Gross tumour volume and poorly differentiated clusters can indicate the high-risk patients for poor survival in pT1- 2 rectum carcinomas

Although stage I and II colon cancers (CC) generally show a very good prognosis, a small proportion of these patients dies from recurrent disease. The identification of high-risk patients, who may benefit from adjuvant chemotherapy, becomes therefore essential. We retrospectively evaluated 107 cases of stage I (n = 28, 26.2%) and II (n = 79, 73.8%) CC for correlations among preoperative inflammatory markers, histopathological factors and long-term prognosis. A neutrophil-to-lymphocyte ratio greater than 3 (H-NLR) and a platelet-to-lymphocyte ratio greater than 150 (H-PLR) were significantly associated with the presence of poorly differentiated clusters (PDC) (p = 0.007 and p = 0.039, respectively). In addition, H-NLR and PDC proved to be significant and independent survival prognosticators for overall survival (OS; p = 0.007 and p < 0.001, respectively), while PDC was the only significant prognostic factor for cancer-specific survival (CSS; p < 0.001,). Finally, the combination of H-NLR and PDC allowed an optimal stratification of OS and CSS in our cohort, suggesting a potential role in clinical practice for the identification of high-risk patients with stage I and II CC.

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Impact of high-risk features for stage II adenocarcinoma of the appendix.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.795 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 795-795

Author(s):

Mehmet Akce ◽

Katerina Mary Zakka ◽

Mckenna Penely ◽

Renjian Jiang ◽

Olatunji B. Alese ◽

...

Keyword(s):

High Risk ◽

Lymphovascular Invasion ◽

Low Risk ◽

Stage Ii ◽

High Risk Patients ◽

Risk Patients ◽

Stage Ii Colorectal Cancer ◽

Poorly Differentiated ◽

Multivariable Analyses ◽

The Impact

795 Background: Clinico-pathological high risk features are frequently utilized in adjuvant chemotherapy (AC) decisions in stage II colorectal cancer and their utility in stage II appendiceal adenocarcinoma (AA) is less established. The aim of this study is to determine the impact of high risk features on clinical outcomes and whether high risk features are predictive of AC benefit in stage II AA. Methods: Patients with pathological stage II AA between 2010 and 2015 were identified from the National Cancer Database (NCDB) using ICD-O-3 morphology and topography codes: 8140, 8480 and C18.1. High risk stage II AA was defined as having at least one of the following clinicopathological features: T4 tumor, < 12 lymph nodes examined, poorly differentiated histology, positive margins, or lymphovascular invasion. Patients with none of these features were defined as low-risk. Results: A total of 1,040 patients were identified. 51.0% males, 84.5% Caucasian; median age 61 (range, 19-90). 46.4% were determined to have high-risk stage II AA. High-risk status was associated with worse OS compared to low-risk in univariate (HR 1.55; 95% CI 1.18-2.02; p = 0.001) and multivariable analyses (HR 1.36; 95% CI 1.03-1.79; p = 0.028). High-risk stage II AA patients had significantly worse 5-year OS compared to low-risk patients (67.1% vs. 74.5%, p = 0.0013). AC was administered in 34.4% (n = 166) of high-risk patients and in 36.5% (n = 203) of low-risk patients. Among high-risk patients, AC was not associated with better OS in univariate (HR 0.86; 95% CI 0.59-1.26; p = 0.722) and multivariable analyses (HR 1.35; 95% CI 0.90-2.04; p = 0.324) compared to no AC. Similarly, among low-risk patients, AC was not associated with better OS in univariate (HR 0.92; 95% CI 0.60-1.39; p = 0.813) and multivariable analyses (HR 1.27; 95% CI 0.81-2.02; p = 0.334) compared to no AC. For high-risk patients, 5-year OS was 68.3% in patients that received AC vs. 66.5% in patients that did not (p = 0.722). For low-risk patients, 5-year OS was 74.0% in patients that received AC vs. 76.3% in patients that did not (p = 0.813). Conclusions: High-risk stage II AA patients had significantly worse 5-year OS compared to low-risk patients. AC did not improve survival regardless of high risk features in stage II AA.

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Absolute monocyte count trichotomizes chronic lymphocytic leukemia into high risk patients with immune dysregulation, disease progression and poor survival

Leukemia Research ◽

10.1016/j.leukres.2013.07.017 ◽

2013 ◽

Vol 37 (10) ◽

pp. 1222-1228 ◽

Cited By ~ 15

Author(s):

Yair Herishanu ◽

Sigi Kay ◽

Nadav Sarid ◽

Pedram Kohan ◽

Rony Braunstein ◽

...

Keyword(s):

High Risk ◽

Chronic Lymphocytic Leukemia ◽

Disease Progression ◽

Immune Dysregulation ◽

Lymphocytic Leukemia ◽

Monocyte Count ◽

Poor Survival ◽

High Risk Patients ◽

Risk Patients

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Impact of High-Risk Features for Stage II Adenocarcinoma of the Appendix

10.21203/rs.3.rs-31568/v1 ◽

2020 ◽

Author(s):

Mehmet Akce ◽

Katerina Zakka ◽

McKenna Penley ◽

Renjian Jiang ◽

Olatunji B. Alese ◽

...

Keyword(s):

High Risk ◽

Low Risk ◽

Stage Ii ◽

Pathological Stage ◽

High Risk Patients ◽

Risk Patients ◽

Stage Ii Colorectal Cancer ◽

Poorly Differentiated ◽

Multivariable Analyses ◽

The Impact

Abstract Background: Clinico-pathological high-risk features are frequently utilized in adjuvant chemotherapy (AC) decisions in stage II colorectal cancer and their utility in stage II appendiceal adenocarcinoma (AA) is not established. The aim of this study is to determine the impact of high-risk features in clinical outcomes and whether high risk features are predictive of AC benefit in stage II AA. Methods: Patients with pathological stage II AA between 2010-2015 were identified from the National Cancer Database (NCDB) using ICD-O-3 morphology and topography codes: 8140, 8480 and C18.1. High risk stage II AA was defined as having at least one of the following clinicopathological features: T4 tumor, <12 lymph nodes examined, poorly differentiated histology, positive margins, or lymphovascular invasion. Patients with none of these features were defined as low-risk.Results: A total of 1,040 patients with pathological stage II AA were identified. 51.0% males, 84.5% Caucasian; median age 61 (range, 19-90). 46.4% were determined to have high-risk stage II AA. High-risk status was associated with worse OS compared to low-risk in univariate (HR 1.55; 95% CI 1.18-2.02; p=0.001) and multivariable analyses (HR 1.36; 95% CI 1.03-1.79; p=0.028). High-risk stage II AA patients had significantly worse 5-year OS compared to low-risk patients (67.1% vs. 74.5%, p=0.0013). AC was administered in 34.4% (n=166) of high-risk patients and in 36.5% (n=203) of low-risk patients. Among high-risk patients, AC was not associated with better OS in univariate (HR 0.86; 95% CI 0.59-1.26; p=0.448) and multivariable analyses (HR 1.35; 95% CI 0.90-2.04; p=0.151) compared to no AC. Similarly, among low-risk patients, AC was not associated with better OS in univariate (HR 0.92; 95% CI 0.60-1.39; p=0.679) and multivariable analyses (HR 1.27; 95% CI 0.81-2.02; p=0.299) compared to no AC. For high-risk patients, 5-year OS was 68.3% in patients that received AC vs. 66.5% in patients that did not (p=0.722). For low-risk patients, 5-year OS was 74.0% in patients that received AC vs. 76.3% in patients that did not (p=0.813).Conclusion: High-risk stage II AA patients had significantly worse 5-year OS compared to low-risk patients. AC did not improve survival regardless of high-risk features in stage II AA.

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