scholarly journals Prognostic impact of advanced lung cancer inflammation index (ALI) on patients with adenocarcinoma of esophagogastric junction (AEG) after radical resection

Author(s):  
Qianchao Liao ◽  
Zifeng Yang ◽  
Xu Hu ◽  
Chengbin Zheng ◽  
Huolun Feng ◽  
...  

Abstract Background To evaluate the prognostic impact of the advanced lung cancer index (ALI) in patients with the adenocarcinoma of esophagogastric junction (AEG) after radical resection. Methods The data of patients with AEG after radical resection at Guangdong Provincial People’s Hospital from January 2008 to December 2018 were retrieved. The cutoff value of ALI was determined and the prognostic impact of clinicopathological factors and ALI were analyzed. A nomogram based on the independent prognostic factors for overall survival was then built. Results A total of 147 patients were eligible and based on a cutoff of ALI 43.1, 90 (61.2%) and 57 (38.8%) patients were classified in a low- (ALI༜43.1) and high-ALI (ALI༞43.1) group. Multivariate Cox proportional hazard analysis showed that low-ALI was associated with poor overall survival (OS) (p༜0.001, HR 2.541, 95%CI 1.408-4.410) and disease-free survival (DFS) (p=0.021, HR 1.789, 95%CI 1.020-2.674). In subgroup analysis, low-ALI was independent predictor for OS (p=0.001, HR 2.628, 95%CI 1.467-4.707) in stage III/IVA AEG patients. A nomogram for OS estimation was constructed and the C-index was 0.699 (95%CI 0.636-0.762) and the calibration plots showed satisfactory consistency between actual observation and nomogram-predicted OS probabilities. Further, satisfactory predictive accuracy for 1-, 2-, and 3-year OS rates with an area under the curve of 0.736, 0.712 and 0.697, respectively, was observed. Conclusions ALI was an independent prognostic factor for AEG patients after radical resection, and demonstrated promising ability for risk stratification of AEG, especially in advanced-stage disease.

2013 ◽  
Vol 139 (7) ◽  
pp. 1157-1167 ◽  
Author(s):  
Pingping Hu ◽  
Weidong Liu ◽  
Liguang Wang ◽  
Miaomiao Yang ◽  
Jiajun Du

2021 ◽  
Vol 20 ◽  
pp. 153473542199525
Author(s):  
Shih Ming Tsao ◽  
Tz Chin Wu ◽  
JiZhen Chen ◽  
Feichi Chang ◽  
Thomos Tsao

Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in patients with cancer receiving immunotherapy. Recent studies have shown that a high NLR was associated with a poor response and decreased survival. However, there is no intervention to reverse abnormally high NLR and improve clinical outcomes. Astragalus polysaccharide injection (PG2) is an immunomodulatory therapy for cancer-related fatigue. This study aimed to examine whether PG2 might normalize the NLR and affect the overall survival of patients with lung cancer treated with immunotherapy. Materials and Methods: We retrospectively examined the medical records of patients with lung cancer treated with immune checkpoint inhibitors (ICIs) between October 1, 2015 and November 30, 2019. All patients received ICI combination chemotherapies, and some similarly received PG2 (Control vs PG2). The NLR was assessed before treatment and 6 weeks after ICI initiation, and the survival data was collected at least 4 years after treatment initiation for the first enrolled patient. Results: Fifty-three patients were included. Six weeks after ICI initiation, 91.3% of the patients in the PG2 group exhibited a predefined “Decrease or no change” in the NLR, which was 28% higher than that in the Control group (63.3%) ( P = .028). The NLR significantly decreased by 31.60% from baseline in the PG2 group ( P = .012), whereas it increased by 5.80% in the Control group ( P = .572). Six weeks after ICI treatment initiation, both groups had a median NLR of 3.73, and the overall survival was also similar (PG2 vs Control, 26.1 months vs 25.4 months, respectively); however, the PG2 group had a higher median baseline NLR than the Control group (PG2 vs Control, 4.51 vs 2.81, respectively). Conclusion: This study demonstrated that PG2 could normalize the NLR in patients with lung cancer receiving ICI combination treatments.


2021 ◽  
Author(s):  
Jie-Yu Zhou ◽  
Kang-Kang Lu ◽  
Wei-Da Fu ◽  
Hao Shi ◽  
Jun-Wei Gu ◽  
...  

Background: Triple-negative breast cancer (TNBC) is an aggressive disease. Nomograms can predict prognosis of patients with TNBC. Methods: A total of 745 eligible TNBC patients were recruited and randomly divided into training and validation groups. Endpoints were disease-free survival and overall survival. Concordance index, area under the curve and calibration curves were used to analyze the predictive accuracy and discriminative ability of nomograms. Results: Based on the training cohort, neutrophil-to-lymphocyte ratio, positive lymph nodes, tumor size and tumor-infiltrating lymphocytes were used to construct a nomogram for disease-free survival. In addition, age was added to the overall survival nomogram. Conclusion: The current study developed and validated well-calibrated nomograms for predicting disease-free survival and overall survival in patients with TNBC.


2021 ◽  
Author(s):  
Junxia Huang ◽  
Juanjuan Hu ◽  
Yan Gao ◽  
Fanjun Meng ◽  
Tianlan Li ◽  
...  

Abstract Background: Advanced lung cancer inflammation index (ALI) is known to predict the overall survival of patients having some solid tumors or B-cell lymphoma. The study investigates the predictive value of ALI in multiple myeloma (MM) patients and the correlation between ALI and prognosis.Methods: A database of 269 MM consecutive patients who underwent chemotherapy between December 2011 and June 2019 in the Affiliated Hospital of Qingdao University was reviewed. ALI cut-off value calculated before the initial chemotherapy and post 4 courses treatment were identified according to the receiver operating characteristic (ROC) curve, and its association with clinical characteristics, treatment response, overall survival (OS), and progression-free survival (PFS) were assessed.Results: Patients in the low ALI group (n=147) had higher risk of β2 microglobulin elevation, more advanced ISS (International Classification System stage), and TP53 gene mutation, with significantly lower median overall survival (OS; 36.29 vs. 57.92 months, P = 0.010) and progression-free survival (PFS; 30.94 vs. 35.67 months, P = 0.013). Independent risk factors influencing the OS of MM patients were ALI (P = 0.007), extramedullary infiltration (P = 0.001), TP53 (P = 0.020), Plt (P = 0.005), and bone destruction (P = 0.024). ALI (P = 0.005), extramedullary infiltration (P = 0.004), TP53 (P = <0.001), Plt (P = 0.017), and complex chromosome karyotype (P = 0.010) were independent risk factors influencing the PFS of MM patients.Conclusions: ALI is a potential independent risk factor predicting the prognosis of newly diagnosed MM patients.


2020 ◽  
Vol 28 (3) ◽  
pp. 496-504
Author(s):  
Muhammet Sayan

Background: This study aims to identify the prognostic factors in Stage IIIA non-small cell lung cancer and to investigate whether there was a significant difference in terms of overall survival and disease-free survival among the subgroups belonging to this disease stage. Methods: Between January 2010 and December 2018, a total of 144 patients (125 males, 19 females; median age 60 years; range, 41 to 80 years) who were operated for non-small cell lung cancer in our clinic and whose pathological stage was reported as IIIA were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, histopathological diagnosis, the standardized uptake value of the mass on positron emission tomography-computed tomography, tumor diameter, type of surgery, lymph node metastasis status, visceral pleural invasion, and overall and disease-free survival rates were recorded. Results: The median survival was 39 (range, 27.8 to 46.1) months and the five-year overall survival rate was 28%. The mean tumor diameter was 4.3±2.7 cm. The median disease-free survival was 37 (range, 28.1 to 48.6) months and the five-year disease-free survival rate was 26.9%. In the multivariate analysis, overall survival and disease-free survival in T2N2M0 subgroup were significantly worse than the other subgroups. The other poor prognostic factors of survival were the standardized uptake value of the tumor, pneumonectomy, and histopathological subtypes other than squamous cell carcinoma and adenocarcinoma. Parietal pleural invasion was significantly associated with worse disease-free survival rates. Conclusion: Our results showed that there may be significant survival differences between subgroups created by tumor histopathology, lymph node invasion and the type of surgery in a heterogeneous lung cancer stage.


2021 ◽  
Author(s):  
Qianchao Liao ◽  
Jiabin Zheng ◽  
Wenjun Xiong ◽  
Junjiang Wang ◽  
Xu Hu ◽  
...  

Abstract Objective The prognostic value of lymphovascular invasion (LVI), perineural invasion (PNI), and poor differentiation (PD) has been widely studied in different solid tumors. However, it was still controversial in adenocarcinoma of esophagogastric junction (AEG). We investigated the prognostic impact of combining LVI, PNI and PD for predicting the survival in patients with AEG.Methods We retrospectively investigated the data of patients who performed surgical resection of AEG on Guangdong Provincial Hospital and Guangdong Provincial Hospital of Chinese Medicine from Jan. 2004 to Dec. 2018. According to the status of LVI, PNI and differentiation, pathological adverse features were divided into three groups: 0, 1 or 2 and 3 adverse features, their impact on prognosis was evaluated. Results Univariate analysis indicated pT, pN, LVI , PNI , PD and pathological adverse features were risk factors for both overall survival (OS) and disease-specific survival (DSS), and multivariate analysis indicated that pathological adverse feature was independent risk factor for both OS and DSS. In subgroup analyses, adverse features were independent risk factor for DSS of stage II AEG but not for stage I or III.Conclusions The pathological adverse features were independent prognostic factors for AEG patients and they can help for further risk stratification in stage II patients.


2021 ◽  
Vol 11 ◽  
Author(s):  
Yanning Wang ◽  
Qianning Zhang ◽  
Chuansheng Chen ◽  
Yuxuan Hu ◽  
Liyun Miao ◽  
...  

BackgroundIn pivotal immunotherapy trials, the efficacy of immune checkpoint inhibitors as treatments for lung cancer patients with brain metastases remains controversial. The aim of this study was to assess the relative efficacy of immunotherapy versus standard systemic therapy in advanced lung cancer patients with and without brain metastases.MethodsSystematic searches of PubMed, Embase, Cochrane database, and conference proceedings up to Aug 6, 2020 without year and language restrictions. The main outcomes were the overall survival in patients with and without brain metastases measured by hazard ratios, and the difference in efficacy between patients with and without brain metastases was measured by ratio of hazard ratios.ResultsNine eligible randomized controlled trials involving 6241 patients (682 [11%] with brain metastases and 5559 [89%] without brain metastases) were included in the analysis. A survival benefit of immunotherapy was observed for both patients with brain metastases (HR, 0.75; 95%CI, 0.53-0.97; P = .026) and patients without brain metastases (HR, 0.75; 95%CI, 0.67-0.83; P &lt;.001). However, patients without brain metastases benefit more from immunotherapy than patients with brain metastases (HR, 1.37; 95%CI, 1.15-1.63; P = .001). Additionally, subgroup analyses indicated that tumor type affect the efficacy of immunotherapy in patients with brain metastases (HR, 1.04 vs 1.54; interaction, P = .041).ConclusionsImmunotherapy can significantly improve overall survival for advanced lung cancer patients with asymptomatic brain metastases, especially in patients with non-small-cell lung cancer, but the magnitude of benefit is brain metastases dependent.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020206597.


2021 ◽  
Vol 29 (8) ◽  
pp. 784-791
Author(s):  
Volkan Erdoğu ◽  
Necati Çitak ◽  
Celal B Sezen ◽  
Levent Cansever ◽  
Cemal Aker ◽  
...  

Background We investigated whether all size-based pathological T4N0–N1 non-small cell lung cancer patients with tumors at any size >7 cm had the same outcomes. Methods We reviewed non-small cell lung cancer patients with tumors >7 cm who underwent anatomical lung resection between 2010 and 2016. A total of 251 size-based T4N0–N1 patients were divided into two groups based on tumor size. Group S ( n = 192) included patients with tumors of 7.1–9.9 cm and Group L ( n = 59) as tumor size ≥10 cm. Results The mean tumor size was 8.83 ± 1.7 cm (Group S: 8.06 ± 0.6 cm, Group L: 11.3 ± 1.6 cm). There were 146 patients with pathological N0 and 105 patients with pathological N1 disease. Mean overall survival and disease-free survival were 64.2 and 51.4 months, respectively. The five-year overall survival and disease-free survival rates were 51.2% and 43.5% (five-year OS; pT4N0:52.7%, pT4N1:47.9%, DFS; pT4N0:44.3%, pT4N1: 42.3%). No significant differences were observed between T4N0 and T4N1 patients in terms of five-year OS or DFS ( p = 0.325, p = 0.505 respectively). The five-year overall survival and disease-free survival rates were 52% and 44.6% in Group S, and 48.5% and 38.9% in Group L. No significant difference was observed between the groups in terms of five-year overall survival or disease-free survival ( p = 0.699, p = 0.608, respectively). Conclusions Above 7 cm, any further increase in tumor size in non-small cell lung cancer patients had no significant effect on survival, confirming it is not necessary to further discriminate among patients with tumors in that size class.


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