Comparison of Lobectomy and Sublobar Resection for Stage IA Elderly NSCLC Patients (≥70 Years): A Population-Based Propensity Score Matching’s Study

BackgroundTo investigate the differences in survival between lobectomy and sub-lobar resection for elderly stage I non-small-cell lung cancer (NSCLC) patients using the Surveillance, Epidemiology, and End Results (SEER) registry.MethodThe data of stage IA elderly NSCLC patients (≥ 70 years) with tumors less than or equal to 3 cm in diameter were extracted. Propensity-matched analysis was used. Lung cancer-specific survival (LCSS) was compared among the patients after lobectomy and sub-lobar resection. The proportional hazards model was applied to identify multiple prognostic factors.ResultsA total of 3,504 patients met criteria after propensity score matching (PSM). Although the LCSS was better for lobectomy than for sub-lobar resection in patients with tumors ≤ 3 cm before PSM (p < 0.001), no significant difference in the LCSS was identified between the two treatment groups after PSM (p = 0.191). Multivariate Cox regression showed the elder age, male gender, squamous cell carcinoma (SQC) histology type, poor/undifferentiated grade and a large tumor size were associated with poor LCSS. The subgroup analysis of tumor sizes, histologic types and lymph nodes (LNs) dissection, there were also no significant difference for LCSS between lobectomy and sub-lobar resection. The sub-lobar resection was further divided into segmentectomy or wedge resection, and it demonstrated that no significant differences in LCSS were identified among the treatment subgroups either. Multivariate Cox regression analysis showed that the elder age, poor/undifferentiated grade and a large tumor size were a statistically significant independent factor associated with survival.ConclusionIn terms of LCSS, lobectomy has no significant advantage over sub-lobar resection in elderly patients with stage IA NSCLC if lymph node assessment is performed adequately. The present data may contribute to develop a more suitable surgical treatment strategy for the stage IA elderly NSCLC patients.

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The Clinicopathological Significance of Jagged1 and DLL4 in Gallbladder Cancer

Tumori Journal ◽

10.5301/tj.5000519 ◽

2016 ◽

Vol 103 (6) ◽

pp. 557-565 ◽

Cited By ~ 3

Author(s):

Yuan Luo ◽

Zhu-lin Yang ◽

Chunwei Wang ◽

Xiongying Miao ◽

Zhiyu Liu ◽

...

Keyword(s):

Tumor Size ◽

Cox Regression ◽

Clinicopathological Characteristics ◽

Gastrointestinal Cancers ◽

Large Tumor ◽

Cox Regression Analysis ◽

Large Tumor Size ◽

Kaplan Meier ◽

Poor Differentiation ◽

Clinicopathological Significance

Purpose Gallbladder cancers (GBCs) are highly aggressive gastrointestinal cancers with high mortality. Biological markers for the diagnosis, prognosis, and targeted therapy of GBCs have not been established. Methods The protein expression of Jagged1 and DLL4 in 80 adenocarcinomas (AC) and 46 squamous cell/adenosquamous carcinomas (SC/ASCs) was measured using immunohistochemistry. Results Positive Jagged1 and DLL4 expression in both SC/ASC and AC was significantly associated with poor differentiation, large tumor size, invasion, metastasis, and low surgical curability. Univariate Kaplan-Meier analysis showed that positive Jagged1 and DLL4 expression was significantly associated with mean survival of SC/ASC and AC patients. Multivariate Cox regression analysis showed that positive Jagged1 and DLL4 expression, as well as poor differentiation, large tumor size, high TNM stage, invasion, lymph node metastasis, and low surgical curability are independent poor prognostic factors in both SC/ASC and AC patients. Conclusions Positive Jagged1 and DLL4 expression is closely correlated with severe clinicopathological characteristics and poor prognosis in patients with SC/ASC and patients with AC.

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Complex segmentectomy in the treatment of stage IA non-small-cell lung cancer

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz185 ◽

2019 ◽

Vol 57 (1) ◽

pp. 114-121 ◽

Cited By ~ 10

Author(s):

Yoshinori Handa ◽

Yasuhiro Tsutani ◽

Takahiro Mimae ◽

Yoshihiro Miyata ◽

Morihito Okada

Keyword(s):

Lung Cancer ◽

Regression Analysis ◽

Cancer Treatment ◽

Cox Regression ◽

Clinical Stage ◽

Cancer Control ◽

Cox Regression Analysis ◽

Lung Cancer Treatment ◽

Clinical Stage Ia ◽

Stage Ia

AbstractOBJECTIVESAlthough segmentectomy for lung cancer has been widely accepted, complex segmentectomy, which creates several, intricate intersegmental planes, remains controversial. Potential arguments include risk of incurability and ‘failure of cancer control’. We compared the outcomes of complex segmentectomy versus lobectomy and evaluated its use in lung cancer treatment.METHODSWe retrospectively reviewed clinical stage IA lung cancer patients who underwent complex segmentectomy (n = 99) or location-adjusted lobectomy (n = 94) between April 2009 and December 2017. Clinicopathological and postoperative results were compared. Factors affecting survival were assessed by the Kaplan–Meier method and the Cox regression analysis.RESULTSNo significant differences were detected in 30-day mortality (0% vs 0%), overall complications (26.3% vs 21.3%) and prolonged air leakage (11.1% vs 9.6%) rates between the 2 groups, respectively. Comparable results were obtained for 5-year overall (93.5% vs 96.4%, respectively; P = 0.21) or recurrence-free (92.3% vs 88.5%, respectively; P = 0.82) survivals after complex segmentectomy or lobectomy. There were 2 (2.0%) recurrences after complex segmentectomy and 7 (7.5%) after lobectomy (P = 0.094), with 0 (0%) margin relapses in each group. Multivariable Cox regression analysis revealed that complex segmentectomy and lobectomy had a numerically similar impact on recurrence-free survival (hazard ratio 0.93, 95% confidence interval 0.32–2.69; P = 0.90).CONCLUSIONSComplex segmentectomy can provide acceptable short- and long-term outcomes in lung cancer treatment.

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Association between number of dissected lymph nodes and survival in stage IA non-small cell lung cancer: a propensity score matching analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02090-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Lei-Lei Wu ◽

Jia-Jian Lai ◽

Xuan Liu ◽

Yang-Yu Huang ◽

Peng Lin ◽

...

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Tumor Size ◽

Wedge Resection ◽

Small Cell ◽

Matched Cohort ◽

Small Cell Lung ◽

Group A ◽

Stage Ia ◽

Group B

Abstract Background For patients with stage IA non-small cell lung cancer (NSCLC) with tumor size ≤ 2 cm, the prognostic significance of the number of removed lymph nodes (NLNs) through different surgical methods remains unclear. To determine the association of NLNs with cancer-specific survival (CSS) and overall survival (OS) in patients with stage IA NSCLC with tumor size ≤ 2 cm who underwent different lung surgeries. Methods We retrospectively enrolled 7293 patients from the Surveillance, Epidemiology and End Results database. Median NLNs was used to classify the patients into two groups: group A with NLNs ≤ 5 and group B with NLNs > 5. Propensity score matching (PSM) was performed to decrease selection bias. Kaplan–Meier analysis and Cox regression analysis were performed to identify the association between NLNs and survival outcomes. Results Group B had better survival than group A in the unmatched cohort and matched cohort (all P < 0.05). Multivariable analyses revealed that the NLNs significantly affected CSS and OS of eligible cases in the unmatched cohort and matched cohort. Additionally, we found that the NLNs was a protective prognostic predictor of OS for patients who underwent wedge resection, segmental resection, or lobectomy. Conclusion The NLNs was a protective prognostic factor in NSCLC patients with tumor size ≤ 2 cm. We demonstrated that patients with > 5 NLNs in the cohort of wedge resection, segmental resection, or lobectomy exhibited a significantly better OS.

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Serum miR-1228-3p and miR-181a-5p as Noninvasive Biomarkers for Non-Small Cell Lung Cancer Diagnosis and Prognosis

BioMed Research International ◽

10.1155/2020/9601876 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Wei-Xiao Xue ◽

Meng-Yu Zhang ◽

Rui Li ◽

Xiao Liu ◽

Yun-Hong Yin ◽

...

Keyword(s):

Lung Cancer ◽

Roc Analysis ◽

Cox Regression ◽

Small Cell ◽

Healthy Controls ◽

Small Cell Lung ◽

Cox Regression Analysis ◽

Diagnosis And Prognosis ◽

Noninvasive Biomarkers ◽

Nsclc Patients

Background. Lung cancer is the leading cause of cancer-related mortality worldwide, and non-small cell lung cancer (NSCLC) accounts for over 80% of all lung cancers. Serum microRNAs (miRNAs), due to their high stability, have the potential to become valuable noninvasive biomarkers. This present study was aimed to identify the serum miRNAs expression signatures for the diagnosis and prognosis of NSCLC using bioinformatics analysis. Methods. A total of 12 miRNAs profiling studies have been identified in Pubmed, Gene Expression Omnibus (GEO), and ArreyExpress databases. Differentially expressed miRNAs (DEmiRNAs) were analyzed according to GEO2R online tool and RRA method from R. Then, prediction of DEmiRNAs’ target genes from TargetScan, PicTar, miRDB, Tarbase, and miRanda database. Furthermore, we using reverse transcription– quantitative polymerase chain reaction (RT-qPCR) to evaluate the expression levels of DEmiRNAs in serum samples obtained from NSCLC patients and healthy controls. Subsequently, the clinical significance of the tested miRNAs was determined using receiver operating characteristic (ROC) analysis and Cox regression analysis. Results. A total of 27 DEmiRNAs were identified and 5 of them (miR-1228-3p, miR-1228-5p, miR-133a-3p, miR-1273f, miR-545-3p) were significantly up-regulated and 4 of them (miR-181a-5p, miR-266-5p, miR-361-5p, miR-130a-3p) were significantly down-regulated in NSCLC patients compared with healthy controls. RT-qPCR validated that miR-1228-3p (P =0.006) and miR-181a-5p (P =0.030) were significantly differentially expressed in the serum of NSCLC patients and healthy controls. ROC analysis on miR-1228-3p and miR-181a-5p revealed the area under the curve (AUC) of 0.685 (95% confidence interval [CI], 0.563–0.806; P =0.006) and 0.647 (95% CI, 0.506–0.758; P =0.049). ROC analysis on miR-1228-3p combined miR-181a-5p revealed the AUC of 0.711 (95% CI, 0.593–0.828; P =0.002). Multivariate Cox regression analysis demonstrated that the high serum miR-1228-3p level was an independent factor for the poor prognosis of NSCLC patients. Conclusions. Serum miR-1228-3p and miR-181a-5p are potential noninvasive biomarkers for the diagnosis and prognosis of NSCLC patients.

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Impact of Large Tumor Size on Survival After Resection of Pathologically Node Negative (pN0) Non–Small Cell Lung Cancer

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2004.09.062 ◽

2005 ◽

Vol 79 (4) ◽

pp. 1142-1146 ◽

Cited By ~ 26

Author(s):

Shin-ichi Takeda ◽

Shimao Fukai ◽

Hikotaro Komatsu ◽

Etsuo Nemoto ◽

Kenji Nakamura ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Tumor Size ◽

Small Cell ◽

Small Cell Lung ◽

Large Tumor ◽

Node Negative ◽

Large Tumor Size

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The Prognostic Value of miR-302b in Patients With NSCLC

10.21203/rs.3.rs-47876/v1 ◽

2020 ◽

Author(s):

Yue Zhao ◽

Xiangjun Kong ◽

Hongbing Wang

Keyword(s):

Lung Cancer ◽

Prognostic Value ◽

Cox Regression ◽

Prognostic Biomarker ◽

Expression Level ◽

Survival Curves ◽

Aberrant Expression ◽

Cox Regression Analysis ◽

Human Cancers ◽

Nsclc Patients

Abstract Background: Lung cancer is the most common cancer worldwide. The most frequent type of lung cancer is non-small cell lung cancer (NSCLC). MicroRNAs (miRNAs) have been reported to play important role in human cancers. Studies suggest that the aberrant expression of miRNAs could act as the diagnostic or prognostic biomarker in human cancers, including lung cancer. MicroRNA-302b (miR-302b) has ever been investigated in several human cancers. The aim of this study was to examine the prognostic value of miR-302b in patients with NSCLC.Methods: Quantitative real-time RT-PCR (qRT-PCR) analysis were used to measure the expression level of miR-302b in NSCLC and adjacent noncancerous samples. The relationship of miR-302b with the clinicopathological data of NSCLC was analyzed by Chi-square test. The prognostic value of miR-302b was assessed by using the Kaplan-Meier survival curves and Cox regression analysis.Results: The expression level of miR-302b was downregulated in the NSCLC samples compared with the paired adjacent noncancerous samples (P < 0.05). The decreased miR-302b was found correlated with the differentiation (P = 0.019) and lymph node metastasis (P = 0.019) of NSCLC. The survival curves suggested that patients with lower miR-302b expression had poor overall survival than those with high miR-302b expression. The results of Cox analysis demonstrated that the expression of miR-302b was an independent and effective prognostic factor in NSCLC patients with the P of 0.002 (HR = 2.508, 95% CI = 1.410 - 4.463).Conclusion: In one word, the expression of miR-302b was decreased in NSCLC samples, and the miR-302 expression might act as a prognostic biomarker in NSCLC patients.

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Relationship between red cell distribution width and prognosis in patients with breast cancer after operation: a retrospective cohort study

Bioscience Reports ◽

10.1042/bsr20190740 ◽

2019 ◽

Vol 39 (7) ◽

Cited By ~ 4

Author(s):

Deshun Yao ◽

Zhiwu Wang ◽

Haifeng Cai ◽

Ying Li ◽

Baosheng Li

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Size ◽

Cox Regression ◽

Disease Free Survival ◽

Cell Distribution ◽

Breast Cancer Patients ◽

Large Tumor ◽

Distribution Width ◽

Cox Regression Analysis

Abstract We retrospectively enrolled 825 breast cancer patients, who was primarily diagnosed in our hospital between January 2009 and December 2014 and explored the relationship between red blood cell distribution width (RDW) and long-term prognosis in patients with breast cancer. There were 412 patients with high RDW (RDW > 13.82) and 413 patients with low RDW (RDW ≤ 13.82). Compared with low RDW group, the high w group has large tumor size (the rate of tumor size >2 cm: 60.7 vs 44.8%, P=0.013). The rate of lymph node metastases was higher in the high RDW group thaten that in the low RDW group (62.1 vs 45.8%, P=0.000). RDW was positively associated with tumor stage. The high RDW tended to be advanced stage (P=0.000). Compared with low RDW group, the high RDW group tended to be higher lymphocyte count (P=0.004), elevated fibrinogen (P=0.043), and elevated high-sensitivity C-reactive protein (P=0.000). The Kaplan–Meier analysis indicated elevated RDW was positively associated with disease-free survival (DFS) (P=0.004) and overall survival (OS) (P=0.011). The multivariate Cox regression analysis indicated that the high RDW group had poorer OS (Hazard risk [HR] = 2.43; 95% CI: 1.62–3.21; P=0.024) and DFS (HR = 1.89; 95% CI: 1.28–3.62; P=0.000) compared with low RDW group. The present study found that high pretreatment RDW levels in breast cancer patients were associated with poor OS and DFS. RDW could be a potential predictive factor in differential diagnosis of poor prognosis from all patients.

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Prediction of Overall Survival for Early-stage Non-small Cell Lung Cancer via a Novel 7-gene Prognostic Signature and Allele Frequency Deviation (AFD)

10.21203/rs.3.rs-68377/v1 ◽

2020 ◽

Author(s):

Aisha AL-Dherasi ◽

Yuwei Liao ◽

Qi-Tian Huang ◽

Yichen Wang ◽

Rulin Hua ◽

...

Keyword(s):

Lung Cancer ◽

Allele Frequency ◽

Prognostic Model ◽

Cox Regression ◽

Gene Signature ◽

Small Cell ◽

Prognostic Signature ◽

Small Cell Lung ◽

Cox Regression Analysis ◽

Nsclc Patients

Abstract Background Due to the late and poor prognosis of non-small lung cancer(NSCLC), the mortality of patients is high, underlines the need to identify a credible prognostic marker for NSCLC patients. The aim of our study is to examine the association of allele frequency deviation (AFD) with the patient's survival, as well as identification and validation of a new prognostic signature to predict NSCLC overall survival(OS).Methods First, we developed a new algorithm to calculate AFD from whole-exome sequencing(WES) data, then we compared the predictability of the patient's survival between AFD, tumor mutation burden (TMB) and change of variants allele frequency (dVAF). Second, we overlapped the differentially expressed genes (DEGs) from our data with the genes associated with the survival of The Cancer Genome Atlas (TCGA) database to confirm all genes significantly related to the survival of lung cancer. We identified 149 genes, 31 of which are new genes and have not been reported for lung cancer, that was used to develop a new prognostic model. Lung cancer adenocarcinoma (LUAD) data from the TCGA database was used to validate the gene-signature model. The prognostic model relating to the genes was established and validated in training and LUAD validation groups.Results There was a significant association found between the high AFD value and poor survival among non-small cell lung cancer (NSCLC) patients. A novel seven genes (UCN2, RIMS2, CAVIN2, GRIA1, PKHD1L1, PGM5, CLIC6) were obtained through multivariate Cox regression analysis and significantly associated with NSCLC patients survival. Cox regression analysis confirmed that AFD and 7-gene signature are an independent prognostic marker in NSCLC patients. The AUC for 5-year survival in AFD and the AUC for 3-year survival in both training and validation groups were greater than 0.7.Conclusion As a result, AFD and 7-gene signatures were identified as new independent predictive factors used for predicting the survival among NSCLC patients.

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Identification and Prognostic Value Exploration of Radiotherapy Sensitivity-Associated Genes in Non-Small-Cell Lung Cancer

BioMed Research International ◽

10.1155/2021/5963868 ◽

2021 ◽

Vol 2021 ◽

pp. 1-14

Author(s):

Qing Ma ◽

Kai Geng ◽

Ping Xiao ◽

Lili Zeng

Keyword(s):

Lung Cancer ◽

Regression Analysis ◽

Risk Score ◽

Cox Regression ◽

Risk Group ◽

High Risk Group ◽

Small Cell ◽

Small Cell Lung ◽

Cox Regression Analysis ◽

Nsclc Patients

Background. Non-small-cell lung cancer (NSCLC) is a prevalent malignancy with high mortality and poor prognosis. The radiotherapy is one of the most common treatments of NSCLC, and the radiotherapy sensitivity of patients could affect the individual prognosis of NSCLC. However, the prognostic signatures related to radiotherapy response still remain limited. Here, we explored the radiosensitivity-associated genes and constructed the prognostically predictive model of NSCLC cases. Methods. The NSCLC samples with radiotherapy records were obtained from The Cancer Genome Atlas database, and the mRNA expression profiles of NSCLC patients from the GSE30219 and GSE31210 datasets were obtained from the Gene Expression Omnibus database. The Weighted Gene Coexpression Network Analysis (WGCNA), univariate, least absolute shrinkage and selection operator (LASSO), multivariate Cox regression analysis, and nomogram were conducted to identify and validate the radiotherapy sensitivity-related signature. Results. WGCNA revealed that 365 genes were significantly correlated with radiotherapy response. LASSO Cox regression analysis identified 8 genes, including FOLR3, SLC6A11, ALPP, IGFN1, KCNJ12, RPS4XP22, HIST1H2BH, and BLACAT1. The overall survival (OS) of the low-risk group was better than that of the high-risk group separated by the Risk Score based on these 8 genes for the NSCLC patients. Furthermore, the immune infiltration analysis showed that monocytes and activated memory CD4 T cells had different relative proportions in the low-risk group compared with the high-risk group. The Risk Score was correlated with immune checkpoints, including CTLA4, PDL1, LAG3, and TIGIT. Conclusion. We identified 365 genes potentially correlated with the radiotherapy response of NSCLC patients. The Risk Score model based on the identified 8 genes can predict the prognosis of NSCLC patients.

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The effect of fibrinolytic therapy on 30-day outcome in patients with intermediate risk pulmonary embolism - propensity score-adjusted analysis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh190710115r ◽

2019 ◽

Vol 147 (11-12) ◽

pp. 676-682

Author(s):

Nebojsa Radovanovic ◽

Mina Radosavljevic-Radovanovic ◽

Jelena Marinkovic ◽

Nebojsa Antonijevic ◽

Milan Dobric ◽

...

Keyword(s):

Pulmonary Embolism ◽

Propensity Score ◽

Cox Regression ◽

Composite Endpoint ◽

Fibrinolytic Therapy ◽

Baseline Risk ◽

Minor Bleeding ◽

Intermediate Risk ◽

Cox Regression Analysis ◽

Significant Difference

Introduction/Objective. Patients with submassive (intermediate risk) pulmonary embolism (PE) represent a very heterogeneous group, whose therapeutic strategy still questions whether some groups of patients would have net clinical benefit from fibrinolytic therapy (FT). Methods. From the institutional pulmonary embolism registry, 116 patients with submassive PE were identified, and the relation of their outcome to FT was analyzed using the propensity score (PS) adjustment. The primary endpoint was the composite of death, in-hospital cardiopulmonary deterioration, or recurrence of PE. Safety outcomes were updated TIMI non-CABG related major and minor bleeding. Results. According to Cox regression analysis, the incidence of composite endpoint was significantly lower in patients treated with FT compared to anticoagulant therapy (AT) only (PS adjusted HR 0.22; 95% CI 0.05?0.89; p = 0.039). But, when patients were stratified into four PS quartiles, only patients in the highest PS quartile that received fibrinolysis, had significantly lower composite event rate than patients treated with AT (HR 0.20; 95% CI 0.01?0.56; p = 0.016). The overall mortality of the study group was 5.2% and there was no significant difference between the treatment groups. Total bleeding was significantly more frequent in FT patients (HR 3.07; 95% CI 1.02?13.29; p = 0.047), but not the major one. Conclusion. The use of FT was associated with a better outcome compared to AT in patients with submassive PE, but the benefit was mainly driven from those with highest values of PS, i.e. with the highest baseline risk. The rate of major bleeding was not significantly increased by FT.

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