scholarly journals Predicting Survival for Nasopharyngeal Carcinoma: Development and Validation of Nomograms With Routine Hematological Biomarkers Based on the 8th Edition of AJCC/UICC Staging System

2020 ◽  
Author(s):  
Yu Liang ◽  
Kaihua Chen ◽  
Jie Yang ◽  
Jing Zhang ◽  
Rurong Peng ◽  
...  
Keyword(s):  
Validation Cohort ◽  
External Validation ◽  
Progression Free Survival ◽  
Staging System ◽  
Tnm Staging ◽  
Prognostic Role ◽  
Tnm System ◽  
Ebv Dna ◽  
8Th Edition

Abstract BackgroundThe 8th edition of AJCC/UICC TNM staging system (TNM system) and the previous nomograms have limitations, therefore we aimed to develop and validate nomograms incorporating routine hematological biomarkers with or without EBV DNA for overall survival (OS) and progression-free survival (PFS). We also evaluated the prognostic role of EBV DNA.Material and Methods1203 patients at our hospital from 2013 to 2016 were retrospectively reviewed and divided into two parts (922 patients for primary cohort and 281 for validation cohort). Nomograms (nomogram with or without EBV DNA) were developed and compared with other models (TNM system alone, TNM system with EBV DNA), via comparison the prognostic role of EBV DNA was evaluated. Internal and external validation were performed. Risk stratification were conducted with recursive partitioning analysis.ResultsThe nomograms with EBV DNA for OS and PFS included sex, age, T category, N category, EBV DNA, albumin, neutrophil to lymphocyte ratio and lactate dehydrogenase. The nomograms without EBV DNA for OS and PFS included the same variables but without EBV DNA. The C-index for nomogram with EBV DNA was 0.715 for OS and 0.705 for PFS. For nomogram without EBV DNA, it was 0.709 and 0.700, respectively. It was 0.639 and 0.636 for TNM system alone and 0.648, 0.646 respectively for TNM system with EBV DNA. The nomograms with or without EBV DNA had better performance than both the TNM system alone and TNM system with EBV DNA, while the TNM system with EBV DNA were better than TNM system alone. The validation cohort indicates great applicability of nomograms. The patients were stratified into 4 risk groups.ConclusionThe nomograms with or without EBV DNA provide better prognostication than the TNM system and also the TNM system with EBV DNA. EBV DNA is valuable in predicting survival, but it is not suggested to incorporate EBV DNA alone to TNM system.

Prognostic role of pretreatment plasma EBV DNA on stage III nasopharyngeal carcinoma staged by AJCC/UICC 8th edition TNM staging classification.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 6055-6055
Author(s):  
Victor Lee ◽  
Dora LW Kwong ◽  
To-Wai Leung ◽  
Cheuk-Wai Choi ◽  
Brian O'Sullivan ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Tnm Staging ◽  
Stage Iii ◽  
Prognostic Role ◽  
Ebv Dna ◽  
Staging Classification ◽  
8Th Edition

scholarly journals Derivation and Validation of a Prognostic Scoring Model Based on Clinical and Pathological Features for Risk Stratification in Oral Squamous Cell Carcinoma Patients: A Retrospective Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiaying Zhou ◽  
Huan Li ◽  
Bin Cheng ◽  
Ruoyan Cao ◽  
Fengyuan Zou ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Validation Cohort ◽  
External Validation ◽  
Staging System ◽  
Tnm Staging ◽  
Pathological Features ◽  
Scoring Model ◽  
Tnm Staging System ◽  
Pathological Model ◽  
Clinical And Pathological Features

ObjectiveTo develop and validate a simple-to-use prognostic scoring model based on clinical and pathological features which can predict overall survival (OS) of patients with oral squamous cell carcinoma (OSCC) and facilitate personalized treatment planning.Materials and MethodsOSCC patients (n = 404) from a public hospital were divided into a training cohort (n = 282) and an internal validation cohort (n = 122). A total of 12 clinical and pathological features were included in Kaplan–Meier analysis to identify the factors associated with OS. Multivariable Cox proportional hazards regression analysis was performed to further identify important variables and establish prognostic models. Nomogram was generated to predict the individual’s 1-, 3- and 5-year OS rates. The performance of the prognostic scoring model was compared with that of the pathological one and the AJCC TNM staging system by the receiver operating characteristic curve (ROC), concordance index (C-index), calibration curve, and decision curve analysis (DCA). Patients were classified into high- and low-risk groups according to the risk scores of the nomogram. The nomogram-illustrated model was independently tested in an external validation cohort of 95 patients.ResultsFour significant variables (physical examination-tumor size, imaging examination-tumor size, pathological nodal involvement stage, and histologic grade) were included into the nomogram-illustrated model (clinical–pathological model). The area under the ROC curve (AUC) of the clinical–pathological model was 0.687, 0.719, and 0.722 for 1-, 3- and 5-year survival, respectively, which was superior to that of the pathological model (AUC = 0.649, 0.707, 0.717, respectively) and AJCC TNM staging system (AUC = 0.628, 0.668, 0.677, respectively). The clinical–pathological model exhibited improved discriminative power compared with pathological model and AJCC TNM staging system (C-index = 0.755, 0.702, 0.642, respectively) in the external validation cohort. The calibration curves and DCA also displayed excellent predictive performances.ConclusionThis clinical and pathological feature based prognostic scoring model showed better predictive ability compared with the pathological one, which would be a useful tool of personalized accurate risk stratification and precision therapy planning for OSCC patients.

scholarly journals Development and validation of nomogram combining serum biomarker for predicting survival in patients with resected rectal cancer

2019 ◽  
Vol 39 (11) ◽  
Author(s):  
Shaonan Fan ◽  
Ting Li ◽  
Ping Zhou ◽  
Qiliang Peng ◽  
Yaqun Zhu
Keyword(s):  
Rectal Cancer ◽  
Clinical Decision Making ◽  
Validation Cohort ◽  
External Validation ◽  
Staging System ◽  
Clinical Decision ◽  
Tnm Staging ◽  
P Value ◽  
Training Cohort ◽  
American Joint Committee

Abstract Purpose: Nomogram is a widely used tool that precisely predicts individualized cancer prognoses. We aimed to develop and validate a reliable nomogram including serum tumor biomarkers to predict individual overall survival (OS) for patients with resected rectal cancer (RC) and compare the predictive value with the American Joint Committee on Cancer (AJCC) stages. Patients and methods: We analyzed 520 patients who were diagnosed with non-metastatic rectal cancer as training cohort. External validation was performed in a cohort of 11851 patients from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors were identified and integrated to build a nomogram using the Cox proportional hazard regression model. The nomogram was evaluated by Harrell’s concordance index (C-index) and calibration plots in both training and validation cohort. Results: The calibration curves for probability of 1-, 3-, and 5-year OS in both cohorts showed favorable accordance between the nomogram prediction and the actual observation. The C-indices of the nomograms to predict OS were 0.71 in training cohort and 0.69 in the SEER cohort, which were higher than that of the seventh edition American Joint Committee on Cancer TNM staging system for predicting OS (training cohort, 0.71 vs. 0.58, respectively; P-value < 0.001; validation cohort, 0.69 vs. 0.57, respectively; P-value < 0.001). Conclusion: We developed and validated a novel nomogram based on CEA and other factors for predicting OS in patients with resected RC, which could assist clinical decision making and improvement of prognosis prediction for individual RC patients after surgery.

scholarly journals Construction and External Validation of a Nomogram for Predicting Survival of Intrahepatic Cholangiocarcinoma Patients Without Lymph Node and Distant Metastasis

2021 ◽  
Author(s):  
Chuang Jiang ◽  
Fei Teng ◽  
Yunyou Tang ◽  
Ziqi Zhang ◽  
Yimin Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Validation Cohort ◽  
External Validation ◽  
Staging System ◽  
Tnm Staging ◽  
Internal Validation ◽  
West China Hospital ◽  
Training Cohort ◽  
West China

Abstract BackgroundThe purpose of this study was to construct and external validate a nomogram for predicting overall survival(OS) in intrahepatic cholangiocarcinoma (ICC) patients classified as N0M0 according to the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system.Methods:812 ICC patients without distant and lymph node metastasis between 2011 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, then randomly assigned to the training cohort(n=648) or internal validation cohort(n=164), external validation cohort consisted of 136 ICC patients with N0M0 stage treated in West China Hospital of Sichuan University from 2013 to 2015. The precision of the nomogram was validated internally using SEER validation cohort and externally using the patients’ data of West China Hospital. Results :The nomogram was established to predict 1-year, 3-year and 5-year OS and the calibration curve showed nomogram prediction performance was in good agreement with the actual results. The C‑index of the nomogram was 0.750(95% CI:0.731-0.769) in the training cohort, and the internal and external validated C-indexes were 0.803(95% CI:0.783-0.823) and 0.681(95% CI:0.524-0.838), respectively. In the training, internal and external validation cohort, the 1-year, 3‑year and 5‑year AUCs were (0.772,0.809,0.798),(0.896,0.868,0.896) and (0.673,0.786,0.886), respectively.Conclusions This nomogram has an excellent predictive effect on the 1- ,3-, 5-year OS of ICC patients with stage N0M0 and guide the optimal treatment for these type of patients.

Establishment of a Nomogram by Integrating Molecular Markers and Tumor-Node-Metastasis Staging System for Predicting the Prognosis of Hepatocellular Carcinoma

2018 ◽  
Vol 36 (5) ◽  
pp. 426-432 ◽  
Author(s):  
Xi-Tai Huang ◽  
Liu-Hua Chen ◽  
Chen-Song Huang ◽  
Jian-Hui Li ◽  
Jian-Peng Cai ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Validation Cohort ◽  
External Validation ◽  
Staging System ◽  
Tnm Staging ◽  
Hazard Ratio ◽  
Tumor Node Metastasis ◽  
Training Cohort ◽  
Tnm Staging System

Aims: This study aimed to develop a valuable nomogram by integrating molecular markers and tumor-node-metastasis (TNM) staging system for predicting the long-term outcome of patients with hepatocellular carcinoma (HCC). Methods: The gene expression profiles of HCC patients undergoing liver resection were obtained from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. One hundred and ninety-nine patients from TCGA and 94 patients from GEO were selected to be part of the training cohort and validation cohort respectively. Univariate and multivariate cox analyses were performed to identify genes with independent prognostic values for overall survival (OS) of HCC patients in training cohort. Risk score was calculated based on the coefficients and Z-score of 3 genes for each patient. The nomogram was developed based on the risk score and TNM staging system. Discrimination and predictive accuracy of the nomogram were measured by using the concordance index (C-index) and calibration curve. The efficacy of the nomogram was tested in the external validation cohort. Results: Univariate and multivariate cox analyses revealed that EXT2 (p = 0.035, hazard ratio 13.412), ETV5 (p = 0.010, hazard ratio 4.325), and CHODL (p < 0.001, hazard ratio 6.286) were independent prognostic factors and chosen for further nomogram establishment. The C-index of the nomogram for predicting the OS in the training cohort was superior to that of the TNM staging system (0.77 vs. 0.64, p < 0.01). The calibration curve of predicted 1-, 3-, and 5-year OS showed satisfactory accuracy. The external validation cohort showed good performance of comprehensive nomogram as well. Conclusion: The novel nomogram by integrating the molecular markers and TNM staging system has better performance in predicting long-term prognosis in HCC patients than the TNM staging system alone.

The Updated AJCC/TNM Staging System for Papillary Thyroid Cancer (8th Edition): From the Perspective of Genomic Analysis

2018 ◽  
Vol 42 (11) ◽  
pp. 3624-3631 ◽  
Author(s):  
Kyubo Kim ◽  
Jin Hwan Kim ◽  
Il Seok Park ◽  
Young Soo Rho ◽  
Gee Hwan Kwon ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Genomic Analysis ◽  
Staging System ◽  
Tnm Staging ◽  
Papillary Thyroid ◽  
Tnm Staging System ◽  
8Th Edition

scholarly journals Eighth Edition Staging of Thoracic Malignancies: Implications for the Reporting Pathologist

2018 ◽  
Vol 142 (5) ◽  
pp. 645-661 ◽  
Author(s):  
Andrew G. Nicholson ◽  
Ming S. Tsao ◽  
William D. Travis ◽  
Deepa T. Patil ◽  
Francoise Galateau-Salle ◽  
...  
Keyword(s):  
Interest Group ◽  
International Association ◽  
External Validation ◽  
Cancer Control ◽  
Tnm Staging ◽  
Classification Systems ◽  
Thymic Epithelial Tumors ◽  
American Joint Committee ◽  
Thoracic Malignancies ◽  
8Th Edition

Context The Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer, in conjunction with the International Mesothelioma Interest Group, the International Thymic Malignancy Interest Group, and the Worldwide Esophageal Cancer Collaboration, developed proposals for the 8th edition of their respective tumor, node, metastasis (TNM) staging classification systems. Objective To review these changes and discuss issues for the reporting pathologist. Data Sources Proposals were based on international databases of lung (N = 94 708), with an external validation using the US National Cancer Database; mesothelioma (N = 3519); thymic epithelial tumors (10 808); and epithelial cancers of the esophagus and esophagogastric junction (N = 22 654). Conclusions These proposals have been mostly accepted by the Union for International Cancer Control and the American Joint Committee on Cancer and incorporated into their respective staging manuals (2017). The Union for International Cancer Control recommended implementation beginning in January 2017; however, the American Joint Committee on Cancer has deferred deployment of the eighth TNM until January 1, 2018, to ensure appropriate infrastructure for data collection. This manuscript summarizes the updated staging of thoracic malignancies, specifically highlighting changes from the 7th edition that are relevant to pathologic staging. Histopathologists should become familiar with, and start to incorporate, the 8th edition staging in their daily reporting of thoracic cancers henceforth.

Prognostic and predictive value of vessels encapsulating tumor clusters (VETC) in renal cell carcinoma (RCC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16554-e16554
Author(s):  
Salvatore Lorenzo Renne ◽  
Marina Valeri ◽  
Matteo Perrino ◽  
Luca Di Tommaso ◽  
Luigi Terracciano ◽  
...  
Keyword(s):  
Kinase Inhibitors ◽  
Cox Regression ◽  
Hierarchical Modeling ◽  
Progression Free Survival ◽  
Type I ◽  
Prognostic Role ◽  
Endothelial Lining ◽  
Mesenchymal Transition ◽  
Tumor Dissemination

e16554 Background: VETC has been described as an epithelial-to-mesenchymal-transition independent process of metastasis in hepatocellular carcinoma (HCC): endothelium covers small clusters of neoplastic cells allowing tumor dissemination. It has also been noted that VETC-positive HCCs benefit more from tyrosine kinase inhibitors (TKI) therapy. Interestingly, this type of angiogenesis was also found in RCC - and other cancers - and associated with poor prognosis. The objectives of the present study are: 1) to investigate the prognostic role of VETC in a cohort of primary consecutive RCC. 2) to model the predictive role VETC to TKI response in a cohort of metastatic RCC patients treated with sunitinib or pazopanib. Methods: The study was observational and retrospective. To evaluate the VETC effect on overall survival (OS) for Cox regression, with power .8, Hazard Ratio 2.35, proportion of subject VETC+ .4, proportion of events .6, correlation among covariates .4 and a type I error rate .5, the estimated sample size was n=89. We included consecutive patients undergoing surgery at our institution for primary RCC from 2005 to 2007, (Surgical Series; n=92 cases). Moreover, to investigate the possible role of VETC in predicting TKIs benefit, we considered all RCC patients treated with first line TKIs at our center (TKI Series; sunitinib, n = 39; pazopanib n = 17), and recorded the progression free survival (PFS). VETC was assessed with CD34 immunohistochemistry and defined as a continuous endothelial lining around tumor clusters. We used Bayesian probabilistic modeling to detect small effects and multilevel hierarchical modeling to reduce overfitting. Models were fit using Stan and R. The study was approved by institutional review board (n. 865/20) and registered on ClinicalTrials.gov. Results: VETC+ RCC had a worse prognosis in the Surgical Series, with a posterior probability density (PPD) of median OS of 88 months (mo) (standard deviation, SD: 16 mo) for VETC positive Vs 136 mo (SD: 26 mo) for VETC-; the expected loss of median OS was 48 mo (SD: 31 mo) for patients having a VETC + RCC. Conversely in the TKI Series, VETC+ RCC showed longer PFS compared to VETC- ones: with sunitinib a PPD of median PFS of 35 mo (SD:11 mo) for VETC+ Vs 19 mo (SD: 5 mo) for VETC-. Under Pazopanib a PPD of median PFS of 20 mo (SD: 8 mo) for VETC+ Vs 11 mo (SD: 7 mo) for VETC-. The expected gain of median PFS for of VETC+ cases, was 17 and 9 mo (SD: 12 and 11 mo), respectively in sunitinib and pazopanib treated cases. Conclusions: Our results confirmed the general adverse prognostic role of VETC in RCC, however this phenotype gave a substantial PFS gain for patients treated with TKI, similarly to what have been observed in HCC. VETC could be a new predictive bio-marker that allows the delivery of a personalized treatment: patients affected by RCC might directly benefit from a better selection of already approved drugs.

HOW DOES THE AJCC/TNM STAGING SYSTEM 8TH EDITION PERFORM IN THYROID CANCER AT A MAJOR MIDDLE EASTERN MEDICAL CENTER?

2020 ◽  
Author(s):  
Ali S. Alzahrani ◽  
Lina Albalawi ◽  
Sedra Mazi ◽  
Noha Mukhtar ◽  
Hadeel AlJamei ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Medical Center ◽  
Middle Eastern ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System ◽  
8Th Edition
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