High Preoperative Serum sVCAM-1 Concentration as a Predictor of Early Ovarian Cancer Recurrence

Abstract Background: Role of soluble vascular cell adhesion molecule-1 (sVCAM-1) in ovarian cancer is largely unclear. It was shown that mesothelial expression mediates tumour cell invasion and is associated with metastases in advanced ovarian cancer. Material and methods: In our prospective study we measured preoperative serum sVCAM-1 in 37 patients with advanced ovarian cancer and evaluated correlation with disease recurrence. Serum samples were obtained prior to surgery, ascites was collected during the surgery and all analysed by flow cytometric bead-based assay. ROC analysis was used to identify a cut-off value for sVCAM-1. Survival curves were calculated using Kaplan-Meier method. The association between sVCAM-1 and survival was investigated with Cox regression models, adjusting for age at surgery. A p of <0.05 was considered significant. Results: Mean sVCAM-1 serum concentration in all patients before operation was 1564.68 ± 435.65 ng/ml while mean ascites level was 801.84 ±244.35 ng/ml. Follow up period was minimum 27 and the maximum 58 months. Patients were divided in two groups according to time to recurrence. Group A: 20 patients with disease progress or relapse within 12 months (mean serum level 1660.54±417.93 ng/ml; mean ascites level 827.92±290.36) and group B: 17 patients with tumour relapse after more than 12 months (mean serum level 451.91±441.15ng/ml; mean ascites level 771.16±179.93). There was a correlation between serum and ascites concentrations in group A and not in the patients from group B. The statistically significant difference was observed in serum concentration but not in ascites concentrations of sVCAM-1, There were no differences in grade, histology and stage of the tumour between the groups. sVCAM-1 and age resulted correlated (Spearman r=0.32, p=0.048). In Cox regression models after adjusting for age at surgery, sVCAM-1 above 1,400 ng/ml was associated with impaired DFS (hazard ratio 3.824; 95% confidence interval 1.460 to 9.374; p=0.003) and impaired OS (hazard ratio 13.394; 95% confidence interval 1.693 to 105.3985; p=0.014. Conclusions: This is the first study demonstrating that higher serum sVCAM-1 concentrations at the time of diagnosis might be predictive for early relapse. Serum sVCAM-1 can be potential marker for ovarian cancer follow-up.

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High Preoperative Serum sVCAM-1 Concentration as a Predictor of Early Ovarian Cancer Recurrence

10.21203/rs.2.24721/v1 ◽

2020 ◽

Author(s):

Marina Jakimovska ◽

Katarina Černe ◽

Ivan Verdenik ◽

Borut Kobal

Keyword(s):

Ovarian Cancer ◽

Serum Level ◽

Serum Concentration ◽

Cancer Recurrence ◽

Potential Marker ◽

Preoperative Serum ◽

Significant Difference ◽

Group A ◽

Group B

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Prognostic Factors for Late Ventricular Arrhythmias after Repair of Tetralogy of Fallot

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239700500105 ◽

1997 ◽

Vol 5 (1) ◽

pp. 20-24

Author(s):

Fumikazu Nomura ◽

Seiichiro Ikawa ◽

Keishi Kadoba ◽

Masataka Mitsuno ◽

Yoshiki Sawa ◽

...

Keyword(s):

Pulmonary Artery ◽

Right Ventricular ◽

Tetralogy Of Fallot ◽

Ventricular Arrhythmias ◽

Right Atrial ◽

Age At Surgery ◽

Group A ◽

Group B ◽

The Right

During a median follow-up period of 9 years (ranging from 9 months to 25 years), 24-hour ambulatory electrocardiographic studies were undertaken in 155 patients after repair of tetralogy of Fallot. The patients were divided into two groups. Group A consisted of 76 patients in whom the right ventricular approach was used and group B comprised 79 patients whose repair was through the right atrium. A transannular patch was employed in all patients in group A and in none of the patients in group B. Age at surgery was between 1 and 37 years (median age 4.8 years). During follow-up, 37 patients (48.6%) in group A had significant ventricular arrhythmias (Lown grade 2 or higher) and 13 patients (15.4%) in group B had significant ventricular arrhythmias. A close relationship was observed between age at surgery and Lown grade (R2 = 0.374, p < 0.001) and between follow-up duration and Lown grade (R2 = 0.514, p < 0.001), especially when the two groups were analyzed separately (R2 = 0.502, 0.476, p < 0.001). In contrast, no significant relationship was observed between the ratio of right ventricular to left ventricular pressure and Lown grade or between right ventricular systolic pressure and Lown grade. Discriminant analysis revealed risk factors associated with postoperative ventricular arrhythmias are follow-up duration (partial F = 3.22, p < 0.01), right ventricular to pulmonary artery pressure gradient (partial F = 3.35, p < 0.01), and operative method (partial F = 2.4, p < 0.05). Despite antiarrhythmic therapy, 11 of 22 late postoperative deaths occurred suddenly, presumably from ventricular arrhythmias. In this series of patients, the right atrial and pulmonary artery approach significantly reduced the risk of life-threatening ventricular arrhythmias after repair of tetralogy of Fallot.

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Long-term survival outcomes of intravenous versus intraperitoneal chemotherapy in the treatment of advanced ovarian cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.6046 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 6046-6046 ◽

Cited By ~ 1

Author(s):

Rachel Soyoun Kim ◽

Manjula Maganti ◽

Marcus Bernardini ◽

Stephane Laframboise ◽

Sarah E. Ferguson ◽

...

Keyword(s):

Ovarian Cancer ◽

Cox Regression ◽

Residual Disease ◽

Advanced Ovarian Cancer ◽

Term Survival ◽

Long Term Survival ◽

Cox Regression Analysis

6046 Background: The role of intraperitoneal (IP) chemotherapy in the management of advanced ovarian cancer has been questioned given emerging evidence showing lack of survival benefits. The objective of this study was to compare the long-term survival associated with IP chemotherapy at a tertiary cancer center. Methods: We reviewed the long-term survival records of 271 women with stage IIIC or IV high-grade serous ovarian cancer treated with primary cytoreductive surgery (PCS) followed by IP or intravenous (IV) chemotherapy between 2001-2015 with a minimum follow-up of 4 years. 5-year progression free (PFS) and overall survival (OS) rates were compared using Kaplan-Meier survival analysis and covariates were evaluated using Cox regression analysis. Results: Women who received IP chemotherapy after PCS (n = 91) were more likely to have undergone aggressive surgery (p < 0.001), longer surgery (p < 0.001), and had no residual disease (p < 0.001) compared to the IV arm (n = 180). Median follow-up was 51.6 months. Five-year PFS was 19% vs. 18% (p = 0.63) and OS was 73% vs. 44% (p = 0.00016) in the IP vs. IV arms, respectively. After controlling for covariates in a multivariable model, the use of IP was no longer a significant predictor of OS in the entire cohort (p = 0.12). In patients with 0mm residual disease, PFS was 28% vs. 26% (p = 0.67) and OS was 81% vs. 60% (p = 0.059) in IP (n = 61) vs. IV (n = 69), respectively. In patients with residual of 1-9mm, PFS was 30% vs. 48% (p = 0.076) and OS was 60% vs. 43% (p = 0.74) in IP (n = 29) vs. IV (n = 31), respectively. Conclusions: IP chemotherapy showed a trend towards improved survival over conventional IV chemotherapy, especially in patients with no residual disease. Given the retrospective nature and small numbers in this study, prospective non-randomized cohort studies are warranted to evaluate the role of IP chemotherapy in advanced ovarian cancer.

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The Role of HE4, a Novel Biomarker, in Predicting Optimal Cytoreduction After Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000944 ◽

2017 ◽

Vol 27 (4) ◽

pp. 696-702 ◽

Cited By ~ 7

Author(s):

Francesco Plotti ◽

Giuseppe Scaletta ◽

Stella Capriglione ◽

Roberto Montera ◽

Daniela Luvero ◽

...

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Advanced Ovarian Cancer ◽

Debulking Surgery ◽

Gynecology And Obstetrics ◽

Group A ◽

Group B

ObjectivesThis study aimed to evaluate serum human epididymis protein 4 (HE4) changes during neoadjuvant chemotherapy (NACT) to establish HE4 predebulking surgery cutoff values and to demonstrate that CA125, HE4, and computed tomography (CT) taken together are better able to predict complete cytoreduction after NACT in advanced ovarian cancer patients.MethodsFrom January 2006 to November 2015, patients affected by epithelial advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III–IV), considered not optimally resectable, were included in this prospective study. After 3 cycles of NACT, all patients underwent debulking surgery and were allocated, according to residual tumor (RT), into group A (RT = 0) and group B (RT > 0). Serum CA125, HE4, and CT images were recorded during NACT and compared singularly and with each other in term of accuracy, sensitivity, specificity, and positive and negative predictive value.ResultsA total of 94 and 20 patients were included in group A and group B, respectively. The HE4 values recorded before debulking surgery correlated with RT. The identified HE4 cutoff value of 226 pmol/L after NACT was able to classify patients at high or low risk of suboptimal surgery, with a sensitivity of 75% and a specificity of 85% (positive predictive value, 0.87; negative predictive value, 0.70). The combination of CA125, HE4, and CT imaging resulted in the best combination with a sensitivity of 96% and a specificity of 92% (positive predictive value, 0.96; negative predictive value, 0.94).ConclusionsThe novel biomarker HE4, in addition to CA125 and CT, is better able to predict the RT at debulking surgery and the prognosis of patients.

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Prognostic implications of lymph node metastasis in advanced ovarian cancer: Analysis of National Cancer Database.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.5567 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 5567-5567

Author(s):

Sukamal Saha ◽

Sabarina Ramanathan ◽

Suresh Mukkamala ◽

Hayman S. Salib ◽

Rajen Oza ◽

...

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Bowel Resection ◽

Advanced Ovarian Cancer ◽

Stage Iv ◽

Stage Iii ◽

National Cancer Database ◽

Group A ◽

Prognostic Implications ◽

Group B

5567 Background: During debulking surgery (Surg) for advanced ovarian cancer (OvCa), lymph node (LN) sampling are not routinely performed. Hence, prognostic implications of LN involvement following debulking surg and chemotherapy (ChemoRx) were analyzed from National Cancer Database (NCDB). Methods: Only Stage III and Stage IV patients (pts) from 2004 –2014 NCDB pts undergoing Debulking surg. and ChemoRx were included. Group A included pts with debulking surg without bowel resection; Group B with major bowel resection and Group C with bowel and bladder resection. Pts were further subdivided according to the use of 1) NeoAdjuvant (NeoAdj) 2) Adjuvant (Adj) and 3) Neo Adj and Adj ChemoRx. Survival analysis was done based on -ve or +ve LN status. using Pearson Chi Square testing. Results: Out of 10,737 Stage III and 3,102 Stage IV pts, there were 6828 Group A, 6413 Group B and 598 Group C pts. Five year overall survival (OS) for all pts in Stage III with LN-ve vs LN +ve was 59.9% vs 53.9% and Stage IV was 48.7% vs 41.2%. In Group A, B, and C, the 5 yr OS was better in LN – ve than LN +ve pts (Table1). The OS for both LN –ve and LN +ve groups were better in Adjuvant chemoRx in all 3 groups. OS was slightly better in Stage III vs Stage IV pts. Conclusions: Even though LN dissection are not routinely done during debulking surg, overall pts with LN metastasis do worse than LN –ve pts irrespective of the timing of ChemoRx. Hence, LN sampling during debulking surg should be strongly considered as it may provide important prognostic information. [Table: see text]

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A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy

Frontiers in Pediatrics ◽

10.3389/fped.2021.641318 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jin-qiao Liu ◽

Wen-juan Chen ◽

Meng-jie Zhou ◽

Wen-feng Li ◽

Ju Tang ◽

...

Keyword(s):

Biliary Atresia ◽

Cox Regression ◽

External Validation ◽

Liver Stiffness ◽

Training Cohort ◽

Metavir Score ◽

First Onset ◽

Group A ◽

Group B

Background: Although Kasai portoenterostomy (KPE) is performed timely for most children with biliary atresia (BA), the native liver survival (NLS) is still poor due to the progressive liver fibrosis. Many children have to receive liver transplantation (LT) within 2 years after KPE. Early prediction of the prognosis permits the implementation of prophylactic treatments for BA children. However, studies about the prediction are limited.Objective: The purpose of this study is to establish a nomogram to predict the prognosis of BA children within 2 years after KPE.Methods: The follow-up data of 151 BA children were retrospectively reviewed, and were randomly divided into a training cohort for constructing a nomogram (n = 103) and a validation cohort (n = 48). In the training cohort, patients were divided into Group A and Group B according to whether death or LT were observed within 2 years post-KPE. Multivariate Cox regression based on the baseline characteristics, liver function indicators and LSM (liver stiffness measurement) values at KPE and 3 months after KPE was utilized for the establishment of the nomogram in predicting the prognosis of BA within 2 years after KPE. The discrimination and calibration of the nomogram were internally and externally validated.Results: Fifty-six BA children were included in Group A and 47 were included in group B. Age at KPE, METAVIR score F4, LSM at 3 months, first onset of cholangitis within 3 months, and jaundice clearance time were the independent predictors for the prognosis of BA children within 2 years after KPE (all P < 0.05). The developed nomogram based on these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than each predictor in predicting the prognosis (all P < 0.05).Conclusions: The established nomogram based on the indicators from the first 3 months after KPE may be useful for predicting the prognosis of BA children within 2 years post-KPE and helpful for the consideration of LT.

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Clinical Significance of Serum Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels Before Surgery and During Postoperative Follow-Up in Colorectal Cancer

International Surgery ◽

10.9738/intsurg-d-17-00026.1 ◽

2018 ◽

Vol 103 (7-8) ◽

pp. 322-330

Author(s):

Harunobu Sato ◽

Yoshikazu Koide ◽

Miho Shiota ◽

Hiroshi Takahashi ◽

Zenichi Morise ◽

...

Keyword(s):

Colorectal Cancer ◽

Carcinoembryonic Antigen ◽

Disease Free Survival ◽

Carbohydrate Antigen ◽

Preoperative Serum ◽

Serum Carcinoembryonic Antigen ◽

Group A ◽

Serum Cea ◽

Group B

Objective: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most common colorectal cancer markers. We aimed to identify the appropriate clinical conditions for measuring serum CEA and CA19-9 levels before surgery and during follow-up. Methods: This study included 1275 colorectal cancer patients who were divided into 3 groups according to preoperative CEA levels (group A, ≤5 ng/mL; group B, >5–≤11 ng/mL; group C, >11 ng/mL). Each group was subdivided into 2 groups according to preoperative CA19-9 levels (cutoff level: ≤37 U/mL). Recurrence and survival rates were analyzed. Results: Recurrence rate, disease-free survival after curative surgery, and prognosis were significantly worse in group A and B patients with high CA19-9 levels. At recurrence, CEA levels showed a greater increase in group B and C patients; CA19-9 levels increased in group A patients with high CA19-9 levels. At recurrence, high serum CA19-9 levels were observed in group A patients with high preoperative serum CA19-9 levels, even if the serum CEA level did not increase. Preoperative CA19-9 levels could predict recurrence and prognosis in groups A and B. Conclusion: Periodic CA19-9 determination is useful for monitoring recurrence among group A patients with high CA19-9 levels.

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Does Extensive Upper Abdomen Surgery During Primary Cytoreduction Impact on Long-term Quality of Life?

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182842fc4 ◽

2013 ◽

Vol 23 (3) ◽

pp. 442-447 ◽

Cited By ~ 8

Author(s):

Roberto Angioli ◽

Francesco Plotti ◽

Alessia Aloisi ◽

Stella Capriglione ◽

Corrado Terranova ◽

...

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Pelvic Surgery ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Group A ◽

Group B ◽

Upper Abdomen

ObjectivesThe objective of this study was to evaluate the feasibility in terms of safety and quality of life in a sample of Italian patients affected by advanced ovarian cancer and submitted to either extensive upper abdomen or standard surgery, through validated questionnaires.MethodsFrom January 2006 to November 2011, a prospective, observational study was conducted to compare quality of life in patients affected by advanced ovarian cancer and submitted to primary cytoreduction in the Division of Gynecology of the University Campus Bio-Medico of Rome. After surgery patients were stratified into 2 groups (group A: standard surgery or group B: extensive upper abdomen surgery). All patients were submitted to standard chemotherapy. At completion of treatment, during the first follow-up visit, all eligible patients were asked to fill in Quality of Life Questionnaire-C30 (QLQ-C30) (version 3.0) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-OV28 (QLQ-OV28) questionnaires.ResultsEighty-nine patients were enrolled into our study. Nine were excluded, so finally 80 patients were considered in this study. Group A included 40 patients and underwent standard surgery (pelvic surgery); group B, included 40 patients and underwent extensive upper abdomen surgery. There were no statistical differences in terms of major surgical complication rates (15% vs 10%). We registered same times of beginning of chemotherapy (median, 19 vs 21 days) and no severe related toxicities. Quality-of-life scores of both questionnaires were comparable between groups, with the exception of Global Health Status in QLC-30.ConclusionsUpper abdomen surgery is a feasible and safe therapeutic option. Patients present same times of beginning of chemotherapy without an increase in chemorelated toxicities and experience the same general quality of life.

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P2852Risk factors for death and survival after TLE in the groups of eighty- and ninety-year-olds

European Heart Journal ◽

10.1093/eurheartj/ehz748.1161 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

W Jachec ◽

A Polewczyk ◽

L Segreti ◽

M G Bongiorni ◽

A Kutarski

Keyword(s):

Risk Factors ◽

Old Age ◽

Cox Regression ◽

Nyha Class ◽

Lead Extraction ◽

Cox Regression Analysis ◽

Group A ◽

Group B

Abstract Background Despite the fact that the transvenous lead extraction (TLE) is the method of choice of treatment for pacing complications, these procedures are not often performed in the elderly. The prognosis after TLE in these groups of patients is uncertain. Aim Evaluation of risk factors for death of patients who underwent TLE over the age 80 and 90 years. Methods 3368 patients with complete follow-up data (mean age at the time of procedure; 65.38±15.64 years old, 1198 female) who underwent TLE procedures in two high volume experienced European centers. Risk factors for death in patients divided in to three groups depending on the age: below the age of 80 (group A, n=2854) and in groups of eighty-years-old (group B, n=484) and ninety-years old (group C, n=30) were determined using the Cox multivariable model. The survival of eighty-year-olds and ninety-year-olds was worse compared to younger patients and they did not differ between themselves (Figure 1). Results 815 deaths occurred during 3.87±2.76 years of follow-up; 611 (21.4%) in group A, 192 (39.7%) in group B (p<0,001) and 12 (40%) in group C (p<0.001) (B, C vs A, χ2 test). Results of multivariable Cox regression analysis are present in Table 1. Table 1 Group A Group B Group C Age <80 years old Age between 80–90 years old Age ≥90 years old HR (95% CI) HR (95% CI) HR (95% CI) Female (y/n) 1.026; (0.851–1.238) 1.202 (0.874–1.654) 1.332; (0.428–4.146) Age in TLE (year) 1.021; (1.013–1.029) 1.053 (0.996–1.114) 0.997; (0.701–1.418) NYHA class (by one) 1.391; (1.240–1.561) 1.409 (1.134–1.750) 1.312; (0.698–2.466) LVEF (1%) 0.974; (0.967–0.980) 0.993 (0.982–1.005) 1.003; (0.947–1.063) Hypertension (y/n) 1.062; (0.889–1.268) 0.595 (0.428–0.828) 0.679; (0.203–2.271) Diabetes (y/n) 1.384; (1.152–1.662) 1.333 (0.951–1.868) 1.522; (0.398–5.821) Creatinin level (umol/l) 1.045; (1.020–1.070) 1.608 (1.385–1.866) 2.247; (0.704–7.171) Atrial fibrillation (y/n) 1.402; (1.169–1.682) 1.066 (0.783–1.451) 1.278; (0.380–4.296) ICD (y/n) 0.994; (0.825–1.198) 0.942 (0.618–1.437) 1.922; (0.419–8.830) Infectious indications (y/n) 1.137; (0.913–1.415) 1.014 (0.671–1.533) 1.104; (0.298–4.091) Lead related endocarditis 1.511; (1.174–1.945) 1.576 (1.004–2.474) 1.942; (0.385–9.804) Conclusion The survival of eighty-year-olds and ninety-year-olds did not differ between themselves in long term follow-up after TLE. There were no specific risk factors affecting the risk of mortality in long-term observation after TLE in nanogenarius

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Absorbable suture material in carotid surgery

VASA ◽

10.1024/0301-1526/a000468 ◽

2015 ◽

Vol 44 (6) ◽

pp. 451-457 ◽

Cited By ~ 4

Author(s):

Vincenzo Gasbarro ◽

Luca Traina ◽

Francesco Mascoli ◽

Vincenzo Coscia ◽

Gianluca Buffone ◽

...

Keyword(s):

Suture Material ◽

Absorbable Suture ◽

Paediatric Surgery ◽

Carotid Surgery ◽

Suture Materials ◽

Absorbable Suture Material ◽

Absorbable Sutures ◽

Group A ◽

Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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