scholarly journals Preoperative Inflammatory Markers as a Predictor of Three-Year Overall Survival in Older Cancer Patients Undergoing Oncologic Surgery

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1824
Author(s):  
Baukje Brattinga ◽  
Abraham Rutgers ◽  
Jacco J. De Haan ◽  
Anthony R. Absalom ◽  
Hanneke van der Wal-Huisman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Plasma Level ◽  
Cancer Patients ◽  
Inflammatory Markers ◽  
Older Patients ◽  
Specific Group ◽  
Oncologic Surgery ◽  
Older Cancer Patients ◽  
Multivariate Hazard Ratio

Oncologic surgery results in substantially higher morbidity and mortality rates in older patients compared to younger patients, yet little is known about the relation between the preoperative inflammatory state and postoperative outcome in the specific group of older cancer patients. The aim of this study was to examine whether preoperative inflammatory markers could be a predictor of overall survival in older patients undergoing elective surgery for a solid malignant tumor. Patients 65 years and older undergoing surgery for a solid malignant tumor were included in a prospective cohort study. Inflammatory markers C-reactive protein (CRP), interleukin-1 beta (IL-1β), IL-6, IL10, IL-12 and tumor necrosis factor-alpha (TNF-α) were measured in plasma samples preoperatively. The main outcome was overall survival three years after surgery. Between 2010 and 2016, 328 patients with a median age of 71.5 years (range 65–89) were included. A significantly higher mortality rate three years after surgery, was found in patients with high preoperative plasma levels of CRP and IL-6 (p = 0.013 and p = 0.046, respectively). In multivariate analysis, corrected for variables such as age, disease stage, frailty, comorbidities, type of surgery and complications, a preoperative plasma level of CRP ≥ 10 mg/L was an independent prognostic factor for inferior overall survival three years after surgery (multivariate hazard ratio 1.50, 95% confidence interval 1.04–2.16, p = 0.031). Also, for the specific group of patients with colorectal cancer, a preoperative plasma level of CRP ≥ 10 mg/L was a prognostic factor for inferior survival three years after surgery (multivariate hazard ratio 2.40, 95% confidence interval 1.20–4.81, p = 0.014). Preoperative elevated plasma level of CRP is an independent unfavorable prognostic factor for overall survival three years after oncologic surgery. This gives more insight into the relationship between inflammation and survival in older cancer patients, and might contribute to risk stratification for poor outcome after surgery in older cancer patients.

Neutrophil-lymphocyte index as prognostic factor for overall survival and disease-free survival in breast cancer patients

2020 ◽  
Vol 33 (4) ◽  
pp. 137-144
Author(s):  
Guillermo Peralta-Castillo ◽  
Antonio Maffuz-Aziz ◽  
Mariana Sierra-Murguía ◽  
Sergio Rodriguez-Cuevas
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free

Next-generation sequencing to identify predictors of survival after trimodality therapy for esophageal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 153-153
Author(s):  
Patrick Oh ◽  
Minsi Zhang ◽  
Paul Brady ◽  
Smita Sihag ◽  
Daniela Molena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Next Generation Sequencing ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Pathologic Response ◽  
Next Generation ◽  
Trimodality Therapy ◽  
Generation Sequencing ◽  
Mutation Profiling

153 Background: Tumor mutation profiling has changed the prognostication and treatment of a wide variety of malignances. However, little is known about whether mutation profiles affect outcome in localized esophageal cancer treated with multimodality therapy. SMAD4 is a gene involved in the regulation of the TGF-β signal transduction pathway by negatively controlling the growth of epithelial cells and has been implicated as a prognostic factor in pancreatic cancer. We undertook an exploratory analysis of tumor mutation profiles, including SMAD4 status, in localized esophageal cancer patients treated with trimodality therapy at our institution. Methods: We identified 66 Stage II-III esophageal cancer patients treated with chemoradiation followed by surgery who had some form of tumor mutation profiling available. Only patients with mutation profiling from pre-treatment biopsy or post-chemoradiation surgical specimen (i.e. not from a subsequent metastatic lesion) were included. Twenty-two patients underwent next-generation sequencing assessing 341 candidate genes via targeted sequencing. Log-rank test was used to assess correlation of mutations to overall survival, and to pathologic response. Results: The median follow-up was 17.1 months. SMAD4 loss was identified in 3 of 22 patients (13.6%) who underwent next-generation sequencing, and was significantly associated with inferior overall survival (p=0.023). No other candidate genes were significantly associated with survival, and no genes were significantly associated with pathologic response. Conclusions: To our knowledge, this is the first analysis of next-generation mutation profiling and outcome in non-metastatic esophageal cancer patients treated with trimodality therapy. Due to the limited numbers, this was an exploratory analysis only. We identified SMAD4 loss as a potential adverse prognostic factor for survival. More next-generation sequencing data from non-metastatic esophageal cancer patients treated with multimodality therapy is needed to further elucidate the potential relationship of SMAD4 loss or other mutations with outcome.

scholarly journals Immunotherapy and Radiotherapy for Older Cancer Patients during the COVID-19 Era: Proposed Paradigm by the International Geriatric Radiotherapy Group

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Nam Phong Nguyen ◽  
Brigitta G. Baumert ◽  
Eromosele Oboite ◽  
Micaela Motta ◽  
Gokula Kumar Appalanaido ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Local Control ◽  
Older Patients ◽  
Locally Advanced ◽  
The Elderly ◽  
New Paradigm ◽  
Radiotherapy Group ◽  
Potential Synergy ◽  
Physician Bias ◽  
Older Cancer Patients

<b><i>Background:</i></b> Older cancer patients with locally advanced or metastatic disease may benefit from chemotherapy alone or combined with radiotherapy. However, chemotherapy is often omitted either because of physician bias or because of its underlying comorbidity, thus compromising their survival. The coronavirus disease 19 (COVID-19) pandemic is compounding this issue because of the fear of immunosuppression induced by chemotherapy on the elderly which makes them more vulnerable to the virus. <b><i>Summary:</i></b> Immunotherapy has less effect on the patient bone marrow compared to chemotherapy. The potential synergy between radiotherapy and immunotherapy may improve local control and survival for older patients with selected cancer. Preliminary data are encouraging because of better survival and local control in diseases which are traditionally resistant to radiotherapy and chemotherapy such as melanoma and renal cell carcinoma. <b><i>Key Message:</i></b> We propose a new paradigm combining immunotherapy at a reduced dose and/or extended dosing intervals and hypofractionated radiotherapy for older patients with selected cancer which needs to be tested in future clinical trials.

scholarly journals Sarcopenia and chemotherapy-mediated toxicity

2016 ◽  
Vol 14 (4) ◽  
pp. 580-584 ◽  
Author(s):  
Maria Cecília Monteiro Dela Vega ◽  
◽  
Alessandro Laviano ◽  
Gustavo Duarte Pimentel ◽  
◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Dose Reduction ◽  
Cancer Patients ◽  
Healthcare Costs ◽  
Narrative Review ◽  
Treatment Discontinuation ◽  
Negative Outcome

ABSTRACT This narrative review focuses on the role of sarcopenia and chemotherapy-induced toxicity in cancer patients. Consistent evidence shows that sarcopenia in cancer patients leads to decreased overall survival by influencing treatment discontinuation and dose reduction. Therefore, sarcopenia should be considered a robust prognostic factor of negative outcome as well as a determinant of increased healthcare costs.

Cancer in the older person

2008 ◽  
Vol 18 (4) ◽  
pp. 313-321
Author(s):  
Peter Stephens
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Older Patients ◽  
Malignant Disease ◽  
Task Force ◽  
Annual Conference ◽  
Older Person ◽  
European Organisation ◽  
Older Cancer Patients ◽  
American Society

The challenges of treating malignant disease in the older population are gaining greater prominence. In the last 10 years the European Organisation for Research and Treatment of Cancer (EORTC) has established a task force to examine challenges of managing older cancer patients. As an indication of their importance, the American Society of Clinical Oncology (ASCO) specifically addressed the issues raised by older patients at their annual conference in 2004.

scholarly journals PD-1 Expression Status on CD8+ Tumour Infiltrating Lymphocytes Associates With Survival in Cervical Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Peiwen Fan ◽  
Xi Li ◽  
Yaning Feng ◽  
Hongchao Cai ◽  
Danning Dong ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Free Survival ◽  
Cellular Expression ◽  
Tumour Infiltrating Lymphocytes ◽  
Infiltrating Lymphocytes ◽  
Expression Status

Despite the expansion of PD-1 checkpoint blockade to multiple types of cancer, whether the programmed cell death 1 (PD-1) expression status on CD8+ tumour infiltrating lymphocytes (TILs) could be a prognostic factor in cervical cancer is still unclear. In this study, we performed ex vivo phenotypic analysis of PD-1 expression on CD8+ TILs by flow cytometry from 47 treatment-naïve cervical cancer patients. With a median follow-up of 26.1 months (95% confidence interval [CI], 24-28.2 months), we then linked the quantitative cellular expression results to progression-free survival and overall survival. Based on the intensity of PD-1 expression, we further categorised the cervical cancer patients into PD-1high expressers (29.8%, 14/47) and PD-1low expressers (70.2%, 33/47). Multivariate analysis revealed that PD-1high expressers are correlated with early recurrence (HR, 5.91; 95% CI, 1.03-33.82; P= 0.046). Univariate analysis also demonstrated that PD-1high expressers are associated with poor overall survival in cervical cancer (HR, 5.365; 95% CI, 1.55-18.6; P=0.008). Moreover, our study also demonstrated that CD8+/CD4+ TIL ratio and HPV infection status are risk factors for early relapse and mortality in cervical cancer patients. In conclusion, this study confirms that PD-1 expression status is an independent prognostic factor for progression free survival in cervical cancer. These findings could be important in predicting the relapse of cervical cancer as a cellular diagnosis method and could be important knowledge for the selection of prospective PD-1 blockade candidates.

scholarly journals The values of several inflammatory markers, including the neutrophil/lymphocyte ratio, in patients with pancreatic cancer treated by curative resection followed by adjuvant chemotherapy

2017 ◽  
Author(s):  
Yusuke Nakayama ◽  
Naoto Gotohda ◽  
Shinichiro Takahashi ◽  
Masaru Konishi ◽  
Ryuichi Hayashi
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Inflammatory Markers ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Objective: The aim of this study was to determine the relationship between the values of several systemic inflammatory markers and the prognosis in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy. Methods: A total of 110 pancreatic cancer patients who treated by curative resection followed by adjuvant chemotherapy were reviewed for this study. Univariate and multivariate analyses were performed to identify the clinicopathological factors influencing the overall survival, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and the direction of change of the NLR (increase or decrease) after one cycle of adjuvant chemotherapy as compared to the value recorded prior to the start of the chemotherapy. Results: A multivariate analysis identified only the direction of change of the NLR after the first cycle of adjuvant chemotherapy as an independent risk factor for the overall survival (NLR decrease vs. NLR increase, HR=1.925; P=0.044). The NLR, PLR and GPS were not identified as significant predictors of the overall survival. Conclusions: The direction of change of the NLR after the first cycle of adjuvant chemotherapy may help in predicting the effect of chemotherapy in pancreatic cancer patients treated by curative resection followed by adjuvant chemotherapy.

scholarly journals Recent advances in cancer surgery in older patients

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1242 ◽  
Author(s):  
Siri Rostoft ◽  
Riccardo A. Audisio
Keyword(s):  
Cancer Patients ◽  
Older Patients ◽  
Postoperative Morbidity ◽  
Gynecological Cancer ◽  
Functional Limitations ◽  
Preoperative Evaluation ◽  
Cognitive Status ◽  
Frailty Assessment ◽  
Older Cancer Patients

Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations. The importance of incorporating frailty assessment into the preoperative evaluation of older surgical patients has received increasing attention over the last 10 years. Furthermore, studies that include endpoints such as functional status, cognitive status, and quality of life beyond the standard endpoints, i.e. postoperative morbidity and mortality, are starting to emerge. This review looks at recent evidence regarding geriatric assessment and frailty in older surgical cancer patients and provides a summary of newer studies in colorectal, liver, pancreatic, and gynecological cancer and renal and central nervous system tumors.

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