scholarly journals Advanced Lung Cancer Inflammation Index Predicts Survival Outcomes of Patients With Oral Cavity Cancer Following Curative Surgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Yao-Te Tsai ◽  
Cheng-Ming Hsu ◽  
Geng-He Chang ◽  
Ming-Shao Tsai ◽  
Yi-Chan Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Oral Cavity ◽  
Proportional Hazards Model ◽  
Disease Free Survival ◽  
Cox Proportional Hazards Model ◽  
Advanced Lung Cancer ◽  
Survival Outcomes ◽  
Curative Surgery ◽  
Cancer Inflammation

AimThe aim of our study was to investigate the prognostic value of preoperative advanced lung cancer inflammation index (ALI) and to establish prognostic nomograms for the prediction of survival outcomes in patients with oral cavity squamous cell carcinoma (OSCC).Materials and MethodsA total of 372 patients who received primary curative surgery for OSCC during 2008–2017 at a tertiary referral center were enrolled. We used the receiver operating characteristic curve to determine the optimal cutoff point of ALI. Through a Cox proportional hazards model and Kaplan–Meier analysis, we elucidated the ALI–overall survival (OS) and ALI–disease-free survival (DFS) associations. Prognostic nomograms based on ALI and the results of multivariate analysis were created to predict the OS and DFS. We used the concordance indices (C-indices) and calibration plots to assess the discriminatory and predictive ability.ResultsThe results revealed that the ALI cutoff was 33.6, and 105 and 267 patients had ALI values of <33.6 and ≥33.6, respectively. ALI < 33.6 significantly indicated lower OS (44.0% vs. 80.1%, p < 0.001) and DFS (33.6% vs. 62.8%; p < 0.001). In multivariate analysis, ALI < 33.6 was independently associated with poor OS and DFS (both p < 0.001). The C-indices of established nomograms were 0.773 and 0.674 for OS and DFS, respectively; moreover, the calibration plots revealed good consistency between nomogram-predicted and actual observed OS and DFS.ConclusionALI is a promising prognostic biomarker in patients undergoing primary surgery for OSCC; moreover, ALI-based nomograms may be a useful prognostic tool for individualized OS and DFS estimations.

Clusterin expression (CLU) as a prognostic marker in colorectal carcinoma (CCR).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 563-563
Author(s):  
Julia Alcaide ◽  
Antonio Rueda ◽  
Isabel Rodrigo ◽  
Teresa Tellez ◽  
Rafael Funez ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Normal Mucosa ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Staining Procedure ◽  
Positive Staining

563 Background: Increased CLU is involved in malignant progression and anticlusterin treatment with antisense oligonucleotides enhances apoptosis induced by several citotoxics. However, clinical significance of CLU expression in human CRCs has been scarcely studied. We investigated whether changes in CLU could be related to carcinogenesis and survival (sv) of CRC patients (pts). Methods: Formalin-fixed and paraffin-embedded specimens were examined from 31 adenomas and 103 CRCs resected at Costa del Sol Hospital. The study was approved by Research Ethics Committee. Immunohistochemistry using monoclonal anti-α chain clusterin antibody (Upstate-Millipore, Watford, England) was performed, following standard staining procedure. CLU was scored as negative (CLU–) (no staining) or positive (CLU +) (>10% of tumor cells with strong staining). Cytoplasmic CLU in tumors was evaluated for cancer cells only, and in normal mucosa for epithelial cells only. Sv curves were calculated and plotted according to Kaplan-Meier method. Predictors that were significant at p<0.10 in univariate analysis, were entered into a Cox proportional hazards model for multivariate analysis, remaining significant at p<0.05. Results: Median follow-up was 54 months. Median age was 70 years (45-91). TNM stage distribution was: I (13%), II (48%), III (25%) and IV (14%). Epithelial normal cells were always CLU-, but 16% (5/31) of adenomas was CLU+ and this percentage increased in CRCs (30%, 31/103). Positive staining always presented an apical cytoplasmic pattern. Recurrence was more frequent in CLU+ (61%,19/ 31) than in CLU- tumors (37%, 27/72) and CLU was significantly associated with lower disease-free survival (DFS) (p<0.05). In multivariate analysis, CLU and stage remained significant independent prognostic factors for DFS (Table). Conclusions: CLU has a role in colon carcinogenesis and prognostic value. CLU is associated with decreased DFS among pts with CRCs. These findings have important implications for identifying CRC pts with more aggressive tumors who may benefit from targeted therapy against clusterin. [Table: see text]

scholarly journals Anorexia as a Risk Factor of Mortality in Patients with Advanced Lung Cancer Receiving Home-Base Palliative Care

2021 ◽  
Author(s):  
Jiaxin Cui ◽  
Lanhui Tan ◽  
Pei Fang ◽  
Zifen An ◽  
Jiayi Du ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Home Based

Abstract Purpose To determine the prevalence of anorexia among advanced lung cancer patients at the beginning of receiving home-based palliative care and to examine the predictive role of anorexia in survival of patients with advanced lung cancer. Methods In this retrospective study, we analyzed data from 918 advanced lung cancer patients who had received home-based palliative care between March 2010 and March 2020. We used Kaplan-Meier survival curves to determine the factors associated with survival time and applied the Cox proportional hazards model to examine the effect of anorexia on survival. Results The study included 918 patients with a mean age of 63.5 years; and 72.2% of them were men. Factors associated with shortened survival included gender, place of residence, weight loss, anorexia, nausea and Karnofsky performance status (KPS). In a multivariable Cox proportional hazards model, after adjusting for male gender, patient lives in city, and low KPS, we found that anorexia was an independent negative predictor of survival. Conclusions As an independent factor predicting the survival of patients with advanced lung cancer, anorexia should be taken seriously by medical staff. This predictive factor may serve as early risk identification indicator for healthcare workers who provide home-based palliative care, thereby providing personalized palliative care for advanced lung cancer patients.

Venous thromboembolism among patients with advanced lung cancer randomized to prinomastat or placebo, plus chemotherapy

2003 ◽  
Vol 90 (10) ◽  
pp. 734-737 ◽  
Author(s):  
Rolando Ruiz ◽  
Carolyn Behrendt
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Venous Thromboembolism ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Performance Status ◽  
Univariate Analysis ◽  
Combined Treatment ◽  
Advanced Lung Cancer ◽  
Double Blind

SummaryTwo clinical trials have suggested that the combination of vascular endothelial growth factor inhibitor with chemotherapy is associated with venous thromboembolism (VTE). This retrospective cohort study investigates whether a similar association exists when matrix metalloproteinase inhibitor (prinomastat) is combined with chemotherapy.Patients (n=1,023) with stage IIIB, IV, or recurrent non-small cell lung cancer (NSCLC) were followed during 2 randomized, double-blind trials of prinomastat versus placebo orally bid, plus gemcitabine/cisplatin (GC) or paclitaxel/carboplatin (PC). VTE included deep venous thrombosis (DVT) or pulmonary embolism (PE) confirmed by imaging or autopsy. Risks identified in univariate analysis (incidence densities compared by t test) were confirmed in multivariate analysis (proportional hazards model).During 7,500.3 patient-months, 58 VTE (31 PE, 27 isolated DVT) were confirmed in 54 patients. On univariate analysis, VTE was associated with central venous catheter placed within 3 months,15 mg prinomastat plus GC, and to a lesser extent, 15 mg prinomastat plus PC, baseline performance status, and histologic type. VTE incidence was not increased by 15 mg prinomastat alone (post-discontinuation of chemotherapy), by chemotherapy plus placebo, or by 5 or 10 mg prinomastat plus chemotherapy. On multivariate analysis, VTE hazards (95% confidence interval) were 5.69 (2.61, 12.40) with recently placed central catheter, 2.78 (1.42, 5.43) with 15 mg prinomastat plus GC, and 2.06 (0.98, 4.31) with 15 mg prinomastat plus PC; performance status and histology were nonsignificant.We can conclude that combined treatment with 15 mg prinomastat plus chemotherapy approximately doubles the hazard of VTE among patients with advanced NSCLC.Research support: Pfizer Inc

scholarly journals The Effectiveness of Surgery-Based Treatment in Advanced Oropharyngeal Cancers

2021 ◽  
Vol 64 (7) ◽  
pp. 486-490
Author(s):  
Young-Chan Kim ◽  
Hyeongeun Kim ◽  
Jiwon Kwak ◽  
Hoyoung Lee ◽  
Kwang-Yoon Jung ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Group ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Disease Free Survival ◽  
Treatment Method ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Primary Surgery ◽  
Lower Stage

Background and Objectives Oropharyngeal cancers (OPCs) can be staged down to a lower stage with p16 positivity and de-escalated therapy has been the common practice. The aim of this study is to evaluate the survival outcomes based on various clinical factors in advanced OPC patients. Subjects and Method A total of 58 OPC patients in the stage IVA based on the American Joint Committee on Cancer 7th edition were treated with primary surgery or primary chemoradiation therapy from 2010 to 2016. A survival analysis was carried out using the Kaplan- Meier method, log-rank test, and Cox proportional hazards model. Results The median follow-up was 39.5 months. Thirty-eight and 20 patients received surgery- based and radiation therapy (RT)-based treatments, respectively. Clinical T-stage and treatment method were significant risk factors for 5-year disease-free survival (DFS) rate, and the treatment method was the only significant risk factor for overall-survival (OS) rate. 5-year DFS rate in the surgery-based treatment and RT-based treatment was 76.1% and 36.0% (p=0.001). On multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death [the hazard ratio (HR) for the radiation-based treatment was 6.565 compared to the surgery-based treatment, p=0.002]. 5-year OS rate in the surgery-based treatment and RT-based treatment was 91.1% and 53.4% (p=0.003), respectively. On the multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death (the HR for the radiation-based treatment was 7.544 compared to the surgerybased treatment, p=0.012). Conclusion The primary surgery-based treatment for advanced OPC showed a better survival outcome than the primary radiation-based treatment, irrespective of p16 positivity.

Low Initial Human Papilloma Viral Load Implicates Worse Prognosis in Patients With Uterine Cervical Cancer Treated With Radiotherapy

2009 ◽  
Vol 27 (30) ◽  
pp. 5088-5093 ◽  
Author(s):  
Joo-Young Kim ◽  
Sohee Park ◽  
Byung-Ho Nam ◽  
Ju-Won Roh ◽  
Chae Hyeong Lee ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Viral Load ◽  
Proportional Hazards Model ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Uterine Cervical Cancer ◽  
Cox Proportional Hazards Model ◽  
Hpv Dna ◽  
Hpv Viral Load

Purpose To evaluate whether human papillomavirus (HPV) viral load measured in cervical smear and HPV type 18 are associated with radiotherapy outcomes in uterine cervical cancer. Patients and Methods HPV DNA was semiquantitatively measured in the cervical smears of 169 radiotherapy patients. HPV viral load was classified as low or high according to median HPV DNA titer and examined for its prognostic value. The multivariable Cox proportional hazards model was used to adjust for covariates. A relapse-predicting model was constructed to classify three risk groups for disease-free survival (DFS), which were used for internal validation. Results Patients with lower HPV viral load showed worse DFS in univariate analysis. HPV type 18, younger patient age, stage group, nodal status, histologic grade, and histologic type were other prognostic factors for poor DFS. Among these factors, all except stage group were associated with HPV viral load. Multivariate analysis showed the strong influence of HPV viral load for poor DFS. The prognostic model developed using our outcome data performed well in predicting the risk of relapse. Conclusion Our data suggest that HPV viral load is a strong independent prognostic factor for DFS. HPV type 18 showed a significant relationship with poor radiotherapy outcome in univariate analysis, but not in multivariate analysis.

scholarly journals Prognostic significance of advanced lung cancer inflammation index (ALI) in multiple myeloma patients – a retrospective study

2021 ◽  
Author(s):  
Junxia Huang ◽  
Juanjuan Hu ◽  
Yan Gao ◽  
Fanjun Meng ◽  
Tianlan Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Progression Free Survival ◽  
Advanced Lung Cancer ◽  
Free Survival ◽  
Factors Influencing ◽  
Independent Risk Factors ◽  
Cancer Inflammation

Abstract Background: Advanced lung cancer inflammation index (ALI) is known to predict the overall survival of patients having some solid tumors or B-cell lymphoma. The study investigates the predictive value of ALI in multiple myeloma (MM) patients and the correlation between ALI and prognosis.Methods: A database of 269 MM consecutive patients who underwent chemotherapy between December 2011 and June 2019 in the Affiliated Hospital of Qingdao University was reviewed. ALI cut-off value calculated before the initial chemotherapy and post 4 courses treatment were identified according to the receiver operating characteristic (ROC) curve, and its association with clinical characteristics, treatment response, overall survival (OS), and progression-free survival (PFS) were assessed.Results: Patients in the low ALI group (n=147) had higher risk of β2 microglobulin elevation, more advanced ISS (International Classification System stage), and TP53 gene mutation, with significantly lower median overall survival (OS; 36.29 vs. 57.92 months, P = 0.010) and progression-free survival (PFS; 30.94 vs. 35.67 months, P = 0.013). Independent risk factors influencing the OS of MM patients were ALI (P = 0.007), extramedullary infiltration (P = 0.001), TP53 (P = 0.020), Plt (P = 0.005), and bone destruction (P = 0.024). ALI (P = 0.005), extramedullary infiltration (P = 0.004), TP53 (P = <0.001), Plt (P = 0.017), and complex chromosome karyotype (P = 0.010) were independent risk factors influencing the PFS of MM patients.Conclusions: ALI is a potential independent risk factor predicting the prognosis of newly diagnosed MM patients.

Impact of genomic aberrations and additional therapies on survival outcomes of patients with operable non-small cell lung cancer (NSCLC) from the NEOSTAR study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 8542-8542
Author(s):  
Nicolas Zhou ◽  
Boris Sepesi ◽  
Cheuk Hong Leung ◽  
Heather Y. Lin ◽  
William Nassib William ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Median Time ◽  
Proportional Hazards Model ◽  
Primary Lung Cancer ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Egfr Mutations ◽  
Genomic Aberration ◽  
Curative Intent ◽  
Genomic Aberrations

8542 Background: The NEOSTAR study compared nivolumab (N) vs. nivolumab plus ipilimumab (NI) with major pathological response (MPR; ≤10% viable tumor) as primary outcome. We report updated rates of treatment failure (TF), including in patients whose tumors harbored genomic aberrations, and outcomes of additional treatments. Methods: Patients (pts) with stage I-IIIA resectable NSCLC (AJCC 7th) were randomized to either neoadjuvant N or NI followed by surgery (n = 44). TF was defined as radiographic and/or biopsy-proven recurrence from primary lung cancer and/or death (treatment or cancer-related). Additional systemic therapy at recurrence included immuno-oncology (IO)-based therapy (IO or chemo-IO), targeted therapy (TT), or chemotherapy. Disease control rate (DCR) was defined as the proportion of pts with radiographic objective responses and stable disease at first restaging. Cox proportional hazards model was used to associate baseline characteristics and time to TF. Results: A total of 44 randomized pts were evaluated, the median follow-up was 35 months (mts) as of February 4, 2021. Among the 12 TF pts (12/44, 27%), 42% (5/12) did not undergo surgery on trial, 9 (9/44, 20%) experienced recurrence and 6 (6/44, 14%) died (1 non-cancer-related, 5 cancer-related). TF was less likely in smokers vs. never smokers (hazard ratio = 0.20, 95% confidence interval = 0.06-0.65, p = 0.007). Among pts with pathological specimen resected on trial, MPR was achieved in 40% (12/30) of non-TF pts. Only 1 (1/7, 14%) TF pt achieved MPR, but died of a non-cancer related cause. TF-free survival rate at 2 years was 92% in MPR and 78% in non-MPR pts. Eight (8/9, 89%) pts had tumors with canonical oncodriver aberrations (5 EGFR mutations, 1 with STK11+ KRAS Q61H mutations, 1 ALK translocation and 1 RET fusions). Of the 9 recurrences, 44% (4/9) were treated with IO therapy, and all 7 pts with targetable aberrations were treated with TT (3 after retreatment with IO therapies). Of the 4 pts retreated with IO therapy, duration between end of neoadjuvant and retreatment were 20, 17, 23, and 19 mts. Duration from retreatment until progression (PD) were 1, 1, and 2 mts, respectively. Last pt was treated without PD for 2 mts but switched to TT due to discovery of genomic aberration. IO retreatment achieved 25% DCR (1/4). In comparison, the DCR for TT treated pts was 71% (5/7, p = 0.242). Median time to treatment was 21 mts, and median time to PD was not reached. Among 32 non-TF pts, 12 had genomic analysis and 7 aberrations were found in 6 pts (2 STK11, 2 ERBB2, 1 STK11 + 1 KRAS G12C, and 1 KRAS G12C mutation). Conclusions: A 27% TF rate was observed after neoadjuvant IO. TF was less likely to occur in smokers and MPR pts, and 42% of TF pts did not undergo curative-intent surgery on trial. Genomic aberrations were common in pts with recurrence (89%), and treatment with TT achieved 71% DCR vs. 25% DCR with IO-based retreatment. Clinical trial information: NCT: 03158129.

Association between breast cancer’s prognostic factors and 3D textural features of non-contrast-enhanced T1-weighted breast MRI

2021 ◽  
Author(s):  
Anni Lepola ◽  
Otso Arponen ◽  
Hidemi Okuma ◽  
Kirsi Holli-Helenius ◽  
Heikki Junkkari ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Texture Analysis ◽  
Proportional Hazards Model ◽  
Histological Grade ◽  
Prognostic Index ◽  
Disease Free Survival ◽  
Breast Mri ◽  
Cox Proportional Hazards Model ◽  
Tumour Grade ◽  
Contrast Enhanced

Objectives: The aim of this exploratory study was to evaluate whether three-dimensional texture analysis (3D-TA) features of non-contrast-enhanced T1-weighted MRI associate with traditional prognostic factors and disease-free survival (DFS) of breast cancer. Methods: 3D-T1-weighted images from 78 patients with 81 malignant histopathologically verified breast lesions were retrospectively analysed using standard-size volumes of interest. Grey-level co-occurrence matrix (GLCM) based features were selected for statistical analysis. In statistics the Mann–Whitney U and the Kruskal–Wallis tests, the Cox proportional hazards model and the Kaplan-Meier method were used. Results: Tumours with higher histological grade were significantly associated with higher contrast (1voxel: p = 0.033, two voxels: p = 0.036). All the entropy parameters showed significant correlation with tumour grade (p = 0.015–0.050) but there were no statistically significant associations between other TA parameters and tumour grade. The Nottingham Prognostic Index (NPI) was correlated with contrast and sum entropy parameters. A higher sum variance TA parameter was a significant predictor of shorter DFS. Conclusion: Texture parameters, assessed by 3D-TA from non-enhanced T1-weighted images, indicate tumour heterogeneity but have limited independent prognostic value. However, they are associated with tumour grade, NPI, and DFS. These parameters could be used as an adjunct to contrast-enhanced TA parameters. Advances in knowledge: 3D texture analysis of non-contrast enhanced T1-weighted breast MRI associates with tumour grade, NPI, and DFS. The use of non-contrast 3D TA parameters in adjunct with contrast-enhanced 3D TA parameters warrants further research.

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