scholarly journals The Clinical and Prognostic Factors for Biliary Neuroendocrine Neoplasm: A Study Based on the SEER Database

Author(s):  
Bohao Zheng ◽  
Cheng Zhang ◽  
Wenze Wan ◽  
Wentao Sun ◽  
Xi Cheng ◽  
...  

Abstract Background: In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN).Methods: Cases of biliary system NEN and adenocarcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan-Meier analysis was carried out for survival analysis. Results:A total of 243 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P<0.001). For GB-NENs, surgery method (P=0.020) and lymph node metastasis (P=0.018) were identified as independent prognostic factors. In terms of AOV NENs, age (P=0.017) and lymph node metastasis (P=0.006) were identified was independent prognostic factor, while grade (P=0.002) and lymph node metastasis (P=0.036) were identified as independent prognostic factors for EBD NENs. PSM analysis indicated that patients with biliary duct NENs have better postoperative prognosis than biliary duct adenocarcinoma.Conclusions: Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has adverse prognosis than that of biliary tract NEN. Pathological subtype, differentiation, lymph node metastasis, surgery method and lymph node resection could affect postoperative prognosis of gallbladder and biliary tract NEN.

2014 ◽  
Vol 24 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Chien-Hsing Lu ◽  
I-Hui Chen ◽  
Yi-Jen Chen ◽  
Kung-Liahng Wang ◽  
Jian-Tai Timothy Qiu ◽  
...  

ObjectiveThis study aimed to determine the clinical prognostic factors involved in carcinosarcoma of the ovary, fallopian tube, and peritoneum.Materials and MethodsThis retrospective study was undertaken by the Taiwanese Gynecologic Oncology Group. The retrieved clinical data included demographic characteristics, medical disease, tumor status, extent of surgery, and adjuvant chemotherapy.ResultsIn total, 63 patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum were identified. Sixty-one patients with complete data were enrolled for further data analysis. The mean follow-up period was 1.0 year, and the mean overall survival was 15.4 months. By log-rank tests, age, menopausal status, parity, hypertension, diabetes, primary tumor size, para-aortic lymph node metastasis, pretreatment CA-125, preceding diagnostic surgery, hysterectomy, lymphadenectomy, other surgeries, and paclitaxel use were not predictive of overall survival.Omentectomy, no gross residual implants after surgery, platinum treatment, and no pelvic lymph node metastasis had a trend toward better survival. Early diagnosis at stage I and cisplatin/ifosfamide regimen were significant associated with a better overall survival in log-rank and simple Cox regression tests. Bilateral ovarian tumors and metastatic tumors larger than 2 cm were significantly associated with a poorer overall survival.ConclusionsEarly diagnosis at stage I, unilateral ovarian tumor, metastatic tumors less than 2 cm, and cisplatin/ifosfamide regimen were predictive of a better survival.Omentectomy and complete debulking surgery also showed a trend toward better survival. Thus, these treatment strategies should be applied in patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum.


2020 ◽  
Author(s):  
Kai Zhang ◽  
Changcheng Tao ◽  
Jianxiong Wu ◽  
Weiqi Rong

Abstract Background: The presence of lymph node metastases is related to poor survival outcomes in hepatocellular carcinoma patients and because of the reported low probability of lymph node metastasis, research into the prognoses of such patients is difficult to conduct. In this study, we aimed to develop a nomogram model to predict the prognosis of HCC patients with lymph node metastasis and provided a reasonable basis for the choice of follow-up treatment.Methods: HCC patients diagnosed with LN metastasis from 2010 to 2015 were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate Cox regression and lasso regression were used to screen prognostic factors. Cox multiple-factor analysis was employed to investigate the independent prognostic factors for survival. The concordance index (C-index) and calibration curve were used to evaluate the predictive performance of our model. The clinical benefit was assessed via decision curve analysis (DCA). The survival was analyzed using Kaplan-Meier method and the differences among survival curves were compared by the log-rank test.Results: Patients were randomized into the training group (944 patients) and the validation group (402 patients) in a 70:30 ratio. Grade, T stage, surgery to the liver, chemotherapy, radiation recode, AFP, fibrosis score, tumor size group, M stage were selected as independent prognostic factors, and we developed nomograms using these variables. The c-indices of the training and validation groups were 0.70 and 0.73, respectively. The calibration curves for probability of survival showed good agreement. The DCA indicated that the nomogram had positive net benefits. Patients were divided into two risk groups according to our model, survival curves were drawn, and the log-rank test was performed, the p-value of which was <0.001.Conclusions: The nomogram can accurately predict the prognosis of HCC patients with lymph nodes metastasis and provide a reasonable basis for treatment.


2020 ◽  
pp. 194589242096405
Author(s):  
Wanpeng Li ◽  
Hanyu Lu ◽  
Huan Wang ◽  
Huankang Zhang ◽  
Xicai Sun ◽  
...  

Background This study aimed to investigate the demographics, treatment outcomes, and prognostic factors of salvage endoscopic nasopharyngectomy in recurrent nasopharyngeal carcinoma (NPC). Methods We conducted a retrospective analysis of 189 patients who underwent treatment for recurrent NPC from January 2006 to June 2018. The Kaplan–Meier method and log-rank test were used to assess survival rates. A Cox regression model was used for multivariate survival analyses. Results We included 132 men and 57 women in the study, with a median age of 51 (range, 25–85) years. The overall 1-, 3-, and 5-year survival rates were 82.2%, 59.5%, and 43.6%, respectively, during a median follow-up of 24 (range, 2–111) months. In subjects over 50 years of age, diabetes, low body mass index (BMI < 20 kg/m2), low hemoglobin (<120 g/l) levels, increased neutrophil to lymphocyte ratio (NLR; ≥ 6), advanced T stage (rT3 and rT4), lymph node metastasis, and positive surgical margins were associated with a poor prognosis in terms of overall survival. Cox multivariate regression analyses showed significant differences in age, BMI, NLR, diabetes, T stage, N stage, and tumor necrosis. Conclusions In subjects over 50 years of age, diabetes, low BMI, increased NLR, advanced T stage, lymph node metastasis, and tumor necrosis were independent prognostic factors for overall survival.


2015 ◽  
Vol 81 (3) ◽  
pp. 289-296 ◽  
Author(s):  
Sae Byeol Choi ◽  
Hyung Joon Han ◽  
Pyoung Jae Park ◽  
Wan Bae Kim ◽  
Tae Jin Song ◽  
...  

Surgical resection is the treatment of choice for bile duct cancers. The aim of this study was to investigate disease recurrence patterns and prognostic factors for recurrence of distal bile duct cancers after surgical resection. A retrospective study was performed on 122 patients with distal bile duct cancers who underwent R0 or R1 surgical resection at Korea University Guro Hospital from 1991 to 2010. Sites of initial disease recurrence were classified as locoregional or distant. Univariate and multivariate analyses were performed to investigate the factors affecting recurrence. Of the 122 patients, 80 patients developed recurrence. The disease-free survival rate was 63.1 per cent at one year and 36.4 per cent at three years. The patterns of recurrence at diagnosis were locoregional in 25 patients, locoregional and distant metastasis in 14 patients, and distant metastasis in 41 patients. Multivariate analyses revealed that recurrence pattern, lymph node metastasis, and differentiation are independent prognostic factors affecting disease-free survival. R status (marginal significance) and tumor differentiation were independent prognostic factors associated with locoregional recurrence. Differentiation and lymph node metastasis were independent prognostic factors associated with distant metastasis. The prognosis after recurrence was poor with a 1-year survival rate after recurrence of 26.1 per cent. Adjuvant chemo- or radiation therapy, delivered in patients mainly with R1 resection or with presence of lymph node metastasis, did not demonstrate the survival benefit. Significant factors for recurrence were tumor differentiation and lymph node metastasis. Therefore, close follow-up and adjuvant therapy will be necessary in patients with lymph node metastasis or poorly differentiated tumor.


2020 ◽  
Author(s):  
Gang-Cheng Wang ◽  
Chong-Qing Gao ◽  
You-cai Wang ◽  
Hui-Fang Lv ◽  
Bei-Bei Chen ◽  
...  

Abstract Purpose Extended multi-organ resection for locally advanced (T4) gastric cancer remains controversial. Herein we aimed to evaluate the surgical outcomes and survival of patients with T4 gastric cancer extending to the transverse colon. Materials and Methods Between 2011 and 2015, forty patients had undergone curative resection for T4 gastric cancer extending to the transverse colon. Patient characteristics, related complications, long-term survival, and prognostic factors for T4 gastric cancer were analyzed. Results ost-operative morbidity occurred in 5 (12.5%) patients. The 1-, 3-, and 5-year overall survival rates were 75.0%, 49.2%, and 36.9%, respectively. Univariate analysis revealed that tumor size ( P =0.049), advanced T stage ( P =0.013), and lymph node metastasis ( P =0.006) are poor prognostic factors of overall survival. Based on multivariate analysis, advanced T stage and lymph node metastasis were identified as independent prognosis factors. Conclusions Patients with T4 gastric cancer extending to the transverse colon might benefit from curative resection with acceptable morbidity and mortality.


2017 ◽  
Vol 13 (6) ◽  
pp. 4327-4333 ◽  
Author(s):  
Tomonari Cho ◽  
Eisuke Shiozawa ◽  
Fumihiko Urushibara ◽  
Nana Arai ◽  
Toshitaka Funaki ◽  
...  

2020 ◽  
Author(s):  
Hiroki Konno

Abstract Background : This study analyzed the effects of four candidate prognostic factors on length of hospital stay among inpatients following thyroid cancer resection; specifically, age ≥ 45 years, cervical lymph node metastasis, impaired calcium metabolism, and postoperative hypothyroidism.Methods : This was a retrospective study reviewing 434 patients’ medical and claim records (n=434; male 21.0%/female 79.0%, age: 57.31±13.52). Results : Patients who met one of the four prognostic criteria were more likely to have a longer hospital stay using acute-care beds than corresponding cases negative for these criteria. Regression analysis indicated that patient’s length of hospital stay was increased with each factor by the following rates: 1) 14.57% if 45 years or older, 2) 26.24% if positive for cervical lymph node metastasis, 3) 28.79% if positive for impaired calcium metabolism, and 4) 29.95% if positive for postoperative hypothyroidism. Moreover, estimations of cumulative probability of length of hospital stay indicate that: 1) 26.6% of the age≥45 patient group is expected to be discharged by the 7 th day in contrast to 42.9% of age<45 patient group (91.0%,97.4% at 14 th day); 2) 16.1% of the cervical lymph node metastasis patient group is expected to be discharged by the 7 th day in contrast with 30.5% of non-patient group (83.9%,92.8% at 14 th day); 3) 14.8% of the impaired calcium metabolism patient group is expected to be discharged by the 7 th day in contrast with 30.5% of non-patient group (70.4%,93.6% at 14 th day), and 4) 21.4% of the postoperative hypothyroidism patient group is expected to be discharged by the 7 th day in contrast with 29.8% of non-patient group (71.4%,92.9% at 14 th day). Conclusions : Disorders of calcium metabolism and postoperative hypothyroidism were the most likely postoperative complications to occur, yet these are not identified as prognostic factors in the Diagnosis Procedure Combination / Per-Diem Payment System (DPC/PDPS) framework in Japan. The findings suggest that patients with these two conditions should receive care in beds of a lower, sub-acute category, and they should be quickly transferred to such beds or, if possible, to outpatient care.


2010 ◽  
Vol 20 (6) ◽  
pp. 1000-1005 ◽  
Author(s):  
Masamichi Hiura ◽  
Takayoshi Nogawa ◽  
Takashi Matsumoto ◽  
Takashi Yokoyama ◽  
Yuko Shiroyama ◽  
...  

Objective:The purposes of this study were to assess modified radical hysterectomy including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy in patients with para-aortic lymph node (PAN) metastasis in endometrial carcinoma and to identify the multivariate independent prognostic factors for long-term survival during the past 10 years.Methods:Between December 1987 and December 2002, we performed modified radical hysterectomy with bilateral salpingo-oophorectomy including systematic pelvic and para-aortic lymphadenectomy and peritoneal cytology in 284 endometrial carcinoma patients according to the classification of the International Federation of Gynecology and Obstetrics (stage IA, n = 66; stage IB, n = 96; stage IC, n = 33; stage IIA, n = 5; stage IIB, n = 20; stage IIIA, n = 28; stage IIIC, n = 28; and stage IV, n = 8) who gave informed consents at our institute. Patients with tumor confined to the uterus (stages IC and II) were treated by 3 courses of cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, and cisplatin 75 mg/m2 regimen 3 to 4 weeks apart, and patients with extrauterine lesions involving adnexa and/or pelvic lymph node (PLN) were treated by 5 courses. In addition, 10 courses were given to patients with PAN metastasis. Patients with PLN metastasis received adjuvant chemotherapy, and adjuvant radiation was not part of our institutional protocol. For multivariate regression modeling with proportional hazards, the regression model of Cox was used. Survival curves were analyzed by the Kaplan-Meier method, and analysis of the differences was performed by the log-rank test.Results:The overall incidence of retroperitoneal lymph node metastasis assessed by systematic pelvic and para-aortic lymphadenectomy was 12.0% (34/284) in stages I to IV endometrial carcinoma, and incidences of PLN and PAN metastases were 9.2% (26/284) and 7.4% (21/284), respectively. However, PAN metastasis rate is 50% (13/26) in patients with PLN metastasis. Univariate analysis of prognostic factors revealed that International Federation of Gynecology and Obstetrics clinical stage (P < 0.0001), histological finding (P = 0.0292), myometrial invasion (P < 0.0001), adnexal metastasis (P < 0.0001), lymphovascular space invasion (P < 0.0001), tumor diameter (P = 0.0108), peritoneal cytology (P = 0.0001), and retroperitoneal lymph node metastasis (P < 0.0001) were significantly associated with 10-year overall survival. Survival was not associated with age (P = 0.1558) or cervical involvement (P = 0.1828). A multivariate analysis showed that adnexal metastasis (P = 0.0418) and lymphovascular space invasion (P = 0.0214) were significantly associated with 10-year overall survival. The 5- and 10-year overall survival rates in patients with negative PAN were 96% and 93% versus 72% and 62% in patients with positive PAN (P = 0.006).Conclusions:It is suggested that surgery with systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy could improve long-term survival in patients with PAN metastasis, although there are only 21 patients with PAN metastasis.


Author(s):  
Kohei Nishio ◽  
Kenjiro Kimura ◽  
Shimpei Eguchi ◽  
Daisuke Shirai ◽  
Jun Tauchi ◽  
...  

2019 ◽  
Vol 18 ◽  
pp. 153303381989680
Author(s):  
Hongxiao Chen ◽  
Xiufang Tian ◽  
Yajing Luan ◽  
Hui Lu

Emerging evidence have indicated that dysregulated long noncoding ribonucleic acids act as a novel diagnostic and therapeutic target in the progression of ovarian cancer. Long noncoding RNA DiGeorge syndrome critical region gene 5 has been reported to participate in some types of human cancer progresses, but its clinical roles in ovarian cancer had been rarely reported. This study aimed to explore the expression, clinicopathological features, diagnostic, and prognostic values of DiGeorge syndrome critical region gene 5 in ovarian cancer. The total levels of DiGeorge syndrome critical region gene 5 transcript variant 1 (NR_002733.2) and 2 (NR_045121.1) in patients with ovarian cancer were determined by quantitative reverse transcription polymerase chain reaction. The correlation of DiGeorge syndrome critical region gene 5 expression with clinicopathological factors was statistically analyzed by χ2 test. Overall survival analysis was carried out with the Kaplan–Meier curves with the log-rank test. Univariate and multivariate Cox regression analyses were performed to identify the prognostic significance of DiGeorge syndrome critical region gene 5 expression. Receiver operating characteristic curves were constructed to estimate the diagnostic and prognostic usefulness of DiGeorge syndrome critical region gene 5 in ovarian cancer. Results showed that relative DiGeorge syndrome critical region gene 5 expression was reduced by 36.81% and 65.79% in ovarian cancer tissues of patients and Gene Expression Omnibus DataSets (GSE119056) in contrast to normal tissues, respectively. Patients with lymph node metastasis and distant metastasis exhibited lower levels of DiGeorge syndrome critical region gene 5 in contrast to those patients with non-lymph node metastasis and non-distant metastasis, respectively. Low expression of DiGeorge syndrome critical region gene 5 was significantly associated with large tumor size, more lymph node metastasis, present distant metastasis, advanced clinical stage, and short overall survival in patients with ovarian cancer. Low expression of DiGeorge syndrome critical region gene 5 was an independent unfavorable prognostic factor for overall survival in patients with ovarian cancer. Receiver operating characteristics curves for prognosis yielded significant area under curves for lymph node metastasis, clinical stage, and overall survival. In conclusion, our study demonstrated that downregulated DiGeorge syndrome critical region gene 5 may be a new promising biomarker for predicting clinical progression and prognosis in patients with ovarian cancer.


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