scholarly journals Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 10
Author(s):  
Masahiro Matsui ◽  
Hiroki Nishikawa ◽  
Masahiro Goto ◽  
Akira Asai ◽  
Kosuke Ushiro ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Prognostic Impact ◽  
Advanced Malignancies ◽  
Ecog Ps ◽  
Sensitivity Specificity ◽  
Strong Suspicion

We sought to elucidate the prognostic impact of the SARC-F score among patients with gastrointestinal advanced malignancies (n = 421). A SARC-F score ≥ 4 was judged to have a strong suspicion for sarcopenia. In patients with ECOG-PS 4 (n = 43), 3 (n = 61), and 0–2 (n = 317), 42 (97.7%), 53 (86.9%) and 8 (2.5%) had the SARC-F score ≥ 4. During the follow-up period, 145 patients (34.4%) died. All deaths were cancer-related. The 1-year cumulative overall survival (OS) rate in patients with SARC-F ≥ 4 (n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the OS, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score (GPS) 1 (p = 0.0147, GPS 0 as a standard), GPS 2 (p < 0.0001, GPS 0 as a standard), ECOG-PS 2 (p < 0.0001, ECOG-PS 0 as a standard), ECOG-PS 3 (p < 0.0001, ECOG-PS 0 as a standard), and ECOG-PS 4 (p < 0.0001, ECOG-PS 0 as a standard) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and best cutoff point of the SARC-F score was two. In conclusion, the SARC-F score is useful in patients with gastrointestinal advanced malignancies.

scholarly journals The Glasgow Prognostic Score Determined During Concurrent Chemoradiotherapy Is an Independent Predictor of Survival for Cervical Cancer

2015 ◽  
Vol 25 (7) ◽  
pp. 1306-1314 ◽  
Author(s):  
Takeshi Nishida ◽  
Keiichiro Nakamura ◽  
Junko Haraga ◽  
Chikako Ogawa ◽  
Tomoyuki Kusumoto ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Multivariate Analyses ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Kaplan Meier ◽  
The Glasgow Prognostic Score ◽  
Prediction Of Prognosis

ObjectiveThe Glasgow prognostic score (GPS) determined at pretreatment is important in the prediction of prognosis in various cancers. We investigated if the GPS used both at pretreatment and during concurrent chemoradiotherapy (CCRT) could predict the prognosis of patients with cervical cancer.MethodsWe collected GPS and clinicopathological data from the medical records of 91 patients who underwent CCRT for cervical cancer; their GPSs at pretreatment and during CCRT were retrospectively analyzed for correlations with recurrence and survival. Statistical analyses were performed using the Mann-WhitneyUtest. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox’s proportional hazard regression was used for univariate and multivariate analyses.ResultsThe median follow-up for all patients who were alive at the time of last follow-up was 38.0 months (range, 1–108 months). The DFS and OS rates of patients with a high GPS during CCRT (GPS 1 + 2; 55 patients; 60.4%) were significantly shorter than those for patients with a low GPS (GPS 0; 36 patients; 39.6%) (DFS,P< 0.001; OS,P< 0.001). Furthermore, multivariate analyses showed that high GPS during CCRT was an independent prognostic factor of survival for OS (P= 0.008).ConclusionsDuring CCRT, a high GPS was revealed to be an important predictor of survival for cervical cancer.

scholarly journals Significance of a Preoperative Systemic Immune-inflammation Index as a Predictor of Postoperative Survival Outcomes in Gastric Cancer

2020 ◽  
Author(s):  
Hiroyuki Inoue ◽  
Toshiyuki Kosuga ◽  
Takeshi Kubota ◽  
Hirotaka Konishi ◽  
Atsushi Shiozaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Postoperative Survival ◽  
Prognostic Indicators ◽  
Survival Outcomes ◽  
Prognostic Impact ◽  
Curative Gastrectomy ◽  
Inflammatory Status ◽  
Immune Inflammation

Abstract Background Since inflammation and the immune system contribute to the development and progression of malignancies, parameters that reflect a host’s immune-inflammatory status may be useful prognostic indicators of gastric cancer (GC). The present study examined the clinical significance of a preoperative systemic immune-inflammation index (SII) for predicting postoperative survival outcomes in GC.Methods A total of 447 patients who underwent curative gastrectomy for GC were included in the present study. SII was calculated as platelet count × neutrophil count/lymphocyte count. The prognostic impact of preoperative SII was examined using univariate and multivariate analyses.Results Preoperative SII ranged between 105 and 4455 (median 474), and the optimal cut-off value for predicting overall survival (OS) was 395 based on a receiver operating characteristic curve. The 5-year OS rate of the SII≥395 group was 80.0%, which was significantly worse than that (92.7%) of the SII<395 group (p<0.001). The multivariate analysis identified SII≥395 (Hazard ratio [HR] 3.016; 95% confidence interval [CI] 1.593-6.262; p<0.001), carcinoembryonic antigen≥5.0 (HR 2.224, 95% CI 1.128-4.100), pT4 (HR 4.554, 95% CI 2.525-8.234), and pN+ (HR 3.621, 95% CI 1.916-7.074) as independent predictors of worse OS. Peritoneal recurrence was more frequent in the high SII group than in the low SII group (p=0.028).Conclusion Preoperative SII may be a useful predictor of postoperative survival outcomes in GC. The meticulous surveillance of GC relapse, particularly peritoneal dissemination, is necessary for patients with SII≥395 even after curative gastrectomy.

scholarly journals CT-Based Radiomics Helps to Predict Residual Lung Lesions in COVID-19 Patients at Three Months after Discharge

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1814
Author(s):  
Jia Huang ◽  
Feihong Wu ◽  
Leqing Chen ◽  
Jie Yu ◽  
Wengang Sun ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Lung Region ◽  
Training Set ◽  
Test Set ◽  
Psychological Burden ◽  
Lung Lesions ◽  
Model Based ◽  
Entire Lung

Background: In this study, our focus was on pulmonary sequelae of coronavirus disease 2019 (COVID-19). We aimed to develop and validate CT-based radiomic models for predicting the presence of residual lung lesions in COVID-19 survivors at three months after discharge. Methods: We retrospectively enrolled 162 COVID-19 confirmed patients in our hospital (84 patients with residual lung lesions and 78 patients without residual lung lesions, at three months after discharge). The patients were all randomly allocated to a training set (n = 114) or a test set (n = 48). Radiomic features were extracted from chest CT images in different regions (entire lung or lesion) and at different time points (at hospital admission or at discharge) to build different models, sequentially, or in combination, as follows: (1) Lesion_A model (based on the lesion region at admission CT); (2) Lesion_D model (based on the lesion region at discharge CT); (3) Δlesion model (based on the lesion region at admission CT and discharge CT); (4) Lung_A model (based on the lung region at admission CT); (5) Lung_D model (based on the lung region at discharge CT); (6) Δlung model (based on the lung region at admission CT and discharge CT). The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the predictive performances of the radiomic models. Results: Among the six models, the Lesion_D and the Δlesion models achieved better predictive efficacy, with AUCs of 0.907 and 0.927, sensitivity of 0.898 and 0.763, and specificity of 0.855 and 0.964 in the training set, and AUCs of 0.875 and 0.837, sensitivity of 0.920 and 0.680, and specificity of 0.826 and 0.913 in the test set, respectively. Conclusions: The CT-based radiomic models showed good predictive effects on the presence of residual lung lesions in COVID-19 survivors at three months after discharge, which may help doctors to plan follow-up work and to reduce the psychological burden of COVID-19 survivors.

scholarly journals Changes and prognostic impact of inflammatory nutritional factors during neoadjuvant chemoradiotherapy for patients with resectable and borderline resectable pancreatic cancer

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Minoru Oshima ◽  
Keiichi Okano ◽  
Hironobu Suto ◽  
Yasuhisa Ando ◽  
Hideki Kamada ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Prognostic Score ◽  
Neoadjuvant Chemoradiotherapy ◽  
Glasgow Prognostic Score ◽  
Ductal Adenocarcinoma ◽  
Prognostic Impact ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Nutritional Factors ◽  
Neutrophil Lymphocyte Ratio

Abstract Background Inflammatory nutritional factors, such as the neutrophil/lymphocyte ratio (NLR), Glasgow Prognostic Score (GPS), modified GPS (mGPS), and C-reactive protein/albumin (CRP/Alb) ratio, have prognostic values in many types of cancer. In this study, the prognostic values of inflammatory nutritional scores were evaluated in the patients with resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant chemoradiotherapy (NACRT). Methods A total of 49 patients who underwent pancreatectomy after NACRT from September 2009 to May 2016 were enrolled. The NACRT consisted of hypofractionated external-beam radiotherapy (30 Gy in 10 fractions) with concurrent S-1 (60 mg/m2) delivered 5 days/week for 2 weeks before pancreatectomy. Inflammatory nutritional scores were determined before and after NACRT in this series. Results The median NLR increased after NACRT (from 2.067 to 3.302), with statistical difference (p < 0.001). In multivariate analysis, high pre-NACRT mGPS (2 or 1; p = 0.0478) and significant increase in CRP/Alb ratio after NACRT (≧ 0.077; p = 0.0036) were associated with shorter overall survival. All patients were divided into two groups according to the ΔCRP/Alb ratio after NACRT: the group with high ΔCRP/Alb ratio (≧ 0.077) and the group with low ΔCRP/Alb ratio (< 0.077). The group with high ΔCRP/Alb ratio after NACRT (n = 13) not only had higher post-NACRT CRP levels (p < 0.001) but also had lower post-NACRT Alb levels (p = 0.002). Patients in the group with high ΔCRP/Alb ratio lost more body weight during NACRT (p = 0.03). Conclusion In addition to pre-NACRT mGPS, ΔCRP/Alb after NACRT could provide prognostic value in the patients with PDAC treated by NACRT.

Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas

2020 ◽  
pp. 028418512097362
Author(s):  
Xiefeng Yang ◽  
Yu Lin ◽  
Zhen Xing ◽  
Dejun She ◽  
Yan Su ◽  
...  
Keyword(s):  
Predictive Value ◽  
Operating Characteristic ◽  
Cerebral Blood Volume ◽  
Characteristic Curve ◽  
Lower Grade ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Conventional Mri ◽  
Susceptibility Contrast ◽  
Sensitivity Specificity

Background Isocitrate dehydrogenase (IDH)-mutant lower-grade gliomas (LGGs) are further classified into two classes: with and without 1p/19q codeletion. IDH-mutant and 1p/19q codeleted LGGs have better prognosis compared with IDH-mutant and 1p/19q non-codeleted LGGs. Purpose To evaluate conventional magnetic resonance imaging (cMRI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) for predicting 1p/19q codeletion status of IDH-mutant LGGs. Material and Methods We retrospectively reviewed cMRI, DWI, SWI, and DSC-PWI in 142 cases of IDH mutant LGGs with known 1p/19q codeletion status. Features of cMRI, relative ADC (rADC), intratumoral susceptibility signals (ITSSs), and the value of relative cerebral blood volume (rCBV) were compared between IDH-mutant LGGs with and without 1p/19q codeletion. Receiver operating characteristic curve and logistic regression were used to determine diagnostic performances. Results IDH-mutant and 1p/19q non-codeleted LGGs tended to present with the T2/FLAIR mismatch sign and distinct borders ( P < 0.001 and P = 0.038, respectively). Parameters of rADC, ITSSs, and rCBVmax were significantly different between the 1p/19q codeleted and 1p/19q non-codeleted groups ( P < 0.001, P = 0.017, and P < 0.001, respectively). A combination of cMRI, SWI, DWI, and DSC-PWI for predicting 1p/19q codeletion status in IDH-mutant LGGs resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and an AUC of 80.36%, 78.57%, 83.30%, 75.00%, and 0.88, respectively. Conclusion 1p/19q codeletion status of IDH-mutant LGGs can be stratified using cMRI and advanced MRI techniques, including DWI, SWI, and DSC-PWI. A combination of cMRI, rADC, ITSSs, and rCBVmax may improve the diagnostic performance for predicting 1p/19q codeletion status.

scholarly journals Feasibility and Validity of Computed Tomography-Derived Fractional Flow Reserve in Patients With Severe Aortic Stenosis

2020 ◽  
Author(s):  
Michael Michail ◽  
Abdul-Rahman Ihdayhid ◽  
Andrea Comella ◽  
Udit Thakur ◽  
James D. Cameron ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Diagnostic Accuracy ◽  
Operating Characteristic ◽  
Severe Aortic Stenosis ◽  
Characteristic Curve ◽  
Fractional Flow ◽  
Predictive Values ◽  
Flow Reserve ◽  
Artery Disease ◽  
Sensitivity Specificity

Background: Coronary artery disease is common in patients with severe aortic stenosis. Computed tomography-derived fractional flow reserve (CT-FFR) is a clinically used modality for assessing coronary artery disease, however, its use has not been validated in patients with severe aortic stenosis. This study assesses the safety, feasibility, and validity of CT-FFR in patients with severe aortic stenosis. Methods: Prospectively recruited patients underwent standard-protocol invasive FFR and coronary CT angiography (CTA). CTA images were analyzed by central core laboratory (HeartFlow, Inc) for independent evaluation of CT-FFR. CT-FFR data were compared with FFR (ischemia defined as FFR ≤0.80). Results: Forty-two patients (68 vessels) underwent FFR and CTA; 39 patients (92.3%) and 60 vessels (88.2%) had interpretable CTA enabling CT-FFR computation. Mean age was 76.2±6.7 years (71.8% male). No patients incurred complications relating to premedication, CTA, or FFR protocol. Mean FFR and CT-FFR were 0.83±0.10 and 0.77±0.14, respectively. CT calcium score was 1373.3±1392.9 Agatston units. On per vessel analysis, there was positive correlation between FFR and CT-FFR (Pearson correlation coefficient, R =0.64, P <0.0001). Sensitivity, specificity, positive predictive value, and negative predictive values were 73.9%, 78.4%, 68.0%, and 82.9%, respectively, with 76.7% diagnostic accuracy. The area under the receiver-operating characteristic curve for CT-FFR was 0.83 (0.72–0.93, P <0.0001), which was higher than that of CTA and quantitative coronary angiography ( P =0.01 and P <0.001, respectively). Bland-Altman plot showed mean bias between FFR and CT-FFR as 0.059±0.110. On per patient analysis, the sensitivity, specificity, positive predictive, and negative predictive values were 76.5%, 77.3%, 72.2%, and 81.0% with 76.9% diagnostic accuracy. The per patient area under the receiver-operating characteristic curve analysis was 0.81 (0.67–0.95, P <0.0001). Conclusions: CT-FFR is safe and feasible in patients with severe aortic stenosis. Our data suggests that the diagnostic accuracy of CT-FFR in this cohort potentially enables its use in clinical practice and provides the foundation for future research into the use of CT-FFR for coronary evaluation pre-aortic valve replacement.

scholarly journals Utility of Thrombin Time in Management of Patients with Green Pit Vipers Bite

2020 ◽  
Vol 8 ◽  
pp. 205031212096646
Author(s):  
Achara Tongpoo ◽  
Pimjai Niparuck ◽  
Charuwan Sriapha ◽  
Winai Wananukul ◽  
Satariya Trakulsrichai
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Fibrinogen Level ◽  
Characteristic Curve ◽  
International Normalized Ratio ◽  
Thrombin Time ◽  
Coagulation Tests ◽  
Sensitivity Specificity ◽  
Gold Standards

Objectives: GGreen pit vipers (GPV) envenomation causes consumptive coagulopathy mainly by thrombin-like enzymes. Fibrinogen levels are generally investigated to help evaluate systemic envenomation. However, tests of fibrinogen levels may not be available in every hospital. This study aimed to determine the sensitivity, specificity and accuracy for a range of various coagulation tests (20 minute whole blood clotting test (20WBCT), prothrombin time, international normalized ratio and thrombin time (TT)), comparing to the two gold standards performed in patients with GPV bite. Methods: This was the pilot study which we retrospectively reviewed fibrinogen level results including the hospital records of 24 GPV ( Trimeresurus albolabris or macrops) bite patients visiting Ramathibodi Hospital, Thailand during 2013–2017 with 65 results of fibrinogen levels. The fibrinogen levels <164 and <100 mg/dL were used as the standard cut-off points or gold standards as the abnormal low and critical levels, respectively. Results: Most were male. All had local effects. For fibrinogen levels <164 and <100 mg/dL, prolonged TT had the highest sensitivity of 57.1% and 82.4%; the negative predictive value of 74.5% and 93.6%; the accuracy of 81.0% and 92.1%; and the area under a receiver operating characteristic curve of 0.762 and 0.873, respectively. For fibrinogen levels <164, unclotted 20WBCT and prolonged TT had the highest specificity and positive predictive value of 100% all. For fibrinogen levels <100, unclotted 20WBCT had the highest specificity and positive predictive value of 100% both, while prolonged TT had the specificity and positive predictive value of 95.7% and 87.5%, respectively. One patient developed isolated thrombocytopenia without hypofibrinogenemia and coagulopathy. Conclusions: Among four coagulation tests, TT was the most sensitive and accurate test to indicate hypofibrinogenemia in GPV bite patients. In case of unavailable fibrinogen levels thrombin time might be investigated to help evaluate patients’ fibrinogen status. Isolated thrombocytopenia could occur in GPV envenomation.

scholarly journals Prognostic Impact of Macroscopic Complete Resection and Inflammatory Status for Colorectal Cancer With Peritoneal Dissemination

2018 ◽  
Vol 103 (7-8) ◽  
pp. 331-338
Author(s):  
Satoru Yamaguchi ◽  
Keisuke Ihara ◽  
Yosuke Shida ◽  
Haruka Yokoyama ◽  
Hideo Ogata ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Peritoneal Metastasis ◽  
Peritoneal Dissemination ◽  
Prognostic Score ◽  
Case Series ◽  
Glasgow Prognostic Score ◽  
Carbohydrate Antigen ◽  
Complete Resection ◽  
Prognostic Impact ◽  
Inflammatory Status

Objective: To clarify the appropriate treatment policy for colorectal cancer with peritoneal metastasis, case series were analyzed retrospectively. Summary of background data: The frequency of colorectal cancer and peritoneal dissemination occurring simultaneously is 4% to 7%. The prevention of peritoneal metastasis and the development of a strategy for cure are considered important factors in improving the treatment outcome of colorectal cancer. Methods: A total of 60 patients with colorectal cancer with peritoneal dissemination were enrolled in this study. Tumor and host condition characteristics and treatment regimens affecting patient survival were tested by using Kaplan-Meier survival analysis. Results: Histologic type, carbohydrate antigen 19-9, macroscopic complete resection, and Glasgow Prognostic Score were found to be independent prognostic factors for overall survival. Conclusions: Peritoneal carcinomatosis can result in better patient prognoses in patients with well-differentiated carcinoma, less peritoneal spread, low levels of tumor markers, and a low Glasgow Prognostic Score. In these patients, curative resection of peritoneal metastases followed by intensive chemotherapy might be effective.

scholarly journals Variables Affecting Peri-Implant Radiographic Bone Loss-8-23 Years Follow-Up

2020 ◽  
Vol 10 (23) ◽  
pp. 8591
Author(s):  
Michael Saminsky ◽  
Anat Ben Dor ◽  
Jacob Horwitz
Keyword(s):  
Bone Loss ◽  
Goodness Of Fit ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Factors Associated ◽  
Implant Placement ◽  
Dental Records

The aim of this study is to evaluate factors associated with long-term peri-implant bone-loss and to create a statistical model explaining bone-loss. The dental records in a private periodontal practice were screened for implant-patients with a minimal follow-up period of 8 years with periapical radiographs at implant-placement (T0) and last follow-up (Tf). Collected data included demographics, general health, medications, periodontal parameters, implant parameters, bone augmentation procedures, restoration and antagonist data, number of supportive periodontal appointments (SPT), and radiographic bone-loss between T0 and Tf. Bivariate and Mixed Logistic Regression analyses were performed. “Goodness-of-fit” of the model was elaborated with Receiver Operating Characteristic Curve (ROC) analyses. Thirty-seven patients receiving 142 implants were included. Mean clinical follow-up period was 11.7 ± 3.7 years (range 8–23). Most implants 64.4% were SPT-maintained more than twice a year. Patients with osteoporosis and smokers were prone to increased radiographic peri-implant bone-loss. External-hex implants placed without guided bone regeneration (GBR) and implants 10–12 mm long and diameter of 3.7–4 mm showed less peri-implant bone-loss. The model’s Area Under the Curve (AUC) was 76.9% (Standard Error 4.6%, CI 67.8%–86%).

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