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Journal of Investigative Surgery : the... Dec 2023The prognostic significance of neural invasion (NI) in gastric cancer (GC) has not been established. This study is to investigate the characteristic and prognostic value...
BACKGROUND
The prognostic significance of neural invasion (NI) in gastric cancer (GC) has not been established. This study is to investigate the characteristic and prognostic value of NI in GC.
METHODS
592 patients who had undergone gastrectomy for GC were retrospectively analyzed. NI was defined when cancer cells infiltrated into the perineurium or neural fascicles by hematoxylin and eosin staining of surgical specimens. NI and the other clinical factors were analyzed.
RESULTS
NI was detected in 270 of the 592 patients. NI was associated with tumor size, site, depth of invasion, lymph node metastasis, TNM stage, D dissection, tumor differentiation, Lauren classification, and blood vessel invasion. NI was associated with the overall survival. Multivariate analysis indicated that NI was not an independent prognostic factor for total patients, while NI independently predicted prognosis for age < 60 and lymph node metastasis negative patients by subgroup analysis. Concomitant existence of NI with tumor size ≥3cm, TNM stage III, or diffused Lauren classification independently predicted prognosis.
CONCLUSIONS
The frequency of NI is high in GC patients and increases with disease progression. NI is related to poor survival in GC patients who underwent curative gastrectomy and provides independent prognostic value for young and lymph node metastasis negative patients.
Topics: Humans; Stomach Neoplasms; Lymphatic Metastasis; Prognosis; Retrospective Studies; Gastrectomy; Lymph Nodes
PubMed: 37731247
DOI: 10.1080/08941939.2023.2257785 -
Asia-Pacific Journal of Clinical... Aug 2023Colorectal cancer (CRC) is characterized by high morbidity and mortality. Inflammatory, metabolic, and immune factors are closely related to survival of patients with...
BACKGROUND
Colorectal cancer (CRC) is characterized by high morbidity and mortality. Inflammatory, metabolic, and immune factors are closely related to survival of patients with CRC, but their combined impact is unknown. Hence, we chose and evaluated the prognostic value of glucose to lymphocyte ratio (GLR) and a nomogram that include GLR for patients with CRC.
METHODS
A total of 1448 patients with CRC were included in our study, and their baseline clinicopathological characteristics and laboratory investigations were collected for analysis. We used Cox proportional hazard regression analyses (both univariate and multivariate) to determine prognostic values of clinical indicators. A nomogram was constructed, and concordance index (C-index) was used to assess the predictive power.
RESULTS
Multivariate analyses demonstrated GLR as an independent prognostic factor (hazard ratios 1.060; 95% confidence interval 1.030-1.091; p < .001). A nomogram was constructed integrating factors with clinical significance (sex) and those with independent prognostic value (age, body mass index, tumor stage, and GLR), and the model showed a C-index of .778 (.757-.799), which was higher than that of .738 (.717-.759) for tumor stage.
CONCLUSION
GLR can independently predict the prognoses of patients with CRC, and our nomogram provides more accurate prediction than TNM staging.
Topics: Humans; Prognosis; Nomograms; Neoplasm Staging; Lymphocytes; Colorectal Neoplasms
PubMed: 36479824
DOI: 10.1111/ajco.13904 -
Journal of Cancer Research and Clinical... Oct 2023Pancreatic solid pseudopapillary neoplasms (pSPNs) are a rare tumor type with a limited understanding of their clinical characteristics and survival outcomes. We aimed...
Comprehensive study of clinical features, prognostic factors, and survival in patients with pancreatic solid pseudopapillary neoplasms based on the 2019 WHO classification.
BACKGROUND
Pancreatic solid pseudopapillary neoplasms (pSPNs) are a rare tumor type with a limited understanding of their clinical characteristics and survival outcomes. We aimed to investigate potential prognostic factors among the existing clinical features in patients diagnosed with pSPN.
METHODS
For this study, we utilized data from the Surveillance Epidemiology and End Results (SEER) database, specifically selecting patients with a histology type of pSPN from the years 2000 to 2019. Subsequently, we conducted both univariate and multivariate Cox regression analyses in a systematic manner to identify potential prognostic factors associated with overall survival (OS) and cancer-specific survival (CSS) in the selected group of patients. To assess the disparity in OS and CSS among different clinical features and treatments, Kaplan-Meier curves were generated. Furthermore, utilizing the results obtained from the multivariate analysis, we developed a nomogram predictive model to effectively forecast the prognosis of patients diagnosed with pSPN. Calibration plots were presented to demonstrate the predictive accuracy and reliability of the nomogram predictive model.
RESULTS
The study comprised a total of 433 participants, with 85.7% of the patients diagnosed with pSPN being female and the remaining 14.3% being male. The Kaplan-Meier curves indicated that patients with pSPN who underwent primary tumor resection (PTR) and those who were younger than 70 years old had significantly improved OS and CSS compared to those who did not undergo PTR or were aged 70 years or older, respectively (P < 0.001). Male patients diagnosed with pSPN exhibited poor OS compared to female pSPN patients (P = 0.015). The multivariate Cox regression analysis indicated that age (OS: HR = 1.055, 95% CI = 1.027-1.084, P < 0.001. CSS: HR = 1.054, 95% CI = 1.019-1.091, P = 0.002) and PTR (OS: HR = 6.074, 95% CI = 1.922-19.194, P = 0.002. CSS: HR = 4.912, 95% CI = 1.188-20.312, P = 0.028) were independent prognostic factors for both OS and CSS. Moreover, tumor size (≥ 5 vs < 5 cm CSS: HR = 4.788, 95% CI = 1.012-22.661, P = 0.048) was an independent prognostic factor for CSS. The independent prognostic factors identified through the multivariate Cox regression analysis were utilized to construct a nomogram model for predicting both OS and CSS in patients with pSPN. The accuracy of the nomogram model was visually testified by the calibration plot with acceptable predictive performance.
CONCLUSION
Although the majority of patients diagnosed with pSPN are females, it was observed that male patients tend to have poorer OS compared to their female counterparts. The independent prognostic factors identified in the study were age and PTR, which were associated with both OS and CSS. Tumor size was an independent prognostic factor for CSS. Patients who underwent PTR exhibited improved OS and CSS outcomes. The developed nomogram and corresponding reference table provided promising prognostic predictions for pSPN outcoms, serving as a valuable resource for clinicians and patients alike.
Topics: Humans; Female; Male; Aged; Prognosis; Reproducibility of Results; Neoplasms; Nomograms; World Health Organization; SEER Program
PubMed: 37438539
DOI: 10.1007/s00432-023-04982-x -
Thoracic Cancer Sep 2022The histological subtype has been introduced in invasive lung adenocarcinoma. The predominant micropapillary and solid subtypes are categorized as high-grade patterns...
BACKGROUND
The histological subtype has been introduced in invasive lung adenocarcinoma. The predominant micropapillary and solid subtypes are categorized as high-grade patterns and provide a worse prognosis. However, the prognostic analysis of high-grade patterns has not previously been fully investigated. Thus, this study aimed to investigate the prognostic role of high-grade patterns in pathological stage I lung adenocarcinoma.
METHODS
Patients with stage I lung adenocarcinoma and micropapillary or solid components were reviewed. Clinicopathological features and clinical course were compared in these subtypes, and prognostic factors were analyzed in high-grade patterns.
RESULTS
The patients were classified into five groups based on the presence of micropapillary or solid subtypes, namely, micropapillary predominant, solid predominant, both nonpredominant subtypes, only minor micropapillary subtype, and only minor solid subtype present. Disease-free interval was significantly different, and the micropapillary predominant group showed worse disease-free interval (p = 0.001). Contrastingly, the solid predominant group showed significantly worse overall survival among high-grade patterns (p = 0.035). The multivariate analysis revealed an association between smoking, micropapillary predominant, blood vessel invasion, and visceral pleural invasion with recurrence and more association between solid predominant and visceral pleural invasion with overall survival.
CONCLUSIONS
Clinical results were different in stage I high-grade adenocarcinoma. The predominant micropapillary subtype is the independent prognostic factor for recurrence. However, the solid subtype is the significant factor for overall survival. Furthermore, the predominant subtype is the most valuable and independent prognostic factor for predicting recurrence or survival.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Humans; Lung Neoplasms; Neoplasm Staging; Prognosis; Retrospective Studies
PubMed: 35820717
DOI: 10.1111/1759-7714.14578 -
Diseases of the Esophagus : Official... Jul 2022Adjuvant treatment after upfront esophagectomy for esophageal squamous cell carcinoma (ESCC) is indicated only for patients with lymph node metastasis in Japan. However,...
Adjuvant treatment after upfront esophagectomy for esophageal squamous cell carcinoma (ESCC) is indicated only for patients with lymph node metastasis in Japan. However, the recurrence rate after curative resection is high even for node-negative patients; thus, understanding the prognostic factors for patients with node-negative ESCC, which still remains unidentified, is important. Here, we aimed to reveal the prognostic factors for the long-term outcomes of patients with node-negative ESCC. Moreover, we compared the long-term outcomes among high-risk node-negative and node-positive patients. This single-institution retrospective study included 103 patients with pT1b-3N0 ESCC who underwent upfront surgery to identify the population at a high risk of recurrence. To compare overall survival (OS) and recurrence-free survival (RFS) between high-risk node-negative and node-positive patients, 51 node-positive ESCC patients with pStage IIIA or less who had undergone upfront surgery were also included. Univariable and multivariable analyses were performed using the Cox proportional hazard regression model. OS and RFS were compared using the log-rank test. Only lymphatic invasion (Ly+) was associated with worse 3-year OS (hazard ratio, 8.63; 95% confidence interval, 2.09-35.69; P = 0.0029) and RFS (hazard ratio, 4.87; 95% confidence interval, 1.69-14.02; P = 0.0034). The node-negative and Ly+ patients showed significantly worse OS (P = 0.0242) and RFS (P = 0.0114) than the node-positive patients who underwent chemotherapy. Ly+ is the only independent prognostic factor in patients with node-negative ESCC. Patients with node-negative and Ly+ ESCC may benefit from adjuvant treatment.
Topics: Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Humans; Neoplasm Staging; Prognosis; Retrospective Studies
PubMed: 34937084
DOI: 10.1093/dote/doab087 -
Clinical Colorectal Cancer Jun 2022The prognostic value of tumor regression grade (TRG) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy has been explored...
BACKGROUND
The prognostic value of tumor regression grade (TRG) in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy has been explored extensively. However, whether TRG is predictive of outcome in colon cancer following preoperative chemotherapy has not been reported.
MATERIALS AND METHODS
A total of 276 colon cancer patients who had undergone preoperative chemotherapy and surgery in Fudan University Shanghai Cancer Center during the period March 2014 through November 2019 were recruited in this study. 113 (40.9%) and 163 (59.1%) patients were diagnosed with locally advanced colon cancer (LACC) and metastatic colon cancer (mCC) before preoperative chemotherapy, respectively. The TRG was divided into TRG0 (complete response), TRG1 (good response), TRG2 (moderate response), and TRG3 (poor response).
RESULTS
Of the 276 patients 4.0% were TRG0, 5.4% were TRG1, 29.3% were TRG2, 61.2% were TRG3. TRG0 and TRG1 or TRG0, TRG1 and TRG2 were combined to simplify analysis due to limited sample size. In entire cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 80.0%, 68.8% and 43.3% (P = .003). In LACC cohort, TRG was not associated with patients' prognosis, which largely resulted from limited outcome events. In mCC cohort, the 3-year overall survival for TRG0-1, TRG2, and TRG3 groups were 74.3%, 62.8% to 28.1% (P<0.001). Multivariate analysis demonstrated that TRG was an independent prognostic factor for overall survival in both entire cohort and mCC cohort (TRG3 vs. TRG0-2).
CONCLUSION
TRG is a prognostic factor in predicting long-term outcomes of mCC patients treated with preoperative chemotherapy.
Topics: Chemoradiotherapy; China; Colonic Neoplasms; Disease-Free Survival; Humans; Neoadjuvant Therapy; Neoplasm Staging; Prognosis; Rectal Neoplasms; Retrospective Studies; Treatment Outcome
PubMed: 34895989
DOI: 10.1016/j.clcc.2021.10.006 -
Clinical and Experimental Medicine Oct 2023Platelets (PLTs) are believed to play a role in the process by which tumors can accelerate their growth rate, as well as offer the physical and mechanical support... (Review)
Review
Platelets (PLTs) are believed to play a role in the process by which tumors can accelerate their growth rate, as well as offer the physical and mechanical support necessary to evade the immunological system and metastasis. There is, however, no literature available if PLTs have a role in leukemia. It is significant for PLTs to play a part in hematological malignancies from a therapeutic standpoint and to have the capacity to serve as a prognostic marker in the evolution of leukemia. This is because PLTs play a crucial role in the development of cancer and tumors. In this study, it will be shown that PLT count can be used to predict long-term prognosis after chemotherapy especially in the case of acute myeloid leukemia patients. Furthermore, low PLT-to-lymphocyte ratio and mean PLT volume, as well as high PLT distribution width, are associated with poor prognosis and may represent a novel independent prognostic factor.
Topics: Humans; Platelet Count; Prognosis; Blood Platelets; Neoplasms; Leukemia
PubMed: 36622510
DOI: 10.1007/s10238-022-00985-z -
Inflammation Research : Official... Oct 2017Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in infected patients. The present study evaluated the diagnostic accuracy of DNI as a predictive and prognostic factor in infected patients.
METHODS
We performed a PubMed search on January 1st, 2017 and identified studies that evaluated DNI as either a predictive or prognostic factor in infected patients. Studies with appropriate information to construct 2 × 2 contingency tables were extracted. We calculated pooled sensitivity and specificity. Meta-analysis of the multivariate logistic regression data set was performed to assess whether DNI functions as an independent factor.
RESULTS
Overall, 12 articles fulfilled the inclusion criteria and a total of 499 cases and 9549 controls were examined. As a predictive factor of infection, DNI's pooled sensitivity was 0.67 (95% CI 0.62-0.71, I = 86.0%) and pooled specificity was 0.94 (95% CI 0.94-0.95, I = 92.8%). Area under the receiver operating characteristics (ROC) curve was 0.89. As a prognostic factor for death in infected patients, DNI's pooled sensitivity was 0.70 (95% CI 0.56-0.81, I = 0.0%) and pooled specificity was 0.78 (95% CI 0.73-0.83, I = 26.6%). Area under the ROC curve was 0.84. Meta-analysis of the multivariate logistic regression data set showed insignificant results.
CONCLUSIONS
DNI is a potentially useful diagnostic tool and predicts mortality among infected patients and should be more widely used in the clinical practice.
Topics: Animals; Biomarkers; Humans; Infections; Neutrophils; Prognosis; Sensitivity and Specificity
PubMed: 28646289
DOI: 10.1007/s00011-017-1066-y -
Arquivos Brasileiros de Cardiologia Nov 2022
Topics: Female; Humans; Brazil; ST Elevation Myocardial Infarction; Prognosis
PubMed: 36453761
DOI: 10.36660/abc.20220688 -
Cirugia Espanola May 2022In the gastric cancer the most widely used classification is the AJCC TNM system. However, it presents limitations, such as staging migration in cases with suboptimal...
INTRODUCTION
In the gastric cancer the most widely used classification is the AJCC TNM system. However, it presents limitations, such as staging migration in cases with suboptimal lymphadenectomies. The nodal ratio has been proposed as an alternative system, proving to be a good prognostic predictor of survival. The aim was to assess the influence of the nodal ratio measured in tertiles [tNR] as a prognostic factor and compare with the TNM systems (7th ed.) and log odds of positive lymph nodes [LODDS].
MATERIAL AND METHODS
Retrospective and single-center study on 199 patients operated on with curative intent between 2010 and 2014. For each system an univariate and multivariate analysis was performed and the overall survival rates [OS] were compared by the ROC test.
RESULTS
The prognostic factors that showed statistical significance in the multivariate analysis were: tRN2 (HR2.87) and tRN3 (HR7.29); LODDS 2 (HR1.55), LODDS3 (HR2.6) and LODDS4 (HR4.9); pN2 (HR1.84) and pN3 (HR2.91). The 5-year OS was 75.8%, 61.4%, 25.8%, and 3.84% for tRN0, tRN1, tRN2 and tRN3; 72.4%, 60%, 29.1% and 13.9% for LODDS1, LODDS2, LODDS3 and LODDS4; and 77.6%, 59.4%, 28.8% and 25.5% for pN0, pN1, pN2 and pN3, respectively. The three systems behaved as good predictors, with areas under the curve >0.75.
CONCLUSION
tNR was an independent prognostic factor for estimating survival in gastric cancer. Furthermore, the ease of its calculation in clinical practice could reduce the effect of staging migration.
Topics: Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasm Staging; Prognosis; Retrospective Studies; Stomach Neoplasms
PubMed: 35487434
DOI: 10.1016/j.cireng.2022.04.003