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International Journal of Colorectal... Mar 2019The aim of the present study is to explore the prognostic impact of a subdivision of pT2 by the depth of invasion into the muscularis propria in rectal carcinomas.
PURPOSE
The aim of the present study is to explore the prognostic impact of a subdivision of pT2 by the depth of invasion into the muscularis propria in rectal carcinomas.
METHODS
Data from 269 consecutive patients with rectal carcinoma treated with primary tumor resection and lymph node dissection between 1986 and 2012 were analyzed with respect to locoregional and distant recurrence, disease-free survival, and overall survival. The depth of invasion into the muscularis propria of pT2 carcinomas was categorized by the pathologist into two groups: pT2a, invasion into the inner half of the muscularis propria; pT2b, invasion into the outer half of the muscularis propria.
RESULTS
One hundred nineteen of the 269 patients (44.2%) were classified pT2a and 150 patients (55.8%) were classified pT2b. In univariate analysis, significant differences between pT2a and pT2b carcinomas were found for locoregional recurrences (5-year rates 5.3 vs 14.0%; p = 0.025), distant metastases (14.1 vs 18.7%; p = 0.026), disease-free survival (78.2 vs 62.5%; p = 0.022), and overall survival (87.4 vs 72.5%; p = 0.013). In multivariate Cox regression analysis, the pT2 subdivision was found to be an independent risk factor for locoregional recurrence (hazard ratio 2.6; p = 0.023), disease-free survival (HR 1.4; p = 0.022), and overall survival (HR 1.5; p = 0.020), but only marginally for distant metastasis (HR 1.7; p = 0.083). Other independent prognostic factors were lymph node status, lymphatic invasion, and grading.
CONCLUSIONS
The depth of invasion into the muscularis propria is an independent prognostic factor for pT2 rectal carcinomas that will support decision-making for preoperative, surgical, and postoperative treatment.
Topics: Adult; Aged; Aged, 80 and over; Disease-Free Survival; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Rectal Neoplasms; Young Adult
PubMed: 30515557
DOI: 10.1007/s00384-018-3216-2 -
Journal of Clinical Epidemiology Apr 1999The prognosis of solid tumors is predominantly influenced by the anatomic extent before and after initial treatment. It is defined by the TNM/pTNM system and the...
The prognosis of solid tumors is predominantly influenced by the anatomic extent before and after initial treatment. It is defined by the TNM/pTNM system and the residual tumor (R) classification as internationally agreed on and published by the International Union Against Cancer (UICC). However, there are several independent factors effective in prognosis in addition to TNM and R. Their identification is the first objective in prognostic factor research. Correctly applied multivariate methods appropriate for the specific situation play a key role. Cooperation between clinical oncologists and experienced medical statisticians is indispensable. Putative new prognostic factors have to be carefully evaluated before they can be accepted for general use in clinical oncology. In the future, we have to focus on the development of prognostic systems. Such systems integrate multiple independent prognostic factors with present staging (TNM, R) to improve the assessment of prognosis.
Topics: Humans; Multivariate Analysis; Neoplasms; Prognosis
PubMed: 10235178
DOI: 10.1016/s0895-4356(98)00177-2 -
Asian Journal of Surgery Dec 2023
Topics: Humans; Blood Glucose; Prognosis; Thrombectomy; Treatment Outcome; Retrospective Studies
PubMed: 37640643
DOI: 10.1016/j.asjsur.2023.08.100 -
Annals of Palliative Medicine Apr 2021Nowadays, controlling nutritional status (CONUT) has been used as a prognostic factor in variety of cancers. However, no consensus has been reached on the prognostic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nowadays, controlling nutritional status (CONUT) has been used as a prognostic factor in variety of cancers. However, no consensus has been reached on the prognostic value of CONUT in lung cancer. In this study, we aim to investigate the role of CONUT in survival of patients with lung cancer.
METHODS
EMBASE, web of science, and Medline were used to search articles in English-language journals. The association between CONUT score and survival of patients with lung cancer was evaluated by using pooled HRs and their 95% CIs. Chi-square test and I-Square was used to test heterogeneity among studies. Analyses were all performed using Stata 13.0 (Stata Corporation, College Station, TX).
RESULTS
Eight studies with 1,836 patients were eventually included in this meta-analysis. The pooled results showed that high CONUT score had an unfavorable impact on OS (HR =1.63, 95% CI: 1.30-2.04), DFS (HR =1.75, 95% CI: 1.35-2.26), CSS (HR =1.45, 95% CI: 1.01-2.07) and PFS (HR =1.67, 95% CI: 0.99-2.35), compared with those with low-CONUT.
CONCLUSIONS
CONUT can be used as a predictor of prognosis in patients with lung cancer. High-CONUT score was significantly associated with poor OS, DFS, CSS and PFS.
Topics: Humans; Lung Neoplasms; Nutritional Status; Prognosis; Retrospective Studies
PubMed: 33548999
DOI: 10.21037/apm-20-2328 -
International Journal of Oral and... Jan 2022Oral cancer is the most common malignancy of the head and neck region, characterized by a poor prognosis. Novel prognostic markers are needed to better stratify these... (Review)
Review
Oral cancer is the most common malignancy of the head and neck region, characterized by a poor prognosis. Novel prognostic markers are needed to better stratify these patients. Lymphovascular invasion (LVI) has been included in the eighth edition of the AJCC Cancer Staging Manual as an additional prognostic factor, but its influence on the recurrence risk and lymph node metastasis is relatively understudied. This is a comprehensive review of the literature on the clinical and prognostic role of LVI in oral cancer. A relevant search of the PubMed, Scopus, and Web of Science databases yielded 29 articles that satisfied the inclusion criteria. Findings indicated that LVI is an independent negative prognostic factor in oral cancer patients and appears to be associated with cervical lymph node metastasis and loco-regional recurrence. Notably, in oral tongue cancer, survival outcomes progressively worsen when LVI is associated with other adverse pathological features, especially in the early stages. Therefore, these patients could benefit from elective neck dissection and/or adjuvant therapy. The high variability of LVI prevalence hinders the comparison of literature results. Several methodological limitations were found to be present in the collected articles, including the lack of a rigorous definition for LVI, the difficult detection in routine histological section, the presence of potential confounders, the retrospective nature, and an inadequate sample size in most studies. Therefore, it is necessary to conduct prognostic studies using standardized methods to define and quantify LVI.
Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Mouth Neoplasms; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck
PubMed: 33814227
DOI: 10.1016/j.ijom.2021.03.007 -
Neuro-Chirurgie May 2021Unfavorable outcomes occur in 15-20% of patients with mild traumatic brain injury (mTBI). Early identification of patients at risk of unfavorable outcome is crucial for... (Review)
Review
BACKGROUND
Unfavorable outcomes occur in 15-20% of patients with mild traumatic brain injury (mTBI). Early identification of patients at risk of unfavorable outcome is crucial for suitable management to be initiated, increasing the chances of full recovery. Many studies have been published on prognostic factors, but are not of a high level of evidence and certainty. A number of factors have been proposed and predictive models have been constructed that, although attractive, have not yet been externally validated.
OBJECTIVES
A review of literature (systematic search of PubMed and Google Scholar) assembled relevant available information about prognostic factors for unfavorable outcome after mTBI. We discuss the consistency of these findings, and the possibility and difficulty of using these factors in a daily practice.
RESULTS
It appears that the strongest and most consistent predictors are the number, severity and duration of symptoms present in the first few days after the trauma.
Topics: Brain Concussion; Humans; Predictive Value of Tests; Prognosis; Treatment Outcome
PubMed: 32593671
DOI: 10.1016/j.neuchi.2020.04.129 -
JAMA Otolaryngology-- Head & Neck... Feb 2019
Topics: Hearing; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Humans; Prognosis; Vertigo
PubMed: 30520981
DOI: 10.1001/jamaoto.2018.3332 -
Thoracic Cancer Dec 2022Many non-small cell lung cancer (NSCLC) tumors present complex histology with various components. The effects of the lepidic growth component (LGC) on the prognosis of...
BACKGROUND
Many non-small cell lung cancer (NSCLC) tumors present complex histology with various components. The effects of the lepidic growth component (LGC) on the prognosis of NSCLC have not been investigated. Here, we investigated whether an LGC is a relevant prognostic factor for NSCLC.
METHODS
This study retrospectively investigated the clinicopathologic characteristics of 379 patients with NSCLC ≤3 cm who underwent complete surgical resection between 2004 and 2016 at the University of Yamanashi Hospital. The histologic subtypes were classified into NSCLC with or without an LGC. We evaluated the effect of an LGC on the clinicopathologic features and 5-year overall survival of patients with NSCLC.
RESULTS
On final pathology, 214 (56%) of 379 patients had an LGC, and 165 (44%) did not. Sex, smoking history, ground-glass opacity component, pathologic invasive size, lymph node metastasis, pleural invasion, vessel invasion, pathologic stage, and histologic type were significantly different between the groups. Multivariate analysis of 5-year overall survival, identified age (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.035-1.105; p < 0.001), pathologic invasive size (HR, 1.548; 95% CI, 1.088-2.202; p = 0.015) and LGC (HR, 2.11; 95% CI, 1.099-4.051; p = 0.025) as independent prognostic factors. When the pathologic invasive size was matched, the 5-year overall survival of the LGC and non-LGC groups was 93% and 77%, respectively (p = 0.006).
CONCLUSIONS
LGC is a significantly favorable prognostic factor for NSCLC with a pathologic invasive size of ≤3 cm.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Prognosis; Lung Neoplasms; Retrospective Studies; Neoplasm Staging; Neoplasm Invasiveness
PubMed: 36218004
DOI: 10.1111/1759-7714.14680 -
Asian Journal of Surgery Apr 2023
Preoperative hydronephrosis represents an unfavorable prognostic factor in patients with muscle-invasive bladder cancer undergoing radical cystectomy from a single high-volume center.
Topics: Humans; Cystectomy; Prognosis; Urinary Bladder Neoplasms; Hydronephrosis; Muscles; Retrospective Studies; Neoplasm Staging
PubMed: 36207207
DOI: 10.1016/j.asjsur.2022.09.111 -
Journal of Gastroenterology Mar 2022The prognostic nutritional index (PNI) and Charlson comorbidity index (CCI) have been useful for predicting the prognosis based on nutritional condition and...
BACKGROUND
The prognostic nutritional index (PNI) and Charlson comorbidity index (CCI) have been useful for predicting the prognosis based on nutritional condition and comorbidities in surgery and endoscopic mucosal dissection. The age-adjusted CCI (ACCI) has also been reported to be useful in surgery, but it has not been applied to endoscopic treatment. We therefore clarified the prognostic factors associated with ampullary tumors treated with endoscopic papillectomy (EP).
METHODS
From January 2003 to December 2020, 236 patients who underwent EP for sporadic ampullary tumors at Nagoya University Hospital were included in this study. The 5-year survival and ability to predict the prognosis were evaluated in terms of the sex, PNI, ACCI, final pathological diagnosis, and intraductal extension.
RESULTS
During a median follow-up period of 1558 days, 17 patients died. No patient died of the primary disease. The 5-year survival rate was 91.1%. In a univariate analysis, only a high ACCI (≥ 5) was extracted as a significant prognostic factor (Odds ratio, 12.2; 95% confidence interval, 3.81-39.3; p < 0.001). The 5-year survival rates for a low ACCI (≤ 4) and high ACCI were 96.6% and 73.5%, respectively (p < 0.001).
CONCLUSIONS
A high ACCI is an important prognostic factor associated with the 5-year survival and a risk of death from other illness. Ampullary tumors suitable for EP are less likely to be a prognostic factor, and treatment-free follow-up may be acceptable in patients with a high ACCI.
Topics: Comorbidity; Humans; Pancreatic Neoplasms; Prognosis; Retrospective Studies; Survival Rate
PubMed: 35098349
DOI: 10.1007/s00535-022-01853-z