-
European Journal of Pain (London,... Sep 2021Numerous systematic reviews have attempted to synthesize evidence on prognostic factors for predicting future outcomes such as pain, disability and return-to-work/work... (Review)
Review
BACKGROUND
Numerous systematic reviews have attempted to synthesize evidence on prognostic factors for predicting future outcomes such as pain, disability and return-to-work/work absence in neck and low back pain populations.
DATABASES AND DATATREATMENT
An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for each prognostic factor investigated. Searches were limited to the last 10 years (2008-11th April 2018, updated 28th September 2020). A two-stage approach was undertaken: in stage one, data on prognostic factors was extracted from systematic reviews identified from the systematic search that met the inclusion criteria. Where a prognostic factor was investigated in ≥1 systematic review and where 50% or more of those reviews found an association between the prognostic factor and one of the outcomes of interest, it was taken forward to stage two. In stage two, additional information extracted included the strength of association found, consistency of effects and risk of bias. The GRADE approach was used to grade confidence in the evidence.
RESULTS
Stage one identified 41 reviews (90 prognostic factors), with 35 reviews (25 prognostic factors) taken forward to stage two. Seven prognostic factors (disability/activity limitation, mental health; pain intensity; pain severity; coping; expectation of outcome/recovery and fear-avoidance) were judged as having moderate confidence for robust findings.
CONCLUSIONS
Although there was conflicting evidence for the strength of association with outcome, these factors may be used for identifying vulnerable subgroups or people able to self-manage. Further research can investigate the impact of using such prognostic information on treatment/referral decisions and patient outcomes.
Topics: Humans; Low Back Pain; Pain Measurement; Prognosis; Self Report; Systematic Reviews as Topic
PubMed: 33864327
DOI: 10.1002/ejp.1782 -
Medical Oncology and Tumor... 1989The predictive value of nuclear DNA content in mammary carcinoma is still under debate in spite of several reports indicating a relationship between DNA ploidy and... (Review)
Review
The predictive value of nuclear DNA content in mammary carcinoma is still under debate in spite of several reports indicating a relationship between DNA ploidy and prognosis. The impact of differences in methodology on the evaluation of DNA data is discussed, and a recent study demonstrating DNA ploidy as a statistically significant prognostic variable on a prospective material of breast cancer patients is presented.
Topics: Aneuploidy; Breast Neoplasms; Female; Follow-Up Studies; Humans; Prognosis
PubMed: 2664371
DOI: 10.1007/BF02985233 -
Annals of Surgical Oncology Jun 2021
Topics: Humans; Pancreatic Neoplasms; Prognosis
PubMed: 33230752
DOI: 10.1245/s10434-020-09386-6 -
European Journal of Surgical Oncology :... Sep 2016TNM staging is no doubt the most critical prognostic factors, representing tumor (T)/lymph node metastasis (N)/distant metastasis (M) in gastric cancer. Lymph node... (Review)
Review
TNM staging is no doubt the most critical prognostic factors, representing tumor (T)/lymph node metastasis (N)/distant metastasis (M) in gastric cancer. Lymph node ratio-based N system (Nr) has been repeatedly reported to be of prognostic relevance in advanced gastric cancer independent of stage in the multivariate analysis world-wide, and proposed as more sophisticated than N with regard to predicting accurate prognosis. As a result, proposed TNrM system may predict survival more accurately than the present TNM staging system for patients undergoing limited lymph node analysis. It could adjust stage migration when the lymph node number was used as staging factor. Although correlation of the number of metastatic lymph nodes and lymph node ratio is obvious, biological characteristics other than that could also have been reflected on. It may indicate how successful the operation of lymph node dissection was, or it may be revealing the potential of the patient's lymph node immune-reaction. Recently, high lymph node ratio is closely associated with EGFR expression in advanced gastric cancer. When efficiency of applying lymph node ratio as a biomarker is verified and confirmed in an expansive research, and when cancer causing molecules are identified, as well as the competence as a treatment target is studied, the new biomarker, namely, lymph node ratio, could find itself in a limelight in gastric cancer treatment in the future.
Topics: Carcinoma; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Multivariate Analysis; Neoplasm Staging; Prognosis; Stomach Neoplasms
PubMed: 27017273
DOI: 10.1016/j.ejso.2016.03.001 -
Journal of Cosmetic Dermatology Jul 2022Ten-year survival rates in mycosis fungoides (MF) broadly varies, however, there is no standardized prognostic index available. This is presumably due to low prevalence,... (Review)
Review
BACKGROUND
Ten-year survival rates in mycosis fungoides (MF) broadly varies, however, there is no standardized prognostic index available. This is presumably due to low prevalence, heterogeneity, and diagnostic challenges in MF. Recent studies have focused on identifying objective prognostic indices by using different parameters for survival determinants. The Cutaneous Lymphoma International Prognostic Index (CLIPI) and the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) represent prototypical studies that identify prognostic factors, seeking to improve management and outcomes in early-stage MF. Detecting these factors and stratifying MF patients according to their disease progression risk may help to manage these patients more efficiently.
AIMS
Review the current literature to determine the risk factors determining prognosis in MF.
METHODOLOGY
A Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar" using key words 'prognostic factor', 'prognostic indicator', 'mycosis fungoides', 'Sezary syndrome', 'Skin Lymphoma', 'Cutaneous Lymphoma'. Articles published in English language were considered for the review.
RESULTS
The strongest prognostic factor in MF patients is the stage of the disease. T stage and the presence of extracutaneous disease are the most important factors for survival. Other factors that are associated with worse prognosis are male gender, age >60, presence of plaques, folliculotropism, eosinophilia and lymph node stage above N1/Nx. Elevated LDH was associated with later tumor stages and large cell phenotype at diagnosis had a better prognosis. KIR3DL2 was associated with malignant transformation.
CONCLUSION
The PROCLIPI study has assessed risk factors collected in MF patients from different countries and across different ethnicities following a rigorous clinicopathologic process. The findings presented here illustrated that disease prognosis in early stages depends on many contributing factors. Detection and stratification of such factors may allow a personalized approach to management of these patients.
Topics: Female; Humans; Male; Mycosis Fungoides; Neoplasm Staging; Prognosis; Prospective Studies; Skin Neoplasms
PubMed: 34687485
DOI: 10.1111/jocd.14528 -
Nutrition and Cancer 2021Many reports have shown that the prognostic nutritional index (PNI) is associated with the clinical outcomes of patients with biliary tract cancer (BTC), with the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Many reports have shown that the prognostic nutritional index (PNI) is associated with the clinical outcomes of patients with biliary tract cancer (BTC), with the results being inconsistent. We therefore comprehensively evaluated the prognostic significance of the PNI in BTC by performing a meta-analysis.
METHODS
We identified relevant studies by searching PubMed, Embase, Web of Science and, the Cochrane Library. The combined hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used to evaluate the association between PNI and overall survival (OS) and the clinical characteristics of BTC.
RESULTS
We included seven studies with 1608 patients in this meta-analysis. The pretreatment low PNI correlated significantly with worse OS (HR = 1.65, 95%CI = 1.42-1.93, < 0.001). In addition, the prognostic effect of PNI are reliable in different subgroups of ethnicity, sample size, histology, treatment, PNI cutoff, and cutoff determination. The low PNI was also related to poor differentiation (OR = 1.95, 95%CI = 1.34-2.85, = 0.001) as well as higher T stage (OR = 2.51, 95%CI = 1.69-3.74, < 0.001) in BTC.
CONCLUSION
The low PNI is significantly associated with inferior prognosis of patients with BTC and aggressive clinical factors. The PNI could be applied as an independent prognostic marker for patients with BTC.
Topics: Biliary Tract Neoplasms; Humans; Neoplasm Staging; Nutrition Assessment; Prognosis; Proportional Hazards Models; Retrospective Studies
PubMed: 32933337
DOI: 10.1080/01635581.2020.1817955 -
Experimental Gerontology Dec 2018
Topics: Aged; Frail Elderly; Frailty; Geriatric Assessment; Humans; Prognosis
PubMed: 30393131
DOI: 10.1016/j.exger.2018.10.014 -
Surgical Oncology Clinics of North... Apr 2003Over the past decade, there has been significant emphasis on the elucidation of clinicopathologic prognostic factors in STS. This has allowed for identification of the... (Review)
Review
Over the past decade, there has been significant emphasis on the elucidation of clinicopathologic prognostic factors in STS. This has allowed for identification of the "high-risk" patient at presentation. Molecular factors may further refine the identification of high-risk patients. Setting-related prognostic factors are often amenable to change, and all STS patients should probably be referred for specialty consultation before treatment so that they can benefit from optimal diagnostic, therapeutic, and multidisciplinary approaches. The ongoing pursuit of prognostic issues should also recognize the dynamic nature of prognosis course in a patient's disease.
Topics: Clinical Trials as Topic; Humans; Neoplasm Staging; Prognosis; Sarcoma; Soft Tissue Neoplasms; Survival Analysis
PubMed: 12916458
DOI: 10.1016/s1055-3207(03)00011-5 -
Journal of Clinical Epidemiology Jan 2020Primary studies and systematic reviews of prognostic factors commonly analyze and report relative measures of association between the factor(s) and outcome(s) of...
BACKGROUND AND OBJECTIVES
Primary studies and systematic reviews of prognostic factors commonly analyze and report relative measures of association between the factor(s) and outcome(s) of interest. For decision making, however, guideline panelists, systematic reviewers, and health care professionals at the point of care will ultimately need the absolute risk of the outcome(s) in those with and without the prognostic factor(s) of interest. The objective of the study was to develop a framework for calculating the absolute risk of the outcome(s) in those with and without the prognostic factor(s) of interest.
METHODS
We developed a mathematical approach to calculate the absolute risk of events from the relative measure of association, the total number of events and patients at risk, and the prevalence of the prognostic factor, all of which are usually reported in cohort studies assessing prognostic factors. We demonstrate how simpler approximations lead to biased estimates of absolute risk and thus the need for these formulas. We explain our logical framework using the simplest case, in which the measure of association is a relative risk, and provide extensions of the formula to odds ratios and hazard ratios. The same formulas can be applied to reports providing only the relative measure of association (e.g., case-control studies) by using external evidence regarding prevalence of the prognostic factor and overall risk of events.
CONCLUSIONS
Our proposed formulas facilitate accurate calculation of measures of absolute risk in those with and without prognostic factors of interest for studies reporting the total number of events and patients at risk, the prevalence of the prognostic factor and a relative risk, odds ratio, or hazard ratio.
Topics: Bias; Humans; Models, Theoretical; Prognosis; Risk Assessment; Treatment Outcome
PubMed: 31589954
DOI: 10.1016/j.jclinepi.2019.08.012 -
European Journal of Cancer & Clinical... Mar 1989
Review
Topics: Breast Neoplasms; Female; Humans; Prognosis
PubMed: 2649377
DOI: 10.1016/0277-5379(89)90251-4