Elevated preoperative levels of CA 19-9 and CA 125 predicts overall survival time in the pancreatic adenocarcinoma. Single institution series.

Background: Pancreatic cancer is a devastating disease, being the fourth cause of cancer-related death worldwide. Several studies have investigated the use of multiple cancer biomarkers, such as C 19-9, CA 125, and CEA, as prognostic factors for overall survival in pancreatic cancer. CA 125 seems to have superior predictive utility in selected groups of PDAC patients. Material and methods: We retrospectively analyzed data collected from 129 patients admitted to our Department due to diagnosis with pancreatic cancer. Prior to the survival analysis, the preliminary assessment of pre-treatment levels of biomarkers was carried out. The overall survival time was defined as that elapsing from the admission date to the date of death. Results: The patients mean age was 62 +/- 9.5 years, while the median overall survival (OS) was 7mo 12d. As for tumor localization, most of the patients had PDAC within the head of the pancreas (n=93), followed by PDAC of the pancreatic body (n=15), pancreatic tail (n=14) and both pancreatic body and tail (n=7). Ninety-five patients had an unresectable tumor and 34 were diagnosed with a resectable tumor (tab.1). The statistically significant correlation was found for CA 125 (ρ=-0.355 p<0.001) and CA 19-9 (ρ=-0.225 p=0.012). We chose the following cut-off points: CA 125>=20 IU/mL was considered as high, and CA 19-9>=200 IU/mL as significantly elevated. In the univariate analysis in the Kaplan-Meier survival model, adjusted for age, both elevated biomarkers were statistically significant prognostic factors of OS (CA 125<20 median OS- 10mo 3d vs. CA 125>=20- 4mo 17d p=0.001) and (CA19-9<200 median OS- 8mo 3d vs. CA 19-9>=200- 4mo 20d p=0.001). Patients’ gender and, PDAC resectability and its localization were not statistically significant prognostic factors (log rank test p=0.8; p=0.108 and p=0.578 respectively). In the age-adjusted multivariate analysis, both biomarkers remained significant- CA 125>=20 (HR: 1.73 95%CI 1.27-2.58 p=0.006) CA 19-9>=200 (HR: 1.78 95%CI 1.19-2.66 p=0.005) Conclusions: Our study proves the utility of the pretreatment assessment of CA 125 because its level is tightly correlated with OS. It may be hypothesized that the pretreatment measurement of both CA 19-9 and CA 125 can provide the valuable information about patients’ prognosis.

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Comparison between clinical features and prognosis of malignancy- and non-malignancy–associated pediatric hemophagocytic lymphohistiocytosis

BMC Pediatrics ◽

10.1186/s12887-019-1702-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Hua Pan ◽

Yongmin Huo ◽

Lirong Sun

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Survival Time ◽

Clinical Features ◽

Hemophagocytic Lymphohistiocytosis ◽

Clinical Characteristics ◽

Univariate Analysis ◽

Control Group ◽

Survival Times ◽

Overall Survival Time

Abstract Background The differences between the clinical characteristics and survival time in malignancy- and non-malignancy–associated secondary hemophagocytic lymphohistiocytosis (HLH) are unclear. Here, we describe the clinical characteristics, prognostic factors, and survival outcomes of malignancy-associated HLH compared to that of non-malignancy–associated HLH. Methods We retrospectively analyzed 91 pediatric patients with HLH (age < 14 years) at the Affiliated Hospital of Qingdao University Pediatric Department between January 2005 and October 2016. The patients were divided into the malignancy-associated group (n = 22) and non-malignancy–associated group (n = 69, also considered the control group). The clinical features were compared using the Mann–Whitney U and χ2 tests. The overall survival time was compared using log rank and Mann–Whitney U tests. Results Hemoglobin (HGB; p = 0.004), alanine aminotransferase (ALT; p = 0.002), and aspartate aminotransferase (AST; p = 0.001) levels in the malignancy-associated group differed from that in the non-malignancy–associated group. The mean survival times were 26.9 ± 3.82 months (malignancy-associated HLH) and 35.03 ± 2.19 months (non-malignancy–associated HLH). The overall survival time between the two groups was not statistically significantly different (p = 0.055). Univariate analysis showed that disseminated intravascular coagulation (DIC) score > 5 (p = 0.001), albumin < 25 g/L (p = 0.000), HGB < 60 g/L (p = 0.001), and platelet count (PLT) < 30 × 109/L (p = 0.042) correlated with prognosis. Multivariate Cox analysis showed that albumin < 25 g/L (p = 0.017), HGB < 60 g/L (p = 0.027), and bone marrow hemophagocytosis (p = 0.034) correlated with worse prognosis. Conclusions Patients with non-malignancy–associated HLH do not have better survival, although their prognosis is relatively better in clinical practice. A higher DIC score at diagnosis and lower albumin, HGB, and PLT levels are negative prognostic factors in malignancy-associated HLH.

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Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

Innovative Surgical Sciences ◽

10.1515/iss-2020-0030 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Andrés Moreno Roca ◽

Luciana Armijos Acurio ◽

Ruth Jimbo Sotomayor ◽

Carlos Céspedes Rivadeneira ◽

Carlos Rosero Reyes ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Survival Time ◽

Univariate Analysis ◽

Rank Test ◽

Kaplan Meier ◽

Significant Difference ◽

Icd 10 ◽

The Difference ◽

Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

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Comparison of ADAM19 and CUEDC2 expression in EHCC and their clinicopathological significance

Biomarkers in Medicine ◽

10.2217/bmm-2020-0321 ◽

2020 ◽

Vol 14 (16) ◽

pp. 1573-1584

Author(s):

Shu Xu ◽

Shengfu Huang ◽

Daiqiang Li ◽

Qiong Zou ◽

Yuan Yuan ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Survival Time ◽

Biliary Tract ◽

Extrahepatic Cholangiocarcinoma ◽

Positive Correlation ◽

Overall Survival Time ◽

Positive Expression ◽

Dismal Prognosis ◽

Clinicopathological Significance

Background: To evaluate the expression and clinicopathological significance of a disintegrin and metalloproteinases 19 (ADAM19) CUE domain containing protein 2 (CUEDC2) in extrahepatic cholangiocarcinoma (EHCC). Materials & methods: Immunostaining of ADAM19 and CUEDC2 was performed by EnVision immunohistochemistry in benign and malignant biliary tract tissues. Result: The expression of ADAM19 and CUEDC2 were significantly higher in EHCC (p < 0.05). ADAM19 expression was positive correlated with CUEDC2 expression in EHCC (p < 0.05). The overall survival time of those with positive expression of ADAM19 and CUEDC2 was lower (p < 0.001). Both positive expression of ADAM19 and CUEDC2 were independent prognostic factors in EHCC. Conclusion: ADAM19 and CUEDC2 have a positive correlation to the pathogenesis and dismal prognosis in EHCC.

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Prognostic Factors for Survival in 60 Patients with Classical Hodgkin Lymphoma From Peru

Blood ◽

10.1182/blood.v118.21.4863.4863 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4863-4863

Author(s):

Brady E Beltran ◽

Jose C Alva ◽

Domingo Morales ◽

Pilar Quinones ◽

Roberto N. Miranda ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Prognostic Factor ◽

Hodgkin Lymphoma ◽

Lymphocyte Count ◽

Research Funding ◽

Univariate Analysis ◽

Foxp3 Expression ◽

Rank Test ◽

Classical Hodgkin Lymphoma

Abstract Abstract 4863 Introduction: Hodgkin lymphoma (HL) is an uncommon lymphoma with a good prognosis. However, the characteristics of HL in Peruvian patients have not been previously reported. HL is thought to be related to chronic Epstein Barr virus (EBV) infection, and new biological markers such as EBV, CD68 and FOXP3 expression could be of potential biological interest in this entity. Our study aims to identify prognostic factors for survival in Peruvian patients with classical HL. Methods: This study was approved by the IRB at our institution. Between January 2001 and December 2009, patients diagnosed with classical HL were selected for this study. HIV-negative patients were excluded. Clinical data were reviewed retrospectively and patient's biopsies were analyzed for the immunohistochemical expression of CD20, PAX5, CD30, CD15, FOXP3 and CD68. Samples were also analyzed for the presence of EBV-encoded RNA (EBER) using an in situ hybridization (ISH) technique. Clinicopathological characteristics will be presented using descriptive statistics. Overall survival (OS) estimates were calculated using the Kaplan-Meier method and compared using the log-rank test. For the multivariate survival analysis, Cox proportional-hazard regression test was used. P-values <0.05 were considered statistically significant. RESULTS: A total of 60 patients with a pathological diagnosis of classical HL were included in our study. The median age was 55 years (range: 18–98 years) with a 7:3 male predominance. Advanced stages (stage 3 and 4) were seen in 52%, ECOG performance status >1 in 15% and B symptoms in 67%. White blood cell (WBC) counts >15,000 cells/mm3 was seen in 7%, lymphocyte count <600 cells/mm3 in 12%, albumin levels <4 g/dl in 70% and hemoglobin <10.5 g/dl in 40% of the patients. FOXP3 expression >25% was seen in 45%, CD68 >25% in 48% and EBER 2–3+ in 53%. ABVD was the preferred therapy, accounting for 90% of the cases and a complete response to ABVD was obtained in 78%. With a median follow-up 34 months, the median overall survival (OS) has not been reached and the 5-yr OS was 80%. In the univariate analysis, ECOG >1 (p=0.0001), elevated LDH levels (p=0.04) and lymphocyte count <600 cells/mm3 (p=0.05) were adverse prognostic factors. Age, sex, B symptoms, WBC, albumin and hemoglobin levels were not associated with survival. In the multivariate analysis, only ECOG >1 (p=0.01) was an independent adverse prognostic factor in Peruvian patients with classical HL. CONCLUSION: ECOG is a best prognostic factor in Peruvian patients with a diagnosis of classical Hodgkin lymphoma. CD68 expression, EBV status and FOXP3 expression by the malignant cells were not prognostic factors for OS in our cohort of patients. Disclosures: Castillo: GlaxoSmithKline: Research Funding; Millennium Pharmaceuticals: Research Funding.

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Clinical outcomes of gemcitabine plus nab-paclitaxel (GnP) in initially diagnosed locally advanced pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.407 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 407-407 ◽

Cited By ~ 1

Author(s):

Yusuke Hashimoto ◽

Hideaki Takahashi ◽

Izumi Ohno ◽

Hiroshi Imaoka ◽

Mitsuhito Sasaki ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Median Time ◽

Univariate Analysis ◽

Objective Response ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Pancreatic Head ◽

Tumor Board ◽

Rank Test

407 Background: Gemcitabine plus nab-Paclitaxel has shown improved survival in patients with metastatic pancreatic cancer in MPACT. Many studies have been investigating the survival benefit of GnP in LACP patients. The aim of this study is to clinical outcome of GnP in initially diagnosed LAPC in our single tertiary institution. Methods: LACP patients who received GnP as initial chemotherapy were identified between December 2014. and December 2016 from our database retrospectively. Demographic characteristics, disease status, response, conversion to resection and survival was reviewed. Resectability was determined at our hepatobiliary pancreatic tumor board, reflecting Japanese guideline of pancreatic cancer. Results: We identified 55 LACP patients initially treated with GnP (median age: 67 year old, female was 49%, ECOG PS 0/1, 62%/38%, pancreatic head 58%, baseline tumor size: median 32mm (18-62), CA19-9: median 139ng/ml (3.9-12956)). Best objective response rate was 58% and median time to partial response was 60 days (40-212). Median overall survival (mOS) was 24.7 months (95%CI :15.5-not reached). Nine patients (16%:9/55) were re-evaluated as resectable with CT and normalized CA19-9/CEA and subsequently proceeded to conversion to resection. Seven patients (13%:7/55) achieved R0 resection and sequentially performed adjuvant six- month duration of GnP. Median time to resection from initial GnP administration was 5.2 months (4.0-7.3). LAPC patients who achieved conversion to resection was associated with better overall survival than non-resected LAPC in log-rank test (mOS: all alive :12.1-25.4months vs 21.5 months 95%Cl:15.5-, HR:0.493 range: NA, P = 0.043). Shrinking tumor minimal size from the baseline was the factor to successful conversion in univariate analysis (P = 0.006). Conclusions: GnP showed promising results of response and overall survival in uLAPC patients. Conversion to resection in carefully selected uLAPC currently suggests an early surgical benefit, but longer follow-up and more cases will be required to assess the potential long-term benefit of conversion therapy.

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The Significance of Inflammatory Markers in the Prognosis of Newly Diagnosed Multiple Myeloma Patients

Blood ◽

10.1182/blood-2020-136326 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 15-15

Author(s):

Lin Gui ◽

Fei Wang ◽

Jinning Shi ◽

Baoan Chen

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Overall Survival ◽

Multivariate Analysis ◽

Survival Time ◽

Cox Regression ◽

Conflicts Of Interest ◽

Univariate Analysis ◽

Rank Test ◽

Newly Diagnosed

Objective: To explore the significance of the ratio of neutrophils to lymphocytes (NLR), monocytes to lymphocytes (MLR), and platelets to lymphocytes (PLR) in the prognosis of patients with newly diagnosed multiple myeloma. Methods: We retrospectively reviewed the data for 60 multiple myeloma patients who were diagnosed in Jiangning Hospital Affiliated to Nanjing Medical University from August 2011 to March 2020. According to NLR、MLR、PLR, the patients were divided into the low NLR group (NLR<3.61) or high NLR group (NLR≥3.61), low MLR group (MLR<0.33) or high MLR group (MLR ≥0.33), low PLR group (PLR< 129.78) and high PLR group (PLR ≥129.78). Overall survival time (OS) was used as the prognostic evaluation criteria, and Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to carry out univariate and multivariate analysis on clinical and laboratory parameters. Results: Among the 60 patients, 33 were male and 27 were female, the median age of onset was 65 years old, 19 were in the high NLR group, 41 were in the low NLR group, 24 were in the high MLR group, 36 were in the low MLR group, 26 were in the high PLR group, and 34 were in the low PLR group. The univariate analysis showed the prognosis was influenced by factors including NLR, PLR, age, ISS stages, hemoglobin (HGB), albumin (ALT). MLR, type of immunoglobulin, white globulin ratio (A/G), gender, β2-microglobulin, lactate dehydrogenase (LDH) and creatinine were not correlated with the total survival time of patients. The multivariate analysis showed that ISS III stages, PLR≥129.78、HGB<100g/L were independent risk factors influencing the prognosis of MM patients. Conclusion: ISS III stages, PLR≥129.78、HGB<100g/L are independent prognostic risk factors in newly diagnosed multiple myeloma patients, which can be used as an economical and effective method for early evaluation of patient prognosis. Key Wordsmultiple myeloma; overall survival; NLR; PLR; MLR Disclosures No relevant conflicts of interest to declare.

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Value of postoperative adjuvant chemotherapy (ac) for patients with completely resected hepatic (hm) and/or pulmonary metastases (pm) from colorectal cancer (crc): retrospective analysis of 146 patients

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.13509 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 13509-13509

Author(s):

A. Muñoz ◽

R. Barceló ◽

A. Gil-Negrete ◽

S. Carrera ◽

G. López-Argumedo ◽

...

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Survival Probability ◽

Cox Regression ◽

Lung Metastases ◽

Univariate Analysis ◽

Stage Iv ◽

Early Death ◽

Rank Test

13509 Background: AC is indicated for stage III and high risk stage II colon cancer, as well as for stages II-III rectal cancers combined with RT. Moreover, chemotherapy improves survival in metastatic disease. There are no randomised trials evaluating the role of systemic AC after resection of metastases from CRC. Methods: We retrospectively reviewed patients with completely (R0) removed HM and/or PM from CRC, analysing prognostic factors for overall survival, including AC. Kaplan-Meier method with log rank test was used to assess and compare survival curves. Cox regression model was applied for multivariate analysis. Results: From Jan 1993 to Jun 2004, 146 patients were identified: 98 (67%) with HM, 39 with PM (27%) and 9 (6%) with both HM and PM. Gender (M/F): 102/44. Median age: 65.5 y-o (39.3–82.6). Primary CRC: rectum 62 (42.5%), pN+ 87 (60%), stage IV at diagnosis 57 (39%). Number of metastatic nodules resected: mean 2.25 (1–10). Size of the largest metastasis: mean 4 cm (0.5–18). Mean serum CEA value before surgery 20.6 (0–332): normal 73 (50%), increased 45 (31%), missing data 28 (19%). Ninety seven patients (66.5%) received postoperative AC (5FU/LV: 81, CPT11: 15, FOLFOX 1), 10 patients were not treated because of postoperative death (1) or early progression (9), and 39 due to several causes: not referred, medical contraindication or patient refusal. Median overall survival was 46.4 m, with a 3, 5 and 7-year survival probability of 59%, 35% and 22%. At univariate analysis, number (2 vs >2) of metastases resected (60.1 vs 38.3m, p=0.0004) and AC (54.3 vs 31.2m, p=0.0001) were significant prognostic factors. Increased CEA (p=0.088), involved nodes in the primary (p=0.0618) and PM+HM (p=0.0538) showed a trend towards worse survival. In multivariate analysis (excluding patients with early death/progression) AC was associated with longer survival probability (HR 2.049, 95%CI 1.149–3.656, p=0.015). Conclusions: In our retrospective series AC seems to improve survival after resection of liver and/or lung metastases from CRC. The best use of chemotherapy (adjuvant, neoadjuvant or both) in patients with resectable metastatic CRC should be evaluated in a randomised fashion. No significant financial relationships to disclose.

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Survival Analysis of Traditional Chinese Herbal Medicine Spleen-invigorating Compound in Patients with Pancreatic cancer

10.21203/rs.3.rs-23172/v1 ◽

2020 ◽

Author(s):

Xin Li ◽

Ling Chen ◽

Xiaoqiang Gu ◽

Jiahua Xu ◽

Hongwei Li ◽

...

Keyword(s):

Pancreatic Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Herbal Medicine ◽

Survival Time ◽

Cancer Patients ◽

Chinese Herbal Medicine ◽

Median Overall Survival ◽

Traditional Chinese Herbal Medicine ◽

Chinese Herbal

Abstract Background Traditional Chinese herbal medicine (TCHM) is widely used in the treatment of pancreatic cancer in China. In this retrospective study, the authors mainly analyzed the effect of TCHM on the survival time of patients with pancreatic cancer. Methods From 2011 to 2018, 121 pancreatic cancer patients were enrolled in this study. All patients were divided into either the TCHM group or non-TCHM group based on received TCHM or not. TCHM group received three months or more of TCHM treatment on the basis of comprehensive treatment. Kaplan-Meier method was used to assess the difference in survival time, and Cox proportional hazards regression analysis was performed to identify independent prognostic factors. Results The overall survival was different between all patients with and without TCHM (P = 0.000), COX analysis showed the clinical staging (P = 0.050), surgery (P = 0.000), chemotherapy (P = 0.000) and TCHM (P = 0.000) were independent prognostic factors. In a stratification analysis of stage for patients who received chemotherapy, there was a significant increase in median overall survival from 10.7 (non-TCHM group) to 19.5 (TCHM group) months (hazard ratio [HR] = 3.197, 95% confidence interval [CI] 1.989–5.137, P = 0.000). Patients who did not receive chemotherapy, but best supportive care, there was a significant increase in median overall survival from 4.3 (non-TCHM group) to 15.1 (TCHM group) months (HR = 0.041, 95% CI = 0.005–0.329, P = 0.003). Conclusions TCHM was an important independent prognostic factor of pancreatic cancer and have an effect on improving the prognosis of pancreatic cancer patients.

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Contribution of intraoperative stimulation mapping to glioblastoma surgery within or adjacent to descending motor pathways: survival analysis and functional outcome comparison between two series in a single institution

10.21203/rs.3.rs-302485/v1 ◽

2021 ◽

Author(s):

Jimmy Ming-Jung Chuang ◽

Li-Han Lin ◽

Meng-Hsiang Chen ◽

Wei-Che Lin ◽

Cheng-Hsien Lu ◽

...

Keyword(s):

Overall Survival ◽

Survival Time ◽

Neurological Outcome ◽

Median Overall Survival ◽

Extent Of Resection ◽

Rank Test ◽

Positive Effects ◽

Overall Survival Time ◽

Significant Difference ◽

Median Overall Survival Time

Abstract Purpose Extensive resection probably confers a modest survival advantage in patients with glioblastoma. Studies have revealed the positive effects of intraoperative stimulation mapping (ISM) on the extent of resection, but no consensus for contribution of intraoperative stimulation mapping is reached. Methods This retrospective study enrolled two groups of patients who underwent surgery for motor-eloquent glioblastoma: the non-ISM group of 57 patients (surgery in 2008–2013) and ISM group of 13 patients (surgery in 2014–2015). The two groups and subgroups based on resection extent and postoperative additional neurological deficit were compared using Kaplan–Meier analysis and the log-rank test. Results Gross or near total resection (≥ 90% resection quality) was significantly more common in the ISM group than the non-ISM group (76.9% versus 24.6%; p = 0.001). The extent of resection was also significantly greater (90.5% ± 15.6% versus 64.6% ± 29.2%; p = 0.002). The neurological outcome in the ISM group was thus superior, but the two differences were not significant. The median progression-free survival time was significantly longer in the ISM group (22.0 ± 5.1 months vs 8.0 ± 1.0 months; p = 0.037) but a significant difference was not indicated in median overall survival time (22.0 ± 8.4 months vs 16.0 ± 2.2 months; p = 0.167). Conclusion ISM was discovered to lead to higher quality of resection and delayed recurrence. The neurological outcome and median overall survival time in the ISM group was thus superior, but the two differences were not significant. Trial registration number (for clinical trials) Nil

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Prognostic value of genomic alterations (GA) on overall survival in appendiceal adenocarcinoma (AA).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.554 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 554-554

Author(s):

Alexandre A Jacome ◽

Kanwal Pratap Singh Raghav ◽

Kenna Rael Shaw ◽

Keith F. Fournier ◽

Richard Eldon Royal ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Prognostic Value ◽

Cox Model ◽

Univariate Analysis ◽

Stage Iv ◽

Tumor Grade ◽

Rank Test ◽

Cancer Center ◽

Rare Tumors

554 Background: AA are extremely rare tumors, with potentially aggressive clinical behavior. The characterization of the molecular alterations of the disease is poorly described, as well as its association with clinical outcomes. The present study aims to evaluate the prognostic influence of GA on overall survival (OS) of AA patients (pts). Methods: We performed a retrospective study involving AA pts at MD Anderson Cancer Center between October 2012 and April 2017 who underwent next-generation sequencing (NGS) (at least 45 genes), using either tumor tissue specimens or peripheral blood for cell-free DNA (cfDNA). GA identified by NGS and clinicopathological variables were correlated with OS. Survival curves were performed by the Kaplan-Meier method and compared with log-rank test. Multivariate analysis of prognostic factors was performed by the Cox model. Results: A total of 78 pts were identified, of which 35 had died (45%) in a median follow-up time of 4.8 y. The majority of pts presented with stage IV disease (72%); 46% underwent cytoreductive surgery (CRS) + HIPEC. Tissue-based and cfDNA-based sequencing were performed on 73% and 23% of the pts, respectively, and 4% had both. The most frequent GA were KRAS (62%), TP53 (36%), GNAS (28%), SMAD4 (18%), PIK3CA (16%), and APC (15%). By univariate analysis, stage, tumor grade, and CRS + HIPEC demonstrated prognostic value (p < 0.05). Multivariate subset analysis of stage IV pts adjusting for age, tumor grade (TG), CRS + HIPEC, KRAS, GNAS, and p53, demonstrated that poorly differentiated tumors and a KRAS mutated tumor resulted in worse OS (HR: 12.1 and HR: 3.9, respectively, both with p < 0.05) and CRS + HIPEC resulted in an improved OS (HR: 0.32, p < 0.05). Conclusions: Our analysis indicates that TG and the presence of the KRAS mutation are poor prognostic factors in the OS of pts with AA. CRS + HIPEC offers survival advantage . Molecular characterization and prognostication of these rare tumors may help guide therapy. These findings need validation, thereby continued evaluation in a larger population and utilizing a wider molecular platform is ongoing.

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