Prognostic Significance of Subungual Anatomic Site in Acral Lentiginous Melanoma

Context.— Acral lentiginous melanoma is a rare and aggressive type of cutaneous melanoma that arises on the acral skin and the nail unit. The prognostic significance of subungual anatomic site in acral lentiginous melanoma is not established. Objective.— To assess the impact of subungual anatomic site on overall survival and disease-specific survival in acral lentiginous melanoma. Design.— Retrospective cohort analysis. Clinicopathologic characteristics of 627 primary acral lentiginous melanomas (45 [7%] subungual and 582 [93%] nonsubungual) were summarized, and the impact of these characteristics on overall survival and disease-specific survival was determined using univariate and multivariable analyses. Results.— No significant differences in clinicopathologic features were identified between the subungual and nonsubungual acral lentiginous melanomas. The 1-, 5-, and 10-year overall survival rates were 81%, 40%, and 28%, respectively, for subungual acral lentiginous melanoma and 94%, 59%, and 38%, respectively, for nonsubungual acral lentiginous melanoma (P = .04); risk of death was significantly higher for subungual tumors (hazard ratio [95% confidence interval] = 1.59 [1.02–2.50]; P = .04). The 1-, 5-, and 10-year disease-specific survival rates were 94%, 56%, and 48%, respectively, for subungual acral lentiginous melanoma versus 96%, 69%, and 55%, respectively, for nonsubungual acral lentiginous melanoma (P = .18). By multivariable analysis, independent poor prognostic factors included older age and ulceration for overall survival and greater Breslow thickness and sentinel lymph node positivity for overall survival and disease-specific survival. Subungual anatomic site was not an independent prognostic factor for overall or disease-specific survival. Conclusions.— Subungual anatomic site is not an independent prognostic factor for acral lentiginous melanoma.

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Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000707 ◽

2019 ◽

Vol 133 (05) ◽

pp. 404-412 ◽

Cited By ~ 4

Author(s):

M B Asik ◽

B Satar ◽

M Serdar

Keyword(s):

Overall Survival ◽

Robotic Surgery ◽

Surgical Procedures ◽

Meta Analysis ◽

Survival Rates ◽

Published Data ◽

Disease Specific Survival ◽

Success Rates ◽

Surgery Group ◽

Disease Specific

AbstractObjectiveTo assess published reports of oncological surgical success rates in patients who underwent transoral laser supraglottic surgery and robotic surgery for supraglottic cancer.MethodsA systematic review of the literature was conducted and a meta-analysis of published data was performed. PubMed, Sage, Medline and Cochrane data sources were investigated. Overall survival rates, disease-specific survival rates, additional treatments and recurrence rates were investigated to determine the success of the surgical procedures.ResultsThe meta-analysis included 24 studies; 1617 studies were excluded. There were no statistically significant differences between the transoral laser supraglottic surgery and transoral robotic supraglottic surgery groups in terms of overall survival (77.0 per cent and 82.4 per cent respectively) and disease-specific survival (75.8 per cent and 87.0 per cent respectively). There was recurrence in 164 out of 832 patients (19.7 per cent) in the transoral laser supraglottic surgery group and in only 6 out of 66 patients (9 per cent) in the transoral robotic supraglottic surgery group.ConclusionTransoral laser surgery and robotic surgery appear to have comparable and acceptable oncological success rates.

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p27kip1 Protein Expression Correlates With Survival in Myxoid and Round-Cell Liposarcoma

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.15.2888 ◽

2000 ◽

Vol 18 (15) ◽

pp. 2888-2893 ◽

Cited By ~ 24

Author(s):

Andre M. Oliveira ◽

Antonio G. Nascimento ◽

Scott H. Okuno ◽

Ricardo V. Lloyd

Keyword(s):

Overall Survival ◽

Cell Differentiation ◽

Prognostic Factor ◽

Kinase Inhibitor ◽

Survival Rates ◽

Independent Prognostic Factor ◽

Rank Test ◽

Round Cell ◽

Ki 67 ◽

Low Expression

PURPOSE: The p27kip1 protein (p27) is a cyclin-dependent kinase inhibitor that has been shown to be an independent prognostic factor in a variety of human neoplasms. Low expression of p27 tends to occur in more aggressive neoplasms. The role of p27 as an independent prognostic factor in the spectrum of myxoid and round-cell liposarcomas has not been examined. MATERIALS AND METHODS: Forty-seven cases of myxoid and round-cell liposarcomas were examined. Clinicopathologic features and immunohistochemical expression of p27 and Ki-67 antigen were studied in all cases. Survival analysis was performed using the log-rank test and the Cox multivariate regression model. RESULTS: The male:female ratio was 1.4:1, and the mean age at diagnosis was 45 years. The tumors were located in the lower extremities (94%) and retroperitoneum (6%). The median tumor size was 13.5 cm. The median follow-up was 6.3 years, and the overall 5- and 10-year survival rates were 76% and 67%, respectively. Low expression of p27 was identified in 34 cases (72%) and correlated with decreased metastasis-free (P = .026) and overall survival (P = .008). In a multivariate analysis, only round-cell differentiation and low expression of p27 independently predicted decreased metastasis-free and overall survival. CONCLUSION: p27 expression predicts the clinical behavior of myxoid and round-cell liposarcomas, even in neoplasms with few or no round-cell differentiation.

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Comparison of survival rates in carcinoma in situ of the breast treated with total mastectomy to breast-conserving surgery and radiotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.519 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 519-519 ◽

Cited By ~ 1

Author(s):

M. N. Ibrahim ◽

Z. Abdullah ◽

L. Healy ◽

C. Murphy ◽

I. Y. Yousif ◽

...

Keyword(s):

Overall Survival ◽

Proportional Hazards ◽

Survival Rates ◽

Breast Conserving Surgery ◽

Cox Proportional Hazards ◽

Disease Specific Survival ◽

Total Mastectomy ◽

Kaplan Meier ◽

Disease Specific

519 Background: Carcinoma in situ (CIS) of the breast is a precancerous lesion with the potential to progress to invasive cancer. In 2003, CIS accounted for 19% of all newly diagnosed invasive and non-invasive breast lesions combined in the United States. Current treatment options are mastectomy ± tamoxifen, and breast-conserving surgery with radiotherapy ± tamoxifen. As there are no randomized comparisons of these 2 treatments, data from the Surveillance Epidemiology and End Results (SEER) database was used to compare their survival rates. Methods: 88,285 patients were identified with CIS from 1988 - 2003. Of these, 27,728 patients were treated with a total mastectomy, and 25,240 patients received breast-conserving surgery with radiotherapy. Kaplan-Meier survival analyses and Cox proportional hazards regression were used to compare overall survival and disease specific survival at 5 and 10 years. Results: Kaplan-Meier analyses demonstrated 5 year overall survival rates for total mastectomy vs. breast conserving surgery with radiotherapy of 95.46% vs. 97.59% respectively (Log-rank P < 0.0001). The 5 year rates for disease specific survival were 99.16% vs. 99.72% respectively (Log-rank P < 0.0001). At 10 years the overall survival rates had fallen to 91.96% vs. 96.09% respectively (Log-rank P < 0.0001). The 10 year disease specific survival rates were 98.61% vs. 99.50% respectively (Log-rank P < 0.0001). Cox proportional hazards regression demonstrated a relative risk of 0.847 (95% confidence interval (CI) 0.790 - 0.907) and 1.110 (95% CI 0.931 - 1.324) for 5 year overall survival and disease specific survival respectively, when total mastectomy was compared with breast conserving surgery and radiotherapy. At 10 years, the relative risks were 0.865 (95% CI 0.820 - 0.913) and 1.035 (95% CI 0.900 - 1.190) for overall survival and disease specific survival respectively. Conclusions: Overall, when looking at disease-specific survival rates by multi-variate analysis, there does not appear to be a significant difference between total mastectomy and breast-conserving surgery with radiotherapy in the treatment of CIS. No significant financial relationships to disclose.

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Prognostic significance of tumor size in patients with stage III non-small cell lung cancer: A SEER database survey

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.7529 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 7529-7529

Author(s):

S. N. Waqar ◽

F. Gao ◽

R. Govindan ◽

D. Morgensztern

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Tumor Size ◽

Prognostic Significance ◽

Demographic Variables ◽

Small Cell ◽

Stage Iii ◽

Disease Specific Survival ◽

Small Cell Lung ◽

Disease Specific

7529 Background: Although tumor size is a known predictor of stage I and II non-small cell lung cancer (NSCLC) treated with surgery or radiotherapy, there is limited information regarding its prognostic significance in patients with mediastinal lymph node involvement. Methods: The Surveillance Epidemiology and End Results (SEER) registry was queried for patients with unresected NSCLC stage III, without malignant pleural effusion, aged 21 or older, and diagnosed between 1998 and 2003. Tumor size was defined as S1 (0.1–3 cm), S2 (3.1–5 cm), S3 (5.1–7 cm) and S4 (7.1–20 cm). Demographic variables included age, gender, race and histology. The Kaplan-Meier method was used to estimate the overall survival (OS) and disease-specific survival (DSS), and the Cox proportional hazard model to evaluate whether tumor size remained an independent risk factor after adjusting for stage and other demographic variables. Results: A total of 12,205 patients met the eligibility criteria. Median age at diagnosis was 70 years and most patients were male (58.8%) and white (81.3%). Tumor size was a statistically significant predictor for both overall survival (p<0.0001) and disease-specific survival (p<0.0001) on multivariate analysis. Selected groups of patients with smaller stage IIIB disease had better OS compared to patients with stage IIIA, including; IIIBS1 vs. IIIAS3 (p=0.0005) or IIIA S4 (p<0.0001) and IIIBS2 vs. IIIAS4 (p=0.0001). Conclusions: Tumor size is an independent predictor for OS and DSS in patients with unresected stage III NSCLC and should be considered in the stratification of patients treated in this setting. [Table: see text] No significant financial relationships to disclose.

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The Impact of Insurance and Marital Status on Survival in Patients with Nasopharyngeal Carcinoma

Biology ◽

10.3390/biology9040084 ◽

2020 ◽

Vol 9 (4) ◽

pp. 84

Author(s):

Chih-Chun Wang ◽

Ching-Chieh Yang ◽

Shyh-An Yeh ◽

Chung-I Huang ◽

Tzer-Zen Hwang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Marital Status ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Disease Specific Survival ◽

Uninsured Patients ◽

The Impact ◽

To Receive ◽

Disease Specific

Objective: This study aimed to explore the influence of social support on the survival outcomes of patients with nasopharyngeal carcinoma (NPC). We examined whether the combined proxy influenced whether patients were more likely to receive radiotherapy. Methodology: data were collected from the 18 registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. The association between both insurance status and marital status and disease-specific survival rates were evaluated with a multivariate Cox proportional-hazards regression model to calculate the hazard ratios and associated confidence intervals. Odds ratio (OR) computed by logistic regression was also used to examine the relationship between the receipt of radiotherapy and insurance and marital status. Results: insured and uninsured patients differed significantly in T-stage, N-stage, M-stage, radiotherapy use, race, and marital status. The uninsured-non-married patients showed the lowest 5-year disease-specific survival rates. We further found unmarried patients with either Medicaid (OR, 0.40), or no insurance (OR, 0.24) had lower odds of receiving radiotherapy than those with insurance at diagnosis. Conclusions: uninsured-unmarried NPC patients had a significantly higher risk of distant metastasis at diagnosis, poorer 5-year disease-specific survival, and were less likely to receive radiotherapy than insured-married patients.

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Serum Soluble Syndecan-1 Levels at Diagnosis Constitute an Independent Prognostic Factor of Survival in Myeloma That May Further Differentiate Patients within the ISS Stages.

Blood ◽

10.1182/blood.v106.11.3404.3404 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3404-3404

Author(s):

Marie-Christine Kyrtsonis ◽

Theodoros P. Vassilakopoulos ◽

Argyro Papadogiannis ◽

Tatiana Tzenou ◽

Christina Kalpadakis ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factor ◽

Plasma Cells ◽

Prognostic Significance ◽

Classification Systems ◽

Independent Prognostic Factor ◽

Soluble Form ◽

Number Of Patients ◽

Staging Systems ◽

Stage 1

Abstract Syndecan-1 (CD138) is a heparin sulphate proteoglycan overexpressed on the surface of both normal and malignant plasma cells. Its role in multiple myeloma (MM) pathogenesis remains unclear. It may be shed from plasma cell surface and released in its soluble form (soluble syndecan-1: s-synd-1). Serum s-synd-1 levels have been shown to be a powerful prognostic factor of survival in myeloma patients. The role of s-synd-1 in the current prognostic classification systems requires further investigation. We have retrospectively determined soluble syndecan-1 in frozen sera of 99 MM patients, 18 MGUS patients, and 25 healthy individuals (HI). In all patients sera samples were collected at diagnosis. Serum s-synd-1 levels were determined by ELISA (Diaclone Research, Besanson, France) according to the manufacturer’s instructions. MM patients median age was 69 y (44–82), 51 were female, 48 male, 26 were Durie-Salmon (DS) stage I, 41 stage II, and 32 stage III while, according to the International Scoring System for MM (ISS), 32 were in stage 1, 25 in stage 2 and 42 in stage 3. Median serum s-synd-1 was 15 ng/ml (7–40) in HI, 16.5 ng/ml (8–220) in MGUS and 64 ng/ml (7–3500) in MM. Differences between HI and MM patients levels and between MGUS and MM patients levels were both significant (0.01 and 0.05 respectively). Overall survival was decreased in patients with elevated (mean + 2SD) serum s-synd-1 (5-year overall survival 35±9 vs 80±13, p=0.004). S-synd-1 levels were an independent prognostic factor of survival compared to DS and ISS staging systems. In multivariate analysis, only ISS and s-synd-1 were significant parameters of prognosis (the prognostic significance of DS, ISS and s-synd-1 was 0.06, 0.006 and 0.02 respectively). Further analysis of survival of patients stratified according to the ISS system showed a difference in survival within groups according to s-synd-1 levels. The 5-year overall survival was 100 vs 58±16 in ISS stage 1 patients with low or elevated s-synd-1 respectively, 100 vs 18±16 in stage 2 and 50±25 vs 14±13 in stage 3. The difference was statistically significant for stage 2 only (p=0.04) and there was only a trend due to the low number of patients in stages 1 and 3. In conclusion serum s-synd-1 levels at diagnosis constitute an independent prognostic factor of survival, able to further differentiate MM patients within the ISS stages.

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The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Cancer

Diagnostics ◽

10.3390/diagnostics10110973 ◽

2020 ◽

Vol 10 (11) ◽

pp. 973

Author(s):

Olivia Knittelfelder ◽

Daniela Delago ◽

Gabi Jakse ◽

Sabine Reinisch ◽

Richard Partl ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factor ◽

Cox Regression ◽

Cell Cancer ◽

Survival Rates ◽

Prognostic Significance ◽

Independent Prognostic Factor ◽

Operating Characteristics ◽

Roc Curve Analysis ◽

Cancer Specific Survival

Aminotransaminases, including aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT), are strongly involved in cancer cell metabolism and have been associated with prognosis in different types of cancer. The purpose of the present study was to evaluate the prognostic significance of the pre-treatment AST/ALT ratio in a large European cohort of patients with oral and oropharyngeal squamous cell cancer (OOSCC). Data from 515 patients treated for OOSCC at a tertiary academic center from 2000–2017 were retrospectively analyzed. Levels of AST and ALT were measured prior to the start of treatment. Uni- and multivariate Cox regression analyses were applied to evaluate the prognostic value of the AST/ALT ratio for cancer-specific survival (CSS) and overall survival (OS), survival rates were calculated. Univariate analyses showed a significant association of the AST/ALT ratio with CSS (hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.38–2.12; p < 0.001) and OS (HR 1.69, 95% CI 1.41–2.02; p < 0.001). In multivariate analysis, the AST/ALT ratio remained an independent prognostic factor for CSS and OS (HR 1.45, 95% CI 1.12–1.88, p = 0.005 and HR 1.42, 95% CI 1.14–1.77, p = 0.002). Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the AST/ALT ratio was 1.44, respectively. In multivariate analysis, an AST/ALT ratio > 1.44 was an independent prognostic factor for poor CSS and OS (HR 1.64, 95% CI 1.10–2.43, p = 0.014 and HR 1.55, 95% CI 1.12–2.15; p = 0.008). We conclude that the AST/ALT ratio is a prognostic marker for survival in OOSCC patients and could contribute to a better risk stratification and improved oncological therapy decisions.

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External Beam Radiotherapy for Medullary Thyroid Cancer Following Total or Near-Total Thyroidectomy

Otolaryngology ◽

10.1177/0194599820947696 ◽

2020 ◽

pp. 019459982094769

Author(s):

Michael Jin ◽

Uchechukwu C. Megwalu ◽

Julia E. Noel

Keyword(s):

Overall Survival ◽

Advanced Disease ◽

External Beam Radiotherapy ◽

National Database ◽

External Beam ◽

Disease Specific Survival ◽

Lymph Node Yield ◽

Medullary Thyroid ◽

The Impact ◽

Disease Specific

Objectives Medullary thyroid carcinoma (MTC) often presents with advanced disease and takes an aggressive course as compared with more well-differentiated thyroid cancers. The role of adjuvant therapy, specifically external beam radiotherapy (EBRT), remains disputed. This study investigated the impact of EBRT on survival in MTC. Study Design Cross-sectional analysis of a national database. Setting Patients with MTC were identified from the SEER program (Surveillance, Epidemiology, and End Results). Methods Collected variables included age, sex, race, T and N stages, lymph node yield, and use of EBRT. Propensity score matching was performed to determine the association of EBRT with overall and disease-specific survival. Results A total of 2046 patients with locoregional MTC were identified. Of these, 152 received EBRT. Patients receiving EBRT were older and had more advanced disease. EBRT was not associated with differences in overall survival (hazard ratio, 1.12; 95% CI, 0.76-1.65) or disease-specific survival (1.66; 0.93-2.95), as well as in subset analysis of age and disease extent. Long-term overall survival was similar, with 77.3% (95% CI, 70.1%-85.3%) and 58.3% (48.2%-70.5%) of patients without EBRT alive at 5 and 10 years, respectively (vs 70.7% [63.2%-79.1%] and 52.3% [43.3%-63.2%] of patients with EBRT). There were no differences in 5- and 10-year disease-specific survival. Conclusion EBRT was not associated with improved overall or disease-specific survival in patients with MTC. Decisions regarding EBRT must be made with consideration of morbidity relative to benefit for individual patients.

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Low preoperative serum ALB level is independently associated with poor overall survival in endometrial cancer patients

Future Oncology ◽

10.2217/fon-2019-0732 ◽

2020 ◽

Author(s):

Jia Lei ◽

Yue Wang ◽

Xiangqian Guo ◽

Shuping Yan ◽

Dimeng Ma ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Prognostic Factor ◽

Proportional Hazards ◽

Univariate Analysis ◽

Prognostic Significance ◽

Cox Proportional Hazards ◽

Independent Prognostic Factor ◽

Poor Overall Survival ◽

Preoperative Serum

Aim: To reveal the prognostic significance of serum albumin (ALB) concentration in endometrial cancer (EC) patients in China. Patients & methods: 345 EC patients were enrolled in a single center, and the preoperative serum ALB concentration were measured. Kaplan–Meier curve analysis and Cox proportional hazards regression model were performed to evaluate the associations between ALB concentration and overall survival (OS) of EC patients. Results: The EC patients with lower preoperative serum ALB concentration exhibited a significantly poorer OS (p < 0.05). Univariate analysis and multivariate analysis indicated that serum ALB concentration was an independent prognostic factor of unfavorable OS for EC patients. Conclusion: Our results showing that ALB concentration may serve as an independent prognostic factor for EC patients.

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Prognostic Significance of CIP2A in Esophagogastric Junction Adenocarcinoma: A Study of 65 Patients and a Meta-Analysis

Disease Markers ◽

10.1155/2019/2312439 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Yanhong Li ◽

Mei Wang ◽

Xueping Zhu ◽

Xu Cao ◽

Yi Wu ◽

...

Keyword(s):

Overall Survival ◽

Tumor Progression ◽

Solid Tumors ◽

Esophagogastric Junction ◽

Meta Analysis ◽

Prognostic Significance ◽

Disease Specific Survival ◽

Esophagogastric Junction Adenocarcinoma ◽

Disease Specific ◽

Time To Tumor Progression

Background. The expression of the cancerous inhibitor protein phosphatase 2A (CIP2A) appears to be predictive of the prognosis of various solid tumors. However, the association between this protein and the risk of esophagogastric junction adenocarcinoma (EGJA) remains unclear. We investigated CIP2A expression and its clinical significance in EGJA and conducted a meta-analysis to explore the relationship between CIP2A and the prognosis of patients with solid tumors. Methods. Immunohistochemistry (IHC) was performed to detect the expression of CIP2A in EGJA. Kaplan-Meier estimation, Cox analysis, and ROC curves were performed to analyze the survival of patients and the prognostic factors. In the meta-analysis, we searched relevant publications in several widely used databases and used 15 studies (2348 patients). Results. IHC demonstrated that CIP2A was elevated in EGJA and correlated with poor survival as an independent indicator. It could forecast the survival more precisely when combined with the grade, which is another independent prognosis marker of EGJA. Meta-analysis demonstrated that the associations between the expression of CIP2A and the prognosis were detected for overall survival (HR=1.98, 95%CI=1.69‐2.32), disease-specific survival (HR=1.72, 95%CI=1.50‐1.97), and time to tumor progression (pooled HR=1.95, 95%CI=1.56‐2.43). Conclusion. High expression of CIP2A was a poor indicator of the prognosis of EGJA, and CIP2A may be a new biomarker for the diagnosis and treatment of EGJA. The meta-analysis suggested that CIP2A expression can be a predictive marker of overall survival, disease-specific survival, and time to tumor progression in patients with solid tumors.

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