scholarly journals A CT-Based Radiomic Signature Can Be Prognostic for 10-Months Overall Survival in Metastatic Tumors Treated with Nivolumab: An Exploratory Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 979
Author(s):  
Valentina D. A. Corino ◽  
Marco Bologna ◽  
Giuseppina Calareso ◽  
Lisa Licitra ◽  
Mariagrazia Ghi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Practice ◽  
Tumor Volume ◽  
Performance Status ◽  
Intraclass Correlation ◽  
Practice Volume ◽  
Support Vector ◽  
Lesion Volume ◽  
Volume Number ◽  
Total Tumor Volume

Baseline clinical prognostic factors for recurrent and/or metastatic (RM) head and neck squamous cell carcinoma (HNSCC) treated with immunotherapy are lacking. CT-based radiomics may provide additional prognostic information. A total of 85 patients with RM-HNSCC were enrolled for this study. For each tumor, radiomic features were extracted from the segmentation of the largest tumor mass. A pipeline including different feature selection steps was used to train a radiomic signature prognostic for 10-month overall survival (OS). Features were selected based on their stability to geometrical transformation of the segmentation (intraclass correlation coefficient, ICC > 0.75) and their predictive power (area under the curve, AUC > 0.7). The predictive model was developed using the least absolute shrinkage and selection operator (LASSO) in combination with the support vector machine. The model was developed based on the first 68 enrolled patients and tested on the last 17 patients. Classification performance of the radiomic risk was evaluated accuracy and the AUC. The same metrics were computed for some baseline predictors used in clinical practice (volume of largest lesion, total tumor volume, number of tumor lesions, number of affected organs, performance status). The AUC in the test set was 0.67, while accuracy was 0.82. The performance of the radiomic score was higher than the one obtainable with the clinical variables (largest lesion volume: accuracy 0.59, AUC = 0.55; number of tumoral lesions: accuracy 0.71, AUC 0.36; number of affected organs: accuracy 0.47; AUC 0.42; total tumor volume: accuracy 0.59, AUC 0.53; performance status: accuracy 0.41, AUC = 0.47). Radiomics may provide additional baseline prognostic value compared to the variables used in clinical practice.

Comparison of Total Tumor Volume, Size and Number of Colorectal Liver Metastases in Prediction of Survival in Patients after Liver Resection

2015 ◽  
Vol 87 (2) ◽  
Author(s):  
Wacław Hołówko ◽  
Michał Grąt ◽  
Karolina Maria Wronka ◽  
Jan Stypułkowski ◽  
Rafał Roszkowski ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Resection ◽  
Liver Metastases ◽  
Predictive Value ◽  
Colorectal Liver Metastases ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Total Tumor Volume ◽  
Right Hemihepatectomy ◽  
Volume Size

AbstractLiver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease.The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy.Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve.Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively.Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatment

scholarly journals Gamma Knife radiosurgery for brain metastasis: review of 103 patients

2009 ◽  
Vol 28 (04) ◽  
pp. 133-138
Author(s):  
Marcos Antônio Dellaretti Filho ◽  
George de Albuquerque Cavalcanti Mendes ◽  
Nicolas Reyns ◽  
Gustavo Touzet ◽  
François Dubois ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastasis ◽  
Gamma Knife ◽  
Local Control ◽  
Tumor Volume ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Gamma Knife Radiosurgery ◽  
Intracranial Metastasis ◽  
Free Survival

Abstract Objective: To assess clinical and imaging outcomes in patients treated with Gamma Knife stereotactic radiosurgery (SRS) for brain metastasis. Methods: One hundred and three patients with 158 intracranial metastasis consecutively underwent Gamma Knife SRS between January, 2004 and December, 2006. The results were based on last imaging and the date of the last visit. Average age of the patients was 56 years (range 32-84 years). Karnofsky performance status average was 87.6. Fifty-eight (56.3%) patients had single brain metastasis. The average tumor volume was 2.5cc (range 0.02-16.6 cc). The SRS marginal dose average was 23.4 Gy (range 15-25 Gy). Results: Treatment sequence was SRS alone (89 patients) or SRS plus whole-brain radiotherapy (WBRT) (14 patients). The 1-year local control was 80%, being better for tumors with volume <5cc than for ≥5 cc: 86% vs 53% (p<0.05). The 1-year distant brain metastasis-free survival incidence was 73%. The initial number of brain lesions (single vs multiple) was not a significant factor on distant brain metastasis: free survival at 1 year was 75% for single metastases and 70% for multiple lesions. Renal cancer was the only factor with a significant effect on distant brain metastasis. The median overall survival was 15 months. According to unifactorial and multifactorial analysis, three prognostic factors for overall survival were retrieved recursive partitioning analysis (RPA) class, Karnofsky index performance and tumor volume. Conclusion: In this series, SRS provided excellent local control with relatively low morbidity in patients with brain metastases.

scholarly journals RADI-09. DEFINING PROGRESSION IN PATIENTS TREATED WITH TEN OR MORE BRAIN METASTASES FOLLOWING STEREOTACTIC RADIOSURGERY

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i23-i23
Author(s):  
Sirisha Devi Viswanatha ◽  
Zaker Rana ◽  
Matthew Ehrlich ◽  
Michael Schulder ◽  
Anuj Goenka
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Tumor Control ◽  
Initial Increase ◽  
Lesion Volume ◽  
Brain Volumes ◽  
Mri Scans

Abstract BACKGROUND: An increasing trend has been to elect for Stereotactic Radiosurgery (SRS) for the treatment of brain metastases. Progression following treatment is typically defined as a 20% increase in the initial lesion volume treated. Challenges in defining progression can arise as the reported incidence of pseudoprogression or radiation necrosis following treatment ranges from 5%-30%. The purpose of this study was to assess patterns of failure in patients treated with 10 or more brain metastases. METHODS: From March 2014 to April 2018, fifty-five patients with 10 or more total brain metastases were retrospectively reviewed following frame-based radiosurgery to a dose of 12–20 Gy. Post-treatment MRI scans were used to assess tumor response in 3 month intervals. Tumor control was defined as tumor volume ≤ 1.2 times the baseline tumor volume at each measured interval. RESULTS: Fifty-five patients received 75 total radiosurgery treatments to 692 tumors. Forty patients received synchronous treatment, while 15 received metachronous treatment. 20 patients (36%) and 72 tumors (10%) experienced progression following treatment. 46 tumors were larger after first MRI in 15 patients (28%). Of these 15 patients, eight had complete resolution in 15 tumors on subsequent scan. Of the eight patients who had resolution, six patients received immunotherapy during and after treatment and all but one patient saw an initial increase &gt;100% of their initial tumor volume. Median overall survival was 11 months. Univariate analysis revealed an association between larger brain volumes irradiated with 12 Gy and decreased overall survival (p &lt; 0.05). CONCLUSION: It is important to consider tumor growth velocity and concurrent therapy when assessing true progression after SRS treatment of brain metastases.

scholarly journals Role of 3D quantitative tumor analysis for predicting overall survival after conventional chemoembolization of intrahepatic cholangiocarcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Irvin Rexha ◽  
Fabian Laage-Gaupp ◽  
Julius Chapiro ◽  
Milena Anna Miszczuk ◽  
Johanna Maria Mijntje van Breugel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Volume ◽  
Liver Volume ◽  
Tumor Burden ◽  
Tumor Diameter ◽  
Cross Sectional ◽  
Total Tumor Volume ◽  
Tumor Area

AbstractThis study was designed to assess 3D vs. 1D and 2D quantitative tumor analysis for prediction of overall survival (OS) in patients with Intrahepatic Cholangiocarcinoma (ICC) who underwent conventional transarterial chemoembolization (cTACE). 73 ICC patients who underwent cTACE were included in this retrospective analysis between Oct 2001 and Feb 2015. The overall and enhancing tumor diameters and the maximum cross-sectional and enhancing tumor areas were measured on baseline images. 3D quantitative tumor analysis was used to assess total tumor volume (TTV), enhancing tumor volume (ETV), and enhancing tumor burden (ETB) (ratio between ETV and liver volume). Patients were divided into low (LTB) and high tumor burden (HTB) groups. There was a significant separation between survival curves of the LTB and HTB groups using enhancing tumor diameter (p = 0.003), enhancing tumor area (p = 0.03), TTV (p = 0.03), and ETV (p = 0.01). Multivariate analysis showed a hazard ratio of 0.46 (95%CI: 0.27–0.78, p = 0.004) for enhancing tumor diameter, 0.56 (95% CI 0.33–0.96, p = 0.04) for enhancing tumor area, 0.58 (95%CI: 0.34–0.98, p = 0.04) for TTV, and 0.52 (95%CI: 0.30–0.91, p = 0.02) for ETV. TTV and ETV, as well as the largest enhancing tumor diameter and maximum enhancing tumor area, reliably predict the OS of patients with ICC after cTACE and could identify ICC patients who are most likely to benefit from cTACE.

Quantitative volumetric assessment of baseline enhancing tumor volume as an imaging biomarker predicts overall survival in patients with glioblastoma

2020 ◽  
pp. 028418512095379
Author(s):  
Timo A Auer ◽  
Marta Della Seta ◽  
Federico Collettini ◽  
Julius Chapiro ◽  
Sebastian Zschaeck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Methyltransferase ◽  
Tumor Volume ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Imaging Biomarker ◽  
Entire Cohort ◽  
Volumetric Assessment

Background Glioblastoma multiforme (GBM) is the commonest malignant primary brain tumor and still has one of the worst prognoses among cancers in general. There is a need for non-invasive methods to predict individual prognosis in patients with GBM. Purpose To evaluate quantitative volumetric tissue assessment of enhancing tumor volume on cranial magnetic resonance imaging (MRI) as an imaging biomarker for predicting overall survival (OS) in patients with GBM. Material and Methods MRI scans of 49 patients with histopathologically confirmed GBM were analyzed retrospectively. Baseline contrast-enhanced (CE) MRI sequences were transferred to a segmentation-based three-dimensional quantification tool, and the enhancing tumor component was analyzed. Based on a cut-off percentage of the enhancing tumor volume (PoETV) of >84.78%, samples were dichotomized, and the OS and intracranial progression-free survival (PFS) were evaluated. Univariable and multivariable analyses, including variables such as sex, Karnofsky Performance Status score, O6-methylguanine-DNA-methyltransferase status, age, and resection status, were performed using the Cox regression model. Results The median OS and PFS were 16.9 and 7 months in the entire cohort, respectively. Patients with a CE tumor volume of >84.78% showed a significantly shortened OS (12.9 months) compared to those with a CE tumor volume of ≤84.78% (17.7 months) (hazard ratio [HR] 2.72; 95% confidence interval [CI] 1.22–6.03; P = 0.01). Multivariable analysis confirmed that PoETV had a significant prognostic role (HR 2.47; 95% CI 1.08–5.65; P = 0.03). Conclusion We observed a correlation between PoETV and OS. This imaging biomarker may help predict the OS of patients with GBM.

Evaluation of imatinib mesylate (IM) in patients with large volume gastrointestinal stromal tumors (GISTs)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10054-10054 ◽  
Author(s):  
D. M. Byrd ◽  
G. D. Demetri ◽  
H. Joensuu ◽  
M. von Mehren ◽  
M. Heinrich ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Volume ◽  
Cox Regression ◽  
Performance Status ◽  
Tumor Burden ◽  
Overall Response ◽  
Kaplan Meier ◽  
Dose Levels ◽  
The Relationship ◽  
Baseline Hemoglobin

10054 Background: GIST size is one of the most important prognostic markers for recurrence and poor survival. However, little information exists regarding the relationship between tumor volume and clinical outcome after treatment with IM. A phase II randomized clinical trial of two dose levels of IM (400 vs. 600 mg daily) in pts with incurable GIST was previously presented (Proc ASCO 2001; Combined GI Symp 2004 and 2007). With median follow-up of 64 months, we report additional analyses of the relationship between tumor volume and IM efficacy. Methods: Data on initial tumor bulk were prospectively collected, and 146 pts were separated into quartiles according to total tumor volume: < 39.1 cm2 (n=36), 39.1 = 102.16 cm2 (n=37), 102.16 = 262.6 cm2 (n=36), = 262.6 cm2 (n=37). Tumor bulk was correlated with standard efficacy outcomes. Results: The overall response rate (CR + PR) for all pts was 68.1% (95% CI 59.8% - 75.5%). Median time-to-progression (TTP) was 24 months, and overall survival (OS) was 57 months. The overall response rates for the four quartiles according to tumor burden (lowest to highest) were: 64%, 70%, 75%, and 65% respectively. Median TTP by quartile was: 57, 25, 18, and 17 months. Median OS for these same groups: not reached, 57, 47, and 35 months. The Kaplan-Meier estimates of patients alive at 64 months based on tumor bulk were 62%, 40%, 44%, and 31% respectively. Disease bulk was an independent prognostic factor for overall survival using a Cox regression model including sex, performance status, IM dose, gender, age, prior chemotherapy, and tumor volume, but not when baseline hemoglobin was included. Conclusions: Pts with bulky GISTs progress sooner and die more quickly than those with lesser tumor volumes, though other factors may contribute as well. Even pts with the bulkiest tumors frequently respond to treatment with IM, however. TTP for this population approaches 1.5 yrs, and median survival for these pts approximates 3 yrs. One-third of pts with extraordinarily bulky GISTs are long-term survivors. The potential relationship between baseline hemoglobin and tumor bulk requires further investigation. [Table: see text]

scholarly journals PSMA PET total tumor volume predicts outcome of patients with advanced prostate cancer receiving [177Lu]Lu-PSMA-617 radioligand therapy in a bicentric analysis

2020 ◽  
Author(s):  
Robert Seifert ◽  
Katharina Kessel ◽  
Katrin Schlack ◽  
Manuel Weber ◽  
Ken Herrmann ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Tumor Volume ◽  
Cox Regression ◽  
Radioligand Therapy ◽  
Total Tumor Volume ◽  
Psma Pet ◽  
Pet Ct ◽  
Lesion Number ◽  
Patients At Risk

Abstract Introduction [177Lu]Lu-PSMA-617 (Lu-PSMA) radioligand therapy is an emerging treatment option for patients with end-stage prostate cancer. However, response to Lu-PSMA therapy is only achieved in approximately half of patients. It is clinically important to identify patients at risk of poor outcome. Therefore, the aim of this study was to evaluate pretherapeutic PSMA PET derived total tumor volume and related metrics as prognosticators of overall survival in patients receiving Lu-PSMA therapy. Methods A total number of 110 patients form the Departments of Nuclear Medicine Münster and Essen were included in this retrospective analysis. Baseline PSMA PET-CT was available for all patients. Employing a previously published approach, all tumor lesions were semi-automatically delineated in PSMA PET-CT acquisitions. Total lesion number, total tumor volume (PSMA-TV), total lesion uptake (PSMA-TLU = PSMA-TV * SUVmean), and total lesion quotient (PSMA-TLQ = PSMA-TV / SUVmean) were quantified for each patient. Log2 transformation was used for regressions. Results Lesion number, PSMA-TV, and PSMA-TLQ were prognosticators of overall survival (HR = 1.255, p = 0.009; HR = 1.299, p = 0.005; HR = 1.326, p = 0.002). In a stepwise backward Cox regression including lesion number, PSMA-TV, PSA, LDH, and PSMA-TLQ, only the latter two remained independent and statistically significant negative prognosticators of overall survival (HR = 1.632, p = 0.011; HR = 1.239, p = 0.024). PSMA-TLQ and LDH were significant negative prognosticators in multivariate Cox regression in contrast to PSA value. Conclusion PSMA-TV was a statistically significant negative prognosticator of overall survival in patients receiving Lu-PSMA therapy. PSMA-TLQ was an independent and superior prognosticator of overall survival compared with PSMA-TV.

Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery

2013 ◽  
Vol 119 (5) ◽  
pp. 1139-1144 ◽  
Author(s):  
Andrew M. Baschnagel ◽  
Kurt D. Meyer ◽  
Peter Y. Chen ◽  
Daniel J. Krauss ◽  
Rick E. Olson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Brain Metastases ◽  
Local Control ◽  
Tumor Volume ◽  
Continuous Variable ◽  
Total Tumor Volume ◽  
Extracranial Disease ◽  
Brain Failure ◽  
Distant Brain Failure

Object The aim of this study was to examine tumor volume as a prognostic factor for patients with brain metastases treated with Gamma Knife surgery (GKS). Methods Two hundred fifty patients with 1–14 brain metastases who had initially undergone GKS alone at a single institution were retrospectively reviewed. Patients who received upfront whole brain radiation therapy were excluded. Survival times were estimated using the Kaplan-Meier method. Univariate and multivariate analyses using Cox proportional hazard regression models were used to determine if various prognostic factors could predict overall survival, distant brain failure, and local control. Results Median overall survival was 7.1 months and the 1-year local control rate was 91.5%. Median time to distant brain failure was 8.0 months. On univariate analysis an increasing total tumor volume was significantly associated with worse survival (p = 0.031) whereas the number of brain metastases, analyzed as a continuous variable, was not (p = 0.082). After adjusting for age, Karnofsky Performance Scale score, and extracranial disease on multivariate analysis, total tumor volume was found to be a better predictor of overall survival (p = 0.046) than number of brain metastases analyzed as a continuous variable (p = 0.098). A total tumor volume cutoff value of ≥ 2 cm3 (p = 0.008) was a stronger predictor of overall survival than the number of brain metastases (p = 0.098). Larger tumor volume and extracranial disease, but not the number of brain metastases, were predictive of distant brain failure on multivariate analysis. Local tumor control at 1 year was 97% for lesions < 2 cm3 compared with 75% for lesions ≥ 2 cm3 (p < 0.001). Conclusions After adjusting for other factors, a total brain metastasis volume was a strong and independent predictor for overall survival, distant brain failure, and local control, even when considering the number of metastases.

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