scholarly journals A Nomogram Model to Predict Prognosis of Patients With Genitourinary Sarcoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Linde Li ◽  
Jiayu Liang ◽  
Turun Song ◽  
Saifu Yin ◽  
Jun Zeng ◽  
...  
Keyword(s):  
Cox Regression ◽  
Surgical Excision ◽  
Rank Test ◽  
Training Set ◽  
Positive Margins ◽  
Prognostic Effect ◽  
Kaplan Meier ◽  
Sufficient Power ◽  
Validation Set ◽  
The Impact

ObjectivesThe aim of this study is to evaluate the significant factors influencing the overall survival (OS) and recurrence free survival (RFS) and make an attempt to develop a nomogram for predicting the prognosis of patients with genitourinary sarcoma (GS).MethodsData on adult GS from 1985 to 2010 were collected. The impact of clinical factors on OS and RFS were estimated by Kaplan–Meier (KM) analysis, and differences between groups were analyzed by the log-rank test. To establish a nomogram, all patients were randomly divided into a training set (n = 125) and a testing set (n = 63). Cox proportion hazard model was utilized to assess the prognostic effect of variables. Then, a nomogram was established to estimate 1-, 3-, and 5-year OS based on Cox regression model. Subsequently, the nomogram was validated by a training set and a validation set.ResultsA total of 188 patients were enrolled into our study. Male patients with bladder sarcoma had better OS rather than RFS when stratified by gender (P = 0.022). According to histological subtypes, patients with leiomyosarcoma (LMS) undergoing chemotherapy were associated with favorable OS (P = 0.024) and RFS (P = 0.001). Furthermore, LMS in kidney sarcoma were associated with lower recurrence rate in comparison to rhabdomyosarcoma (RMS) (P = 0.043). Margin status after surgical excision markedly influenced the OS and RFS of GS patients and negative margins presented optimal prognosis. Chemotherapy was associated with improved OS for patients without surgery (P = 0.029) and patients with positive margins (P = 0.026). Based on the multivariate analysis of the training cohort, age, gender, surgery status, histological subtype, and chemotherapy were included in our nomogram for prediction of OS. The nomogram had sufficient power with concordance index (C-index) of OS: 0.770, 95%CI: 0.760–0.772 and area under curve (AUC) of OS: 0.759, 95%CI: 0.658–0.859 in the training set and with C-index of OS: 0.741, 95%CI: 0.740–0.765, and AUC of OS: 0.744, 95%CI: 0.576–0.913 in the validation set.ConclusionsAdults GS is a group of extremely rare tumors with poor prognosis. Of all histological types, LMS is sensitive to chemotherapy. We highlighted the cardinal role of surgical resection and the importance of achieving negative margins. We identified the efficacy of chemotherapy for patients with positive margins and those without surgery as well. A nomogram is validated as an effective tool predicting short-term outcomes.

Prognostic value of immunohistochemical phenotypes (IP) of 141 operable breast cancer patients (pts) included in phase III trials of adjuvant therapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21040-21040
Author(s):  
R. Trujillo ◽  
E. Gallego ◽  
A. Márquez ◽  
N. Ribelles ◽  
J. Trigo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Phase Iii ◽  
Rank Test ◽  
Prognostic Effect ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Phase Iii Trials ◽  
Her 2

21040 Background: Gene expression arrays and IP studies classified breast cancer in three distinct subtypes: basal, HER2/neu and luminal that are associated with different clinical outcomes. Methods: In 141 pts with operable breast cancer, included in phase III trials of adjuvant therapy in our center, immunohistochemical staining was performed on 3μm sections of paraffin blocks, containing tissue-arrays of tumour tissue.A basal phenotype (BP) was defined by negative estrogen receptor (ER) and progesterone receptor (PR) and positive cytokeratin (CK) 5/6 or EGFR immunoreactivity. HER2/neu phenotype as positive c-erb B2 by HercepTest™ and luminal phenotype (LP) by positive ER, PR and CK 7/8 and negative HER-2. Survival curves were calculated by the Kaplan-Meier method. The differences between survivals were estimated using the log rank test. Multivariate Cox regression analysis was used to evaluate any independent prognostic effect of the variables on disease-free survival (DFS). Results: Complete clinical follow-up information was available for 141 pts. The median follow-up period was 52 months (range 1–103 months). During this period, 13.8% pts died from breast cancer and 27.7% pts relapsed. At the time of the primary diagnosis 10.4% of the pts had lymph node negative disease and 89.6% had positive lymph nodes. 50.8% pts received taxane chemotherapy, 7.7% Trastuzumab, 62.3% radiotherapy and 61% pts received hormonotherapy. Positivity for LP was 65.2%, BP 9.9% and Her-2 phenotype 8.5%. 16.3% didn't fit for any of the three subtypes. Median DFS for BP: 24 moths, for LP and Her-2 phenotypes median DFS was not reached. 5 years DFS were; BP: 19%, LP: 63% and Her-2: 56%. Kaplan-Meier survival analyses demonstrated that the presence of a detectable BP was highly significantly associated with a worse DFS compared with the presence of a LP, log rank test (p= 0.0001). Multivariate Cox regression analyses estimated that the prognostic effect of BP in relation to DFS was independent of lymph node, stage and tumor size, HR: 0.12 95% CI (0.05–0.2). Conclusions: We found that expression of BP was associated with poor prognostic in the context of randomized phase III trials. No significant financial relationships to disclose.

Can sidedness predict for survival in primary locoregional colon cancers?

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 584-584
Author(s):  
Weining Wang ◽  
Chin Jin Seo ◽  
Grace Hwei Ching Tan ◽  
Claramae Shulyn Chia ◽  
Khee Chee Soo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Rank Test ◽  
Rectosigmoid Junction ◽  
Colon Cancers ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact

584 Background: Right and left-sided colon cancers are embryonically distinct and present differently. Recently, there has been growing belief that sidedness could be independently associated with survival outcomes. This has important clinical implications regarding the prognostication, management and surveillance of colon cancer patients. Hence, we aim to investigate the impact of sidedness on survival in our patient population in this study. Methods: Patients who had primary treatment naïve colon cancer who underwent curative surgical resection in our institution from September 2002 to December 2010 were included in this study. Demographic and clinicopathological data was collected from electronic records and clinical charts. Tumours arising from the cecum, ascending colon, hepatic flexure and transverse colon were considered right-sided, while those arising from splenic flexure and descending colon were considered left-sided. Cancers of the rectosigmoid junction and rectum were excluded. Kaplan-Meier curves and log-rank test were used to compare overall, locoregional recurrence-free and distant recurrence-free survivals (OS, LRFS, DRFS respectively) between both groups. Multivariate analysis was performed using Cox regression proportional hazards. Results: 389 patients were included in this study. 238 had left-sided tumours while the remaining 151 had right-sided tumours. In our cohort, right-sided tumours were associated with older age and mucinous histology. Kaplan-Meier curves plotted showed improved LRFS in left-sided tumours (p = 0.04, median survival not reached) but no significant difference in OS and DRFS. On multivariate analysis, sidedness was also found to be an independent prognostic factor for LRFS but not OS and DRFS despite factoring in age, size of tumour, pT, pN and histology. Conclusions: Our study suggests that left-sided tumours in primary colon cancer are independently prognostic for improved locoregional survival as compared to the right-sided tumours, even after taking into account other known factors such as age, staging and histology.

Selective benefit of adjuvant chemoradiation in resectable pancreatic cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4122-4122 ◽  
Author(s):  
Jesse P Wright ◽  
Cameron Schlegel ◽  
Rebecca A Snyder ◽  
Liping Du ◽  
Yu Shyr ◽  
...  
Keyword(s):  
Cox Regression ◽  
Margin Status ◽  
Resectable Pancreatic Cancer ◽  
Adjuvant Chemoradiation ◽  
Related Factors ◽  
Large Hospital ◽  
Positive Margins ◽  
Kaplan Meier ◽  
Independent Effects ◽  
The Impact

4122 Background: Although level 1 data supports the use of adjuvant chemotherapy (ACT) in resected pancreatic adenocarcinoma (PDAC), the role of adjuvant chemoradiation (ACRT) remains controversial. The objective of this study is to investigate the impact of adding ACRT to ACT on overall survival (OS), based on lymph node (LN) and margin status. Methods: Resected AJCC Stage I and II PDAC patients from 2004-2013 identified within the National Cancer Database were classified into groups based on treatment: surgery alone (SX), ACT alone, ACT+ACRT, and ACRT only. Kaplan-Meier analyses were performed to determine median OS. Multivariable (MV) Cox regression models with interactions of treatment with LN and margin status were constructed to examine the independent effects of ACT and ACT+ACRT in these subgroups. Results: Of 31,348 patients, 30% were treated with SX, 30% with ACT, 38% with ACT+ACRT, and 2% with ACRT alone. Median OS (mos.) for ACT (22.5, 95% CI 21.9-23.1) and ACT+ACRT (23.7, 23.3-24.2) were significantly longer than SX (14, 13.4-14.5) or ACRT (11.2, 9.8-12.9). MV analysis confirmed a significant OS benefit of both ACT and ACT+ACRT controlling for patient and tumor related factors. ACRT+ACT was associated with improved OS compared to ACT in patients with positive margins and/or LN. Those with negative margins and LN did not benefit from the additional use of ACRT (Table). Conclusions: This large hospital-based study demonstrates that ACT and ACRT are associated with improved OS when compared to SX. The addition of ACRT to ACT, however, was only beneficial in high-risk patients with positive margins and/or LN. ACT+ACRT in patients with both margin and LN negative disease may not be warranted. Future clinical trials should stratify patients based on LN and margin status in order to determine which patients are most likely to benefit from the use of ACRT. [Table: see text]

scholarly journals FAM225B Is a Prognostic lncRNA for Patients with Recurrent Glioblastoma

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Junsheng Li ◽  
Qian Zhang ◽  
Peicong Ge ◽  
Chaofan Zeng ◽  
Fa Lin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Value ◽  
Cox Regression ◽  
Recurrent Glioblastoma ◽  
Regulation Of Transcription ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Validation Set ◽  
Pathway Analyses

Objective. The overall survival of patients with recurrent glioblastoma (rGBM) is quite different, so clinical outcome prediction is necessary to guide personalized clinical treatment for patients with rGBM. The expression level of lncRNA FAM225B was analyzed to determine its prognostic value in rGBMs. Methods. We collected 109 samples of Chinese Glioma Genome Atlas (CGGA) RNA sequencing dataset and divided into training set and validation set. Then, we analyzed the expression of FAM225B, clinical characteristics, and overall survival (OS) information. Kaplan-Meier survival analysis was used to estimate the OS distributions. The prognostic value of FAM225B in rGBMs was tested by univariate and multivariate Cox regression analyses. Moreover, we analyzed the biological processes and signaling pathways of FAM225B. Results. We found that FAM225B was upregulated in rGBMs ( P = 0.0009 ). The expression of FAM225B increased with the grades of gliomas ( P < 0.0001 ). The OS of rGBMs in the low-expression group was significantly longer than that in the high-expression group ( P = 0.0041 ). Similar result was found in the training set ( P = 0.0340 ) and verified in the validation set ( P = 0.0292 ). In multivariate Cox regression analysis, FAM225B was identified to be an independent prognostic factor for rGBMs ( P = 0.003 ). Biological process and KEGG pathway analyses implied FAM225B mainly played a functional role on transcription, regulation of transcription, cell migration, focal adhesion, etc. Conclusions. FAM225B is expected to be as a new prognostic biomarker for the identification of rGBM patients with poor outcome. And our study provided a potential therapeutic target for rGBMs.

scholarly journals Proton Pump Inhibitor Taking Associates with Higher All-Cause Mortality and CV Events in Peritoneal Dialysis Patients

2020 ◽  
Author(s):  
Yingsi Zeng ◽  
Lingling Liu ◽  
Liya Zhu ◽  
Xiaojiang Zhan ◽  
Fenfen Peng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Proton Pump ◽  
Regression Models ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
All Cause Mortality ◽  
The Impact

Abstract Background: A long period of inappropriate proton pump inhibitors (PPI) treatment have been proved to be associated with adverse prognosis in general population and hemodialysis (HD) patients. This study was conducted to clarify the impact of PPI taking on mortality and adverse cardiovascular (CV) events in peritoneal dialysis (PD) patients.Methods: This is a retrospective study. We enrolled 904 patients from two PD centers, included 211 patients on PPI treatment and 618 patients not taking PPIs. Kaplan-Meier curves were used to identify the incidence of adverse outcomes. Multivariate Cox regression models and inverse probability of treatment weighting (IPTW) were applied to analyze hazard ratios (HRs) for adverse outcomes. Results: During follow-up, 162 deaths and 102 CV events were recorded. Kaplan-Meier curve demonstrated all-cause mortality (log-rank test P=0.018) and CV events (log-rank test P=0.024) were significantly higher in PPI usage group. Multivariate COX regression models and IPTW showed that PPI taking was an indicator for all-cause mortality (HR=1.33, 95%CI=1.07-1.65, P=0.010) and CV events (HR=1.81, 95%CI=1.38-2.38, P<0.001). Conclusions: PPI usage associates with higher all-cause mortality and CV events in PD patients. Clinicians are supposed to be more careful when using PPI and need to master the indications more rigorously in patients receiving PD treatment.

scholarly journals The impact of depression on survival of Parkinson's disease patients: a five-year study

2013 ◽  
Vol 62 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Cláudia Débora Silberman ◽  
Cláudia Soares Rodrigues ◽  
Eliasz Engelhardt ◽  
Jerson Laks
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cox Regression ◽  
Rank Test ◽  
First Year ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact ◽  
Mean Time

OBJECTIVE: The aim of this study is to evaluate the survival rate in a cohort of Parkinson's disease patients with and without depression. METHODS: A total of 53 Parkinson's disease subjects were followed up from 2003-2008 and 21 were diagnosed as depressed. Mean time of follow up was 3.8 (SD 95% = 1.5) years for all the sample and there was no significant difference in mean time of follow up between depressed and nondepressed Parkinson's disease patients. Survival curves rates were fitted using the Kaplan-Meier method. In order to compare survival probabilities according to the selected covariables the Log-Rank test was used. Multivariate analysis with Cox regression was performed aiming at estimating the effect of predictive covariables on the survival. RESULTS: The cumulative global survival of this sample was 83% with nine deaths at the end of the study - five in the depressed and four in the nondepressed group, and 55.6% died in the first year of observation, and none died at the fourth and fifth year of follow up. CONCLUSION: Our finding point toward incremental death risk in depressed Parkinson's disease patients.

Impact of adjuvant therapies on survival in patients with cholangiocarcinoma.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 360-360
Author(s):  
Laura Dover ◽  
Rojymon Jacob ◽  
Thomas Wang ◽  
Robert Oster ◽  
Derek Dubay
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Surgical Resection ◽  
Cox Regression ◽  
Tumor Stage ◽  
Rank Test ◽  
Resection Margins ◽  
Positive Margins ◽  
Number Of Patients ◽  
The Impact

360 Background: Surgical resection is the only curative option for Cholangiocarcinoma (CC) and currently there are no clear guidelines for adjuvant therapy following resection. Given the high incidence of local and distant recurrences following resection, we evaluated the impact of adjuvant chemotherapy or chemoradiation (CRT) on median survival (OS). Methods: A retrospective review was performed identifying all patients with CC who underwent curative surgical resection at our institution between 2002 and 2012. Patients who underwent aborted or palliative procedures were excluded. Survival estimates were quantified using Kaplan Meier curves, and differences between groups were compared with the log-rank test and Cox regression models. Results: During the study period, 103 patients underwent curative resection for CC at our institution. Tumor location was intrahepatic, perihilar and distal in 37% (n=38), 23% (n=24) and 40% (n=41) respectively. A total of 49 (48%) patients received adjuvant chemotherapy (n= 28) or CRT (n=21). Observation with no additional therapy was employed in the remaining 54 (52%) patients. No patient was treated using radiation alone. OS was 21.4 and 41.4 months (m) for those receiving adjuvant therapy versus observation (p=0.08). OS for adjuvant therapy versus observation were 28.4 m and 19.4 m respectively, if surgical margins were positive (p=0.036); and 79.1 m and 26.3 m respectively (p=0.4) with negative resection margins. OS was 41.4 m and 38.0 m with adjuvant chemo versus CRT respectively (p=0.1). Tumor stage was the only statistically significant pathologic indicator of outcome (p=0.019). Conclusions: A trend towards significant improvement in OS was observed with the use of adjuvant therapy among all patients following resection of CC. Adjuvant therapy significantly improved OS among CC patients with positive margins of resection. The small number of patients with negative margins of resection also benefitted, though not significantly. These data suggest that while adjuvant therapy should be considered for all patients irrespective of margin status; patients with positive margins are likely to benefit the most.

scholarly journals Impact of AKAP6 polymorphisms on Glioma susceptibility and prognosis

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ming Zhang ◽  
Yonglin Zhao ◽  
Junjie Zhao ◽  
Tingqin Huang ◽  
Yuan Wu
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
High Grade Glioma ◽  
Rank Test ◽  
Nucleotide Polymorphisms ◽  
Chinese Han ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Surgical Methods ◽  
The Impact

Abstract Purpose Glioma is the most common primary malignant brain tumor with high mortality and poor prognosis. Our aim was to clarify the correlation between Kinase-anchored protein 6 (AKAP6) gene polymorphisms and glioma susceptibility and prognosis in Chinese Han population. Methods Five single-nucleotide polymorphisms (SNPs) of AKAP6 were genotyped by Agena MassARRAY in 575 glioma patients and 500 healthy controls. Logistic regression model was utilized to calculate odds ratios (OR) and 95% confidence intervals (CI). The associations between polymorphisms and survival were assessed using the log-rank test, Kaplan-Meier analysis and Cox regression model. Results We found that rs2239647 polymorphism was strongly associated with an increased risk of glioma (OR = 1.90, p = 0.007) and a worse prognosis for glioma, especially in high-grade glioma (HR = 1.67, p = 0.034). Stratified analysis showed that rs2239647 increased the risk of glioma in female (OR = 1.62, p = 0.016). Whereas, rs4261436 (HR = 0.70, p = 0.045) and rs17522122 (HR = 0.75, p = 0.016) were associated with better prognosis of astrocytoma. In addition, we also found that surgical methods and chemotherapy are critical factors for the prognosis of glioma patients. Conclusions This study firstly provided evidence for the impact of AKAP6 polymorphisms on susceptibility and prognosis of glioma, suggesting AKAP6 variants might have potential roles in the etiology of glioma.

Scoring treatment response in patients with relapsing multiple sclerosis

2012 ◽  
Vol 19 (5) ◽  
pp. 605-612 ◽  
Author(s):  
MP Sormani ◽  
J Rio ◽  
M Tintorè ◽  
A Signori ◽  
D Li ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Scoring System ◽  
Cox Regression ◽  
Disability Progression ◽  
Training Set ◽  
T2 Lesions ◽  
Kaplan Meier ◽  
Patient Responses ◽  
Magnetic Resonance Imaging Mri ◽  
Validation Set

Background: We employed clinical and magnetic resonance imaging (MRI) measures in combination, to assess patient responses to interferon in multiple sclerosis. Objective: To optimize and validate a scoring system able to discriminate responses to interferon treatment in patients with relapsing–remitting multiple sclerosis (RRMS). Methods: Our analysis included two large, independent datasets of RRMS patients who were treated with interferons that included 4-year follow-up data. The first dataset (“training set”) comprised of 373 RRMS patients from a randomized clinical trial of subcutaneous interferon beta-1a. The second (“validation set”) included an observational cohort of 222 RRMS patients treated with different interferons. The new scoring system, a modified version of that previously proposed by Rio et al., was first tested on the training set, then validated using the validation set. The association between disability progression and risk group, as defined by the score, was evaluated by Kaplan Meier survival curves and Cox regression, and quantified by hazard ratios (HRs). Results: The score (0–3) was based on the number of new T2 lesions (>5) and clinical relapses (0,1 or 2) during the first year of therapy. The risk of disability progression increased with higher scores. In the validation set, patients with score of 0 showed a 3-year progression probability of 24%, while those with a score of 1 increased to 33% (HR = 1.56; p = 0.13), and those with score greater than or equal to 2 increased to 65% (HR = 4.60; p < 0.001). Conclusions: We report development of a simple, quantitative and complementary tool for predicting responses in interferon-treated patients that could help clinicians make treatment decisions.

P1505COMORBIDITY AND AGE OF DIALYSIS PATIENTS OUTPERFORMS FRAILTY BURDEN AS A PREDICTOR FOR MORTALITY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mimoza Milenkova ◽  
Adrijana Spasovska Vasilova ◽  
Aleksandra Canevska ◽  
Vladimir Pushevski ◽  
GJULSEN SELIM ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Cox Regression ◽  
Absolute Number ◽  
Chronic Hemodialysis ◽  
Rank Test ◽  
Dialysis Patients ◽  
Kaplan Meier ◽  
Dialysis Vintage ◽  
Comorbidity Index ◽  
The Impact

Abstract Background and Aims The life expectancy in dialysis patients depends on patients’ age and comorbidities. Frailty in elderly patients is a state of impaired homeostasis with loss of physiologic reserve and a consequent impaired responses to dialysis burden. In this study we assessed the impact of age, comorbidities and frailty on dialysis patients’ survival. Method The study enrolled 162 prevalent patients on chronic hemodialysis with mean dialysis vintage of 100 months, 55% were women and 21 % had diabetes. Patients were divided into three groups by the Khan Comorbidity index score, highest score was considered worse. Frailty was assessed by presence of 3 or more symptoms (unintentional weight loss, feeling exhausted, weak grip strength, slow walking speed and low physical activity) and expressed as absolute number. Estimates of five years life expectancy were assessed by Kaplan Meier survival log-rank test and Cox regression hazard model. Results There were 26 (16%) with lowest score, 85 (52%) with medium score and worst highest score in 51 (31%). During the 5 years of follow up 69(43%) patients died of all-cause mortality. There were no deaths in the group with lowest score and mortality rates in the intermediate and worse score group increased by double (0; 30%; 69%, respectively). Significantly higher mean life expectancy was found in lower Khan Score groups: 60mo; 48.40 ± 18.51; 32.44 ± 22.06, log-rank: p &lt; 0.012. Patients that scored worse had four folds higher risk for death HR 4.2 (95% CI: 2.72 – 6.36), p=0.0001. In the multivariate model Khan Score was a more powerful predictor of mortality than frailty in elderly, with HR 3.2 (95% CI: 2.88 – 5.41), p=0.0001. Conclusion Comorbidities and age outperforms frailty burden as a predictor of mortality in dialysis patients.

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