scholarly journals Tumor size as a prognostic factor improves the accuracy of the prognostic prediction of T4 stage colon cancer: a propensity score analysis

2021 ◽  
Author(s):  
Yuexiang Liang ◽  
Qiang Li ◽  
Donglei He ◽  
Yong Chen ◽  
Jingquan Li
Keyword(s):  
Adjuvant Chemotherapy ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Propensity Score Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
T4 Stage ◽  
Prognostic Prediction

Abstract The aim of this study was to evaluate the potential impact of tumor size on the long-term outcome of CC patients after curative surgery. A total of 782 curatively resected T4 stage CC patients without distant metastasis were enrolled. Patients were categorized into 2 groups according to the best threshold of tumor size: larger group (LG) and smaller group (SG). Propensity score matching was used to adjust for the differences in baseline characteristics. The ideal cutoff points for tumor size was 5 cm. In the multivariate analysis for the whole study series, tumor size was an independent prognostic factors. Patients in the LG had a significant lower 5-year OS rate, but higher distant metastatic rate than those in the SG (37.1% versus 25.2%, P < 0.001). After matching, patients in the LG still demonstrated a significant lower 5-year OS rate than those in the SG (63.5% versus 74.2%, P < 0.001). Patients in the LG benefited more from postoperative adjuvant chemotherapy than patients in the SG. The modified stage including tumor size was found to be more appropriate for predicting the OS of T4 stage CC than TNM stage. In conclusion, tumor size was an independent prognostic factor and could correlate with higher distant metastasis rate and better response of adjuvant chemotherapy. We maintain that tumor size should be incorporated into the staging system to enhance the accuracy of the prognostic prediction of T4 stage CC patients.

scholarly journals Tumor size improves the accuracy of the prognostic prediction of T4a stage colon cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuexiang Liang ◽  
Qiang Li ◽  
Donglei He ◽  
Yong Chen ◽  
Jingquan Li
Keyword(s):  
Colon Cancer ◽  
Prognostic Factor ◽  
Tumor Size ◽  
Staging System ◽  
Independent Prognostic Factor ◽  
Tnm Stage ◽  
Curative Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Prognostic Prediction

AbstractThe aim of this study was to evaluate the potential impact of tumor size on the long-term outcome of colon cancer (CC) patients after curative surgery. A total of 782 curatively resected T4a stage CC patients without distant metastasis were enrolled. Patients were categorized into 2 groups according to the best threshold of tumor size: larger group (LG) and smaller group (SG). Propensity score matching was used to adjust for the differences in baseline characteristics. The ideal cutoff point of tumor size was 5 cm. In the multivariate analysis for the whole study series, tumor size was an independent prognostic factor. Patients in the LG had significant lower 5-year overall survival (OS) and relapse-free survival (RFS) rates (OS: 63.5% versus 75.2%, P < 0.001; RFS: 59.5% versus 72.4%, P < 0.001) than those in the SG. After matching, patients in the LG still demonstrated significant lower 5-year OS and RFS rates than those in the SG. The modified tumor-size-node-metastasis (mTSNM) staging system including tumor size was found to be more appropriate for predicting the OS and RFS of T4a stage CC than TNM stage, and the -2log likelihood of the mTSNM staging system was smaller than the value of TNM stage. In conclusion, tumor size was an independent prognostic factor for OS and RFS. We maintain that tumor size should be incorporated into the staging system to enhance the accuracy of the prognostic prediction of T4a stage CC patients.

scholarly journals Luminal-like HER2-negative stage IA breast cancer: a multicenter retrospective study on long-term outcome with propensity score analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (68) ◽  
pp. 112816-112824 ◽  
Author(s):  
Carmine De Angelis ◽  
Massimo Di Maio ◽  
Anna Crispo ◽  
Mario Giuliano ◽  
Francesco Schettini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Score Analysis ◽  
Stage Ia

scholarly journals Are Type 2 Diabetes Patients Who Self-Monitor Blood Glucose Special? The Role of Confounders in the Observational ROSSO Study

2009 ◽  
Vol 3 (6) ◽  
pp. 1507-1515 ◽  
Author(s):  
Hubert Kolb ◽  
Stephan Martin ◽  
Volker Lodwig ◽  
Lutz Heinemann ◽  
Werner A. Scherbaum ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Matched Pair ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Score Analysis

Background: In the German multicenter, retrospective cohort study (ROSSO), those patients with type 2 diabetes who performed self-monitoring of blood glucose (SMBG) had a better long-term clinical outcome. We analyzed whether confounders accounted for the lower rate of clinical events in the SMBG cohort. Methods: ROSSO followed 3268 persons from diagnosis of type 2 diabetes for a mean of 6.5 years. Data were retrieved from patient files of randomly contacted primary care practices. Results: In total, more than 60 potential confounders were documented, including nondisease-associated parameters such as patient's health insurance, marital status, habitation, and characteristics of diabetes centers. There were only modest differences for these parameters between groups with versus without SMBG, and multiple adjustments did not weaken the association of SMBG use with better outcome (odds ratio 0.65, 95% confidence interval 0.53–0.81, p < .001). This was also true for subgroups of patients defined by type of antidiabetes treatment. Propensity score analysis confirmed the association of SMBG use with outcome. Using key baseline parameters, 813 matching pairs of patients were identified. The analysis again showed a better long-term outcome in the SMBG group (hazard ratio 0.67 p = .004). Conclusion: An influence of nonrecognized confounders on better outcome in the SMBG group is rendered improbable by similar results obtained with adjustments for disease-associated or disease-independent parameters, by the analysis of patient subgroups, by propensity score analysis and by performing a matched-pair analysis. The higher flexibility in pharmacological antidiabetes treatment regimens in the SMBG cohort suggests a different attitude of treating physicians and patients in association with SMBG.

scholarly journals Sarcopenia Is a Negative Prognostic Factor in Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatic Malignancies

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1503 ◽  
Author(s):  
Loosen ◽  
Schulze-Hagen ◽  
Bruners ◽  
Tacke ◽  
Trautwein ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Psoas Muscle ◽  
Muscle Size ◽  
Rapid Decline ◽  
Term Outcome ◽  
Long Term Outcome

: Background and Aims: While transarterial chemoembolization (TACE) represents a standard of therapy for intermediate-stage hepatocellular carcinoma (HCC) and is also routinely performed in patients with liver metastases, it is still debated which patients represent the ideal candidates for TACE therapy in terms of overall survival. Sarcopenia, the degenerative loss of skeletal muscle mass and strength, has been associated with an adverse outcome for various malignancies, but its role in the context of TACE has largely remained unknown. Here, we evaluated the role of sarcopenia on the outcome of patients undergoing TACE for primary and secondary liver cancer. Methods: The patients’ psoas muscle size was measured on axial computed tomography (CT) scans and normalized for the patients’ height squared. This value was referred to as the psoas muscle index (PMI). The PMI was correlated with clinical and laboratory markers. Results: While pre-interventional sarcopenia had no impact on the direct tumor response to TACE, sarcopenic patients with a pre-interventional PMI below our ideal cut-off value of 13.39 mm/m2 had a significantly impaired long-term outcome with a median overall survival of 491 days compared to 1291 days for patients with a high PMI. This finding was confirmed by uni- and multivariate Cox-regression analyses. Moreover, a progressive rapid decline in muscle mass after TACE was a predictor for an unfavorable prognosis. Conclusion: Our data suggest that sarcopenia represents a previously unrecognized prognostic factor for patients undergoing TACE therapy which might yield important information on the patients’ post-interventional outcome and should therefore be implemented into clinical stratification algorithms.

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