Prognostic Score
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Yota Shimoda ◽  
Hirohito Fujikawa ◽  
Keisuke Komori ◽  
Hayato Watanabe ◽  
Kosuke Takahashi ◽  

Abstract Purpose Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC. Methods This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model. Results The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037). Conclusion The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.

Blood ◽  
2021 ◽  
Ana Henriques ◽  
Javier I Muñoz-González ◽  
Laura Sánchez-Muñoz ◽  
Almudena Matito ◽  
Lidia Torres-Rivera ◽  

Circulating tumor mast cells (CTMC) have been identified in the blood of a small number of patients with advanced systemic mastocytosis (SM). However, limited data exists about their frequency and prognostic impact in patients with mast cell activation syndromes (MCAS), cutaneous and non-advanced SM. We investigated the presence of CTMC and mast cell-committed CD34+ precursors in blood of 214 patients with MCAS, cutaneous mastocytosis and SM using highly sensitive next-generation flow cytometry. CTMC were detected at progressively lower counts in almost all advanced SM (96%) and smoldering SM (100%), nearly half (45%) indolent SM cases and few (7%) bone marrow mastocytosis patients, but were systematically absent in cutaneous mastocytosis and MCAS (P<0.0001). In contrast to CTMC counts, the number of mast cell-committed CD34+ precursors progressively decreased from MCAS, cutaneous mastocytosis and bone marrow mastocytosis to indolent SM, smoldering SM and advanced SM (P<0.0001). Clinically, the presence (and number) of CTMC in blood of patients with SM in general and non-advanced SM (indolent SM and bone marrow mastocytosis) in particular was associated with more adverse features of the disease, poorer risk prognostic subgroups as defined by the International Prognostic Scoring System for advanced SM (P<0.0001) and the Global Prognostic Score for mastocytosis (P<0.0001) and a significantly shortened progression-free survival (P<0.0001) and overall survival (P=0.01). Based on our results, CTMC emerge as a novel candidate biomarker of disseminated disease in SM that is strongly associated with advanced SM and poorer prognosis in patients with indolent SM.

2021 ◽  
Jiatao Hao ◽  
Minghai Ma ◽  
Peipei Li ◽  
Luyuan Wang ◽  
Hui Yu ◽  

Abstract Purpose: To analyze clinical features of gestational trophoblastic neoplasia (GTN) patients who received initial treatments at the First Affiliated Hospital of Xi'an Jiaotong University.Methods: The patient record system was screened to extract clinical data including demographics, pregnancy history, diagnosis, staging, prognostic score, treatment. Student t test, x2 test, and Fischer’s exact test were used.Results: This study included 387 patients with GTN. Patients were divided into 2009-2014 and 2015-2020 groups, including 177 and 210 cases, respectively. Patients in 2015-2020 group had higher parity than those in 2009-2014 group (1.2±1.2 vs 0.9±1.2, P=0.030). Nullípara (73 [41.2%] vs 65 [31.0%]) and primípara (71 [40.1%] vs 84 [40.0%]) were more frequently seen in 2009-2014 group than those in 2015-2020 group, but multípara (61 [29.0%] vs 33 [18.7%]) was more common in 2015-2020 group (P=0.028). For patients in 2015-2020 group, more patients demonstrated 1 or more metastases (107 [51.0%] vs 63 [35.6%], P=0.014) than those in 2009-2014 group. Patients in 2015-2020 group had more distant invasions affecting more organs, including lungs (76 [36.2%] vs 52 [29.4%]) and lungs combining with other organs (31 [14.8%] vs 11 [6.2%]), than those in 2009-2014 group (P=0.003).Conclusions: Although patients diagnosed with GTN between 2015 to 2020 is associated with higher parity, more children, and more distant metastases, we cannot simply conclude that clinical features of GTN has changed over time.

2021 ◽  
Vol 11 ◽  
Feng Qi ◽  
Xiaojing Du ◽  
Zhiying Zhao ◽  
Ding Zhang ◽  
Mengli Huang ◽  

Tumor mutation burden (TMB) is associated with immune infiltration, while its underlying mechanism in hepatocellular carcinoma (HCC) remains unclear. A long noncoding RNA (lncRNA)-related competitive endogenous RNA (ceRNA) network can regulate various tumor behaviors, and research about its correlation with TMB and immune infiltration is warranted. Data were downloaded from TCGA and ArrayExpress databases. Cox analysis and machine learning algorithms were employed to establish a lncRNA-based prognostic model for HCC. We then developed a nomogram model to predict overall survival and odds of death for HCC patients. The association of this prognostic model with TMB and immune infiltration was also analyzed. In addition, a ceRNA network was constructed by using DIANA-LncBasev2 and the starBase database and verified by luciferase reporter and colocalization analysis. Multiplex immunofluorescence was applied to determine the correlation between ULBP1 and PD-L1. An eight-lncRNA (SLC25A30-AS1, HPN-AS1, LINC00607, USP2-AS1, HCG20, LINC00638, MKLN1-AS and LINC00652) prognostic score model was constructed for HCC, which was highly associated with TMB and immune infiltration. Next, we constructed a ceRNA network, LINC00638/miR-4732-3p/ULBP1, that may be responsible for NK cell infiltration in HCC with high TMB. However, patients with high ULBP1 possessed a poorer prognosis. Using multiplex immunofluorescence, we found a significant correlation between ULBP1 and PD-L1 in HCC, and patients with high ULBP1 and PD-L1 had the worst prognosis. In brief, the eight-lncRNA model is a reliable tool to predict the prognosis of HCC patients. The LINC00638/miR-4732-3p/ULBP1 axis may regulate immune escape via PD-L1 in HCC with high TMB.

2021 ◽  
Vol Volume 14 ◽  
pp. 4577-4588
Xin-Ying Li ◽  
Shuang Yao ◽  
Yang-Ting He ◽  
Song-Qing Ke ◽  
Yi-Fei Ma ◽  

2021 ◽  
Vol 11 ◽  
Lei Ji ◽  
Lei Fan ◽  
Xiuzhi Zhu ◽  
Yu Gao ◽  
Zhonghua Wang

BackgroundThere is a significant survival difference and lack of effective treatment among breast cancer patients with liver metastasis. This present study aimed to construct a novel prognostic score for predicting the prognosis and locoregional treatment benefit of de novo metastatic breast cancer with liver metastasis (BCLM).MethodsIn total, 2,398 eligible patients between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. They were assigned to the training set including 1,662 patients (2010–2014) and validation set comprising 736 patients (2015–2016) depending on the time of diagnosis. The prognostic score was based on regression coefficients in the multivariate Cox regression analysis. And then, patients were stratified into low-, intermediate-, and high-risk groups by the prognostic score. The discrimination and calibration of prognostic score were evaluated using time-dependent receiver operating characteristic (ROC) curves analysis and calibration curves, respectively. Subgroup analysis was performed to evaluate locoregional surgery and chemotherapy benefit in different risk groups.ResultsAge, race, insurance and marital status, T stage, pathological grade, molecular subtypes, and extrahepatic metastasis were identified as independent prognostic variables in the prognostic score. The prognostic score showed high discrimination power with an area under the curve (AUC) of 0.77 and 0.72 and excellent agreement suggested by calibration plots in the training and validation sets, respectively. Intermediate-risk [hazard ratio (HR) 2.39, 95% confidence interval (CI) 2.09–2.73, P<0.001] and high-risk groups (HR 4.88; 95% CI 4.13–5.76; P<0.001) had significantly worse prognosis in comparison with the low-risk group. The median overall survival (OS) in three prognostic groups were 44, 18, and 7 months, with a 3-year survival rate of 56, 23, and 7%, respectively. Apart from the high-risk group (HR 0.79; 95% CI 0.56–1.10; P=0.157), the low-risk (HR 0.64; 95% CI 0.49–0.84; P=0.001) and intermediate-risk groups (HR 0.68; 95% CI 0.55–0.85; P=0.001) could benefit from the surgery of primary site, while chemotherapy improved prognosis in all risk groups.ConclusionsA prognostic score was developed to accurately predict the prognosis of de novo BCLM patients. Moreover, it may be useful for further subdividing them into different risk groups and helping guide clinicians in treatment decisions.

2021 ◽  
pp. 1-11
Annesha Chatterjee ◽  
Seema Khadirnaikar ◽  
Sudhanshu Shukla

BACKGROUND: An increasing number of studies are indicating that the stemness phenotype is a critical determinant of the Lung adenocarcinoma (LUAD) patient’s response. Thus, it is crucial to identify novel biomarkers for stemness determination. OBJECTIVE: Here, we aim to develop a robust LncRNAs based prognostic signature with a stemness association for the LUAD patients. METHODS: RNA-seq and clinical data were downloaded from the existing database. The data were analysed using Cox regression, KM-plot, GSEA, and T-test. RESULTS: Initially, we used the TCGA dataset to characterize the stemness phenotype in LUAD. The commonly expressed LncRNAs in TCGA and MCTP cohort were then used as input for the Cox-regression analysis. The top three LncRNAs were selected to build a prognostic model, which was the best prognosticator in multivariate analysis with stage and previously published prognosticators. The characterization of poor surviving patients using various analysis showed high stemness properties and low expression of differentiation markers. Furthermore, we validated the prognostic score in an independent MCTP cohort of patients. In the MCTP cohort, prognostic score significantly predicted survival independent of stage and previous prognosticators. CONCLUSION: Taken together, in this study, we have developed and validated a new prognostic score associated with the stemness phenotype.

2021 ◽  
Vol 11 (1) ◽  
Kiyoshi Minohara ◽  
Takuma Matoba ◽  
Daisuke Kawakita ◽  
Gaku Takano ◽  
Keisuke Oguri ◽  

AbstractAlthough several prognostic factors in nivolumab therapy have been reported in recurrent or metastatic head and neck cancer (RM-HNC) patients, these factors remain controversial. Here, we conducted a multicenter retrospective cohort study to investigate the impact of clinico-hematological factors on survival in RM-HNC patients treated with nivolumab. We reviewed 126 RM-HNC patients from seven institutes. We evaluated the prognostic effects of clinico-hematological factors on survival. The median overall survival (OS) was 12.3 months, and the 1 year-OS rate was 51.2%. Patients without immune-related adverse events, lower relative eosinophil count, worse best overall response, higher performance status, and higher modified Glasgow Prognostic Score had worse survival. The score, generated by combining these factors, was associated with survival. Patients with score of 4–5 had worse survival than those with score of 2–3 and 0–1 [adjusted HR for PFS: score of 4–5, 7.77 (3.98–15.15); score of 2–3, 3.44 (1.95–6.06), compared to score of 0–1], [adjusted HR for OS: score of 4–5, 14.66 (4.28–50.22); score of 2–3, 7.63 (2.29–25.37), compared to score of 0–1]. Our novel prognostic score utilizing clinico-hematological factors might be useful to establish an individual treatment strategy in RM-HNC patients treated with nivolumab therapy.

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