scholarly journals The Presence of Small Nerve Fibers in the Tumor Microenvironment as Predictive Biomarker of Oncological Outcome Following Partial Hepatectomy for Intrahepatic Cholangiocarcinoma

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3661
Author(s):  
Jan Bednarsch ◽  
Xiuxiang Tan ◽  
Zoltan Czigany ◽  
Dong Liu ◽  
Sven Arke Lang ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Oncological Outcome ◽  
Nerve Fibers ◽  
Nodal Metastases ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome

The oncological role of the density of nerve fibers (NFs) in the tumor microenvironment (TME) in intrahepatic cholangiocarcinoma (iCCA) remains to be determined. Therefore, data of 95 iCCA patients who underwent hepatectomy between 2010 and 2019 was analyzed regarding NFs and long-term outcome. Extensive group comparisons were carried out and the association of cancer-specific survival (CSS) and recurrence-free survival (RFS) with NFs were assessed using Cox regression models. Patients with iCCA and NFs showed a median CSS of 51 months (5-year-CSS = 47%) compared to 27 months (5-year-CSS = 21%) in patients without NFs (p = 0.043 log rank). Further, NFs (hazard ratio (HR) = 0.39, p = 0.002) and N-category (HR = 2.36, p = 0.010) were identified as independent predictors of CSS. Patients with NFs and without nodal metastases displayed a mean CSS of 89 months (5-year-CSS = 62%), while patients without NFs or with nodal metastases but not both showed a median CCS of 27 months (5-year-CSS = 25%) and patients with both positive lymph nodes and without NFs showed a median CCS of 10 months (5-year-CSS = 0%, p = 0.001 log rank). NFs in the TME are, therefore, a novel and important prognostic biomarker in iCCA patients. NFs alone and in combination with nodal status is suitable to identify iCCA patients at risk of poor oncological outcomes following curative-intent surgery.

Adjuvant chemotherapy following curative intent hepatectomy for intrahepatic cholangiocarcinoma: Results from a multi-institutional analysis of 575 patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4110-4110
Author(s):  
Dario Ribero ◽  
Antonio Daniele Pinna ◽  
Gennaro Nuzzo ◽  
Alfredo Guglielmi ◽  
Luca Aldrighetti ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Radical Resection ◽  
Continuous Variable ◽  
Outcome Data ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis

4110 Background: Surgical resection alone is the standard of care for patients with resectable intrahepatic cholangiocarcinoma (IHC). This study evaluates the benefit of adjuvant chemotherapy (AdjCTx) following curative intent hepatectomy for IHC. Methods: Clinicopathologic and long-term outcome data of 575 consecutive patients treated with curative intent hepatectomy for IHC (1995-2011) were extracted from a multi-institutional registry. After excluding operative mortality and M1 (n=46), Cox regression analysis was used to identify independent determinants of early recurrence (i.e., within 3 years). Propensity scores, which are used in observational studies to reduce selection bias by equating groups on the basis of relevant covariates, were calculated and utilized to match patients who had or had not AdjCTx (one-to-one match). Cases whose propensity score deviated more than 0.10 were considered unmatched and excluded from the analysis. Primary end-point was recurrence-free survival (RFS) at 3-years. Results: At a median FU of 42 months, 247 patients had recurred. Predictors of recurrence were LN metastases (HR 1.83 [1.36-2.44]), radical resection (HR 0.64 [0.45-0.9]), an elevated preoperative CA19.9 (HR 1.54 [1.15-2.07]), vascular invasion (HR 1.97 [1.49-2.61]), multiple tumors (HR 2.21 [1.71-2.86]), and size (analysed as continuous variable) (HR 1.01 [1.01-1.01]). After matching, no difference was observed between patients who had or had not AdjCTx (n=155 per group; 3-yrs RFS 28.3% vs. 38.0%, respectively; p=NS). When the analysis was restricted to patients who had gemcitabine, GEMOX or FOLFOX for 3 or more cycles (n=64 per group) again no difference emerged between patients who had or had not AdjCTx (3-yrs RFS 27.7% vs. 40.0% respectively, p=NS ). Conclusions: Our data suggest that AdjCTx following resection of IHC does not increase 3-years RFS.

Clinicopathological Features of Remnant Gastric Cancer After Gastrectomy

2021 ◽  
pp. 000313482110562
Author(s):  
Kenichi Iwasaki ◽  
Edward Barroga ◽  
Yota Shimoda ◽  
Masaya Enomoto ◽  
Erika Yamada ◽  
...  
Keyword(s):  
Medical Records ◽  
Tumor Invasion ◽  
Cox Regression ◽  
Remnant Stomach ◽  
Invasion Depth ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis ◽  
Tumor Invasion Depth

Background Remnant gastric cancer (RGC) encompasses all cancers arising from the remnant stomach. Various studies have reported on RGC and its prognosis, but no consensus on its surgical treatment and postoperative management has been reached. Moreover, the correlation between the clinicopathological characteristics and long-term outcomes of RGC remains unclear. This study investigated the clinicopathological factors associated with the long-term survival of RGC patients. Methods The medical records (March 1993-September 2020) of 104 RGC patients from Tokyo Medical University Hospital database were analyzed. Of these 104 patients, the medical records of 63 patients who underwent surgical curative resection were analyzed using R. Kaplan-Meier plots of cumulative incidence of RGC were made. Differences in survival rates were compared using the log-rank test. Prognostic factors were analyzed using multivariate Cox regression analysis ( P < .05). Results Of the 104 RGC patients, 63 underwent total remnant stomach excision. The median time from the first surgery to the total excision was 10 years. The 5-year survival rate of the 63 RGC patients was .55 ((95% CI); .417-.671). The clinicopathological factors that were significantly associated with the long-term outcome of the RGC patients were tumor diameter (≥3.5 cm), presence or absence of combined resection of multiple organs, tumor invasion (deeper than T2), TNM stage, and postoperative morbidity. The multivariate Cox regression analysis showed that tumor invasion depth was the only independent prognostic factor for RGC patients [HR (95% CI): 5.49 (2.629-11.5), P ≤ .005]. Conclusions Among prognostic factors, tumor invasion depth was the only independent factor affecting RGC’s long-term outcome.

scholarly journals Sarcopenia Is a Negative Prognostic Factor in Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatic Malignancies

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1503 ◽  
Author(s):  
Loosen ◽  
Schulze-Hagen ◽  
Bruners ◽  
Tacke ◽  
Trautwein ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Psoas Muscle ◽  
Muscle Size ◽  
Rapid Decline ◽  
Term Outcome ◽  
Long Term Outcome

: Background and Aims: While transarterial chemoembolization (TACE) represents a standard of therapy for intermediate-stage hepatocellular carcinoma (HCC) and is also routinely performed in patients with liver metastases, it is still debated which patients represent the ideal candidates for TACE therapy in terms of overall survival. Sarcopenia, the degenerative loss of skeletal muscle mass and strength, has been associated with an adverse outcome for various malignancies, but its role in the context of TACE has largely remained unknown. Here, we evaluated the role of sarcopenia on the outcome of patients undergoing TACE for primary and secondary liver cancer. Methods: The patients’ psoas muscle size was measured on axial computed tomography (CT) scans and normalized for the patients’ height squared. This value was referred to as the psoas muscle index (PMI). The PMI was correlated with clinical and laboratory markers. Results: While pre-interventional sarcopenia had no impact on the direct tumor response to TACE, sarcopenic patients with a pre-interventional PMI below our ideal cut-off value of 13.39 mm/m2 had a significantly impaired long-term outcome with a median overall survival of 491 days compared to 1291 days for patients with a high PMI. This finding was confirmed by uni- and multivariate Cox-regression analyses. Moreover, a progressive rapid decline in muscle mass after TACE was a predictor for an unfavorable prognosis. Conclusion: Our data suggest that sarcopenia represents a previously unrecognized prognostic factor for patients undergoing TACE therapy which might yield important information on the patients’ post-interventional outcome and should therefore be implemented into clinical stratification algorithms.

scholarly journals Functional Inflammatory Genotypes in Ischemic Stroke: Could We Use Them to Predict Age of Onset and Long-Term Outcome?

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Stella Marousi ◽  
Anna Antonacopoulou ◽  
Haralambos Kalofonos ◽  
Panagiotis Papathanasopoulos ◽  
Marina Karakantza ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cox Regression ◽  
Age Of Onset ◽  
Adverse Outcome ◽  
Nucleotide Polymorphisms ◽  
Term Outcome ◽  
Single Nucleotide ◽  
Long Term Outcome ◽  
Tnf Α

Functional single-nucleotide polymorphisms (SNPs) of inflammatory cytokines have been previously related to the occurrence of an ischemic stroke (IS). We investigated whether five functional SNPs (i.e., TNF-α-308G>A, IL6-174G>C, IL12B 1188A>C, IL4-589C>T, and IL10-1082G>A) might be associated with the age of onset and 6-month outcome of an acute IS. A probe-free real-time PCR methodology was used to genotype 145 consecutively admitted cases with a first-ever IS. Simple Kaplan-Mayer and adjusted Cox regression analyses showed no association between inflammatory genotypes and the age of IS onset. IL6-174G>C, IL12B 1188A>C, IL4-589C>T, and IL10-1082G>A were not found to significantly contribute to the long-term outcome of the disease. However, carriage of the TNF-α-308 GG genotype was significantly associated with reduced odds for an adverse outcome. Larger studies are needed to confirm our results.

Prognostic factors in the persistence of posttraumatic epilepsy after penetrating head injuries sustained in war

2009 ◽  
Vol 110 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Behzad Eftekhar ◽  
Mohammad Ali Sahraian ◽  
Banafsheh Nouralishahi ◽  
Ali Khaji ◽  
Zahra Vahabi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cox Regression ◽  
Head Injuries ◽  
Clinical Findings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis ◽  
Posttraumatic Epilepsy ◽  
Kaplan Meier

Object The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq–Iran war (1980–1988). Methods In this retrospective study, the authors evaluated 189 patients who sustained penetrating head injury and suffered posttraumatic epilepsy during the Iraq–Iran war (mean 18.6 ± 4.7 years after injury). The probabilities of persistent seizures (seizure occurrence in the past 2 years) in different periods after injury were estimated using the Kaplan-Meier method. The possible prognostic factors (patients and injury characteristics, clinical findings, and seizure characteristics) were studied using log-rank and Cox regression analysis. Results The probability of persistent seizures was 86.4% after 16 years and 74.7% after 21 years. In patients with < 3 pieces of shrapnel or no sphincter disturbances during seizure attacks, the probability of being seizure free after these 16 and 21 years was significantly higher. Conclusions Early seizures, prophylactic antiepileptics drugs, and surgical intervention did not significantly affect long-term outcome in regard to persistence of seizures.

Laboratory values and their relationship with short- and long-term outcome following transthoracic esophagectomy in patients with esophageal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 37-37
Author(s):  
Dirk Bosch ◽  
Maarten Nijsten ◽  
John Theodorus Plukker
Keyword(s):  
Esophageal Cancer ◽  
Laboratory Data ◽  
Area Under The Curve ◽  
Laboratory Measurements ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Reactive Protein ◽  
Laboratory Values ◽  
One Year

37 Background: Surgical resection in esophageal cancer patients remains the mainstay of therapy, but carries a considerable risk of post-operative complications. Deranged laboratory data in the early post-operative period could provide guidance in decision making for further treatment strategy. Therefore we related standard laboratory measurements on 90-day and 1-year mortality after esophagectomy. Methods: Esophagectomy with curative intent was performed in 226 consecutive patients with cancer of the esophagus between January 2000 and December 2009. Prognostic analyses for albumin, lactate dehydrogenase (LDH), ALAT, ASAT, gGT, urea, creatinine, C-reactive protein (CRP), white blood cell count (WBC) and platelet count were performed with a Mann-Whitney U-test (p<0.05) and ROC curve (area under the curve (AUC) >0.7) for postoperative day (POD) 1, 2, 3, 4, 5, 10 and 15. Extreme laboratory values (cutoff points) were calculated (5th or 95th percentile) in the case of significant outcomes. Results: Laboratory measurements between survivors and patients deceased within 90-days (n=16) were significantly different in the case of albumin on POD 1, 3, 5, 10 and 15 (5th percentile between 10-13.02, AUC: 0.761), CRP on POD 3, 4, 5, 10 and 15 (95th percentile between 228.8-324.7, AUC: 0.861) and LDH in the late postoperative period on POD 4, 10 and 15 (95th percentile between 387.1-512.2, AUC: 0.864). The other laboratory values showed no systematic differences. For one-year mortality (N=36), only albumin and CRP showed to have significant differences for non-survivors: albumin on POD 10 and 15 (5th percentile between13.2-13.75, AUC: < 0.7) and CRP on POD 3, 4 and 10 (95th percentile between 220.9-319.5, AUC: < 0.7). Conclusions: Albumin and CRP are the strongest prognostic measurements in predicting 90-day and one-year mortality after esophagectomy.

Adjuvant chemotherapy in small node-negative triple-negative breast cancer (TNBC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 536-536 ◽  
Author(s):  
Tessa Gerjanne Steenbruggen ◽  
Mette S. Van Ramshorst ◽  
Erik van Werkhoven ◽  
Vincent O. Dezentjé ◽  
Sabine Siesling ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cox Regression ◽  
Large Population ◽  
Absolute Difference ◽  
Cancer Specific Survival ◽  
Long Term Outcome ◽  
Node Negative ◽  
Netherlands Cancer Registry ◽  
Grade 3

536 Background: International guidelines differ in their recommendation for adjuvant chemotherapy in small node negative TNBC. We evaluated associations of chemotherapy with long-term outcome in a large population-based TNBC cohort. Methods: All patients diagnosed with pT1N0M0 TNBC between 2005 and 2015 were identified from the Netherlands Cancer Registry. Patient, tumor and therapy characteristics were recorded. Date and cause of death were obtained from Statistics Netherlands. We used multivariable cox regression models to evaluate associations of chemotherapy with overall survival (OS) and breast-cancer specific survival (BCSS), adjusted for baseline characteristics. Subgroup analyses were performed by tumor size and grade. Results: We identified 4393 patients: 284 with T1a, 924 with T1b, and 3185 with T1c tumors. Chemotherapy was administered in 53% of patients: 6% with T1a, 17% with T1b and 67% with T1c. Chemotherapy use increased over time and varied by geographic region. Patients receiving chemotherapy were younger, had larger tumors, higher tumor grade, and more often isolated tumor cells (itc) in the lymph nodes. At a median follow-up of 7 years (IQR 5-10 years), 611 patients had died, of whom 287 due to breast cancer. Chemotherapy was associated with improved OS in the whole group (adjusted hazard ratio [aHR] 0.55; 95% CI 0.44–0.69), in the pT1c subgroup (aHR 0.53, 95% CI 0.41-0.67), and in grade 3 tumors (aHR 0.50, 95% CI 0.39-0.65). Associations were not significant for pT1ab or grade 1-2 tumors (table). Findings for BCSS were in line with OS results (table). To illustrate the absolute difference we estimated 10-year OS and BCSS for a 60-year old woman with a pT1cN0(itc+) grade 3 TNBC. The predicted 10-year OS was 67% with chemotherapy and 49% without; predictions for 10-year BCSS were 80% and 66%, respectively. Conclusions: Adjuvant chemotherapy is associated with higher OS and BCSS in small node negative TNBC. Benefit is most evident in grade 3 tumors and tumors > 1cm and not evident in tumors ≤1cm and grade 1-2.[Table: see text]

scholarly journals Impact of Morphological Status on Long-Term Outcome Among Patients Undergoing Liver Surgery for Intrahepatic Cholangiocarcinoma

2017 ◽  
Vol 24 (9) ◽  
pp. 2491-2501 ◽  
Author(s):  
Fabio Bagante ◽  
Gaya Spolverato ◽  
Matthew Weiss ◽  
Sorin Alexandrescu ◽  
Hugo P. Marques ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Liver Surgery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Morphological Status
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