scholarly journals Examination of Prognostic Factors Affecting Long-Term Survival of Patients with Stage 3/4 Gallbladder Cancer without Distant Metastasis

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2073
Author(s):  
Ryota Higuchi ◽  
Takehisa Yazawa ◽  
Shuichirou Uemura ◽  
Yutaro Matsunaga ◽  
Takehiro Ota ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Gallbladder Cancer ◽  
Distant Metastasis ◽  
Surgical Outcome ◽  
Hepatoduodenal Ligament ◽  
Entire Area ◽  
Factors Affecting ◽  
Left Margin

In advanced gallbladder cancer (GBC) radical resection, if multiple prognostic factors are present, the outcome may be poor; however, the details remain unclear. To investigate the poor prognostic factors affecting long-term surgical outcome, we examined 157 cases of resected stage 3/4 GBC without distant metastasis between 1985 and 2017. Poor prognostic factors for overall survival and treatment outcomes of a number of predictable preoperative poor prognostic factors were evaluated. The surgical mortality was 4.5%. In multivariate analysis, blood loss, poor histology, liver invasion, and ≥4 regional lymph node metastases (LNMs) were independent prognostic factors for poor surgical outcomes; invasion of the left margin or the entire area of the hepatoduodenal ligament and a Clavien–Dindo classification ≥3 were marginal factors. The analysis identified outcomes of patients with factors that could be predicted preoperatively, such as liver invasion ≥5 mm, invasion of the left margin or the entire area of the hepatoduodenal ligament, and ≥4 regional LNMs. Thus, the five-year overall survival was 54% for zero factors, 34% for one factor, and 4% for two factors (p < 0.05). A poor surgical outcome was likely when two or more factors were predicted preoperatively; therefore, new treatment strategies are required for such patients.

The time trends of gallbladder cancer and cholangiocarcinoma in 1,047 patients.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 376-376
Author(s):  
Shuichi Mitsunaga ◽  
Masafumi Ikeda ◽  
Satoshi Shimizu ◽  
Izumi Ohno ◽  
Hideaki Takahashi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Gallbladder Cancer ◽  
Distant Metastasis ◽  
Initial Treatment ◽  
Time Trends ◽  
Performance Status ◽  
Survival Times ◽  
Group 2 ◽  
Group 1

376 Background: Gallbladder cancer (Gb ca) and cholangiocarcinoma (CC ca) are major primary sites in biliary tract cancer. Progresses of diagnosis and anti-cancer therapy for Gb and CC ca lead to the changes of patients’ characteristics and overall survival time, but is not fully understood. This study aimed to identify the time trends in patients with Gb and CC ca. Methods: The inclusive criteria in this study was the patients receiving initial treatment including surgery (Op), chemotherapy (Chemo), radiotherapy (RT), or best supportive care (BSC) for Gb or CC ca in our institution, and 1047 patients were reviewed. Patient who received initial treatment at 1992-2005 were in 54.1 % of the study subjects and was defined as Group 1. Patients with initial treatment at 2006-2012 were categorized to Group 2 and were in 45.9% of all patients. The differences between two groups were evaluated, and the features of Group 2 were identified. Results: Age more than 60 years (Odd ratio [OR]: 2.37), the absence of distant metastasis (OR: 2.13), and ECOG performance status score (PS) = 0 (OR: 1.70) were identified as the independent features of Group 2. The rates of Op, Chemo, RT, and BSC were 38.5, 24.7, 14.9, and 21.7% in Group 1, and 40.8, 49.9, 1.5, and 6.0% in Group 2. The rate of Chemo in Group 2 was higher than that in Group 1 (P < 0.01). The median times of overall survival (OS) in Op, Chemo, RT, and BSC were 21.1, 5.2, 6.9, and 2.4 months in Group 1 and 60.6, 9.2, 10.5, 2.8 months in Group 2. The OS in Op or Chemo of Group 2 was longer than that in Group 1 (P < 0.01, P < 0.01). The independent poor prognostic factors were distant metastasis (HR: 3.91), Group 1 (1.81), and PS > 0 (1.72) in all patients, distant metastasis (HR: 3.56), Group 1 (2.12), biliary drainage (1.75) in Op, and PS>0 (HR: 1.97), Group 1 (1.74), and distant metastasis (1.64) in Chemo. Conclusions: The recent trends in patients with Gb and CC ca were aging, low rates of distant metastasis, good PS, increased cases with chemotherapy, and the prolonged survival times in surgery and chemotherapy. The presence of distant metastasis, the worsened PS, and the previous treatment group were the independent poor prognostic factors.

scholarly journals Long Term Surgical Outcome and Prognostic Factors of Atypical and Malignant Meningiomas

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yu-Chi Wang ◽  
Chi-Cheng Chuang ◽  
Kuo-Chen Wei ◽  
Cheng-Nen Chang ◽  
Shih-Tseng Lee ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Surgical Outcome

scholarly journals Improved Overall Survival and Decreased Metastasis With Adjuvant 5-Fluorouracil and Platinum Chemotherapy After Definitive Concurrent Chemoradiotherapy for N3 Nasopharyngeal Cancer: A Registry-Based Analysis

2021 ◽  
Author(s):  
Mu-Hung Tsai ◽  
Shang-Yin Wu ◽  
Tsung Yu ◽  
Sen-Tien Tsai ◽  
Yuan-Hua Wu
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Concurrent Chemoradiotherapy ◽  
Locally Advanced ◽  
Nasopharyngeal Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
Risk Of Death

Abstract Background and purpose Concurrent chemoradiotherapy is the established treatment for locally advanced nasopharyngeal carcinoma (NPC). However, there is no evidence supporting routine adjuvant chemotherapy. We aimed to demonstrate the effect of adjuvant chemotherapy on survival and distant metastasis in high-risk N3 NPC patients. Materials and methods We linked the Taiwan Cancer Registry and Cause of Death database to obtain data. Clinical N3 NPC patients were divided as those receiving definitive concurrent chemoradiotherapy (CCRT) with adjuvant 5-fluorouracil and platinum (PF) chemotherapy and those receiving no chemotherapy after CCRT. Patients receiving neoadjuvant chemotherapy were excluded. We compared overall survival, disease-free survival, local control, and distant metastasis in both groups using Cox proportional hazards regression analysis. Results We included 431 patients (152 and 279 patients in the adjuvant PF and observation groups, respectively). Median follow-up was 4.3 years. The 5-year overall survival were 69.1% and 57.4% in the adjuvant PF chemotherapy and observation groups, respectively (p = 0.02). Adjuvant PF chemotherapy was associated with a lower risk of death (hazard ratio [HR] = 0.61, 95% confidence interval [CI]: 0.43–0.84; p = 0.003), even after adjusting for baseline prognostic factors (HR = 0.61, 95% CI: 0.43–0.86; p = 0.005). Distant metastasis-free survival at 12 months was higher in the adjuvant PF chemotherapy group than in the observation group (98% vs 84.8%; p < 0.001). After adjusting for baseline prognostic factors, adjuvant PF chemotherapy was associated with freedom from distant metastasis (HR = 0.11, 95% CI: 0.02–0.46; p = 0.003). Conclusion Prospective evaluation of adjuvant PF chemotherapy in N3 NPC patients treated with definitive CCRT is warranted because adjuvant PF chemotherapy was associated with improved overall survival and decreased risk of distant metastasis.

scholarly journals Analysis of Prognostic Factors Affecting Short-term and Long-term Outcomes of Gastric Cancer Resection

2021 ◽  
Vol 41 (7) ◽  
pp. 3523-3534
Author(s):  
PIOTR KULIG ◽  
PRZEMYSŁAW NOWAKOWSKI ◽  
MAREK SIERZĘGA ◽  
RADOSŁAW PACH ◽  
OLIWIA MAJEWSKA ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Long Term Outcomes ◽  
Short Term ◽  
Factors Affecting ◽  
Cancer Resection ◽  
Gastric Cancer Resection

scholarly journals Prognostic factors affecting the surgical outcome of anterolateral benign tumors in the foramen magnum region

2016 ◽  
Vol 33 ◽  
pp. 172-176
Author(s):  
Chuanyuan Tao ◽  
Xiaowei Liu ◽  
Yuekang Zhang ◽  
Fan Liu ◽  
Chao You
Keyword(s):  
Prognostic Factors ◽  
Surgical Outcome ◽  
Foramen Magnum ◽  
Benign Tumors ◽  
Factors Affecting

Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value

2020 ◽  
Vol 37 (5) ◽  
pp. 390-400
Author(s):  
Yusuke Yamamoto ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
Ryo Ashida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Gallbladder Cancer ◽  
Major Hepatectomy ◽  
Carbohydrate Antigen ◽  
Clinical Impact ◽  
Surgical Indication ◽  
Cutoff Value ◽  
Advanced Gallbladder Cancer

Background: Selecting patients who will benefit from resection among those with advanced gallbladder cancer (GBCa) having poor prognostic factors is difficult. Methods: One hundred twenty-one patients who underwent resection for stage II–IV GBCa and 19 unresected patients (unresectable group) were enrolled. The clinical impact of carbohydrate antigen 19-9 (CA19-9) and advanced surgical procedures for GBCa was evaluated. Results: The optimal CA19-9 cutoff value (based on the greatest difference in overall survival) was 250 U/mL. CA19-9 ≥250 U/mL was found to be an independent prognostic factor. Patients with CA19-9 <250 U/mL who developed jaundice (median survival time [MST], 49.1 months) or who required major hepatectomy (MST, 21.5 months) or pancreatoduodenectomy (PD; MST, 50.3 months) had a better prognosis than those with CA19-9 ≥250 U/mL who developed jaundice (MST, 16.1 months; p = 0.061) or who required major hepatectomy (MST, 9.2 months; p = 0.066) or PD (MST, 8.6 months; p = 0.025); their prognosis was comparable to that of the unresectable group (jaundice: p = 0.145, major hepatectomy: p = 0.292, PD: p = 0.756). Conclusions: Even if GBCa patients develop jaundice or require major hepatectomy, or combined PD, resection can be considered for those with CA19-9 <250 U/mL. However, surgical indication should be carefully determined in patients with CA19-9 ≥250 U/mL.

64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
T Nishimura
Keyword(s):  
Prognostic Factors ◽  
Esophageal Varices ◽  
Endoscopic Treatment ◽  
Survival Period ◽  
Term Survival ◽  
Gastroesophageal Varices ◽  
Long Term Survival ◽  
Factors Affecting ◽  
Long Term Prognosis

Abstract   Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p &lt; 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p &lt; 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p &lt; 0.05], total bilirubin value≧ 2 [HR:2.5573, p &lt; 0.05], and presence of HCC [HR:2.2450, p &lt; 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p &lt; 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

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