scholarly journals Exploring the Clinical Characteristics of the Lymph Nodal Metastatic Regions in Patients with Endometrial Cancer

2021 ◽  
Author(s):  
Wonkyo Shin ◽  
Sun-Young Kim ◽  
Sangyoon Park ◽  
Sokbom Kang ◽  
Myong Cheol Lim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Risk Group ◽  
Survival Rates ◽  
Cox Proportional Hazards Model ◽  
Clinical Factors ◽  
Gynecology And Obstetrics ◽  
Overall Survival Rates

Abstract Objective To evaluate clinical factors that can help determine the extent of lymphadenectomy required in endometrial cancer patients and confirm the differences of metastatic lymph node regions based on the risk factors for endometrial cancer patients. Methods The medical records of 468 endometrial cancer patients were retrospectively reviewed between January 2006 and December 2018. Patients were categorized into pelvic lymph node dissection (PLND) and pelvic plus para-aortic lymph nodes dissection (PPALND) groups. Demographics, recurrence-free survival, and 5-year overall survival rates were compared, and the clinical factors affecting survival were evaluated using Cox proportional hazards model. Results The median follow-up period was 55 months (range, 6–142 months). The mean age was higher in the PPALND group than in the PLND group (51.0 vs. 54.5 years; P < 0.001). The PPALND group had a higher International Federation of Gynecology and Obstetrics (FIGO) stage, lymphovascular invasion, endocervical invasion, and FIGO grade (P = 0.001) than the PLND group. The PPALND group had higher 5-year recurrence-free and overall survival rates than the PLND group. While comparing lymph node (LN) metastasis confirmed pathologically, the group with confirmed metastasis showed a higher number of high-risk group patients than lymph node-negative patients. However, no difference was observed in pelvic LN metastasis, pelvic plus para-aortic LN metastasis, and isolated para-aortic LN metastasis groups. Conclusions When treating patients with endometrial cancer, risk group evaluation is an important factor for determining LN dissection. Our study found no differences in clinical factors of metastatic LN regions.

scholarly journals Association of chemotherapy with survival in stage II colon cancer patients who received radical surgery: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhihao Lv ◽  
Yuqi Liang ◽  
Huaxi Liu ◽  
Delong Mo
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Prediction Models ◽  
Radical Surgery ◽  
Survival Rates ◽  
Stage Ii ◽  
Survival Prediction ◽  
Stage Ii Colon Cancer ◽  
Overall Survival Rates

Abstract Background It remains controversial whether patients with Stage II colon cancer would benefit from chemotherapy after radical surgery. This study aims to assess the real effectiveness of chemotherapy in patients with stage II colon cancer undergoing radical surgery and to construct survival prediction models to predict the survival benefits of chemotherapy. Methods Data for stage II colon cancer patients with radical surgery were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (1:1) was performed according to receive or not receive chemotherapy. Competitive risk regression models were used to assess colon cancer cause-specific death (CSD) and non-colon cancer cause-specific death (NCSD). Survival prediction nomograms were constructed to predict overall survival (OS) and colon cancer cause-specific survival (CSS). The predictive abilities of the constructed models were evaluated by the concordance indexes (C-indexes) and calibration curves. Results A total of 25,110 patients were identified, 21.7% received chemotherapy, and 78.3% were without chemotherapy. A total of 10,916 patients were extracted after propensity score matching. The estimated 3-year overall survival rates of chemotherapy were 0.7% higher than non- chemotherapy. The estimated 5-year and 10-year overall survival rates of non-chemotherapy were 1.3 and 2.1% higher than chemotherapy, respectively. Survival prediction models showed good discrimination (the C-indexes between 0.582 and 0.757) and excellent calibration. Conclusions Chemotherapy improves the short-term (43 months) survival benefit of stage II colon cancer patients who received radical surgery. Survival prediction models can be used to predict OS and CSS of patients receiving chemotherapy as well as OS and CSS of patients not receiving chemotherapy and to make individualized treatment recommendations for stage II colon cancer patients who received radical surgery.

Clinical relevance of high–intermediate risk endometrial cancer according to European risk classification

2020 ◽  
Vol 30 (10) ◽  
pp. 1528-1534
Author(s):  
Agnieszka Rychlik ◽  
Ignacio Zapardiel ◽  
Laura Baquedano ◽  
María Ángeles Martínez Maestre ◽  
Denis Querleu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
European Society ◽  
Risk Group ◽  
Risk Groups ◽  
Intermediate Risk ◽  
Nodal Metastases ◽  
Disease Free

ObjectiveRisk models in endometrial cancer define prognosis and indicate adjuvant therapy. One of the currently used classifications was designed in 2016 in collaboration with the European Society of Medical Oncology (ESMO), the European Society of Gynecologic Oncology (ESGO), and the European Society of Radiotherapy (ESTRO). A high–intermediate risk group was introduced within the intermediate risk group. The purpose of this study was to evaluate the clinical relevance of this subclassification.MethodsA multicenter retrospective study was carried out at five international tertiary institutions. Patients diagnosed with intermediate risk endometrial cancer on the basis of definitive pathology findings were included. Patients were stratified into intermediate and high–intermediate risk groups. Incidence of nodal metastases, and disease free and overall survival were compared between the two risk groups in univariate and multivariate analysis.Results477 patients were included: 325 (68%) patients were identified as intermediate and 152 (32%) as high–intermediate endometrial cancer patients. Nodal metastases were found in 18 patients (11.8%) in the high–intermediate risk endometrial cancer group and 16 patients (4.9%) in the intermediate risk group. Lymphovascular space invasion was found to be a strong predictive factor of lymph node involvement. High–intermediate risk was found to be an independent factor of disease free survival (hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.00 to 3.08; p=0.050) and overall survival (HR 1.99; 95% CI 1.10 to 3.60; p=0.022) in the multivariate analysis.ConclusionsThe study validates the clinical significance of the intermediate risk endometrial cancer subclassification. Prognosis for high–intermediate risk endometrial cancer was significantly poorer. The prevalence of lymph node metastases was higher in this group of patients.

scholarly journals Stage IB Endometrioid Type Endometrial Cancer: The Role of Lymphadenectomy and Adjuvant Radiation Therapy

2018 ◽  
Vol 24 (3) ◽  
pp. 156
Author(s):  
Osman Turkmen ◽  
Tolga Tasci ◽  
Derman Basaran ◽  
Gunsu Comert Kimyon ◽  
Alper Karalök ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Stage Ib ◽  
Gynecology And Obstetrics ◽  
Disease Free

<p><strong>Objective:</strong> Both performances of lymphadenectomy and benefit of adding adjuvant radiotherapy are controversial for patients with International Federation of Gynecology and Obstetrics stage IB endometrioid type endometrial cancer. We aimed to identify the role of lymphadenectomy and adjuvant radiation therapy as well as clinicopathological prognostic factors for this group of patients.<br /><strong></strong></p><p><strong>Study Design:</strong> Records of all patients (n=132) with stage IB endometrioid endometrial cancer who were referred to or treated in our institution between Jan 1992 and Dec 2013 were retrospectively reviewed. Cox Proportional Hazard Regression Analysis was used to determine the effects of lymphadenectomy and adjuvant radiation as well as other clinicopathological factors on disease free survival and overall survival.</p><p><strong>Results:</strong> Mean age was 59.9 years (range, 45-82). Lymphadenectomy didn't perform in 36 (27.3%) patients and 23 (17.4%) patients did not have any kind of adjuvant treatment. Mean lymph node count was 18.8 (range, 3-67). Federation of Gynecology and Obstetrics grade, lymphovascular space invasion, lymphadenectomy, receiving adjuvant treatment and type of received adjuvant therapy were not associated with disease free survival and overall survival for the entire cohort. In a subgroup of patients with grade1&amp;2 tumor, 5-year disease free survival rates were 80% and 50% (p=0.4), respectively and overall survival rates were 94.8% and 93.8% (p=0.2), respectively for patients who had or didn't have adjuvant radiotherapy. While performance of lymphadenectomy was not significantly associated with disease free survival in this subgroup (p=0.56), this association was statistically significant for overall survival (97.9% vs. 86.4%, p=0.04) <br /><strong></strong></p><p><strong>Conclusion:</strong> Benefit of adjuvant radiotherapy in regard to prevention of recurrence needs to be confirmed by further studies. Lymphadenectomy had a survival benefit for patients with myometrial invasion greater than a half of myometrial thickness.</p>

scholarly journals Lymph Node Number Predicts the Efficacy of Adjuvant Chemoradiotherapy in Node-Positive Endometrial Cancer Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 373
Author(s):  
Jie Lee ◽  
Tsung Yu ◽  
Mu-Hung Tsai
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards Model ◽  
Adjuvant Chemoradiotherapy ◽  
Node Number ◽  
Cancer Data ◽  
Node Positive ◽  
Lymph Node Number

This study aimed to evaluate the value of lymph node (LN) number as a predictor for adjuvant treatment in node-positive endometrial cancer. Data of 441 patients diagnosed with International Federation of Gynaecology and Obstetrics (FIGO) stage IIIC endometrial cancer and who underwent adjuvant chemotherapy alone or chemoradiotherapy between 2009 and 2015 from the Taiwan Cancer Registry were reviewed. The patients were stratified based on the number of positive LN as follows: 1, 2–5, and ≥ 6. The overall survival (OS) was analysed using the Kaplan–Meier method and the Cox proportional hazards model. In multivariable analysis, chemoradiotherapy was independently associated with improved OS (hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.43–0.90; p = 0.01) compared with chemotherapy alone. Patients with ≥ 6 positive LNs were associated with a worse OS (HR: 2.22, 95% CI: 1.25–3.95; p = 0.006) and those with 2–5 LNs were not associated with a worse OS (HR: 1.56, 95% CI: 0.94–2.59; p = 0.09) compared to patients with one LN. When stratified based on LN number, chemoradiotherapy was found to significantly improve the 5-year OS of patients with ≥ 6 positive LNs compared to chemotherapy alone (35.9% vs. 70.0%, p < 0.001). No significant differences between chemotherapy alone and chemoradiotherapy were observed in 5-year OS among patients with one LN (73.1% vs. 80.8%, p = 0.31) or 2–5 positive LNs (71.4% vs. 75.7%, p = 0.68). Lymph node number may be used to identify node-positive endometrial cancer patients who are likely to have improved OS with intensification of adjuvant therapy.

scholarly journals Cofilin-1, LIMK1 and SSH1 are differentially expressed in locally advanced colorectal cancer and according to consensus molecular subtypes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annie Cristhine Moraes Sousa-Squiavinato ◽  
Renata Ivo Vasconcelos ◽  
Adriana Sartorio Gehren ◽  
Priscila Valverde Fernandes ◽  
Ivanir Martins de Oliveira ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Molecular Subtypes ◽  
Survival Rates ◽  
Metastatic Potential ◽  
Protein Levels ◽  
Clinical Cohort ◽  
Tumor Stages ◽  
Immunohistochemical Analyses ◽  
Overall Survival Rates

Abstract Background Colorectal cancer (CRC) is among the deadliest cancers, wherein early dissemination of tumor cells, and consequently, metastasis formation, are the main causes of mortality and poor prognosis. Cofilin-1 (CFL-1) and its modulators, LIMK1/SSH1, play key roles in mediating the invasiveness by driving actin cytoskeleton reorganization in various cancer types. However, their clinical significance and prognostic value in CRC has not been fully explored. Here, we evaluated the clinical contribution of these actin regulators according to TNM and consensus molecular subtypes (CMSs) classification. Methods CFL-1, LIMK1 and SSH1 mRNA/protein levels were assessed by real-time PCR and immunohistochemical analyses using normal adjacent and tumor tissues obtained from a clinical cohort of CRC patients. The expression levels of these proteins were associated with clinicopathological features by using the chi square test. In addition, using RNA-Seq data of CRC patients from The Cancer Genome Atlas (TCGA) database, we determine how these actin regulators are expressed and distributed according to TNM and CMSs classification. Based on gene expression profiling, Kaplan–Meier survival analysis was used to evaluated overall survival. Results Bioinformatic analysis revealed that LIMK1 expression was upregulated in all tumor stages. Patients with high levels of LIMK1 demonstrated significantly lower overall survival rates and exhibited greater lymph node metastatic potential in a clinical cohort. In contrast, CFL-1 and SSH1 have expression downregulated in all tumor stages. However, immunohistochemical analyses showed that patients with high protein levels of CFL-1 and SSH1 exhibited greater lymph node metastatic potential and greater depth of local invasion. In addition, using the CMSs classification to evaluate different biological phenotypes of CRC, we observed that LIMK1 and SSH1 genes are upregulated in immune (CMS1) and mesenchymal (CMS4) subtypes. However, patients with high levels of LIMK1 also demonstrated significantly lower overall survival rates in canonical (CMS2), and metabolic (CMS3) subtypes. Conclusions We demonstrated that CFL-1 and its modulators, LIMK1/SSH1, are differentially expressed and associated with lymph node metastasis in CRC. Finally, this expression profile may be useful to predict patients with aggressive signatures, particularly, the immune and mesenchymal subtypes of CRC.

scholarly journals Featuring Trends in the Epidemiology of Lung Cancer Following the Publication of the National Cancer Strategy in Qatar

2021 ◽  
Vol 36 (3) ◽  
pp. e276-e276
Author(s):  
Wanis H. Ibrahim ◽  
Khalid Shariff ◽  
Mufid El Mistiri ◽  
Ussama Alhomsi ◽  
Awni Alshurafa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Incidence Rate ◽  
Cancer Incidence ◽  
Clinical Characteristics ◽  
Survival Rates ◽  
Lung Cancer Incidence ◽  
Males And Females ◽  
Overall Survival Rates

Objectives: Qatar has witnessed significant reforms in its health care system, including the care of cancer patients. In 2011, the National Cancer Strategy was released with the aim to deliver a high standard of care to cancer patients across the country. We sought to investigate the featuring trends in the epidemiological and clinical characteristics of lung cancer in Qatar following the publication of the National Cancer Strategy. Methods: We conducted a retrospective cohort study documenting the epidemiological and clinical characteristics of primary lung cancer cases in Qatar diagnosed from 1 January 2011 to 31 December 2018. Results: The overall age-standardized incidence rate was 8.7 per 100 000 persons (11.6 per 100 000 and 5.4 per 100 000 persons for males and females, respectively). The one, three, and five-year overall survival rates were 67.0%, 48.0%, and 28.0%, respectively. The three-year overall survival rates for stages I, II, III, and IV were 97.0%, 78.0%, 52.0%, and 31.0%, respectively. The three-year survival rates for males and females were 43.0% and 64.0%, respectively (p = 0.029), for Qatari and non-Qatari nationals were 42.0% and 49.0%, respectively (p = 0.252), and for smokers and non-smokers were 39.0% and 69.0%, respectively (p ≤ 0.001). The overall age-standardized mortality rate was 5.5 per 100 000 persons. Adenocarcinoma was the most common histologic type. Conclusions: Despite the low overall lung cancer incidence rate in Qatar, there is a rise in the incidence among females when compared to previous studies. Qatar has favorable five-year lung cancer survival rates compared to many developed and neighboring countries. Policymakers in the country should consider the changing patterns in lung cancer incidence when planning future preventive strategies.

scholarly journals Long-term analysis of bilateral versus unilateral neck dissection in the treatment of early-stage supraglottic laryngeal cancer

2021 ◽  
Vol 9 (3) ◽  
pp. 81-86
Author(s):  
Selin Ünsaler
Keyword(s):  
Overall Survival ◽  
Neck Dissection ◽  
Cancer Patients ◽  
Early Stage ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Tumor Site ◽  
Significant Difference ◽  
Overall Survival Rates

OBJECTIVE: This study aimed to investigate the effect of routine bilateral neck dissection on the survival outcomes of supraglottic laryngeal cancer patients with lateralized tumors and clinically negative necks. METHODS: The data of 234 patients surgically treated for supraglottic squamous cell carcinoma between January 2000 and September 2014 were retrospectively collected. Patients treated previously for head and neck cancer, patients who could not be contacted, and those with missing data were excluded. Of the remaining 187 patients, 124 patients with early-stage primaries (T1-T2) (116 males, 8 females; mean age: 55.5±9.5 years; range, 33 to 82 years) were included. Age and sex of the patients, site of the primary tumor, TNM stage, type of the neck dissection, length of follow-up, and survival rates were evaluated. The tumors were classified into three groups according to their relationship with the median line of the larynx, and the neck dissections were recorded as unilateral or bilateral. Recurrences and survival outcomes were evaluated. RESULTS: There was no statistically significant difference in the recurrences according to tumor site groups (p=0.39). Similarly, there was no statistically significant difference in 10-year overall survival rates in patient groups according to the tumor site (p=0.072). We found no statistically significant difference in 10-year overall survival rates between the patients who underwent unilateral and bilateral neck dissection (p=0.580). CONCLUSION: Long-term survival analysis of 124 patients with supraglottic carcinoma did not show a survival benefit of elective contralateral neck dissection in lateralized supraglottic cancer with contralateral clinically negative neck.

scholarly journals Overweight and obesity predict better overall survival rates in cancer patients with distant metastases

2016 ◽  
Vol 5 (4) ◽  
pp. 665-675 ◽  
Author(s):  
Ngan Ming Tsang ◽  
Ping Ching Pai ◽  
Chi Cheng Chuang ◽  
Wen Ching Chuang ◽  
Chen Kan Tseng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Survival Rates ◽  
Distant Metastases ◽  
Overweight And Obesity ◽  
Overall Survival Rates

A multi-institutional study of radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma: 84 subjects out of over 5,000 population

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5052-5052
Author(s):  
Y. Niibe ◽  
K. Hayakawa ◽  
K. Michimoto ◽  
M. Kenjo ◽  
T. Kazumoto ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Cervical Carcinoma ◽  
Survival Rates ◽  
Overall Survival Rate ◽  
Uterine Cervical Carcinoma ◽  
Lymph Node Recurrence ◽  
Aortic Lymph Node ◽  
Overall Survival Rates

5052 Background: Most patient who had any recurrent sites of cancer, have been considered to be last-stage of life. However, recent advances of clinical research reveal some patients achieve long-term survival even in recurrence cases. Furthermore, patients who had only one recurrent region, even radiation therapy could play an important role. As for uterine cervical carcinoma, the most common recurrent site other than pelvis is para-aortic lymph node. Furthermore, improvement of diagnostic imaging enables us to detect more frequently isolated para-aortic lymph node recurrence. Thus, we conducted the current study. Methods: Between 1994 and 2003, over 5000 uterine cervical carcinoma patients treated with curative intended treatments at sixteen Japanese major hospitals. Out of them, 84 patients developed para-arotic lymph node recurrence as the only site of initial tumor progression. Seventy-four patitents had squamous cell carcinoma and 5 had adenosquamous cell carcinoma and 5 had adenocarcinoma. These patients were treated with external beam radiation therapy prescribing 1.7–2.0 Gy per fraction, 5 fractions per week and median total dose was 50 Gy (25–60 Gy). Thirty-two patients received adjuvant systemic chemotherapy. Results: Median follow-up time of all patients was 20 months (2–92 months). Three- and 5-year overall survival rates of all patients were 49.5% and 31.3%, respectively. Stratified by patients with or without chemotherapy, 3-year overall survival rate of patients with chemotherapy group was 37.7% and those without group was 56.7% (p = 0.69). Moreover, stratified by symptom sign, 3-year overall survival rate of symptom positive group was 27.6% and those of negative group was 56.1% (p = 0.018). Three-year overall survival rates of the total dose ≥ 51Gy and that of ≤ 50 Gy were 58.0% and 42.8%, respectively (p = 0.07). AS for morbidity, no patients received G3 or greater late toxicity (CTCAE ver. 3.0). Conclusions: The current study suggested that radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma could have significant impact on overall survival. Furthermore, no symptom group and over 51Gy irradiation group could achieve better prognosis. No significant financial relationships to disclose.

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