scholarly journals Combined Assessment of Preoperative Frailty and Sarcopenia Allows the Prediction of Overall Survival in Patients with Lung Cancer (NSCLC) and Surgically Treated Brain Metastasis

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3353
Author(s):  
Inja Ilic ◽  
Anton Faron ◽  
Muriel Heimann ◽  
Anna-Laura Potthoff ◽  
Niklas Schäfer ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastasis ◽  
Predictive Value ◽  
Frailty Index ◽  
Assessment Tools ◽  
Treatment Modalities ◽  
Individual Treatment ◽  
Temporal Muscle ◽  
Aged Group

Neurosurgical resection represents an important therapeutic pillar in patients with brain metastasis (BM). Such extended treatment modalities require preoperative assessment of patients’ physical status to estimate individual treatment success. The aim of the present study was to analyze the predictive value of frailty and sarcopenia as assessment tools for physiological integrity in patients with non-small cell lung cancer (NSCLC) who had undergone surgery for BM. Between 2013 and 2018, 141 patients were surgically treated for BM from NSCLC at the authors’ institution. The preoperative physical condition was assessed by the temporal muscle thickness (TMT) as a surrogate parameter for sarcopenia and the modified frailty index (mFI). For the ≥65 aged group, median overall survival (mOS) significantly differed between patients classified as ‘frail’ (mFI ≥ 0.27) and ‘least and moderately frail’ (mFI < 0.27) (15 months versus 11 months (p = 0.02)). Sarcopenia revealed significant differences in mOS for the <65 aged group (10 versus 18 months for patients with and without sarcopenia (p = 0.036)). The present study confirms a predictive value of preoperative frailty and sarcopenia with respect to OS in patients with NSCLC and surgically treated BM. A combined assessment of mFI and TMT allows the prediction of OS across all age groups.

Cell cycle regulators and benefit of adjuvant chemotherapy in patients with non-small cell lung cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7100-7100 ◽  
Author(s):  
R. Pirker ◽  
M. Filipits ◽  
A. Dunant ◽  
S. Lantuejoul ◽  
K. Schmid ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cell Cycle ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Predictive Value ◽  
Small Cell ◽  
Cell Cycle Regulators ◽  
Small Cell Lung ◽  
Ki 67 ◽  
Nsclc Patients

7100 Background: The International Adjuvant Lung Cancer Trial (IALT) demonstrated that adjuvant cisplatin-based chemotherapy improves the 5-year survival rate of patients with completely resected non-small-cell lung cancer (NSCLC) by absolute 4.1% (N Engl J Med 350, 351–360, 2004). The purpose of our study was to determine whether cell cycle regulators are of prognostic and/or predictive value in NSCLC patients who were enrolled into IALT. Methods: Expression of cell cycle regulators and Ki-67 was immunohistochemically assessed in tumor specimens obtained from 778 IALT patients. Prognostic and predictive analyses were based on Cox models adjusted on clinical and pathological parameters. Results: Expression of p16, p27, cyclin D1, cyclin D3, cyclin E and Ki-67 was considered as positive in 37%, 40%, 74%, 37%, 55% and 29% of tumor specimens, respectively. None of these biomarkers was significantly associated with overall survival of the patients. However, there was a relationship of borderline significance between p27 status and benefit of cisplatin-based chemotherapy (test for interaction, p = 0.04). Patients with p27-negative tumors who were treated with cisplatin-based chemotherapy had a longer overall survival than patients from the observation group (hazard ratio for death [95% CI]: 0.71 [0.55–0.93]), whereas in patients with p27-positive tumors overall survival was not different between the two groups (hazard ratio for death [95% CI]: 1.11 [0.81–1.51]). In contrast to p27, the other cell cycle regulators and Ki-67 did not predict benefit of adjuvant cisplatin-based chemotherapy. Conclusions: NSCLC patients with p27-negative tumors appear to benefit most from adjuvant cisplatin-based chemotherapy following complete tumor resection. Thus, the predictive value of p27 should be confirmed in prospective trials. No significant financial relationships to disclose.

scholarly journals Factors Predictive of Improved Survival in Patients With Brain Metastases From Gynecologic Cancer: A Single Institution Retrospective Study of 47 Cases and Review of the Literature

2015 ◽  
Vol 25 (9) ◽  
pp. 1711-1716 ◽  
Author(s):  
Gregory M. Gressel ◽  
Lisbet S. Lundsberg ◽  
Gary Altwerger ◽  
Tasleem Katchi ◽  
Masoud Azodi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Surgical Resection ◽  
Survival Data ◽  
Gynecologic Cancer ◽  
Treatment Modalities ◽  
Single Institution ◽  
Term Survival ◽  
Free Data

ObjectiveThe reported incidence of brain metastasis from epithelial ovarian cancer (EOC), endometrial cancer (EC), and cervical cancer (CC) is exceedingly rare. As the long-term survival for patients with gynecologic cancer increases, there has been a corresponding increase in the number of diagnosed intracranial metastases. We seek to report our experience with managing brain metastatic disease (BMD) in patients with gynecologic cancer.MethodsA retrospective review of all patients with EOC, EC, and CC at our institution revealed 47 patients with concurrent BMD between 2000 and 2013. Demographic data, risk factors, treatment modalities, progression-free data, and overall survival data were collected.ResultsMedian survival time in patients with brain metastasis from EOC, EC, and CC was 9.0, 4.5, and 3.0 months, respectively. Two-year overall survival rates were 31.6%, 13.6%, and 0%, respectively. Patients received surgery, radiation therapy alone, palliative care, or radiation plus surgery. Radiation combined with surgical resection resulted in a significant hazards ratio of 0.36 (95% confidence interval, 0.15–0.86), compared with radiation alone.ConclusionsOur report provides a large single-institution experience of brain metastases from gynecologic cancer. Patients with BMD have poor prognoses; however, treatment with multimodal therapy including surgical resection and radiation may prolong overall survival.

Cell Cycle Regulators and Outcome of Adjuvant Cisplatin-Based Chemotherapy in Completely Resected Non–Small-Cell Lung Cancer: The International Adjuvant Lung Cancer Trial Biologic Program

2007 ◽  
Vol 25 (19) ◽  
pp. 2735-2740 ◽  
Author(s):  
Martin Filipits ◽  
Robert Pirker ◽  
Ariane Dunant ◽  
Sylvie Lantuejoul ◽  
Katharina Schmid ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cell Cycle ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Predictive Value ◽  
Small Cell ◽  
Cell Cycle Regulators ◽  
Small Cell Lung ◽  
Ki 67 ◽  
Cancer Trial

PurposeThe International Adjuvant Lung Cancer Trial (IALT) demonstrated that adjuvant cisplatin-based chemotherapy improves the survival of patients with completely resected non–small-cell lung cancer (NSCLC). The purpose of our study was to determine whether cell cycle regulators are of prognostic and/or predictive value in patients who were enrolled onto the IALT.Patients and MethodsExpression of p27Kip1, p16INK4A, cyclin D1, cyclin D3, cyclin E, and Ki-67 was immunohistochemically assessed in tumor specimens obtained from 778 IALT patients. Prognostic and predictive analyses were based on Cox models adjusted for clinical and pathologic parameters.ResultsThere was a relationship between p27Kip1status and benefit of cisplatin-based chemotherapy (test for interaction, P = .02). Among patients with p27Kip1-negative tumors, cisplatin-based chemotherapy resulted in longer overall survival compared with controls (adjusted hazard ratio [HR] for death = 0.66; 95% CI, 0.50 to 0.88; P = .006). In patients with p27Kip1-positive tumors, overall survival was not different between patients treated with cisplatin-based chemotherapy and controls (adjusted HR for death = 1.09; 95% CI, 0.82 to 1.45; P = .54). The other cell cycle regulators and Ki-67 did not predict benefit of adjuvant cisplatin-based chemotherapy. None of these biomarkers was significantly associated with overall survival of the patients in the total study population.ConclusionNSCLC patients with p27Kip1-negative tumors benefit from adjuvant cisplatin-based chemotherapy after complete tumor resection. Before establishing p27Kip1as a routine marker for selection of patients for adjuvant chemotherapy, the predictive value of p27Kip1has to be confirmed in patients from other trials.

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