scholarly journals Nomogram Predict Overall Survival of Patients with Thymic Epithelial Tumors After Surgery

2021 ◽  
Author(s):  
Yang-Yu Huang ◽  
Lei-Lei Wu ◽  
Xuan Liu ◽  
Shen-Hua Liang ◽  
Guo-Wei Ma
Keyword(s):  
Overall Survival ◽  
Patient Population ◽  
Cox Regression ◽  
Early Stage ◽  
Predictive Ability ◽  
Net Benefit ◽  
Thymic Epithelial Tumors ◽  
Cox Regression Analysis ◽  
Epithelial Tumors ◽  
Novel Approach

Abstract Background: Hematological indicators and clinical characteristics play an important role in the evaluation of the progression and prognosis of thymic epithelial tumors. Therefore, we aimed to combine these potential indicators to establish a prognostic nomogram to determine the overall survival (OS) of patients with thymic epithelial tumors undergoing thymectomy. Methods: This retrospective study was conducted on 167 patients who underwent thymectomy between May 2004 and August 2015. Cox regression analysis were performed to determine the potential indicators related to prognosis and combine these indicators to create a nomogram for visual prediction. The prognostic predictive ability of the nomogram was evaluated using the consistency index (C-index), receiver operating characteristic (ROC) curve, and risk stratification. Decision curve analysis was used to evaluate the net benefits of the model. Results: Preoperative albumin levels, neutrophil-to-lymphocyte ratio (NLR), T stage, and underlying diseases (with hypertension and/or diabetes) were included in the nomogram. In the training cohort, the nomogram showed a stronger prognostic predictive ability than the T staging (C index: 0.886 vs 0.725). Calibration curves for the overall survival (OS) were in good agreement with the standard lines in cohorts. The net benefit of the nomogram was higher than that of the T staging model. Conclusions: The nomogram showed better performance in predicting the prognosis and survival of this patient population than the T staging prediction model. And it has potential to identify high-risk patients at an early stage. This is a relatively novel approach for the prediction of OS in this patient population.

scholarly journals Nomogram predict relapse-free survival of patients with thymic epithelial tumors after surgery

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang-Yu Huang ◽  
Lei-Lei Wu ◽  
Xuan Liu ◽  
Shen-Hua Liang ◽  
Guo-Wei Ma
Keyword(s):  
Patient Population ◽  
Cox Regression ◽  
Early Stage ◽  
Predictive Ability ◽  
Relapse Free Survival ◽  
Thymic Epithelial Tumors ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Epithelial Tumors ◽  
Novel Approach

Abstract Background Hematological indicators and clinical characteristics play an important role in the evaluation of the progression and prognosis of thymic epithelial tumors. Therefore, we aimed to combine these potential indicators to establish a prognostic nomogram to determine the relapse-free survival (RFS) of patients with thymic epithelial tumors undergoing thymectomy. Methods This retrospective study was conducted on 156 patients who underwent thymectomy between May 2004 and August 2015. Cox regression analysis were performed to determine the potential indicators related to prognosis and combine these indicators to create a nomogram for visual prediction. The prognostic predictive ability of the nomogram was evaluated using the consistency index (C-index), receiver operating characteristic (ROC) curve, and risk stratification. Decision curve analysis was used to evaluate the net benefits of the model. Results Preoperative albumin levels, neutrophil-to-lymphocyte ratio (NLR), T stage, and WHO histologic types were included in the nomogram. In the training cohort, the nomogram showed well prognostic ability (C index: 0.902). Calibration curves for the relapse-free survival (RFS) were in good agreement with the standard lines in training and validation cohorts. Conclusions Combining clinical and hematologic factors, the nomogram performed well in predicting the prognosis and the relapse-free survival of this patient population. And it has potential to identify high-risk patients at an early stage. This is a relatively novel approach for the prediction of RFS in this patient population.

Lymphadenectomy in Early-Stage Intermediate-/High-Risk Endometrioid Endometrial Cancer: Clinical Characteristics and Outcomes in an Australian Cohort

2017 ◽  
Vol 27 (7) ◽  
pp. 1379-1386 ◽  
Author(s):  
Rhonda Farrell ◽  
Suzanne C. Dixon ◽  
Jonathan Carter ◽  
Penny M. Webb
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Treatment ◽  
Cox Regression ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Cancer Study ◽  
Stage Ib ◽  
Australian Cohort

ObjectiveThe role of lymphadenectomy (LND) in early-stage endometrial cancer (EC) remains controversial. Previous studies have included low-risk patients and nonendometrioid histologies for which LND may not be beneficial, whereas long-term morbidity after LND is unclear. In a large Australian cohort of women with clinical early-stage intermediate-/high-risk endometrioid EC, we analyzed the association of LND with clinicopathological characteristics, adjuvant treatment, survival, patterns of disease recurrence, and morbidity.Materials and MethodsFrom a larger prospective study (Australian National Endometrial Cancer Study), we analyzed data from 328 women with stage IA grade 3 (n = 63), stage IB grade 1 to 3 (n = 160), stage II grade 1 to 3 (n = 71), and stage IIIC1/2 grade 1 to 3 (n = 31/3) endometrioid EC. Overall survival (OS) was estimated using Kaplan-Meier methods. The association of LND with OS was assessed using Cox regression analysis adjusted for age, stage, grade, and adjuvant treatment. The association with risk of recurrent disease was analyzed using logistic regression adjusted for age, stage, and grade. Morbidity data were analyzed using χ2 tests.ResultsMedian follow-up was 45.8 months. Overall survival at 3 years was 93%. Lymphadenectomy was performed in 217 women (66%), 16% of this group having positive nodes. Median node count was 12. There were no significant differences in OS between LND and no LND groups, or by number of nodes removed. After excluding stage IB grade 1/2 tumors, there was no association between LND and OS among a “high-risk” group of 190 women with a positive node rate of 24%. However, a similar cohort (n = 71) of serous EC in the Australian National Endometrial Cancer Study had improved survival after LND. Women who underwent LND had significantly higher rates of critical events (5% vs 0%, P = 0.02) and lymphoedema (23% vs 4%, P < 0.0001).ConclusionsIn this cohort with early-stage intermediate-/high-risk endometrioid EC, LND did not improve survival but was associated with significantly increased morbidity.

scholarly journals Analysis of genome-wide mutation profile and establishment of risk signature for prognosis of bladder cancer

2020 ◽  
Author(s):  
Yanyun Zhao ◽  
Rong Ma ◽  
Fangxiao Liu ◽  
Liwen Zhang ◽  
Xuemei Lv ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cox Regression ◽  
Predictive Accuracy ◽  
Predictive Ability ◽  
Time Dependent ◽  
Net Benefit ◽  
Data Set ◽  
Clinical Prognosis ◽  
Cox Regression Analysis ◽  
Mutation Profile

Abstract Background: Emerging studies have shown that a variety of gene mutations occur in development and progression of cancer and highly mutation genes could play oncogenic or tumor suppressive roles in cancer. Therefore, our aim is to explore mutation genes which affect the prognosis of bladder.Methods: Mutation profile was obtained and analyzed from TCGA data set. A mutation-based signature was established by multivariable Cox regression analysis. Kaplan-Meier was performed to assess the prognostic power of signature. Time-dependent ROC was conducted to evaluate predictive accuracy of signature for bladder cancer patients.Results: There are 20177 genes have alteration in 403 bladder patients and 662 of them were frequently variation (mutation frequency > 5%). In this study, we assessed the prognostic predictive ability of 662 highly mutated genes and identified a mutation signature as an independent indicator for predicting the prognosis of bladder. The time-dependent ROC showed that AUC were 0.893, 0.896, 0.916 and 0.965 at 1, 3, 5 and 10 year, respectively. Stratified analysis and Multivariate Cox analysis showed that this mutation signature was reliable and independent biomarker. Furthermore, the nomogram predictive model can be used to effectively predict clinical prognosis of bladder patients. The decision analysis curve showed patients with risk threshold of 0.03-0.92 potentially yielded clinical net benefit. Finally, we identified several signaling pathways that associated with risk score by GSEA and KEGG analysis including PI3K-Akt signaling pathway and so on.Conclusions: In general, this study provide an optimal mutation signature as potential prognosis biomarker for bladder patients.

scholarly journals Down-regulation of siglec-2 (CD22) predicts worse overall survival from HBV-related early-stage hepatocellular carcinoma: a preliminary analysis from Gene Expression Omnibus

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Xiaojing Ren ◽  
Yuanyuan Ji ◽  
Xuhua Jiang ◽  
Xun Qi
Keyword(s):  
Gene Expression ◽  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Regression Analysis ◽  
Cox Regression ◽  
Early Stage ◽  
Down Regulation ◽  
Cox Regression Analysis ◽  
Tumor Tissues ◽  
Chi Square Analysis

Sialic-acid-binding immunoglobulin-like lectin (siglec) regulates cell death, anti-proliferative effects and mediates a variety of cellular activities. Little was known about the relationship between siglecs and hepatocellular carcinoma (HCC) prognosis. Siglec gene expression between tumor and non-tumor tissues were compared and correlated with overall survival (OS) from HCC patients in GSE14520 microarray expression profile. Siglec-1 to siglec-9 were all down-regulated in tumor tissues compared with those in non-tumor tissues in HCC patients (all P < 0.05). Univariate and multivariate Cox regression analysis revealed that siglec-2 overexpression could predict better OS (HR = 0.883, 95%CI = 0.806–0.966, P = 0.007). Patients with higher siglec-2 levels achieved longer OS months than those with lower siglec-2 levels in the Kaplan–Meier event analysis both in training and validation sets (P < 0.05). Alpha-fetoprotein (AFP) levels in siglec-2 low expression group were significantly higher than those in siglec-2 high expression group using Chi-square analysis (P = 0.043). In addition, both logistic regression analysis and ROC curve method showed that siglec-2 down-regulation in tumor tissues was significantly associated with AFP elevation over 300 ng/ml (P < 0.05). In conclusion, up-regulation of siglec-2 in tumor tissues could predict better OS in HCC patients. Mechanisms of siglec-2 in HCC development need further research.

Genome-wide methylation and expression profiling identify a novel epigenetic signature in gastrointestinal pan-adenocarcinomas

Epigenomics ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 907-920
Author(s):  
Wei Song ◽  
Jun Ren ◽  
Wen-Jie Wang ◽  
Chun-Tao Wang ◽  
Tao Fu
Keyword(s):  
Overall Survival ◽  
Survival Analysis ◽  
Risk Score ◽  
Cox Regression ◽  
Predictive Ability ◽  
Gene Signature ◽  
The Cancer Genome Atlas ◽  
Cox Regression Analysis ◽  
Clinicopathologic Factors ◽  
Cancer Genome Atlas

Aim: To identify methylation-driven genes and establish a novel epigenetic signature for gastrointestinal (GI) pan-adenocarcinomas. Materials & methods: Methylation and RNA-seq data for GI adenocarcinomas were downloaded from the Cancer Genome Atlas database. A methylation-driven gene signature was established by multivariate Cox regression analysis. We developed a prognostic nomogram using a combination of methylation-driven gene risk score and clinicopathological variables. A joint survival analysis based on gene expression and methylation was conducted to further investigate the prognostic role of methylation-driven genes. Results: An epigenetic signature was established based on five methylation-driven genes. We also established a prognostic nomogram based on methylation-driven gene risk score and clinicopathologic factors, with a favorable predictive ability. Joint survival analysis revealed that 28 methylation-driven genes could be independent prognostic factors for overall survival for GI adenocarcinomas. Conclusion: An epigenetic signature was established that effectively predicts the overall survival for GI adenocarcinomas across anatomic boundaries.

scholarly journals The Clinicopathological Features and Overall Survival of Patients With Gastric Neuroendocrine Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110553
Author(s):  
Bin Xu ◽  
Yuxin Chu ◽  
Qinyong Hu ◽  
Qibin Song
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Early Stage ◽  
Large Population ◽  
Clinicopathological Features ◽  
Retrospective Case ◽  
Cox Regression Analysis ◽  
Gastric Neuroendocrine Carcinoma

Objectives: Gastric neuroendocrine carcinoma (GNEC) is a class of rare histological subtypes in gastric cancer (GC). This retrospective case-control study aimed to explore the clinicopathological features and overall survival (OS) of patients with GNEC. Methods: A large population of GNEC and intestinal-type GC (IGC) patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The 1:1 propensity score matching (PSM) analysis was initiated to adjust the confounders between GNEC and IGC cohorts. Kaplan-Meier (KM) plots with log-rank tests were used to compare the survival differences in GNEC versus IGC. Additionally, Cox proportional hazard regression models were adopted to characterize the prognostic factors relevant to OS of the GNEC patients. Results: An entity of 4596 patients were collected, including 3943 (85.8%) IGC patients and 653 (14.2%) GNEC patients. The PSM analysis well-balanced all confounders in GNEC versus IGC (all P > .05). The KM plots showed that GNEC had significantly superior OS to IGC both before and after PSM analysis. Before PSM, the median OS was 52 (33.6-70.4) months in GNEC versus 32 (29.3-34.7) months in IGC ( P  =  .0015). After PSM, the median OS was 26 (18.3-33.7) months in GNEC versus 21 (17.7-24.3) months in IGC ( P  =  .0039). Stratified analysis indicated that GNEC had superior survivals to IGC in early stage patients and those who received surgery. In Cox regression analysis, age ≥ 60, tumor size > 50 mm, stage II-IV, T2, and N3 were independent risk factors for the GNEC patients (hazard ratio [HR]>1, P < .05). By contrast, year 2010 to 2015, female, and surgery were independent protective factors for these patients (HR < 1, P < .05). Conclusions: GNEC has unique clinicopathological features quite different from IGC and may have a superior survival to IGC in early stage patients. The prognostic factors identified here may assist the clinicians to more individually treat these patients.

scholarly journals Prognostic Nomograms for Predicting Overall Survival and Cancer-Specific Survival in Patients with Angiosarcoma, a SEER population-based study

2021 ◽  
Author(s):  
Ting Jiang ◽  
Zixiang Ye ◽  
TianYu Shao ◽  
YiYang Luo ◽  
BinBin Wang
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Predictive Ability ◽  
Training Group ◽  
Cox Proportional Hazards ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Cancer Management

Abstract Backgrounds: Angiosarcoma (AS) is a kind of highly aggressive cancer with high occurrence and mortality rates. This study aimed to establish a comprehensive and validated prognostic nomogram with various clinical indicators in patients with AS.Methods: Data of patients with AS diagnosed after surgery between 2010 and 2015 was retrieved from the Surveillance Epidemiology and End Results (SEER) database. Univariate and multivariate Cox proportional hazards regression analysis were performed to identify the independent prognostic factors associated with survival to construct the predictive nomogram of 3- and 5-year overall survival (OS) and cancer-specific survival (CSS) rates. Concordance-index(C-index), calibration plots and receiver operating characteristic (ROC) curves were applied to evaluate the predictive ability of the nomograms. The further decision curve analysis (DCA) was drawn to confirm the clinical usefulness of the nomograms.Results: 323 patients in total with AS were divided into the training group (N =226) and the validation group (N = 97). After the multivariate Cox regression analysis, gender, age, AJCC stage group 7th ed, T, N and M stage 7th ed, histologic grade and primary site were statistically identified as independent factors with OS and CSS (P<0.05). The C-index of the nomograms for OS and CCS in the training cohort was 0.760 (95%CI: 0.674–0.847) and 0.793 (95%CI: 0.687–0.898), meanwhile, the C-index of those in the validation cohort was 0.790 (95%CI: 0.725–0.855) and 0.888 (95%CI: 0.799–0.976) respectively. The results of calibration plots and ROC curve showed the nomograms qualified to measure the risk and prognosis. DCA exhibited good clinical utility of nomograms.Conclusion: Our study has developed novel and practical nomograms for predicting prognosis in patients with AS contributing to cancer management.

scholarly journals Evaluating Overall Survival and Competing Risks of Survival in Patients With Early Stage Breast Cancer Using a Comprehensive Nomogram

2019 ◽  
Author(s):  
Yanbo Xu ◽  
Hong Liu ◽  
Qi-Hua Cao ◽  
Jia-Li Ji ◽  
Rong-Rong Dong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Risk Analysis ◽  
Tumor Size ◽  
Cox Regression ◽  
Early Stage ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Cox Regression Analysis ◽  
Specific Mortality

Abstract BackgroundPatients with early stage breast cancer (BC) live long but accompany with competing comorbidities. This study aims to estimate the impact of cancer and non-cancer causes of death in early stage BC patients, and further quantify the survival differences. MethodsPatients diagnosed with breast cancer between 2010 and 2016 from the Surveillance, Epidemiology, and End Results database were enrolled in the study. Cumulative incidence function (CIF) for cause-specific death and other causes of death were estimated, and the differences were tested by Gray’s test. Nomogram for estimating 3-, 4-, and 5-year overall survival, cancer-specific survival and other-cause-specific survival was established based on Cox regression analysis and Fine and Gray’s competing risk analysis. The discriminative ability, calibration and precision of the nomogram was evaluated and compared using C statistics, calibration plots and the area under receiver operating characteristic curve. Results196304 eligible patients with early-stage BC patients were enrolled in this study. Prolonged overall survival (OS) was associated with younger age, well differentiation, smaller tumor size, Luminal subtype and presence of surgery ( p <0.001). For competing events, Fine and Gray's competing risk analysis was used to validate the predictors: i ncreasing age, poorer differentiation, larger tumor size, triple negative subtype, HER2 enriched subtype and absence of surgery for cancer-specific mortality (CSM); and increasing age, larger tumor size and absence of surgery for other-cause-specific mortality (OCSM). The established nomogram was well calibrated, and displayed good discrimination in both training cohort and validation cohort by calibration plots (Figure 4), with a concordance index of 0.801 (95% CI, 0.795-0.806; p =0.003) for OS prediction; 0.830 (95% CI, 0.824-0.836; p =0.003) for CSM prediction and 0.806 (95% CI, 0.798-0.814; p =0.004) for OCSM prediction. Furthermore, the AUC values for predicting survival and death were: OS, 80.2% (3-year), 79.5% (4-year), and 78.7% (5-year); CSM, 83.0% (3-year), 81.7% (4-year), and 80.3% (5-year); OCSM 81.3% (3-year), 80.8% (4-year), and 81.7% (5-year) (Figure 5). ConclusionsWe evaluated OS and CIF of cancer-specific death and other-cause-specific death in patients with early stage BC based on Cox regression analysis and Fine and Gray’s competing risk analysis and developed the first comprehensive prognostic nomogram.

A NOD-Like Receptor Signaling-Based Gene Signature Identified as a Novel Prognostic Biomarker for Predicting Overall Survival of Colorectal Cancer Patients

2021 ◽  
Vol 16 ◽  
Author(s):  
Xin Qi ◽  
Jiachen Zuo ◽  
Donghui Yan ◽  
Guang Hu ◽  
Rui Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Regression Analysis ◽  
Cox Regression ◽  
Predictive Ability ◽  
Gene Signature ◽  
Survival Prediction ◽  
Prognostic Signature ◽  
Cox Regression Analysis ◽  
Chemotherapeutic Response

Background: Colorectal cancer (CRC) is the most frequently diagnosed gastrointestinal tract malignant tumor worldwide, which is closely associated with distant metastasis and poor prognosis. Due to high degree of heterogeneity, reliable prognostic biomarkers are urgently needed to guide the therapeutic intervention of CRC patients. Objective: The present study aimed to develop a NOD-like receptors (NLRs) signaling-based gene signature that can successfully predict the overall survival of CRC patients. Methods: Firstly, differentially expressed NLR signaling-related genes were identified between primary and metastatic human CRC samples. Genes with prognostic value were then screened through univariate Cox regression analysis. Next, the NLR signaling-based prognostic signature was constructed by LASSO-penalized Cox regression analysis, and its predictive ability was further confirmed in an independent cohort. Furthermore, functional studies including GO, GSEA, ssGSEA and chemotherapeutic response analyses were performed to explore the role of the NLR signaling-based signature in CRC pathogenesis and therapy. Results: The established prognostic signature that consisted of 7 NLR signaling-related genes can effectively stratify the high-risk and low-risk CRC patients in both training and validation cohorts. Moreover, the signature proved to be an independent indicator of overall survival in CRC patients. Functional annotation and chemotherapeutic response analyses showed that the signature was closely associated with immune status and chemotherapeutic sensitivity of CRC patients. Conclusion: The novel NLR signaling-based gene signature could serve as a potential tool for survival prediction and therapeutic evaluation, thereby contributing to the personalized prognostic management of CRC patients.

scholarly journals Propensity score‐matched comparison of stenting as a bridge to surgery and emergency surgery for acute malignant left‐sided colonic obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuepeng Cao ◽  
Qing Chen ◽  
Zhizhan Ni ◽  
Feng Wu ◽  
Chenshen Huang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Emergency Surgery ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Colonic Obstruction ◽  
Metal Stents ◽  
Bridge To Surgery ◽  
Cox Regression Analysis ◽  
Self Expanding Metal Stents

Abstract Background Bridge to elective surgery (BTS) using self-expanding metal stents (SEMSs) is a common alternative to emergency surgery (ES) for acute malignant left-sided colonic obstruction (AMLCO). However, studies regarding the long-term impact of BTS are limited and have reported unclear results. Methods A multicenter observational study was performed at three hospitals from April 2012 to December 2019. Propensity score matching (PSM) was introduced to minimize selection bias. The primary endpoint was overall survival. The secondary endpoints included surgical approaches, primary resection types, total stent-related adverse effects (AEs), surgical AEs, length of hospital stay, 30-day mortality and tumor recurrence. Results Forty-nine patients in both the BTS and ES groups were matched. Patients in the BTS group more often underwent laparoscopic resection [31 (63.3%) vs. 8 (16.3%), p < 0.001], were less likely to have a primary stoma [13 (26.5%) vs. 26 (53.1%), p = 0.007] and more often had perineural invasion [25 (51.0 %) vs. 13 (26.5 %), p = 0.013]. The median overall survival was significantly lower in patients with stent insertion (41 vs. 65 months, p = 0.041). The 3-year overall survival (53.0 vs. 77.2%, p = 0.039) and 5-year overall survival (30.6 vs. 55.0%, p = 0.025) were significantly less favorable in the BTS group. In multivariate Cox regression analysis, stenting (hazard ratio(HR) = 2.309(1.052–5.066), p = 0.037), surgical AEs (HR = 1.394 (1.053–1.845), p = 0.020) and pTNM stage (HR = 1.706 (1.116–2.607), p = 0.014) were positively correlated with overall survival in matched patients. Conclusions Self-expanding metal stents as “a bridge to surgery” are associated with more perineural invasion, a higher recurrence rate and worse overall survival in patients with acute malignant left-sided colonic obstruction compared with emergency surgery.

Sign in / Sign up

Export Citation Format

Share Document