scholarly journals Influence of Old Age on Risk of Lymph Node Metastasis and Survival in Patients With T1 Colorectal Cancer: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua Ye ◽  
Bin Zheng ◽  
Qi Zheng ◽  
Ping Chen
Keyword(s):  
Colorectal Cancer ◽  
Regression Analysis ◽  
Lymph Node ◽  
Elderly Patients ◽  
Old Age ◽  
Tumor Size ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
T1 Colorectal Cancer ◽  
Well Differentiated

BackgroundWe aimed at determining the influence of old age on lymph node metastasis (LNM) and prognosis in T1 colorectal cancer (CRC).MethodsWe collected data from eligible patients in Surveillance, Epidemiology, and End Results database between 2004 and 2015. Independent predictors of LNM were identified by logistic regression analysis. Cox regression analysis, propensity score-matched analysis, and competing risks analysis were used to analyze the associations between old age and lymph node (LN) status and to validate the prognostic value of old age on cancer-specific survival (CSS).ResultsIn total, 10,092 patients were identified. Among them, 6,423 patients (63.6%) had greater than or equal to 12 examined lymph nodes (LNE ≥12), and 5,777 patients (57.7%) were 65 years or older. The observed rate of LNM was 4.6% (15 out of 325) in T1 CRC elderly patients, with tumor size <3 cm, well differentiated, with negative carcinoembryonic antigen (CEA) level, and adenocarcinoma. Logistic regression models demonstrated that tumor size ≥3 cm (odds ratio, OR = 1.316, P = 0.038), poorly differentiated (OR = 3.716, P < 0.001), older age (OR = 0.633 for ages 65–79 years, OR = 0.477 for age over 80 years, both P <0.001), and negative CEA level (OR = 0.71, P = 0.007) were independent prognostic factors. Cox regression analysis demonstrated that CSS was not significantly different between elderly patients undergoing radical resection with LNE ≥12 and those with LNE <12 (hazard ratio = 0.865, P = 0.153), which was firmly validated after a propensity score-matched analysis by a competing risks model.ConclusionsThe predictive value of tumor size, grading, primary site, histology, CEA level, and age for LNM should be considered in medical decision making about local resection. We found that tumor size was <3 cm, well differentiated, negative CEA level, and adenocarcinoma in elderly patients with T1 colorectal cancer which was suitable for local excision.

scholarly journals Influence of Old Age on Risk of Lymph Node Metastasis and Survival in Patients With T1 Colorectal Cancer: A Population-Based Analysis

2021 ◽  
Author(s):  
Hua Ye ◽  
Bin Zheng ◽  
Qi Zheng ◽  
Ping Chen
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lymph Node ◽  
Old Age ◽  
Competing Risks ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
T1 Colorectal Cancer

Abstract Background We aimed at determining the influence of old age on lymph node metastasis (LNM) and prognosis in T1 colorectal cancer (CRC). Methods We collected data from eligible patients in Surveillance, Epidemiology, and End Results database between 2004 and 2015. Independent predictors of LNM were identified by the logistic regression analysis. Cox regression analysis, propensity score-matched analysis and competing risks analysis were used to analyze the associations between old age and lymph node (LN) status, and to validate the prognostic value of old age on cancer-specific survival (CSS).Results In total, 10092 patients were identified. Among them, 6423 patients (63.6%) had greater than or equal to 12 examined lymph nodes (LNs) (LNE ³12), and 5777 patients (57.7%) were of 65 years or older. The observed rate of LNM was 14.9 % (960 out of 6423). Logistic regression models demonstrated that tumor size ³3cm (odds ratio, OR = 1.316, P = 0.038), poorly differentiated (OR = 3.716, P <0.001), older age (OR = 0.633 for age 65–79 years, OR= 0.477 for age over 80 years, both P < 0.001), and negative CEA level (OR = 0.71, P =0.007) were independent prognostic factors. Cox regression analysis demonstrated CSS was not significantly different between elderly patients undergoing radical resection with LNE³12 and those with LNE <12 (HR= 0.865, P = 0.153), which were firmly validated after propensity score-matched analysis by a competing risks model.Conclusions We found that tumor size<3cm, well/moderately differentiated, negative CEA level and adenocarcinoma in elderly patients with T1 colorectal cancer who were suitable for Local excision.

scholarly journals Endoscopic Versus Surgical Therapy for Early Esophagogastric Junction Adenocarcinoma Based on Lymph Node Metastasis Risk: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua Ye ◽  
Ping Chen ◽  
Yi-Fan Wang ◽  
Xiu-Jun Cai
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Tumor Size ◽  
Esophagogastric Junction ◽  
Cox Regression ◽  
Radical Surgery ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Poor Differentiation

BackgroundIn this study, we aimed to compare the prognosis and lymph node metastasis (LNM) risk in patients with early-stage esophagogastric junction (EGJ) adenocarcinoma after endoscopic treatment (ET) or radical surgery.MethodsWe collected data from eligible patients based on the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. Logistic regression analysis was used to determine independent predictors of LNM (examination of at least 16 lymph nodes). Cox regression analysis and propensity score-matched (PSM) analysis were subsequently utilized to compare the overall survival (OS) and cancer-specific survival (CSS) of patients treated with ET or radical surgery.ResultsIn total, 3708 patients were identified. Among them, 856 patients had greater than or equal to 16 examined lymph nodes (LNs) (LNE≥16). The LNM rates were 18.8% in all patients 8.3% in T1a patients and 24.6% in T1b patients. Independent predictors of LNM were submucosal invasion, tumor size ≥3cm and decreasing differentiation (P&lt;0.05). The LNM rate decreased to approximately 5.3% in T1b tumors with well differentiation and tumor size &lt;3cm. However, the LNM incidence increased to 17.9% or 33.3% in T1a tumors with poor differentiation or with both tumor size≥3cm and poor differentiation. Cox regression analysis demonstrated CSS was not significantly different in early-stage EGJ adenocarcinoma patients undergoing ET and those treated with radical surgery (HR= 1.004, P=0.974), which were robustly validated after PSM analysis. Moreover, subgroup analysis stratified by T1a and T1b showed similar results.ConclusionsThe findings of this study indicated ET as an alternative to radical surgery in early EGJ adenocarcinoma.

Physical function and quality of life in frail and/or elderly metastatic colorectal cancer patients treated with bevacizumab and capecitabine: An exploratory analysis.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 627-627
Author(s):  
Peter Richard Ward ◽  
Andre K. D. Liem ◽  
He-jing Wang ◽  
Ravi Patel ◽  
Eddie Hong-Lung Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Functional Status ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Functional Measures

627 Background: Optimal treatment strategies in frail and/or elderly patients with metastatic colorectal cancer have not been well defined. Although the safety and efficacy of bevacizumab and capecitabine in this population has been reported, the impact on functional measures and quality of life has not been well described. In a prospective, phase II study of elderly metastatic colorectal patients with ECOG performance status (PS) 1 or 2 treated with first-line bevacizumab and capecitabine, we collected data on geriatric functional status and quality of life. The primary aim of this analysis was to explore the differences in geriatric health measures between patients with ECOG status 1 and 2. Methods: Functional status was measured by patient-reported limitations in ADLs and IADLs and ECOG PS was assessed. A “Get up and Go” test, hearing test, and 3-item recall exam was also performed. Quality of life (QoL) was assessed by means of the FACT-C questionnaire and patient-rated health status was measured by the EQ-5D questionnaire. The prognostic impact of baseline characteristics on survival was studied using univariate Cox-regression analysis. Results: The majority (62%) of the 45 participants treated were ECOG 2. This group had more limitations in IADLs, lower baseline QoL, and a lower patient-rated health score. For all participants, QoL significantly improved from baseline to the start of cycle 2 (FACT-C: 99.9 vs. 105.4, p=0.01) and did not deteriorate when baseline scores were compared to when participants went off study. (FACT-C: 99.9 vs. 98.6, p=0.59). In the Cox-regression analysis, the participant’s ability to perform the “Get up and Go” test was the only baseline characteristic that was prognostic for improved survival (HR = 0.31, p = 0.01). Conclusions: Our analysis shows that in this study of frail and/or elderly patients with metastatic colorectal cancer treated with bevacizumab and capecitabine, there is a significant amount of heterogeneity between the ECOG 1 and 2 groups in both functional measures and quality of life. We also showed that the “Get up and Go” test may be a useful prognostic indicator for survival in this population.

Endoscopic versus surgical therapy for early esophagogastric junction adenocarcinoma based on lymph node metastasis risk：a population-based analysis

2021 ◽  
Author(s):  
Hua Ye ◽  
Ping Chen ◽  
yi-fan Wang ◽  
Xiu-Jun Cai
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Tumor Size ◽  
Esophagogastric Junction ◽  
Cox Regression ◽  
Radical Surgery ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Poor Differentiation

Abstract Background In this study, we aimed to compare the prognosis and lymph node metastasis (LNM) risk in patients with early-stage esophagogastric junction (EGJ) adenocarcinoma after endoscopic treatment (ET) or radical surgery. Methods We collected data from eligible patients based on Surveillance, Epidemiology, and End Results database between 2004 and 2016. Logistic regression analysis was used to determine independent predictors of LNM (examination of at least 16 lymph nodes). Cox regression analysis and propensity score-matched (PSM) analysis were subsequently utilized to compare overall survival (OS) and cancer-specific survival (CSS) of patients treated with ET or radical surgery . Results In total, 5266 patients were identified. Among them, 856 patients had greater than or equal to 16 examined lymph nodes (LNs) (LNE ≥ 16). The LNM rates were 18.8% in: all patients 8.3% in T1a patients and 24.6% in T1b patients. Independent predictors of LNM were submucosal invasion, tumor size ≥ 3cm and decreasing differentiation (P < 0.05). The LNM rate decreased to approximately 5.3% in T1b tumors with well differentiation and tumor size < 3cm. However, the LNM incidence increased to 17.9% or 33.3% in T1a tumors with poor differentiation or with both tumor size ≥ 3cm and poor differentiation. Cox regression analysis demonstrated CSS was not significantly different in early-stage EGJ adenocarcinoma patients undergoing ET and those treated with radical surgery (HR = 0.830, P = 0.062), which were robustly validated after PSM analysis. Moreover, subgroup analysis stratified by T1a and T1b showed similar results. Conclusions Consequently, our findings indicated ET as an alternative to radical surgery in early EGJ adenocarcinoma.

scholarly journals Prediction of Prognostic Biomarkers and Construction of an Autophagy Prognostic Model for Colorectal Cancer Using Bioinformatics

2020 ◽  
Vol 19 ◽  
pp. 153303382098417
Author(s):  
Ting-ting Liu ◽  
Shu-min Liu
Keyword(s):  
Colorectal Cancer ◽  
Regression Analysis ◽  
Prognostic Model ◽  
Cox Regression ◽  
Small Gtpase ◽  
Functional Enrichment ◽  
Clinical Correlation ◽  
Cox Regression Analysis ◽  
Prognostic Analysis ◽  
Key Genes

Objective: The incidence of colorectal cancer is increasing every year, and autophagy may be related closely to the pathogenesis of colorectal cancer. Autophagy is a natural catabolic mechanism that allows the degradation of cellular components in eukaryotic cells. However, autophagy plays a dual role in tumorigenesis. It not only promotes normal cell survival and tumor growth but also induces cell death and suppresses tumors survival. In addition, the pathogenesis of various conditions, including inflammation, neurodegenerative diseases, or tumors, is associated with abnormal autophagy. The present work aimed to examine the significance of autophagy-related genes (ARGs) in prognosis prediction, to construct an autophagy prognostic model, and to identify independent prognostic factors for colorectal cancer (CRC). Methods: This study discovered a total of 36 ARGs in CRC cases using The Cancer Genome Atlas (TCGA) and Human Autophagy-dedicated (HADd) databases along with functional enrichment analysis. Then, an autophagy prognostic model was constructed using univariate Cox regression analysis, and the key prognostic genes were screened. Finally, independent prognostic markers were determined through independent prognostic analysis and clinical correlation analysis of key genes. Results: Of the 36 differentially expressed ARGs, 13 were related to prognosis, as determined by univariate Cox regression analysis. A total of 6 key genes were obtained by a multivariate Cox regression analysis. Independent prognostic values were shown by 3 genes, namely, microtubule-associated protein 1 light chain 3 (MAP1LC3C), small GTPase superfamily and Rab family (RAB7A), and WD-repeat domain phosphoinositide-interacting protein 2 (WIPI2) by independent prognostic analysis and clinical correlation. Conclusions: In this study, molecular bioinformatics technology was employed to determine and construct a prognostic model of autophagy for colon cancer patients, which revealed 3 autophagy-related features, namely, MAP1LC3C, WIPI2, and RAB7A.

scholarly journals Serum exosomal miR-4787-3p as potential lymph node metastasis and prognostic marker in esophageal squamous cell carcinoma.

2021 ◽  
Author(s):  
Shuang Liu ◽  
Zheng Lin ◽  
Jianwen Wang ◽  
Zerong Zheng ◽  
Wenqing Rao ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cox Regression ◽  
High Serum ◽  
Migration And Invasion ◽  
Cox Regression Analysis ◽  
Mirna Array ◽  
Node Metastasis

Abstract Background: To explore the miR-4787-3p expression levels in the serum exosome and tissue and its role in lymph node metastasis and prognosis in ESCC. Methods: The miRNA array was conducted to detect the ESCC serum exosomal miRNAs expression. A receiver operating characteristic (ROC) curve was constructed to determine the predictive ESCC with lymph node metastasis efficacy of serum exosomal miR-4784-3p. The Cox regression analysis was preformed to explore prognostic factors for ESCC. Transwell assay and CCK-8 assays were utilized to evaluate cell migration, invasion, and proliferation, respectively. Results: High serum exosomal miR-4787-3p expression was demonstrated in lymph node metastasis group (P =0.011). The serum exosomal miR-4787-3p expression was significantly associated with histologic grade (P = 0.010), and TNM stage (P = 0.033). However, there was no significant relationship between tissue miR-4787-3p expression and clinical characteristics (P >0.05). ROC analyses revealed that the AUCs of serum exosomal miR-4787-3p for lymph node metastasis prediction was 0.787. The Cox regression analysis found that high expression serum exosomal miR-4787-3p were correlated with poor prognoses (for OS, HR=2.68, 95% CI: 1.02~7.04; for DFS, HR = 2.65, 95% CI: 1.05~6.68). Nevertheless, no association between tissue miR-4787-3p expression and ESCC prognosis. In addition, upregulated expression of miR-4787-3p could promote migration and invasion in vitro. Conclusions: Serum exosomal miR-4787-3p can be promising biomarkers for ESCC metastasis and prognosis

scholarly journals Lymph node ratio is an independent prognostic factor for patients with Siewert type II adenocarcinoma of esophagogastric junction: results from a 10-year follow-up study

2020 ◽  
Author(s):  
Yuling Zhang ◽  
Ditian Liu ◽  
Chunfa Chen ◽  
De Zeng
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Esophagogastric Junction ◽  
Lymph Node Ratio ◽  
Cox Regression ◽  
Type Ii ◽  
Siewert Type ◽  
Cox Regression Analysis ◽  
Siewert Type Ii ◽  
Node Ratio

Abstract Background Emerging evidences suggest that lymph node ratio (LNR), the number of metastatic lymph node (LN) to the total number of dissected lymph nodes (NDLN), may predict survival in multiple types of solid tumor. However, the prognostic role of LNR in adenocarcinoma of the esophagogastric junction (AEG) remains uninvestigated. The study is intended to determine the prognostic value of LNR in the patients with Siewert type II AEG. Methods A total of 342 patients with Siewert type II AEG who underwent R0 resection were enrolled in this study. The optimal cut-off of LNR was stratified into tertiles using X-tile software. The log-rank test was used to evaluate the survival differences, and multivariate Cox regression analysis were performed to determine the independent prognostic variables. Results The optimal cut-off of LNR were classified as LNR = 0, LNR between 0.01 and 0.40 and LNR > 0.41. Patients with high LNR had a shorter 5- and 10-year disease-specific survival (DSS) rate (8.5%, 1.4%) compared with those with moderate LNR (20.4%, 4.9%) and low LNR (58.0%, 27.5%) ( P < 0.001). Multivariate Cox regression analysis indicated that LNR was an independent factor for DSS after adjusting for confounding variables ( P < 0.05). Furthermore, after stratification by NDLN between NDLN < 15 group and NDLN ≥ 15 group, the LNR remained a significant predictor for DSS ( P < 0.05). Conclusions LNR is an independent predictor for DSS in patients with Siewert type II AEG regardless of NDLN. Patients with higher LNR have significantly shorter DSS.

scholarly journals Prognostic factors affecting survival and recurrence in patients with early cervical squamous cell cancer following radical hysterectomy

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051988974
Author(s):  
Dan Li ◽  
Xiaoxian Xu ◽  
Dingding Yan ◽  
Shuhui Yuan ◽  
Juan Ni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
Tumor Size ◽  
Cox Regression ◽  
Squamous Cell Cancer ◽  
Postoperative Radiotherapy ◽  
Cell Cancer ◽  
Cox Regression Analysis

Objective This study aimed to investigate the clinical and histological features affecting the survival of patients with early cervical squamous cell cancer treated with radical hysterectomy. Methods We retrospectively analyzed clinical and histological data for patients with stage IB-IIA cervical cancer treated by radical hysterectomy at Zhejiang Cancer Hospital from August 2008 to January 2013. Results A total of 1435 patients were included in the study. Cox regression analysis identified tumor size >4 cm, lymphovascular space involvement (LVSI), lymph node ratio (LNR), and squamous cell carcinoma antigen (SCC-Ag) >2.65 ng/mL as independent prognostic risk factors. Among 1096 patients without high pathological risk factors, the 5-year local recurrence rates for SCC-Ag ≤2.65 and >2.65 ng/mL were 6.6% and 25.7%, respectively. Among 332 patients with lymph node positivity, the overall survival rates for LNR ≤0.19 and >0.19 were 87.8% and 55.6%, respectively. Conclusions LVSI, tumor size >4 cm, LNR >0.19, and SCC-Ag >2.65 ng/mL may predict a poor prognosis in patients with early cervical squamous cell cancer treated with radical hysterectomy. SCC-Ag >2.65 ng/mL may be a useful prognostic factor guiding the use of postoperative radiotherapy in patients without pathologic risk factors.

scholarly journals The expression of long-chain non-coding RNA DMTF1v4 in colorectal cancer tissue and its relationship with clinicopathological features

2019 ◽  
Vol 17 ◽  
pp. 205873921984554
Author(s):  
Yanjuan Cai ◽  
Shutong Zhuang ◽  
Hongpeng Liu ◽  
Jianfu Qiu ◽  
Li Zeng
Keyword(s):  
Colorectal Cancer ◽  
Regression Analysis ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Cancer Tissue ◽  
Depth Of Invasion ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Non Coding Rna ◽  
Long Chain

Emerging studies have showed that long-chain non-coding RNA DMTF1v4 might participate in the process of multidrug resistance phenotype of gastric cancer. However, its expression and function in colorectal cancer (CRC) is still unknown. In this study, we discovered that DMTF1v4 was generally 5.15 ± 1.67 times upregulated in CRC tissues compared to the adjacent normal tissues. Moreover, the expression level of DMTF1v4 was closely related to the distant metastasis of tumor, but it was not related to age, sex, tumor location, tumor staging, depth of invasion, lymph node metastasis, and differentiation level. Survival analysis showed that the overall survival rate of patients with high expression of DMTF1v4 was 45.0% in cancer tissues, which was significantly lower than 82.5% of DMTF1v4 low expression patients (χ2 = 11.562, P < 0.01). The results of univariate COX regression analysis showed that DMTF1v4, TNM (tumor, node, metastasis) staging, distant metastasis, and tumor differentiation were closely related to the prognosis of patients ( P < 0.05). Multivariate COX regression analysis showed that DMTF1v4 and distant metastasis could be independent prognostic factors for CRC patients. In conclusion, this study revealed that DMTF1v4 might promote the development of CRC, which can be used as an independent factor to judge the prognosis of CRC.

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