scholarly journals Myasthenia Gravis Is Not an Independent Prognostic Factor of Thymoma: Results of a Propensity Score Matching Trial of 470 Patients

2020 ◽  
Vol 10 ◽  
Author(s):  
Yirui Zhai ◽  
Yong Wei ◽  
Zhouguang Hui ◽  
Yushun Gao ◽  
Yang Luo ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Distant Metastasis ◽  
Progression Free Survival ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Metastasis Free Survival ◽  
Matching Trial ◽  
Pathological Subtypes

ObjectiveThe association between the prognosis of thymoma and MG remains controversial. Differences in clinical characteristics and treatments between patients with and without MG may affect the findings of those studies. We designed this propensity score matching trial to investigate whether MG is an independent prognostic predictor in thymoma.MethodsPatients with pathologically diagnosed thymoma and MG were enrolled in the MG group. Moreover, the propensity score matching method was used to select patients who were diagnosed with thymoma without MG from the database of two participating centers. Matched factors included sex, age, Masaoka stage, pathological subtypes, and treatments. Matched patients were enrolled in the non-MG group. Chi-squared test was used to compare the characteristics of the two groups. Overall survival, local-regional relapse-free survival, distant metastasis-free survival, progression-free survival, and cancer-specific survival were calculated from the diagnosis of thymoma using the Kaplan–Meier method.ResultsBetween April 1992 and October 2018, 235 patients each were enrolled in the MG and non-MG groups (1:1 ratio). The median ages of patients in the MG and non-MG groups were 46 years old. The World Health Organization pathological subtypes were well balanced between the two groups (B2 + B3: MG vs. non-MG group, 63.0 vs. 63.4%, p = 0.924). Most patients in both groups had Masaoka stages I–III (MG vs. non-MG group, 90.2 vs. 91.5%, p = 0.631). R0 resections were performed in 86.8 and 90.2% of the MG and non-MG groups, respectively (p = 0.247). The median follow-up time of the two groups was 70.00 months (MG vs. non-MG group, 73.63 months vs. 68.00 months). Five-year overall survivals were 92.5 and 90.3%, 8-year overall survivals were 84.2 and 84.2%, and 10-year overall survivals were 80.2 and 81.4% (p = 0.632) in the MG and non-MG groups, respectively. No differences were found in the progression-free survival, distant metastasis-free survival, and local-regional relapse-free survival between the two groups.ConclusionMG is not an independent or direct prognostic factor of thymoma, although it might be helpful in diagnosis thymoma at an early stage, leading indirectly to better prognosis.

Prognostic Significance of Radiologic Extranodal Extension in Nasopharyngeal Cancer

2021 ◽  
pp. 019459982110088
Author(s):  
Melek Karakurt Eryılmaz ◽  
Cengiz Kadıyoran
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Distant Metastasis ◽  
Prognostic Significance ◽  
Nasopharyngeal Cancer ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Extranodal Extension ◽  
Distant Metastasis Free Survival

Objective The aim of the present study was to evaluate the prognostic value of radiologic extranodal extension (rENE) in patients with nasopharyngeal cancer. Study Design Retrospective review. Setting Tertiary university hospital. Methods We identified patients with nasopharyngeal cancer and lymph node metastasis who underwent pretreatment neck computed tomography or magnetic resonance imaging and evaluated rENE from the involved lymph node. Univariate Kaplan-Meier and multivariate Cox regression analyses were used to compare rENE+ and rENE– groups for local regional relapse–free survival, distant metastasis–free survival, and overall survival. Results Of 61 cases, 24 (39.3%) were rENE+ and 37 (60.7%) were rENE–. The median follow-up was 65.5 months. The 5-year distant metastasis–free survival and overall survival rates were lower in the rENE+ group than the rENE– group (70.8% vs 89.2%, P = .016; 66.7% vs 89.2%, P = .01, respectively). Differences in locoregional control between the groups were not significant ( P = .18). The 5-year rates for local regional relapse–free survival were 87.5% for rENE+ and 91.9% for rENE–. In multivariate analysis, the presence of rENE was a significant independent adverse prognostic factor for distant metastasis–free survival and overall survival. Conclusions We showed that rENE is an independent prognostic factor for poor distant control and survival in patients with nasopharyngeal cancer.

scholarly journals Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lei Du ◽  
Xin-Xin Zhang ◽  
Lin Ma ◽  
Lin-Chun Feng ◽  
Fang Li ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Distant Metastasis ◽  
Helical Tomotherapy ◽  
Antibody Therapy ◽  
Monoclonal Antibody Therapy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Metastasis Free Survival

Background.To evaluate the outcomes of nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT).Methods.Between September 2007 and August 2012, 190 newly diagnosed NPC patients were treated with HT. Thirty-one patients were treated with radiation therapy as single modality, 129 with additional cisplatin-based chemotherapy with or without anti-EGFR monoclonal antibody therapy, and 30 with concurrent anti-EGFR monoclonal antibody therapy.Results.Acute radiation related side effects were mainly grade 1 or 2. Grade 3 and greater toxicities were rarely noted. The median followup was 32 (3–38) months. The local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 96.1%, 98.2%, 92.0%, and 86.3%, respectively, at 3 years. Cox multivariate regression analysis showed that age and T stage were independent predictors for 3-year OS.Conclusions.Helical tomotherapy for NPC patients achieved excellent 3-year locoregional control, distant metastasis-free survival, and overall survival, with relatively minor acute and late toxicities. Age and T stage were the main prognosis factors.

scholarly journals Neoadjuvant Chemotherapy Followed by Radiofrequency Ablation Prolongs Survival for Ablatable Colorectal Liver Metastasis: A Propensity Score Matching Comparative Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yizhen Chen ◽  
Youyao Xu ◽  
Linwei Xu ◽  
Fang Han ◽  
Yurun Huang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Tumor Progression ◽  
Propensity Score Matching ◽  
Progression Free Survival ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Free Survival

BackgroundTypically, colorectal liver metastasis (CRLM) is not a candidate for hepatectomy. Radiofrequency ablation (RFA) plays a critical role in unresectable CRLM patients. Nevertheless, high local tumor progression (LTP) and distant metastasis limit the development and further adoption and use of RFA. Neoadjuvant chemotherapy (NAC) has been widely used in resectable CRLM and is recommended by the guidelines. There are no studies on whether NAC can improve the prognosis in ablatable CRLM patients. The present study aimed to determine the feasibility and effectiveness of RFA plus NAC.MethodsThis retrospective cohort included CRLM patients from Zhejiang Cancer Hospital records, who received RFA from January 2009 to June 2020 and were divided into two groups according to the presence or absence of NAC. The Kaplan–Meier method was used to evaluate the 3-year local tumor progression-free survival (LTPFS), progression-free survival (PFS), and overall survival (OS) of the two groups. The propensity score matching was used to reduce bias when assessing survival. Multivariate Cox proportional hazards regression analysis was used to study the independent factors affecting LTPFS, PFS, and OS.ResultsA total of 149 CRLM patients (88 in the RFA alone group and 61 in the plus NAC group) fulfilled the inclusion criteria. Post-RFA complications were 3.4% in the RFA alone group and 16.4% in the plus NAC group. The 3-year LTPFS, PFS, and OS of the RFA only group were 60.9%, 17.7%, and 46.2%, respectively. The 3-year LTPF, PFS, and OS of the plus NAC group were 84.9%, 46.0%, and 73.6%, respectively. In the 29 pairs of propensity score matching cohorts, the 3-year LTPFS, PFS, and OS in the plus NAC group were longer than those in the RFA group (P < 0.05). NAC was an independent protective factor for LTPFS, PFS, and OS (P < 0.05).ConclusionsFor ablatable CRLM patients, RFA plus NAC obtained a better prognosis than RFA alone. Based on the current results, the application of NAC before RFA may become the standard treatment.

scholarly journals Local treatment combined with chemotherapy improves survival of patients with pulmonary metastases of colorectal cancer—a real-world retrospective study

2020 ◽  
Author(s):  
Zikai Cai ◽  
Qingbing Wang ◽  
Xiaofeng Yang ◽  
Xiaolong Ye ◽  
Jiafeng Fang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Local Treatment ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Free Survival

Abstract Background The effect of local treatments for pulmonary metastases from colorectal cancer (CRC-PM) remains controversial. This study aims to figure out whether local treatments combined with chemotherapy could improve patients’ survival by comparing the outcomes of CRC-PM patients who submitted to local interventions combined with chemotherapy or just chemotherapy.Patients and Methods From January 2009 to July 2019, a total of 119 patients with CRC-PM from two surgical centers were reviewed. Patients were divided into two groups according to treatments for the lung metastases: Local intervention combined with chemotherapy (Group-LI) and Chemotherapy alone (Group-Chem). Overall survival (OS) and progression-free survival (PFS) were assessed with the Kaplan-Meier method. Clinical characteristics associated with prognosis were analyzed by using a Cox proportional hazards regression model. Propensity score matching analyses were used to overcome the possible biases in some baseline characteristics.Result Multivariable analysis revealed that the level of carcinoembryonic antigen (CEA) and treatment for CRC-PM are independent predictors of both OS and PFS. The median OS in Group-LI (n = 39) and Group-Chem (n = 80) were 34.5 months and 13.8 months, respectively(P < 0.001). The 3-year progression-free survival rate in Group-LI and Group-Chem were 75.2% and 45.1% (P < 0.001). After propensity score matching, patients in Group-LI had better OS (HR = 3.304, P = 0.022) and PFS (HR = 4.029, P < 0.001) than Group-Chem.Conclusion. CRC-PM patients with lower lever of CEA or local treatment of lung metastases are more likely to be those with favorable prognosis. Selected CRC-PM patients could benefit from local treatment of pulmonary metastases.

HSD3B1 and resistance to androgen deprivation therapy in prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 156-156 ◽  
Author(s):  
Jason W.D. Hearn ◽  
Ghada AbuAli ◽  
Cristina Magi-Galluzzi ◽  
Chandana A. Reddy ◽  
Kai-Hsiung Chang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Androgen Deprivation Therapy ◽  
Distant Metastasis ◽  
Progression Free Survival ◽  
Wild Type ◽  
Free Survival ◽  
Homozygous Variant ◽  
Distant Metastasis Free Survival ◽  
Variant Alleles

156 Background: The somatic mutation HSD3B1(1245A>C) has been mechanistically linked to castration-resistant prostate cancer by encoding a mutant enzyme that augments intratumoral dihydrotestosterone synthesis. Given the HSD3B1(1245C) allele is also frequently found in the germline, we hypothesized men inheriting this variant allele would exhibit resistance to androgen deprivation therapy (ADT), as manifested by worse clinical outcomes. Methods: We used a prospectively maintained prostate cancer registry to identify men treated with ADT for biochemical failure in the post-prostatectomy setting who were without evidence of metastatic disease at the time of ADT initiation. We analyzed progression-free survival, distant metastasis-free survival, and overall survival according to HSD3B1 genotype using Kaplan-Meier methods. Cox proportional hazards regression was performed to evaluate potential gene-dosage effects, with homozygous wild-type men serving as the reference group. Demographic and treatment characteristics were compared across genotypes to assess for possible confounders using Fisher’s exact test and Kruskal-Wallis analysis of variance. Results: Of 118 men genotyped, 37% were homozygous wild-type, 53% were heterozygous, and 10% were homozygous variant. Demographic and treatment characteristics did not differ across groups. Median progression-free survival diminished as a function of the number of variant alleles inherited (6.6 years in homozygous wild-type men, 4.1 years in heterozygotes, and 2.5 years in homozygous variant men; P=0.01). Median distant metastasis-free survival likewise decreased according to the number of variant alleles inherited (9.1 years in homozygous wild-type men, 6.8 years in heterozygotes, and 3.6 years in homozygous variant men; P=0.01). Finally, overall survival also diminished with the number of variant alleles inherited (5-year and 10-year overall survival: 82% and 55% in homozygous wild-type men, 74% and 35% in heterozygotes, and 58% and 0% in homozygous variant men; P=0.006). Conclusions: Inheritance of the variant HSD3B1(1245C) allele that enhances dihydrotestosterone synthesis may predict resistance to ADT for prostate cancer. These findings require validation.

Comparative efficacy and safety of dabrafenib in combination with trametinib versus competing adjuvant therapies for high-risk melanoma

2019 ◽  
Vol 8 (16) ◽  
pp. 1349-1363 ◽  
Author(s):  
Rohini Sharma ◽  
Roy Koruth ◽  
Steve Kanters ◽  
Eric Druyts ◽  
Ahmad Tarhini
Keyword(s):  
High Risk ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Distant Metastasis ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Comparable Efficacy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Distant Metastasis Free Survival

Aim To conduct a systematic literature review of high-risk resectable cutaneous melanoma adjuvant therapeutics and compare safety and efficacy. Methods: The systematic literature review included randomized controlled trials investigating: dabrafenib plus trametinib (DAB + TRAM), nivolumab, pembrolizumab, ipilimumab, vemurafenib, chemotherapy and interferons. Outcomes included overall survival (OS), relapse-free survival, distant metastasis-free survival and safety. All outcomes were synthesized using Bayesian network meta-analysis. Results: Across relapse-free survival, distant metastasis-free survival and OS, DAB + TRAM had the lowest estimated hazards of respective events relative to all other treatments (exception relative to nivolumab in OS). Differences were significant relative to placebo, chemotherapy, interferons and ipilimumab. Conclusion: DAB + TRAM has improved efficacy over historical treatment options (ipilimumab, interferons and chemotherapy) and comparable efficacy with other targeted and immune checkpoint inhibitors.

Second-Line Intraperitoneal Chemotherapy for Recurrent Epithelial Ovarian, Tubal and Peritoneal Cancer: A Propensity Score-Matching Study

Chemotherapy ◽  
2016 ◽  
Vol 61 (5) ◽  
pp. 240-248 ◽  
Author(s):  
Chien-Hsing Lu ◽  
Yen-Hou Chang ◽  
Wai-Hou Lee ◽  
Yi Chang ◽  
Chia-Wen Peng ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Large Scale ◽  
Progression Free Survival ◽  
Second Line ◽  
Free Survival ◽  
Peritoneal Cancer ◽  
Platinum Sensitive ◽  
Resistant Disease ◽  
Platinum Refractory

Background: The superiority of frontline intraperitoneal (IP) over intravenous (IV) chemotherapy is well established in the treatment of epithelial ovarian cancer. However, the role of IP chemotherapy in the second-line setting has rarely been investigated. Methods: Consecutive patients diagnosed with recurrent epithelial, tubal and peritoneal cancers between January 2000 and December 2012 were recruited using a propensity score-matching technique to adjust relevant risk factors. Results: In total, 310 patients were included in the final analysis (94 for platinum-refractory/resistant disease and 216 for platinum-sensitive disease). IP chemotherapy demonstrated significantly longer median progression-free survival than IV chemotherapy (4.9 vs. 2.4 months, p < 0.001, for platinum-refractory/resistant disease, and 9.8 vs. 6.9 months, p < 0.001, for platinum-sensitive disease). Conclusions: Second-line IP chemotherapy confers longer progression-free survival than IV chemotherapy. Large-scale clinical trials should be conducted to validate the true efficacy.

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