scholarly journals Effect of “Time To Surgery” On The Endometrial Cancer Prognosis

2021 ◽  
pp. 1-9
Author(s):  
Engin Celik ◽  
Harika Yumru Celiksoy ◽  
Hamdullah Sozen ◽  
Hale Goksever Celik ◽  
Semen Onder ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cox Regression ◽  
Gynecological Cancer ◽  
Progression Free Survival ◽  
Disease Specific Survival ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Study Results ◽  
Significant Difference ◽  
Disease Specific

OBJECTIVE: Endometrial cancer is the most common gynecological cancer in developed countries. Our study aims to determine the effect of the time between diagnosis and surgery of endometrial cancer on the prognosis of the disease. STUDY DESIGN: Patients who were diagnosed with epithelial type endometrial cancer and did not receive preoperative chemotherapy, radiotherapy, or hormonal therapy were included in the study. RESULTS: Two hundred eighty-five patients were included in the study. We divided the patients into two groups regarding before and after 8 weeks from diagnosis to surgery. Clinical characteristics of the patients were comparable between the groups, except for comorbid conditions and body mass index. Using cox-regression analysis, time to operation did not have a significant effect on both recurrence and cancer-associated death risk. The log-rank test analysis also showed that there was no significant difference in progression-free survival and disease-specific survival between the patients. There was no significant difference between the groups in terms of progression-free survival and disease-specific survival for cases with endometrioid type grade 1-2 tumors. There was also no significant difference between the groups regarding progression-free survival and disease-specific survival in the patients with tumors of endometrioid type grade 3 and non-endometrioid histology. CONCLUSION: Time delay between diagnosis to surgery of the patients with endometrial cancer has no prognostic importance for recurrence and survival outcomes.

Mismatch repair deficiency as a predictor of adjuvant radiotherapy response in endometrioid endometrial carcinoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5586-5586
Author(s):  
Stefan Kommoss ◽  
Casper Reijnen ◽  
Heidi V.N. Küsters-Vandevelde ◽  
Clemens Prinsen ◽  
Massuger Leon ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Disease Specific Survival ◽  
Multicenter Cohort Study ◽  
Cox Regression Analysis ◽  
Stage Ib ◽  
Grade 3 ◽  
Disease Specific

5586 Background: Adjuvant radiotherapy improves progression-free survival in intermediate and high-risk endometrial cancer. However, so far there is no evidence of improved overall or disease-specific survival after adjuvant radiotherapy. There is accumulating evidence that MMR proteins are involved in DNA repair following radiotherapy. We investigated the predictive value of MMR status in terms of survival benefit after adjuvant radiotherapy in patients with stage IB/II, grade 3 endometrioid endometrial cancer (EEC). Methods: A retrospective multicenter cohort study was performed to compare patients with histopathologically confirmed stage IB/II grade 3 EEC with and without adjuvant radiotherapy. Patients were classified according to the Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) identifying ECs as either MMR-deficient, POLE, p53abn or p53wt. Multivariable Cox regression analysis explored associations between patient characteristics, adjuvant treatment and outcome. Results: A total of 128 patients were analyzed, including 57 patients (43.0%) with MMR-deficient EECs. Baseline characteristics were comparable, except a higher proportion of MMR-deficient EECs were stage II (36.8% vs. 15.5%, p = 0.006). Eighty-two patients (64.1%) received adjuvant radiotherapy (external beam [n = 55], vaginal brachytherapy [n = 27]). In multivariate analysis, adjuvant radiotherapy was independently associated with improved disease-specific survival in patients with MMR-deficient EECs (hazard ratio 0.19, 95%-CI 0.05 - 0.77), but not in patients with MMR-proficient EECs (hazard ratio 0.92, 95%-CI 0.37 - 2.31). Conclusions: Adjuvant radiotherapy improved disease-specific survival in patients with MMR-deficient EECs, but not in those with MMR-proficient EECs. This study demonstrates the predictive ability of MMR IHC to identify women who likely have increased benefit from radiotherapy.

Association between prior radical surgery (RS) and outcomes with immune checkpoint inhibitor (ICI) therapy for advanced urothelial carcinoma (aUC).

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 444-444
Author(s):  
Dimitrios Makrakis ◽  
Daniel Castellano ◽  
Ivan de Kouchkovsky ◽  
Joseph J. Park ◽  
Mehmet Asim Bilen ◽  
...  
Keyword(s):  
Immune Checkpoint Inhibitor ◽  
Overall Response Rate ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Similar Proportion ◽  
Multivariable Model ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Response Table ◽  
Advanced Urothelial Carcinoma

444 Background: It is unclear whether prior RS of primary tumor is associated with response and outcomes with ICI in aUC. We hypothesized that such response and outcomes would not differ based on prior RS. Methods: We performed a retrospective cohort study including patients (pts) with aUC who received ICI. We compared overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) between pts with vs without RS [cystectomy or (nephro)-ureterectomy]. Analysis was stratified based on ICI therapy line (first-line vs salvage). A separate comparison between pts with prior RS or radiation (RT) only or none was also pursued. ORR was compared between groups using logistic regression, as well OS and PFS using cox regression analysis; a multivariable model was built adjusting for calculated Bellmunt score. P<0.05 was significant. Results: We identified 984 pts from 24 institutions; 682, 704 and 673 were included in OS, PFS and ORR analyses, respectively; 54% of pts had prior RS with median age 68 at ICI initiation with RS vs 71 without RS with similar proportion of men (73-74%) and ever smokers (70-71%). The RS group had higher proportion (%) of white pts (77% vs 71%), lower % of pts with Hb<10g/dL at ICI initiation (23% vs 32%) but not significantly higher % of liver metastasis at ICI initiation (23% vs 17%). Bellmunt score with vs without RS was 16% vs 11%, 50% vs 48%, 27% vs 37%, 7% vs 4% for 0, 1, 2, and 3, respectively. ORR and PFS were not significantly different between groups, while prior RS was associated with longer OS (unadjusted HR 0.8, p=0.03). However, after adjustment for Bellmunt score, this association was not significant (table). Upon stratification based on treatment line, OS was longer with prior RS (0.7, p=0.03) for those treated with salvage ICI but this was not significant after adjusting for Bellmunt score. ORR, PFS and OS were not significantly different between pts receiving prior RT only vs RS vs none. Conclusions: Prior RS was not significantly associated with longer OS in pts with aUC receiving ICI after adjusting for Bellmunt score. Further work is needed to interrogate tumor-host immune interactions and identify biomarkers that can be prognostic and/or predictive of ICI response. [Table: see text]

scholarly journals Outcome of Endometrial Cancer Stage IIIA with Adnexa or Serosal Involvement Only

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Jan J. Jobsen ◽  
Lambert Naudin ten Cate ◽  
Marnix L. M. Lybeert ◽  
Astrid Scholten ◽  
Elzbieta M. van der Steen-Banasik ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Distant Metastasis ◽  
Cancer Stage ◽  
Disease Specific Survival ◽  
Stage Iiia ◽  
Free Survival ◽  
Locoregional Failure ◽  
Distant Metastasis Free Survival ◽  
Disease Specific

Objective. The aim of this study is to look at possible differences in outcome between serosa and adnexal involvement stage IIIA endometrial carcinoma.Methods. 67 patients with stage IIIA endometrial carcinoma were included, 46 with adnexal involvement and 21 with serosa. A central histopathological review was performed.Results. The 7-year locoregional failure rate was (LRFR) 2.2% for adnexal involvement and 16.0% for involvement of the serosa (P=.0522). The 7-year distant metastasis-free survival was 72.7% for adnexal involvement and 58.7% for serosa (P=.3994). The 7-year disease-specific survival (DSS) was 71.8% for patients with adnexal involvement and 75.4% for patients with serosa.Conclusion. Endometrial carcinoma stage IIIA with involvement of the adnexa or serosa showed to have a comparable disease-specific survival. Locoregional control was worse for serosa involvement compared to adnexa.

The efficacy of first-line chemotherapy in recurrent pancreatic cancer after S-1 adjuvant chemotherapy.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 475-475
Author(s):  
Ryo Kanata ◽  
Masato Ozaka ◽  
Seita Kataoka ◽  
Kazunaga Ishigaki ◽  
Ikuhiro Yamada ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Chemotherapy ◽  
Cox Regression ◽  
Surrogate Marker ◽  
Cancer Recurrence ◽  
Progression Free Survival ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Recurrent Pancreatic Cancer ◽  
Line Chemotherapy

475 Background: In Japan, adjuvant chemotherapy with S-1 for 6 months is standard care for resected pancreatic cancer. However, the efficacy of chemotherapy for recurrent pancreatic cancer(RPC) after adjuvant S-1 chemotherapy is not well evaluated. Methods: Medical records were retrospectively reviewed for consecutive patients who had RPC after adjuvant S-1 treatment and received chemotherapy between April 2013 and July 2016. Recurrence free interval (RFI) was defined as the interval from adjuvant S-1 initiation to cancer recurrence. Overall survival (OS) and progression free survival (PFS) after 1st line chemotherapy for RPC were compared between patients with RFIs of shorter than 6 month (Group S) and longer than 6 months (Group L). Results: In the 53 patients evaluated, the median duration of adjuvant S-1 chemotherapy was 5.1 months, and the median RFI was 8.3 months. After recurrence, they received Gemcitabine alone (20 patients), Gemcitabine+nab-paclitaxel (28 patients), modified FOLFIRINOX (one patient), and other regimen (4 patients). In all patients, the median PFS was 7.3 months and the median OS was 14.8 months. When compered in two groups (group S and group L), median OS in group S and group L was 6.7 months (95% confidence interval(CI): 4.2-12.9) and NA (95% CI: 13 months-NA) , respectively (p < 0.001), and median PFS was 3.8 months (95%CI: 2.5-9.1) and 7.3 months (95%CI: 3.9-15.3), respectively (p = 0.11). Multivariate Cox regression analysis revealed CEA < 4.0 mg/dl before chemotherapy and an RFI of ≥ 6 months were significantly associated with longer survival. Conclusions: These data suggest that RFI < 6 months is a surrogate marker for a poor prognosis in patients with RPC.

Influences of Uterine Adenomyosis on Muscle Invasion and Prognosis of Endometrioid Adenocarcinoma

2014 ◽  
Vol 24 (8) ◽  
pp. 1429-1433 ◽  
Author(s):  
Akiyo Taneichi ◽  
Hiroyuki Fujiwara ◽  
Yoshifumi Takahashi ◽  
Yuji Takei ◽  
Shizuo Machida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Progression Free Survival ◽  
Stage I ◽  
Endometrioid Adenocarcinoma ◽  
Free Survival ◽  
Histopathological Grade ◽  
Significant Difference ◽  
Uterine Adenomyosis ◽  
Muscle Invasion

ObjectiveEndometrial cancer often coexists with uterine adenomyosis. However, little is known about the clinical characteristics of these cases. Thus, cases of endometrial cancer occurring with and without uterine adenomyosis were compared, and the influences of uterine adenomyosis on the clinical progress of endometrial cancer were examined.Materials and MethodsOf endometrial cancer patients who underwent hysterectomies in our facility from 2002 to 2011, we included only endometrioid adenocarcinoma patients in our study. The patients were divided into 2 groups, adenomyosis group and nonadenomyosis group, according to the presence/absence of uterine adenomyosis. Patient characteristics, stage, histopathological grade, muscle invasion, recurrence, and mortality were retrospectively compared and examined.ResultsThere were 362 cases of endometrioid adenocarcinoma of the uterine body, of which 121 (33.4%) and 241 cases (66.6%) were in the adenomyosis and nonadenomyosis group, respectively. There were no significant differences with respect to the disease stages or ratios of the histopathological grade between the 2 groups. In the adenomyosis group/nonadenomyosis group, 5-year progression-free survival for International Federation of Gynecology and Obstetrics (FIGO) stages I and II was 89.9%/93.7% and that for stages III and IV was 70.6%/62.0%; the 5-year overall survival was 100%/95.9% for FIGO stages I and II, and 88.0%/73.5% for stages III and IV. There were no significant between-group differences for either progression-free survival or overall survival. When limiting the results to only FIGO stage I endometrioid adenocarcinoma, despite no grade variance between the 2 groups, a significant difference was observed in the ratios of outer-half muscle invasion between the adenomyosis and nonadenomyosis groups (19.5% [17/87] vs 10.1% [16/158], P < 0.05); however, the prognosis was similar in the 2 groups.ConclusionsUterine adenomyosis is associated with deep myometrial invasion in stage I endometrioid adenocarcinoma; however, it did not affect the recurrence or mortality rates.

scholarly journals Identification and validation of AKR1C1/2/3 as hepatocellular carcinoma risk modules via an integrated strategy

2020 ◽  
Author(s):  
Mingxing Xu ◽  
Yuesi Zhong ◽  
Fangji Yang ◽  
Kai Liu ◽  
Baoding Zhuang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Significant Risk ◽  
Reduction Process ◽  
Progression Free Survival ◽  
Tumor Stage ◽  
Genetic Alterations ◽  
Metabolic Process ◽  
Free Survival ◽  
Cox Regression Analysis

Abstract Background The human aldo-keto reductase 1 (AKR1) C family comprises four enzymes, AKR1C1–AKR1C4. Lots of studies have investigated the function of AKR1Cs in tumors, however little is known in hepatocellular carcinoma (HCC). Methods Public databases were used to explore expression and role of AKR1Cs in HCC. Meanwhile, data of 134 HCC patients from Firebrowse website was used for validation. Results The results revealed that AKR1Cs expression was negatively correlated with the infiltration level of CD4+ T cells. Overexpression of AKR1C1/2/3 was significantly associated with tumor stage and pathological grade. Moreover, higher mRNA expression of AKR1C1/2/3 was related with shorter overall survival (OS), progression-free survival (PFS) and relapse-free survival (RFS). Multivariate Cox regression analysis showed that AKR1C1/2/3 could be significant risk factors for HCC patients. Additionally, genetic alterations of AKR1Cs can significantly affect patient OS and PFS, and expression of AKR1Cs was linked to functional networks involving oxidation-reduction process, cellular hormone metabolic process and organic hydroxy compound metabolic process, as well as retinol metabolism, steroid hormone biosynthesis, metabolic pathway and fatty acid degradation pathways. Conclusions In conclusion, we successfully elaborated the relationship between AKR1Cs expression and immune infiltrations, and identified AKR1C1/2/3 could be novel prognostic biomarkers for HCC patients.

scholarly journals Prognostic Impact of Tumor Length in Esophageal Cancer: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Zhao Yang Wang ◽  
Yuanzhu Jiang ◽  
Wen Xiao ◽  
Xianbiao Xue ◽  
Xiangwei Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Disease Specific Survival ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Tumor Length ◽  
Disease Free ◽  
Disease Specific

Abstract Background: In clinical work, it has been increasingly found that the prognosis is still very different even for esophageal cancer (EC) patients with the same TNM stage. Tumor length has been analysed as a possible independent prognostic factor in many studies, but no unanimous conclusion has been reached. Therefore, this review used a meta-analysis to evaluate the association between tumor length and prognosis in EC patients.Methods: A systematic search for relevant articles was performed in PubMed, Web of Science, and Embase. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as effective measures to estimate the correlation between tumor length and prognosis, including overall survival, disease-free survival, progression-free survival, disease-specific survival, and cancer-specific survival. STATA 15.0 software was used to perform the meta-analysis and the data synthesis.Results: Finally, 41 articles with 28,973 patients were included in our study. The comprehensive statistical results showed that long tumors are an independent prognostic parameter associated with poor overall survival (OS) (HR=1.30; 95% CI: 1.21-1.40, p<.001) and disease-free survival (DFS) (HR=1.38; 95% CI: 1.18-1.61, p<.001) in EC patients. Subgroup analyses also suggested a significant correlation between long tumors and poor OS. Sensitivity analysis and publication bias evaluation confirmed the reliability and stability of the results. Similar results were obtained in the analyses of progression-free survival (PFS), disease-specific survival (DSS), and cancer-specific survival (CSS).Conclusion: The results of this meta-analysis showed that long tumors were related to poor OS, DFS, PFS, DSS and CSS in EC patients. Tumor length might be an important predictor of prognosis in EC patients, and it can be used as an independent staging index. Further well-designed and large-scale prospective clinical studies are needed to confirm these findings.

scholarly journals Development and Validation of Nomograms to Predict Prognosis of Oral and Oropharyngeal Mucoepidermoid Carcinoma: A SEER-Based Study

2020 ◽  
Author(s):  
muyuan liu ◽  
Litian Tong ◽  
Manbin Xu ◽  
Xiang Xu ◽  
Bin Liang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Mucoepidermoid Carcinoma ◽  
Cox Regression ◽  
Seer Database ◽  
Disease Specific Survival ◽  
Cox Regression Analysis ◽  
T Stage ◽  
N Stage ◽  
Disease Specific

Abstract Background: Due to the low incidence of mucoepidermoid carcinoma, there lacks sufficient studies for determining optimal treatment and predicting prognosis. The purpose of this study was to develop prognostic nomograms, to predict overall survival and disease-specific survival (DSS) of oral and oropharyngeal mucoepidermoid carcinoma patients, using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Methods: Clinicopathological and follow-up data of patients diagnosed with oral and oropharyngeal mucoepidermoid carcinoma between 2004 and 2017 were collected from the SEER database. The Kaplan-Meier method with the log-rank test was employed to identify single prognostic factors. Multivariate Cox regression was utilized to identify independent prognostic factors. C-index, area under the ROC curve (AUC) and calibration curves were used to assess performance of the prognostic nomograms. Results: A total of 1230 patients with oral and oropharyngeal mucoepidermoid carcinoma were enrolled in the present study. After multivariate Cox regression analysis, age, sex, tumor subsite, T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for overall survival. T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for disease-specific survival. Nomograms were constructed to predict the overall survival and disease-specific survival based on the independent prognostic factors. The fitted nomograms possessed excellent prediction accuracy, with a C-index of 0.899 for OS prediction and 0.893 for DSS prediction. Internal validation by computing the bootstrap calibration plots, using the validation set, indicated excellent performance by the nomograms. Conclusion: The prognostic nomograms developed, based on individual clinicopathological characteristics, in the present study, accurately predicted the overall survival and disease-specific survival of patients with oral and oropharyngeal mucoepidermoid carcinoma.

Gastric juice piR-1245: A promising prognostic biomarker for gastric cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16574-e16574
Author(s):  
Wei Peng ◽  
Jianhong Liu ◽  
Xiaorong Zhou ◽  
Hong Fan ◽  
Jianwei Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Juice ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Healthy Individuals ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Diagnosis And Prognosis ◽  
Potential Marker ◽  
Risk Variable

e16574 Background: Emerging reports demonstrated that PIWI-interacting RNAs (piRNAs) played an indispensable role in tumorigenesis. However, it still remains elusive whether piR-1245 in gastric juice specific in stomach could be employed as a biomarker for gastric cancer (GC). The present work is aiming at exploring the possibility of piR-1245 in gastric juice as a potential marker to judge for diagnosis and prognosis of gastric cancer. Methods: Gastric juice was collected from 66 GC patients and 66 healthy individuals. Quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) was employed to measure the levels of piR-1245 expression. Then, the pattern of piR-1245 expression in gastric juice was determined between GC patients and healthy individuals. A receiver operating characteristic (ROC) curve was constructed for distinguishing GC from healthy individuals. Results: Gastric juice piR-1245 levels in GC were higher than those of controls (P < 0.0001). The value of area under ROC (AUC) was 0.885 (sensitivity, 90.9%; specificity, 74.2%; 95% confidence interval, 0.8286 to 0.9414). High gastric juice piR-1245 expression was signally correlated with tumor size (P = 0.013) and TNM stage (P = 0.001). GC patients with high piR-1245 expression in gastric juice exerted a poorer overall survival (OS) (P = 0.0152) and progression-free survival (PFS) (P = 0.013). COX regression analysis verified that gastric juice piR-1245 expression was an independent prognostic risk variable for OS (P < 0.05). Conclusions: The current study suggested that piR-1245 in gastric juice had the potential to be a useful biomarker for GC detection and prognosis prediction.

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