scholarly journals Glucose Metabolism Reprogramming of Primary Tumor and the Liver Is Associated With Disease-Free Survival in Patients With Early NSCLC

2021 ◽  
Vol 11 ◽  
Author(s):  
Hongpei Tan ◽  
Mengtian Ma ◽  
Jing Huang ◽  
Wenhao Zhu ◽  
Shuo Hu ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Tumor Size ◽  
Standardized Uptake Value ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Primary Lesion ◽  
Maximum Diameter ◽  
Free Survival ◽  
Tumor Stages ◽  
Disease Free

PurposeTumor promote disease progression by reprogramming their metabolism and that of distal organs, so it is of great clinical significance to study the changes in glucose metabolism at different tumor stages and their effect on glucose metabolism in other organs.MethodsA retrospective single-centre study was conducted on 253 NSCLC (non-small cell lung cancer) patients with negative lymph nodes and no distant metastasis. According to the AJCC criteria, the patients were divided into different groups based on tumor size: stage IA, less than 3 cm (group 1, n = 121); stage IB, greater than 3-4 cm (group 2, n = 64); stage IIA, greater than 4-5 cm (group 3, n = 36); and stage IIB, greater than 5-7 cm (group 4, n = 32). All of the patients underwent baseline 18F-FDG PET/CT scans, and the primary lesion SUVmax (maximum standardized uptake value), liver SUVmean (mean standardized uptake value), spleen SUVmean, TLR (Tumor-to-liver SUV ratio) and TSR (Tumor-to-spleen SUV ratio) were included in the study, combined with clinical examination indicators to evaluate DFS (disease free survival).ResultsIn NSCLC patients, with the increase in the maximum diameter of the tumor, the SUVmax of the primary lesion gradually increased, and the SUVmean of the liver gradually decreased. The primary lesion SUVmax, liver SUVmean, TLR and TSR were related to disease recurrence or death. The best predictive parameters were different when the tumor size differed. SUVmax had the highest efficiency when the tumor size was less than 4 cm (AUC:0.707 (95% CI, 0.430-0.984) tumor size < 3 cm), (AUC:0.726 (95% CI, 0.539-0.912) tumor size 3-4 cm), liver SUVmean had the highest efficiency when the tumor size was 4-5 cm (AUC:0.712 (95% CI, 0.535-0.889)), and TLR had the highest efficiency when the tumor size was 5-7 cm [AUC:0.925 (95%CI, 0.820-1.000)].ConclusionsIn patients with early NSCLC, glucose metabolism reprogramming occurs in the primary lesion and liver. With the increase in tumor size, different metabolic parameters should be selected to evaluate the prognosis of patients.

Correlation between outcomes and tumor size in >7 cm T4 non-small cell lung cancer patients: A tumor size-based comparison study

2021 ◽  
Vol 29 (8) ◽  
pp. 784-791
Author(s):  
Volkan Erdoğu ◽  
Necati Çitak ◽  
Celal B Sezen ◽  
Levent Cansever ◽  
Cemal Aker ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Lung Cancer Patients ◽  
Disease Free

Background We investigated whether all size-based pathological T4N0–N1 non-small cell lung cancer patients with tumors at any size >7 cm had the same outcomes. Methods We reviewed non-small cell lung cancer patients with tumors >7 cm who underwent anatomical lung resection between 2010 and 2016. A total of 251 size-based T4N0–N1 patients were divided into two groups based on tumor size. Group S ( n = 192) included patients with tumors of 7.1–9.9 cm and Group L ( n = 59) as tumor size ≥10 cm. Results The mean tumor size was 8.83 ± 1.7 cm (Group S: 8.06 ± 0.6 cm, Group L: 11.3 ± 1.6 cm). There were 146 patients with pathological N0 and 105 patients with pathological N1 disease. Mean overall survival and disease-free survival were 64.2 and 51.4 months, respectively. The five-year overall survival and disease-free survival rates were 51.2% and 43.5% (five-year OS; pT4N0:52.7%, pT4N1:47.9%, DFS; pT4N0:44.3%, pT4N1: 42.3%). No significant differences were observed between T4N0 and T4N1 patients in terms of five-year OS or DFS ( p = 0.325, p = 0.505 respectively). The five-year overall survival and disease-free survival rates were 52% and 44.6% in Group S, and 48.5% and 38.9% in Group L. No significant difference was observed between the groups in terms of five-year overall survival or disease-free survival ( p = 0.699, p = 0.608, respectively). Conclusions Above 7 cm, any further increase in tumor size in non-small cell lung cancer patients had no significant effect on survival, confirming it is not necessary to further discriminate among patients with tumors in that size class.

Outcomes of pre-operative brachytherapy followed by hysterectomy for early cervical cancer

2019 ◽  
Vol 30 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Benoit Bataille ◽  
Alexandre Escande ◽  
Florence Le Tinier ◽  
Audrey Parent ◽  
Emilie Bogart ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Tumor Size ◽  
Early Stage ◽  
Disease Free Survival ◽  
Late Toxicity ◽  
Free Survival ◽  
Overweight Status ◽  
Early Stage Cervical Cancer ◽  
Early Cervical Cancer ◽  
Disease Free

ObjectiveThe standard of care for early cervical cancer is radical hysterectomy; however, consideration of pre-operative brachytherapy has been explored. We report our experience using pre-operative brachytherapy plus Wertheim-type hysterectomy to treat early stage cervical cancer.MethodsThis single-center study evaluated consecutive patients with histologically proven node-negative early stage cervical cancer (International Federation of Gynecology and Obstetrics 2009 stage IB1–IIB) that was treated using pre-operative brachytherapy and hysterectomy. Pre-brachytherapy staging was performed using magnetic resonance imaging (MRI) and pelvic lymph node assessment was performed using lymphadenectomy. The tumor and cervical tissues were treated using brachytherapy (total dose 60 Gy) followed by Wertheim-type hysterectomy. The study included patients from January 2000 to December 2013.ResultsA total of 80 patients completed a median follow-up of 6.7 years (range 5.4–8.5). The surgical specimens revealed a pathological complete response for 61 patients (76%). Patients with incomplete responses generally had less than 1 cm residual tumor at the cervix, and only one patient had lymphovascular space involvement. The estimated 5-year rates were 88% for overall survival (95% CI 78% to 94%) and 82% for disease-free survival (95% CI 71% to 89%). Toxicities were generally mild-to-moderate, including 26 cases (33%) of grade 2 late toxicity and 10 cases (13%) of grade 3 late toxicity. Univariate analyses revealed that poor disease-free survival was associated with overweight status (≥25 kg/m2, HR 3.05, 95% CI 1.20 to 7.76, p=0.019) and MRI tumor size >3 cm (HR 3.05, 95% CI 1.23 to 7.51, p=0.016).ConclusionsPre-operative brachytherapy followed by Wertheim-type hysterectomy may be safe and effective for early stage cervical cancer, although poorer outcomes were associated with overweight status and MRI tumor size >3 cm.

scholarly journals Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma

2016 ◽  
Vol 50 (4) ◽  
pp. 360-369 ◽  
Author(s):  
Kursat Okuyucu ◽  
Sukru Ozaydın ◽  
Engin Alagoz ◽  
Gokhan Ozgur ◽  
Semra Ince ◽  
...  
Keyword(s):  
Overall Survival ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Disease Free Survival ◽  
Extranodal Lymphoma ◽  
Free Survival ◽  
Primary Staging ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Disease Free

Abstract Background Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study. Patients and methods There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively). Conclusions High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.

Analysis of lymphangiogenetic factors in invasive bladder cancer—A tissue microarray analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15530-15530
Author(s):  
C. Wulfing ◽  
E. Herrmann ◽  
T. Kopke ◽  
E. Eltze ◽  
J. Neumann ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Tissue Microarray ◽  
Lymph Node Metastases ◽  
Regional Lymph Node ◽  
Disease Free Survival ◽  
Free Survival ◽  
Tumor Stages ◽  
Node Metastases ◽  
Disease Free

15530 Introduction: Vascular endothelial growth factors (VEGF) -C, -D and their receptor Flt-4 play an emerging role in lymphangiogenesis of different tumor types. Our aim was to determine the role of VEGF-C, VEGF-D and Flt-4 in invasive transitional cell carcinoma of the bladder. Material and Methods: Archival tumor tissue of 286 patients, who had previously undergone radical cystectomy at our institution, was reviewed and representative tumor blocks were selected for constructing a tissue microarray (TMA). Paraffin sections were assessed immunohistochemically using mono- and polyclonal antibodies against VEGF-C, VEGF-D and Flt-4. Staining results were analysed semiquantitatively and correlated with various clinicopathological factors. Results: Overexpression of VEGF-C, VEGF-D and Flt-4 was found in 24.1%, 37.4% and 46.3% of cases, respectively. While there was no association of VEGF-C to histopathological parameters and clinical outcome, patients with VEGF-D overexpression had higher pathological tumor stages (p=0.021) and regional lymph node metastases (p=0.016). Furthermore, they had significantly worse disease-free survival (p=0.042). Overexpression of Flt-4 was found in the subgroup of G3- and G4-tumors (p=0.001) and correlated with a shorter period of disease- free survival (p=0.033). Conclusion: VEGF-C, VEGF-D and Flt-4 are overexpressed in bladder cancer. VEGF-D predicts higher tumor stages and regional lymph node metastases. It is associated with a worse disease-free survival as well as Flt-4 in the subgroup of high-grade tumors. Further studies should be initiated to evaluate VEGF-D and Flt-4 as potential targets in bladder cancer. No significant financial relationships to disclose.

Outcomes of multivisceral resection of gastric gastrointestinal stromal tumors.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 91-91
Author(s):  
Sabha Ganai ◽  
Mitchell Posner ◽  
Vivek N. Prachand ◽  
John C. Alverdy ◽  
Eugene A. Choi ◽  
...  
Keyword(s):  
Tumor Size ◽  
Gastrointestinal Stromal Tumors ◽  
Disease Free Survival ◽  
Multivisceral Resection ◽  
Response To Therapy ◽  
Hospital Length Of Stay ◽  
Free Survival ◽  
Stromal Tumors ◽  
Gastric Gists ◽  
Disease Free

91 Background: Despite the recent introduction of imatinib and laparoendoscopic techniques to the management of gastric gastrointestinal stromal tumors (GISTs), outcomes remain uncertain in the setting of multivisceral involvement. Methods: We conducted a retrospective review of 69 consecutive patients who underwent resection of gastric GISTs from October 2002 through August 2011. Median follow-up was 19 months (interquartile range [IQR] 4-37). Results: Patients were 51% female, with a mean age of 65 ± 13 years and BMI of 30 ± 8 kg/m2. Patients undergoing multivisceral resection (n=13) had a longer interval from diagnosis to surgery (7.4 [IQR 1.9 – 15.0] vs. 1.3 [IQR 0.7-3.5] months, p<0.01), greater use of neoadjuvant imatinib (62% vs. 4%, p<0.001), and greater preoperative tumor size (12 ± 8 vs. 4 ± 3 cm, p<0.001) in comparison to gastric-only resections (n=56). Patients were less likely to be managed laparoscopically (8% vs. 71%, p<0.001), had a longer operative time (286 ± 92 vs. 152 ± 65 min, p<0.001), and were less likely to be R0 (69% vs. 98%, p<0.001). While patients undergoing multivisceral resection were more likely to have a pathological complete response to therapy (23% vs. 0, p<0.01), they were also more likely to have metastatic disease present (31% vs. 0, p<0.01). Hospital length of stay was greater (median 8 [IQR 7-9] vs. 3 [IQR 2-6] days, p<0.001). There were no significant differences in grade or mitotic index between groups, or in the use of adjuvant imatinib (54% vs. 23%). Overall survival was less in patients undergoing multivisceral resection (63% vs. 86% at 3 years, p<0.05), as was disease-free survival (52% vs. 71% at 3 years, p<0.05). Median disease-free survival was 50 and 66 months, respectively (p<0.01). Controlling for tumor size, grade, resection status, and the use of neoadjuvant imatinib, multivisceral resection was an independent predictor of disease-free survival (p<0.05). Conclusions: Multivisceral involvement is associated with tumors of greater size, and despite an increased use of neoadjuvant imatinib, it is associated with poor outcome for patients with gastric GISTs.

Clinicopathologic features and prognostic analysis of stage I ovarian clear cell cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17090-e17090
Author(s):  
Tian Tian Wang ◽  
Ning Li ◽  
Lingying Wu
Keyword(s):  
Tumor Size ◽  
Clear Cell ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Stage I ◽  
Initial Symptom ◽  
Free Survival ◽  
Pathologic Features ◽  
Stage Ia ◽  
Disease Free

e17090 Background: Ovarian clear cell carcinoma is one kind of Epithelial ovarian carcinoma and is considered high-grade tumor. This retrospective analysis aimed to evaluate the clinical and pathologic features and to determine prognostic variables in patients with stage I ovarian clear cell cancer. Methods: 378 patients with ovarian clear cell cancer were treated in National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, from February 1999 to December 2018. And 214(56.6%) had stage I disease. We retrospectively analyzed the prognostic relevance of different clinicopathological variables in 102 patients underwent surgery treatment, specifically including age, initial symptom, endometriosis, stage, tumor size, serum CA125 and CA199, chemotherapy regimens and treatment course. Results: The median age was 51 years old. 64(62.7%) patients presented with large pelvic mass (median diameter:12.0cm). 82.4% patients had no more than 200U/ml elevation of serological CA125(median: 50.76U/ml). 81.8% patients had no more than 100U/ml elevation of serological CA199(median: 24.8U/ml). The median follow-up time was 40.5 months. The 5-year disease-free survival was 82.8%. All patients were restaged using the 2014 FIGO staging system. 31(30.4%), 17(16.7%), 25(24.5%), 17(16.7%)patients had stage IA, IC1, IC2, IC3, respectively. Univariate analysis showed that tumor size(P = 0.045) and serum CA199(P = 0.025) were related with poor disease-free survival. 5-year disease-free survival (86.9%) of patients with four course chemotherapy was comparable to that (80.2%) with five or more. Patients at stage IC1 or IC2/IC3(rupture before surgery) had the similar outcomes compared with patients at stage IA. And the results of multivariate statistical analysis showed there was no independent, statistically significant prognostic variable. Conclusions: Tumor size and serum CA199 were related with prognosis. Disease-free survival at stage IC1 or IC2/IC3 was comparable to that at stage IA. Five course chemotherapy or more may not improve the 5-year disease-free survival than four.

Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy

2004 ◽  
Vol 14 (2) ◽  
pp. 286-292 ◽  
Author(s):  
A. Ayhan ◽  
R. A. Al ◽  
C. Baykal ◽  
E. Demirtas ◽  
A. Ayhan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Tumor Size ◽  
Adjuvant Radiotherapy ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Free Survival ◽  
Stage Ib ◽  
Disease Free

Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy.ObjectivesThe aim of this study was to evaluate the clinical and pathologic prognostic variables for disease free survival, overall survival and the role of adjuvant radiotherapy in FIGO stage IB cervical carcinoma without lymph node metastasis.MethodsA retrospective review was performed of 393 patients with lymph node negative stage IB cervical cancer treated by type 3 hysterectomy and pelvic lymphadenectomy at the Hacettepe University Hospitals between 1980 and 1997.ResultsThe disease free survival and overall survival were 87.6 and 91.0%, respectively. In univariate analysis, tumor size, depth of invasion, vaginal involvement, lympho-vascular space involvement (LVSI) and adjuvant radiotherapy were found significant in disease free survival. Overall survival was affected by tumor size, LVSI, vaginal involvement and adjuvant radiotherapy. Tumor size, LVSI and vaginal involvement were found as independent prognostic factors for overall and disease free survival in multivariate analysis. Disease free survival, recurrence rate and site did not differ between patients underwent radical surgery and radical surgery plus radiotherapy.ConclusionTumor size, LVSI and vaginal involvement were independent prognostic factors in lymph node negative FIGO stage IB cervical cancer. Adjuvant radiotherapy in stage IB cervical cancer patients with negative nodes provides no survival advantage or better local tumoral control.

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