its role and the underlying mechanisms in laryngeal squamous cell carcinoma (LSCC) remain unknown. Here, we collected tissues from 105 cases of LSCC to investigate the relationships between KIAA1199 protein expression and clinical factors. Methods Western blotting and real-time quantitative PCR (RT-PCR) were used for detect the protein and mRNA expression of KIAA1199 in LSCC tissue. Immunohistochemistry (IHC) staining was used to detect the expression of KIAA1199. Patient clinical information, for instance sex, age, pathological differentiation, clinical region, T stage, N stage, clinical stage, operation type, neck lymph dissection, smoking status, and drinking status were recorded. Kaplan–Meier survival analysis and Cox analysis were applied to identify the relationship between KIAA1199 and LSCC. Results Western blotting results showed KIAA1199 protein was significantly higher in tumor tissues vs. adjacent non-cancerous tissues (0.9385 ± 0.1363 vs. 1.838 ± 0.3209, P = 0.04). The KIAA1199 mRNA expression was considerably higher in tumor tissues (P < 0.001) than in adjacent non-cancerous tissues by RT-PCR. IHC results showed up-regulated KIAA1199 expression was related with some severe clinicopathological parameters: pathologic differentiation (P = 0.002), T stage (P < 0.001), N stage (P < 0.001), clinical stage (P < 0.001), survival time (P = 0.008) and survival status (P < 0.001). Kaplan–Meier survival analysis showed that patients with high KIAA1199 protein expression had poor overall survival (OS) (P < 0.05). Cox analysis suggested that the KIAA1199 protein expression constituted an independent prognostic marker for LSCC patients (P < 0.001). Conclusion Our findings revealed that KIAA1199 protein expression may be used to predict LSCC patient outcome.

scholarly journals Impact of gender on the survival of patients with glioblastoma

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Minjie Tian ◽  
Wenying Ma ◽  
Yueqiu Chen ◽  
Yue Yu ◽  
Donglin Zhu ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Survival Data ◽  
Cox Regression ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Kaplan Meier ◽  
Male Patients ◽  
Stratified Analysis ◽  
The Impact

Background: Preclinical models have suggested a role for sex hormones in the development of glioblastoma multiforme (GBM). However, the impact of gender on the survival time of patients with GBM has not been fully understood. The objective of the present study was to clarify the association between gender and survival of patients with GBM by analyzing population-based data. Methods: We searched the Surveillance, Epidemiology, and End-Results database who were diagnosed with GBM between 2000 and 2008 and were treated with surgery. Five-year cancer specific survival data were obtained. Kaplan–Meier methods and multivariable Cox regression models were used to analyze long-term survival outcomes and risk factors. Results: A total of 6586 patients were identified; 61.5% were men and 38.5% were women. The 5-year cancer-specific survival (CSS) rates in the male and female groups were 6.8% and 8.3%, respectively (P=0.002 by univariate and P<0.001 by multivariate analysis). A stratified analysis showed that male patients always had the lowest CSS rate across localized cancer stage and different age subgroups. Conclusions: Gender has prognostic value for determining GBM risk. The role of sex hormones in the development of GBM warrants further investigation.

Does Histologic Grade Have a Role in the Management of Head and Neck Cancers?

2001 ◽  
Vol 19 (21) ◽  
pp. 4107-4116 ◽  
Author(s):  
André Fortin ◽  
Christian Couture ◽  
René Doucet ◽  
Michele Albert ◽  
Josée Allard ◽  
...  
Keyword(s):  
Head And Neck ◽  
Independent Predictor ◽  
Cox Model ◽  
Postoperative Radiotherapy ◽  
Distant Metastases ◽  
Histologic Grade ◽  
Kaplan Meier ◽  
N Stage ◽  
Grade 3 ◽  
Cox Analysis

PURPOSE: High histologic grade is usually associated with a greater propensity to distant metastases (DM). Its role to predict DM in head and neck cancer is not yet defined. The aim of this study is to evaluate the role of histologic grade as an independent predictor of DM and to determine a subgroup of patients who may benefit from systemic chemotherapy. PATIENTS AND METHODS: This is a retrospective study of 1,266 consecutive patients treated by definitive or postoperative radiotherapy between 1989 and 1997. All patients received at least 50 Gy. All stages and subsites of head/neck were included. DM rates were evaluated by the Kaplan-Meier method with a subsequent Cox analysis. RESULTS: There is a strong correlation of grade with N stage (P < .000001). The metastases-free survival (MFS) was 98%, 90%, and 72% for grades 1, 2, and 3, respectively (P < .000001). In patients with N0 stage, MFS is always greater than 90%, whatever the grade. In the 222 N1 patients, MFS was more than 90% in grade 1 and 2 but dropped to 75% for grade 3 (P = .001). In patients with N2 and N3, MFS was 91%, 79%, and 59% for grades 1, 2, and 3, respectively (P = .008). The same conclusion is applicable when only patients with neck control are analyzed. In a Cox model, grade was an independent predictor of DM (P = .000001) as well as T stage (P = .003), N stage (P = .000001), and neck failure (P = .0003). Higher grade was also an independent predictor of survival (P = .02). CONCLUSION: Patients with histologic grade 1 and grade 2 (except N3) are at low risk of DM. Patients with grade 2 and N3 or patients with grade 3 and N1 to N3 have a higher risk of distant metastases and should be considered for systemic treatment.

scholarly journals Influences of Tumor Size and Pleural Layer Invasion on the Prognosis of Patients with Stage IB Lung Adenocarcinoma

2021 ◽  
Author(s):  
Qihai Sui ◽  
Jiaqi Liang ◽  
Zhengyang Hu ◽  
Xinming Xu ◽  
Zhencong Chen ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Tumor Size ◽  
Validation Cohort ◽  
Cox Model ◽  
Histological Grade ◽  
Clinical Factors ◽  
Stage Ib ◽  
Kaplan Meier ◽  
Independent Risk Factors ◽  
University Department

Abstract Backgroud: Lung adenocarcinoma (ADC) at stage IB has its own prognostic characteristics. This study aimed to investigate the clinical factors that may affect the prognosis of patients with stage IB ADC.Methods: The data of ADC cases were selected from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2016) and patients in Zhongshan Hospital Affliated to Fudan University (Department of Thoracic Surgery, 2015-2016). Kaplan-Meier method was used to obtain the overall survival (OS). Factors that significantly related to the prognosis were evaluated by univariate and multivariate analysis (UVA, MVA) using the Cox model. A nomogram was developed and validated to predict the 3-year OSs of those patients.Results: 7605 patients with stage IB ADC were included ultimately and were divided into 2 groups, a training cohort (n = 5,324) and a test cohort (n = 2,281). Besides, there was a validation cohort (n = 272) for the verification of the nomogram model. Those with significantly older age, male, the white race, lower grades of tumor differentiation, larger tumor size (31-40mm) without pleural layer (PL) invasion as well as receiving sublobectomy suffered from poorer survival (P < 0.001), which were identified as independent factors for stage IB ADC (P < 0.001), and according to which, a nomogram model was created.Conclusion: Age, sex, race, histological grade, surgery to the primary site, and tumor size combined with PL invasion were independent risk factors for stage IB ADC, based on which a nomogram was constructed to predict the prognosis.

Can Sorafenib Increase Survival for Recurrent Hepatocellular Carcinoma after Liver Transplantation? A Pilot Study

2014 ◽  
Vol 80 (7) ◽  
pp. 680-684 ◽  
Author(s):  
Angel E. Alsina ◽  
Alexia Makris ◽  
Vasilios Nenos ◽  
Eduardo Sucre ◽  
Jade Arrobas ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Pilot Study ◽  
Recurrence Rates ◽  
Term Survival ◽  
Factors Affecting ◽  
Time To Recurrence ◽  
Kaplan Meier ◽  
Life Years ◽  
Impact On Survival ◽  
End Stage

Recurrence of hepatocellular carcinoma (HCC) remains a main detriment to long-term survival in liver transplants (LTx) for HCC. The study aims to review the use of sorafenib in recurrent HCC LTx in the Model End Stage Liver Disease era. Two hundred forty-seven patients with HCC LTx from 2002 to 2013 were included. Survival was calculated by the Kaplan-Meier (KM) method and Cox multivariate model. Twenty-two patients recurred (11%). By KM, overall survival was 27 months (standard deviation [SD], 3.2 months; median, 28.4 months). Mean time to recurrence was 16.9 months (SD, 2.8 months; median, 12 months). Nine patients were treated with sorafenib after recurrence. Median survival for sorafenib-treated patients was 42 months compared with a median of 16.2 months without sorafenib (-2 log likelihood ratio, P = 0.0582). By Cox, only sorafenib ( P = 0.0233; hazard ratio, 8.528) and pathologic stage had a significant impact on survival. The recurrence rates of HCC LTx remain acceptable considering understaging and expansion of beyond Stage A. This pilot study of sorafenib in recurrent HCC demonstrates improved survival over historic controls. Many other factors affecting improved survival are explained. However, treatment remains palliative. Quality-of-life years and cost analysis need to be performed in this population.

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