scholarly journals Prognostic factors in patients with thyroid carcinoma: a competing-risks analysis

2020 ◽  
Author(s):  
Junhu Wang ◽  
Lisong Heng ◽  
Jie Yang ◽  
Feng Tian ◽  
Xiaojun Liang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
Competing Risks ◽  
Hazard Function ◽  
Cox Regression ◽  
Multivariate Analyses ◽  
Regional Lymph Nodes ◽  
Cox Regression Analysis ◽  
Competing Risks Analysis

Abstract Background Cox proportional-hazards models are widely used to describe survival trends and identify prognostic factors for thyroid carcinoma, but they have significant limitations and deficiencies. This study therefore used a competing-risks model to identify the significant prognostic factors for thyroid carcinoma. Methods We identified 38,444 eligible patients in the SEER (Surveillance, Epidemiology, and End Result) database. The potential prognostic factors for thyroid carcinoma were analyzed by competing-risks analysis using both univariate and multivariate analyses. Results The univariate analysis showed that age, sex, race, marital state, insurance status, tumor size, whether regional lymph nodes were examined, AJCC stage, histology, surgery status, radiation status, chemotherapy status, bone metastasis, brain metastasis, liver metastasis, and lung metastasis were prognostic factors for death caused by thyroid carcinoma. The multivariate analyses that comprised Cox regression analysis, the cause-specific hazard function analysis, and subdistribution hazard function (SD) analysis produced different results, identifying age, being unmarried, no regional lymph nodes examined, AJCC stages II, III, and IV, having follicular, medullary, and anaplastic carcinomas, no surgery, no radiation, liver metastasis, and lung metastasis as the significant risk factors for thyroid carcinoma, while being female and not receiving chemotherapy were protective factors. The results from the three multivariate models for being black, tumor size >1 cm, and brain metastasis were inconsistent. Conclusion This study had produced information about the significant prognostic factors for thyroid carcinoma using a competing-risks model that is more accurate than that obtained using Cox regression analysis. The SD model seems to be preferable for establishing a more accurate prognostic model of this disease aimed at guiding clinical treatments and improving prognoses.

scholarly journals Prognostic factors in patients with thyroid carcinoma: a competing-risks analysis

2020 ◽  
Author(s):  
Junhu Wang ◽  
Lisong Heng ◽  
Jie Yang ◽  
Feng Tian ◽  
Xiaojun Liang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
Competing Risks ◽  
Tumor Size ◽  
Hazard Function ◽  
Cox Regression ◽  
Regional Lymph Nodes ◽  
Cox Regression Analysis

Abstract Background: Cox proportional-hazards models are widely used to describe survival trends and identify prognostic factors for thyroid carcinoma, but the prognostic model is not accurate enough. This study therefore used a competing-risks model to identify the significant prognostic factors for different types of thyroid carcinoma.Methods: We identified 38,444 eligible patients in the SEER (Surveillance, Epidemiology, and End Result) database. The potential prognostic factors for thyroid carcinoma were analyzed by Cox regression analysis, cause-specific hazard function (CS) analysis, and subdistribution hazard function (SD).Results: Cox regression analysis, CS analysis and SD analysis found identifying age, being unmarried, no regional lymph nodes examined, AJCC-6 II, III, IV vs I , having follicular, medullary, anaplastic vs Papillary carcinomas, no surgery, no radioiodine, liver metastasis, and lung metastasis as the significant risk factors for thyroid carcinoma, while being female was protective factor. However, the results from the three multivariate models for being black, tumor size >1 cm, and brain metastasis were inconsistent.Conclusion: In addition to finding that age, pathological type, tumor size, AJCC-6 stage, surgery status, radioiodine status, metastasis as common factors affected the prognosis, we also found that women, being unmarried and had their regional lymph nodes examined can improve the prognosis of thyroid cancer. The discovery of these factors will provide evidences for the prevention and treatment of thyroid cancer.

scholarly journals Identification of Prognostic RBPs in Osteosarcoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Bei Li ◽  
Long Fang ◽  
Baolong Wang ◽  
Zengkun Yang ◽  
Tingbao Zhao
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Differential Expression ◽  
Ribosome Biogenesis ◽  
Rna Binding ◽  
Cox Regression ◽  
Rna Binding Proteins ◽  
Malignant Tumors ◽  
Differential Expression Analysis ◽  
Cox Regression Analysis

Osteosarcoma often occurs in children and adolescents and causes poor prognosis. The role of RNA-binding proteins (RBPs) in malignant tumors has been elucidated in recent years. Our study aims to identify key RBPs in osteosarcoma that could be prognostic factors and treatment targets. GSE33382 dataset was downloaded from Gene Expression Omnibus (GEO) database. RBPs extraction and differential expression analysis was performed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to explore the biological function of differential expression RBPs. Moreover, we constructed Protein-protein interaction (PPI) network and obtained key modules. Key RBPs were identified by univariate Cox regression analysis and multiple stepwise Cox regression analysis combined with the clinical information from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Risk score model was generated and validated by GSE16091 dataset. A total of 38 differential expression RBPs was identified. Go and KEGG results indicated these RBPs were significantly involved in ribosome biogenesis and mRNA surveillance pathway. COX regression analysis showed DDX24, DDX21, WARS and IGF2BP2 could be prognostic factors in osteosarcoma. Spearman’s correlation analysis suggested that WARS might be important in osteosarcoma immune infiltration. In conclusion, DDX24, DDX21, WARS and IGF2BP2 might play key role in osteosarcoma, which could be therapuetic targets for osteosarcoma treatment.

scholarly journals Prognostic Significance of PD-L1 and mTOR Expression in Oral Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Nattinee Charoen ◽  
Kitti Jantharapattana ◽  
Paramee Thongsuksai
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Prognostic Significance ◽  
P Value ◽  
Cox Regression Analysis

Objective: Programmed cell death ligand 1 (PD-L1) and mammalian target of rapamycin (mTOR) are key players in host immune evasion and oncogenic activation, respectively. Evidence of the prognostic role in oral squamous cell carcinoma (OSCC) is conflicting. This study examined the associations of PD-L1 and mTOR expression with 5-year overall survival in OSCC patients. Material and Methods: The expressions of PD-L1 and mTOR proteins were immunohistochemically evaluated on tissue microarrays of 191 patients with OSCC who were treated by surgery at Songklanagarind Hospital, Thailand from 2008 to 2011. Cox regression analysis was used to determine independent prognostic factors. Results: PD-L1 expression was observed in 14.1% of cases while mTOR expression was present in 74.3% of cases. Females were more likely to have tumors with PD-L1 (p-value=0.007) and mTOR expressions (p-value=0.003) than males. In addition, lower clinical stage and well differentiated tumor are more likely to have mTOR expression (p-value= 0.038 and p-value<0.001, respectively). Cox regression analysis showed that age, tumor stage, nodal stage, combined surgical treatment with radiation or chemoradiation therapy, surgical margin status, PD-L1 expression and mTOR expression are independent prognostic factors. High PD-L1 expression (hazard ratio (HR) 3.14, 95% confidence interval (CI), 1.26–7.79) and high mTOR expression (HR 1.69, 95% CI, 1.00–2.84) are strong predictors of poor outcome. Conclusion: A proportion of OSCC expressed PD-L1 and mTOR proteins. Expression of PD-L1 and mTOR proteins are strong prognostic factors of OSCC.

scholarly journals Incidence, Survival, and Associated Factors Estimation in Osteosarcoma Patients with Lung Metastasis: A Single-center Experience of 11 Years in Tianjin, China

2021 ◽  
Author(s):  
Chao Zhang ◽  
Haixiao Wu ◽  
Guijun Xu ◽  
Wenjuan Ma ◽  
Lisha Qi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Lung Metastasis ◽  
Associated Factors ◽  
Cox Regression ◽  
Cancer Center ◽  
Single Center ◽  
Cox Regression Analysis

Abstract Background: Osteosarcoma is the most common primary malignant bone tumor. The current study was conducted to describe the general condition of patients with primary osteosarcoma in a single cancer center in Tianjin, China and to investigate the associated factors in osteosarcoma patients with lung metastasis. Methods: From February 2009 to October 2020, patients from Tianjin Medical University Cancer Institute and Hospital, China were retrospectively analyzed. The Kaplan–Meier method was used to evaluate the overall survival of osteosarcoma patients. Prognostic factors of patients with osteosarcoma were identified by the Cox proportional hazard regression analysis. Risk factor of lung metastasis in osteosarcoma were investigated by the logistic regression model. Results: A total of 203 patients were involved and 150 patients were successfully followed up for survival status. The 5-year survival rate of osteo-sarcoma patients was 70.0%. Surgery, bone and lung metastasis were the significant prognostic factors in multivariable Cox regression analysis. Twenty-one (10.3%) patients showed lung metastasis at the diagnosis of osteosarcoma and 67 (33%) lung metastases during the later course. T3 stage (OR=11.415, 95%CI 1.362-95.677, P=0.025) and synchronous bone metastasis (OR=6.437, 95%CI 1.69-24.51, P=0.006) were risk factors of synchronous lung metastasis occurrence. Good necrosis (≥90%, OR=0.097, 95%CI 0.028-0.332, P=0.000) and elevated Ki-67 (≥50%, OR=4.529, 95%CI 1.241-16.524, P=0.022) were proved to be significantly associated with metachronous lung metastasis occurrence. Conclusion: The overall survival, prognostic factors and risk factors for lung metastasis in this single center provided insight about osteosarcoma management.

scholarly journals Application value of nomogram and prognostic factors of gastric cancer patients who underwent D2 radical lymphadenectomy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guang-Chuan Mu ◽  
Yuan Huang ◽  
Zhi-Ming Liu ◽  
Xiang-Hua Wu ◽  
Xin-Gan Qin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Gastric Cancer Patients

Abstract Background The aim of this study was to explore the prognostic factors and establish a nomogram to predict the long-term survival of gastric cancer patients. Methods The clinicopathological data of 421 gastric cancer patients, who were treated with radical D2 lymphadenectomy by the same surgical team between January 2009 and March 2017, were collected. The analysis of long-term survival was performed using Cox regression analysis. Based on the multivariate analysis results, a prognostic nomogram was formulated to predict the 5-year survival rate probability. Results In the present study, the total overall 3-year and 5-year survival rates were 58.7 and 45.8%, respectively. The results of the univariate Cox regression analysis revealed that tumor staging, tumor location, Borrmann type, the number of lymph nodes dissected, the number of lymph node metastases, positive lymph nodes ratio, lymphocyte count, serum albumin, CEA, CA153, CA199, BMI, tumor size, nerve invasion, and vascular invasion were prognostic factors for gastric cancer (all, P < 0.05). However, merely tumor staging, tumor location, positive lymph node ratio, CA199, BMI, tumor size, nerve invasion, and vascular invasion were independent risk factors, based on the results of the multivariate Cox regression analysis (all, P < 0.05). The nomogram based on eight independent prognostic factors revealed a well-degree of differentiation with a concordance index of 0.76 (95% CI: 0.72–0.79, P < 0.001), which was better than the AJCC-7 staging system (concordance index = 0.68). Conclusion The present study established a nomogram based on eight independent prognostic factors to predict long-term survival in gastric cancer patients. The nomogram would be beneficial for more accurately predicting the prognosis of gastric cancer, and provide important basis for making individualized treatment plans following surgery.

Chemoradiation-induced changes in systemic inflammatory markers and their prognostic significance in oesophageal squamous cell carcinoma

2021 ◽  
pp. 20200314
Author(s):  
Ni Sann Khin ◽  
Sze Huey Tan ◽  
Michael LC Wang ◽  
Tian Rui Siow ◽  
Faye LWT Lim ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Cox Regression Analysis ◽  
Inflammatory State

Objective: Chemoradiation (CRT) may induce a change in systemic inflammatory state which could affect clinical outcomes in oesophageal cancer. We aimed to evaluate the changes and prognostic significance of systemic inflammatory markers following definitive CRT in oesophageal squamous cell carcinoma. Methods: A total of 53 patients treated with concurrent CRT were included in this retrospective analysis. We compared neutrophils, lymphocytes, platelets, neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) before and after CRT using Wilcoxon signed-rank test. Overall survival (OS) and progression-free survival (PFS) were calculated. Univariable and multivariable survival analysis were performed using Cox regression analysis. Clinical univariable survival prognostic factors with p < 0.1 were included in a multivariable cox regression analysis for backward stepwise model selection. Results: Both NLR (median ∆+2.8 [IQR −0.11, 8.62], p < 001) and PLR (median ∆+227 [81.3–523.5], p < 0.001) increased significantly after CRT. Higher levels of pre-CRT, post-CRT and change (∆) in NLR and PLR were associated with inferior OS and PFS. Post-CRT NLR (HR 1.04, 95% CI 1.02–1.07, p < 0.001), post-CRT platelets (HR 1.03, 95% CI 1.01–1.05, p = 0.005), cT-stage (HR 3.83, 95% CI 1.39–10.60, p = 0.01) and RT dose (HR 0.41, 95% CI 0.21–0.81, p = 0.01) were independent prognostic factors for OS in multivariable analysis. Change in NLR (HR 1.04, 95% CI 1.01–1.06, p = 0.001), post-CRT platelets (HR 1.03, 95% CI 1.01–1.05, p = 0.002), cT-stage (HR 3.98, 95% CI 1.55–10.25, p = 0.004) and RT dose (HR 0.41, 95% CI 0.21–0.80, p = 0.009) were independent prognostic factors for PFS. Conclusion: Both NLR and PLR increased following definitive CRT. Post-CRT NLR and ∆NLR were associated with adverse survival in oesophageal SCC. Advances in knowledge: We showed that CRT increased PLR and NLR, possibly reflecting a systemic inflammatory state which were associated with poor clinical outcomes in oesophageal SCC.

Nomogram to predict survival of pulmonary large-cell neuroendocrine carcinoma after surgery

2020 ◽  
Author(s):  
Qian Huang ◽  
Jie Liu ◽  
Huifang Cai ◽  
Qi Zhang ◽  
Lina Wang
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Predictive Performance ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Operating Characteristics ◽  
Cox Regression Analysis

Abstract Background Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare primary malignant tumor with a poor prognosis, and surgery is the main treatment. However, there are no effective predictive tools to assess the prognosis of postoperative patients. Our aim is to identify prognostic factors and construct nomogram to accurately assess prognosis. Methods Patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Based on the results of Cox regression analysis, construct nomogram for predicting 1-, 3-, and 5-year survival. The predictive performance of nomogram was evaluated using the consistency index (C-index), the area under the receiver operating characteristics curve (AUC), and calibration plots. Results We finally screened 903 patients with pulmonary LCNEC who underwent surgery. The Cox regression analysis showed that age, SEER stage, T stage, N stage, M stage, tumor size, and chemotherapy were independent prognostic factors for overall survival (P<0.05). The C-index of the nomogram is 0.681 on the training cohort and 0.675 on the validation cohort. The AUC and calibration plots show that the nomogram has good performance. Conclusion We constructed and validated nomogram for predicting 1-, 3-, and 5-year survival of patients with pulmonary LCNEC after surgery. Our nomogram provides reference information for assessing the overall survival of these patients.

scholarly journals Role of the TGFβ/PDCD4/AP-1 Signaling Pathway in Nasopharyngeal Carcinoma and Its Relationship to Prognosis

2017 ◽  
Vol 43 (4) ◽  
pp. 1392-1401 ◽  
Author(s):  
Jie Ma ◽  
Shu-Hong Xuan ◽  
Yan Li ◽  
Zhi-Ping Zhang ◽  
Xin-Hua Li
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Cox Regression ◽  
Advanced Tumor Stage ◽  
Cox Regression Analysis ◽  
Normal Tissues ◽  
Kaplan Meier ◽  
Low Expression

Background: The objective of the present study was to evaluate the role of the TGFβ/PDCD4/AP-1 pathway in nasopharyngeal carcinoma (NPC) and its relationship to NPC prognosis. Methods: NPC tissues collected from 66 NPC patients were compared to 17 nasopharyngeal mucosa biopsy specimens collected as normal tissues. Immunohistochemical staining was performed to assess expression of transforming growth factor-β receptor I (TGFβRI), programmed cell death 4 (PDCD4) and activator protein-1 (AP-1). The Kaplan-Meier method was applied to evaluate NPC patient overall survival (OS) and progression-free-survival (PFS). Cox regression analysis was used to estimate independent prognostic factors for NPC. The human NPC cell line CNE2 was selected and treated with SB431542, an inhibitor of TGFβRI; expression of TGFβRI and PDCD4 in CNE2 cells was determined by western blotting. NPC tissues showed higher expression of TGFβRI and AP-1 but lower expression of PDCD4 than normal tissues (all P < 0.05). Results: The results of Kaplan-Meier analysis showed that TGFβRI-positive patients and AP-1-positive patients had shorter OS and PFS than TGFβRI-negative patients and AP-1-negative patients; additionally, PDCD4-positive patients had higher OS and PFS than PDCD4-negative patients. Cox regression analysis revealed that advanced tumor stage, overexpression of TGFβRI and AP-1, and low expression of PDCD4 were unfavorable factors influencing OS and PFS in NPC patients. Compared with the control group, expression of TGFβRI decreased and that of PDCD4 increased significantly in CNE2 cells treated with the inhibitor (all P < 0.05). These findings indicate that the TGFβ/PDCD4/AP-1 pathway may be associated with NPC development and progression. Conclusion: High expression of TGFβRI and AP-1 and low expression of PDCD4 may be unfavorable prognostic factors for NPC.

Prognostic Factors in CD10 Negative Precursor B-Cell Acute Lymphoblastic Leukemia in Children: Data from Three Consecutive Trials ALL-BFM 86, 90, and 95.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1957-1957
Author(s):  
Anja Möricke ◽  
Richard Ratei ◽  
Wolf-Dieter Ludwig ◽  
Jochen Harbott ◽  
Arndt Borkhardt ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Acute Lymphoblastic Leukemia ◽  
B Cell ◽  
Cox Regression ◽  
Lymphoblastic Leukemia ◽  
Cns Involvement ◽  
Total N ◽  
Cox Regression Analysis ◽  
Cell Acute Lymphoblastic Leukemia

Abstract The overall unfavorable prognosis of CD10 negative (CD10−) precursor B-cell acute lymphoblastic leukemia (BCP-ALL) is well known. We analyzed 4473 pediatric patients (pts) <18 years (y) with BCP-ALL and immunophenotyping of CD10 enrolled from 1986 to 2000 in three consecutive ALL-BFM trials to explore prognostic factors in the CD10− subset. CD10 negativity was defined by CD10 expression in <20% of blasts. 233 pts (5.2%) were CD10−. In comparison to CD10 positive (CD10+) BCP-ALL pts, CD10− pts comprised more infants (age <1y 34% vs. 1%, p(X2)<0.001), more cases with hyperleukocytosis (WBC ≥100/nl 43% vs. 6%, p<0.001), more CNS involvement (CNS positive 10% vs. 2%; p<0.001) and an impaired treatment response (prednisone poor response (PPR) 22% vs. 5%, p<0.001; induction failure 6% vs. 1%, p<0.001). Estimated probability of 5 years event free survival (5y-pEFS) was significantly lower in pts with CD10− as compared to CD10+ BCP-ALL (49±3% vs 81±0.6%, p(log-rank)<0.001). Cox regression analysis including age, WBC, prednisone response (PR) and MLL/AF4 status as covariables revealed CD10 negativity as independent prognostic factor (RR 1.5, 95% confidence interval (CI) 1.1–2.1, p=0.01). Further analyses were performed within the CD10− group: 83% of infants and 60% of pts ≥1y were successfully analyzed for MLL/AF4. MLL/AF4 was detected in 55% of pts <1y and 27% of pts ≥1y. The well known risk factors for BCP-ALL (sex, age, WBC, CNS involvement, MLL/AF4 and PPR) also had prognostic impact within the CD10− group: n* 5y-pEFS* (%) SE (%) p (log-rank) *5 pts w/o reinduction were excluded sex female 109 55 5 0.022 male 119 40 5 age <1y 78 25 5 <0.001 ≥1y 150 62 4 WBC <100/nl 128 62 4 <0.001 ≥100/nl 100 33 5 CNS neg 181 54 4 0.011 pos 21 33 10 MLL/AF4 neg 95 53 5 0.001 pos 61 29 6 PR good 170 57 4 <0.001 poor 50 30 6 Out of a number of immunophenotypic markers, analyzed at different expression cut-off points, CD24 at missing or weak expression of <40% and CD65 at high expression of ≥40% were significantly correlated with unfavorable clinical characteristics and worse outcome within the CD10− group. Significant correlation with PR could only be demonstrated for expression of CD24, which is presumed to act as negative regulator in B-cell development through mediation of apoptosis. age<1y* WBC ≥100/nl* MLL/AF4 pos* PPR# pEFS§ n/total (%) n/total (%) n/total (%) n/total (%) % ±SE * all p(X2)<0.01, #CD24 p=0.01, CD65 n.s., §all p(log-rank]<0.001 CD24 <40% 37/77 (48) 52/77 (68) 33/56 (59) 24/73 (33) 32 ±5 CD24 ≥40% 34/122 (28) 35/122 (29) 18/76 (24) 20/119 (17) 59 ±5 CD65 <40% 56/180 (31) 67/180 (37) 39/120 (33) 39/175 (22) 30 ±7 CD65 ≥40% 22/44 (50) 32/44 (73) 21/34 (62) 10/41 (24) 54 ±4 Including age, WBC, PR and MLL/AF4 status as covariables, out of the analyzed markers only CD65 proved to be an independent prognostic factor in CD10− BCP-ALL (Cox regression analysis: RR 1.5, 95% CI 1.1–2.9, p=0.018). The identification of additional prognosis associated immunophenotypic markers may contribute to further refinement of treatment strategies for CD10− BCP-ALL pts.

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