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BMC Medicine May 2022Factors contributing to the lack of understanding of research studies include poor reporting practices, such as selective reporting of statistically significant findings... (Review)
Review
BACKGROUND
Factors contributing to the lack of understanding of research studies include poor reporting practices, such as selective reporting of statistically significant findings or insufficient methodological details. Systematic reviews have shown that prognostic factor studies continue to be poorly reported, even for important aspects, such as the effective sample size. The REMARK reporting guidelines support researchers in reporting key aspects of tumor marker prognostic studies. The REMARK profile was proposed to augment these guidelines to aid in structured reporting with an emphasis on including all aspects of analyses conducted.
METHODS
A systematic search of prognostic factor studies was conducted, and fifteen studies published in 2015 were selected, three from each of five oncology journals. A paper was eligible for selection if it included survival outcomes and multivariable models were used in the statistical analyses. For each study, we summarized the key information in a REMARK profile consisting of details about the patient population with available variables and follow-up data, and a list of all analyses conducted.
RESULTS
Structured profiles allow an easy assessment if reporting of a study only has weaknesses or if it is poor because many relevant details are missing. Studies had incomplete reporting of exclusion of patients, missing information about the number of events, or lacked details about statistical analyses, e.g., subgroup analyses in small populations without any information about the number of events. Profiles exhibit severe weaknesses in the reporting of more than 50% of the studies. The quality of analyses was not assessed, but some profiles exhibit several deficits at a glance.
CONCLUSIONS
A substantial part of prognostic factor studies is poorly reported and analyzed, with severe consequences for related systematic reviews and meta-analyses. We consider inadequate reporting of single studies as one of the most important reasons that the clinical relevance of most markers is still unclear after years of research and dozens of publications. We conclude that structured reporting is an important step to improve the quality of prognostic marker research and discuss its role in the context of selective reporting, meta-analysis, study registration, predefined statistical analysis plans, and improvement of marker research.
Topics: Biomarkers, Tumor; Humans; Prognosis; Research Design
PubMed: 35546237
DOI: 10.1186/s12916-022-02304-5 -
Asian Journal of Surgery Nov 2023
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Prognosis; Nomograms; Lung Neoplasms; Inflammation
PubMed: 37419796
DOI: 10.1016/j.asjsur.2023.06.042 -
Swiss Medical Weekly Feb 2021We aimed to analyse the nodal spread of our non-small cell lung cancer pN2 cohort according to tumour location, the possible implications of an unusual spreading... (Observational Study)
Observational Study
BACKGROUND
We aimed to analyse the nodal spread of our non-small cell lung cancer pN2 cohort according to tumour location, the possible implications of an unusual spreading pattern, and other factors influencing postoperative survival after anatomical lung resection.
METHODS
In this retrospective observational study, clinical data was collected for 124 consecutive non-small cell lung cancer (NSCLC) patients with a pathological N2 (stage IIIA or B) undergoing anatomical lung resection at our institution between 2001 and 2010. Cox regression was used to analyse independent predictors of 5-year overall survival and recurrence-free survival.
RESULTS
A total of 105 patients were included in the final analysis. Tumour location in the right upper lobe and middle lobe was significantly more often associated with involvement of lymph node stations 2 and 4 than NSCLC in the right lower lobe (station 2: right upper vs right lower lobe, p = 0.001 and middle vs right lower lobe, p = 0.038; station 4: right upper vs right lower lobe, p<0.001 and middle vs right lower lobe, p = 0.056), while tumours in the right upper lobe showed significantly less involvement of stations 7 and 8 compared with right lower lobe tumours (station 7 p <0.001, station 8 p = 0.004). Left sided tumours in the upper lobe had significantly more involvement of station 5 compared to lower lobe tumours (p = 0.009). However, atypical lymphatic nodal zone involvement did not emerge as a significant predictor of survival. Lymphovascular invasion was the only independent prognostic factor for 5-year overall survival (hazard ratio [HR] 2.10, p = 0.015) and recurrence-free survival (HR 1.68, p = 0.049) when controlled for adjuvant therapy.
CONCLUSION
Lymphovascular invasion was identified as the only independent prognostic factor for 5-year overall survival and recurrence-free survival in our pathologically proven N2 NSCLC cohort when controlled for adjuvant therapy. This study extends the current evidence of an adverse prognostic effect of lymphovascular invasion on a stage III population, confirms the adverse prognostic effect of lymphovascular invasion detected by immunohistochemistry, and thereby reveals another subgroup within the pN2 population with worse prognosis regarding 5-year overall survival and recurrence-free survival.  .
Topics: Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Lymphatic Metastasis; Neoplasm Staging; Prognosis; Retrospective Studies
PubMed: 33577703
DOI: 10.4414/smw.2021.20385 -
Leukemia & Lymphoma Apr 2021We retrospectively analyzed immunosuppression status in 287 newly diagnosed multiple myeloma (MM) patients and assessed the prognostic value of immunoparesis on...
We retrospectively analyzed immunosuppression status in 287 newly diagnosed multiple myeloma (MM) patients and assessed the prognostic value of immunoparesis on survival. Deep immunoparesis was defined that one of uninvolved immunoglobulins was below 50% the lower limit of normal ranges, partial immunoparesis was defined at least two suppressed uninvolved immunoglobulins. We found that patients with deep and partial immunoparesis had a significantly shorter median overall survival (OS) and progression-free survival (PFS). Moreover, deep and partial immunoparesis was a poor prognostic factor for OS and PFS in univariate and multivariable analyses. To reduce the bias between the groups, we performed a 1:1 propensity score matching technique for analysis and found that patients with deep and partial immunoparesis also had shorter OS and PFS. Our study showed that deep and partial immunoparesis can be defined an independent poor prognostic factor for patients with newly diagnosed MM.
Topics: Humans; Immunoglobulins; Multiple Myeloma; Prognosis; Progression-Free Survival; Retrospective Studies
PubMed: 33275060
DOI: 10.1080/10428194.2020.1855345 -
Journal of the College of Physicians... Jan 2022To investigate factors that may affect prognosis in gastrointestinal stromal tumors (GISTs).
OBJECTIVE
To investigate factors that may affect prognosis in gastrointestinal stromal tumors (GISTs).
STUDY DESIGN
A descriptive study.
PLACE AND DURATION OF STUDY
Karadeniz Technical University Hospital, Trabzon, Turkey from 2000 to 2019.
METHODOLOGY
All the patients diagnosed with GIST and followed-up in this centre were included. Those who were not followed-up in this centre were excluded. The Chi-square test for differences between variables in independent groups; and the Kaplan-Meier method for survival rates were used.
RESULTS
Median tumor size was larger in patients with recurrence, compared to those without (8cm vs. 5 cm, p <0.001). Recurrence rates were higher with mitosis ≥5 in 50 high-power-fields than with low mitosis (52.6% vs. 23.4%, p = 0.021). Median Ki-67 percentages were higher in patients with recurrence than without (5 vs. 2, p = 0.031). Recurrence rates were higher with necrosis and bleeding than without (57.7% vs. 14.3%, p = <0.001; 50% vs. 13.8%, p = 0.003). Median overall-survival (OS) was shorter in with mitotic counts ≥5 compared to <5 (52.0 vs. 110.0 months, p = 0.051) and with ulceration than without (36.0 vs. 110.0 months, p = 0.017). The groups below (<43.5) and above (>43.5) the median prognostic-nutritional-index (PNI) value were similar in terms of OS and disease-free survival (DFS) (52 vs. 70 months, p = 0.174; 82 vs. 100 months, p = 0.411). Median DFS was shorter with ulceration than without (27 vs. 100 months, p = 0.048).
CONCLUSION
While necrosis, bleeding, ulceration, mitosis, size, and Ki-67 significantly affect the prognosis in GIST, PNI has no significant effect. Key Words: Gastrointestinal stromal tumors (GIST), Survival, Prognosis, Recurrence, Prognostic Nutrition Index (PNI).
Topics: Disease-Free Survival; Gastrointestinal Stromal Tumors; Humans; Nutrition Assessment; Prognosis; Retrospective Studies
PubMed: 34983153
DOI: 10.29271/jcpsp.2022.01.81 -
Pathology Oncology Research : POR Jun 2008A useful prognostic factor in breast cancer has key roles, including identification of a group of patients whose prognosis is so good they do not require further... (Review)
Review
A useful prognostic factor in breast cancer has key roles, including identification of a group of patients whose prognosis is so good they do not require further treatment, such as adjuvant systemic therapy, after local surgery, and secondly a group with a poor prognosis for whom additional treatment would be appropriate. To be of clinical use, prognostic factors must show a wide separation in the outcome of the groups identified and select adequate numbers in each group. No single prognostic factor in invasive carcinoma of the breast satisfies all these criteria. However, the Nottingham prognostic index (NPI), which combines nodal status, tumour size and histological grade, does satisfy these criteria. The NPI has been validated by further studies in Nottingham and by studies in several other countries. Predictive factors, such as oestrogen receptor and HER-2 status, predict whether a tumour is likely to respond to a treatment, and are complimentary to prognostic factors. The NPI can be used in combination with predictive factors to select patients for systemic adjuvant treatments. There is the potential to improve the NPI by inclusion of other factors, such as vascular invasion, but any such alterations would require further validation.
Topics: Breast Neoplasms; Disease Progression; Female; Humans; Lymphatic Metastasis; Prognosis
PubMed: 18543079
DOI: 10.1007/s12253-008-9067-3 -
Aging Aug 2023Glioma is the most common primary intracranial tumor in the central nervous system, with a high degree of malignancy and poor prognosis, easy to recur, difficult to...
Glioma is the most common primary intracranial tumor in the central nervous system, with a high degree of malignancy and poor prognosis, easy to recur, difficult to cure. The mutation of Retinitis Pigmentosa 2 (RP2) can cause retinitis pigmentosa, it is a prognostic factor of osteosarcoma, however, its role in glioma remains unclear. Based on the data from TCGA and GTEx, we identified RP2 as the most related gene for glioma by WGCNA, and used a series of bioinformatics analyses including LinkedOmics, GSCA, CTD, and so on, to explore the expression of RP2 in glioma and the biological functions it is involved in. The results showed that RP2 was highly expressed in glioma, and its overexpression could lead to poor prognosis. In addition, the results of enrichment analysis showed that RP2 was highly correlated with cell proliferation and immune response. And then, we found significant enrichment of Macrophages among immune cells. Furthermore, our experiments have confirmed that Macrophages can promote the development of glioma by secreting or influencing the secretion of some cytokines. Moreover, we investigated the influence of RP2 on the immunotherapy of glioma and the role of m6A modification in the influence of RP2 on glioma. Ultimately, we determined that RP2 is an independent prognostic factor that is mainly closely related to immune for glioma.
Topics: Humans; Prognosis; Glioma; Retinitis Pigmentosa; Bone Neoplasms; Biomarkers; Membrane Proteins; GTP-Binding Proteins
PubMed: 37602882
DOI: 10.18632/aging.204962 -
International Journal of Oral and... Mar 2020The purpose of this study was to analyze the oncological outcomes and predictive factors for successful curative salvage surgery after recurrent oral cavity squamous...
The purpose of this study was to analyze the oncological outcomes and predictive factors for successful curative salvage surgery after recurrent oral cavity squamous cell carcinoma. A retrospective study was conducted involving 73 patients who received surgery-based salvage treatment. The pattern of failure for primary treatment was local failure in 29 patients, regional failure in 29 patients, and loco-regional failure in 15 patients. The 5-year overall, loco-regional failure-free, and disease-free survival rates were 54.8%, 58.9% and 49.3%, respectively. Patients with an advanced initial N stage, previous treatment with combined modality therapy, loco-regional recurrence, advanced recurrent T stage, a disease-free survival of less than 8 months prior to salvage, and recurrence in a previously treated field had a significantly worse prognosis. Given the potential surgical morbidity, salvage surgery should be undertaken after careful consultation with patients who have factors for a poor prognosis.
Topics: Carcinoma, Squamous Cell; Factor Analysis, Statistical; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Salvage Therapy
PubMed: 31492478
DOI: 10.1016/j.ijom.2019.03.967 -
Journal of the Formosan Medical... Mar 2022This retrospective study aimed to determine which factors, such as cognition, motor recovery, swallowing function, and bladder and bowel functions, significantly...
BACKGROUND/PURPOSE
This retrospective study aimed to determine which factors, such as cognition, motor recovery, swallowing function, and bladder and bowel functions, significantly predicted independence in the activities of daily living (ADL) at hospital discharge in a domestic population of patients experiencing post-acute stroke who received in-hospital rehabilitation.
METHODS
We reviewed medical records that were retrieved from the Integrated Medical Database, National Taiwan University Hospital (NTUH-iMD) of 3000 patients who suffered from stroke and were admitted to NTUH from 2014 to 2017. The main outcome measure was independence in the basic ADL (modified Barthel index [mBI]) at discharge. Regression analyses were used to identify prognostic factors for the basic ADL (mBI).
RESULTS
The total mBI improved from 40.7 ± 33.0 to 63.1 ± 34.1 in eligible 2538 patients during their hospital stay. The baseline daily activity function (R change = 0.042) was the most important prognostic factor associated with independence at discharge, followed by dependence in sitting up (R change = 0.014), impaired sitting balance (R change = 0.010), the Brunnstrom stage of hemiplegic lower limb (R change = 0.006), and the presence of bladder incontinence (R change = 0.006) assessed by physician upon rehabilitation admission (R = 0.53, p < 0.05). Dependency in sitting up, impaired sitting balance, and the presence of urinary incontinence were negative prognostic factors of ADL independence at discharge (p < 0.05). By contrast, the Brunnstrom stage of hemiplegic lower limb and baseline mBI scores at rehabilitation admission were positive prognostic factors of ADL independence at discharge (p < 0.05).
CONCLUSION
Baseline ADL function was the most important prognostic factor of functional independence in post-acute stroke. Moreover, the activity limitation of dependency on sitting up and motor function impairment of hemiplegic lower limb prognosticated functional independence.
Topics: Activities of Daily Living; Humans; Prognosis; Recovery of Function; Retrospective Studies; Stroke; Stroke Rehabilitation; Treatment Outcome
PubMed: 34303583
DOI: 10.1016/j.jfma.2021.07.009 -
Clinical Genitourinary Cancer Dec 2023The prognostic value of the distinction between microscopic (pT3a) and macroscopic (pT3b) perivesical fat invasions remains a subject of debate. To explore whether the...
BACKGROUND
The prognostic value of the distinction between microscopic (pT3a) and macroscopic (pT3b) perivesical fat invasions remains a subject of debate. To explore whether the pattern of perivesical fat invasion can serve as a prognostic factor to better subgroup T3 stage bladder cancer.
MATERIALS AND METHODS
One hundred and forty-nine patients diagnosed with T3 stage bladder cancer at Sun Yat-sen University Cancer Center (SYSUCC) were selected for the experimental cohort in this study. Ninety-seven T3 stage bladder cancer patients with pathological slices at the Cancer Genome Atlas (TCGA) were selected as validation cohort in this study. The perivesical fat invasive pattern was examined with hematoxylin and eosin-stained pathological slides by two pathologists independently. Two different perivesical fat invasive patterns, fibrous-surrounded (FS) pattern, and nonfibrous-surrounded (NFS) pattern were assessed.
RESULTS
Perivesical fat invasion pattern had a significant influence on overall survival in T3 stage bladder cancer. Compared to the NFS pattern, the FS pattern was related to a better prognosis in both the SYSUCC cohort and TCGA cohort. The patients with NFS pattern tumor who underwent cisplatin-based adjuvant chemotherapy experienced an obvious improvement compared to observation after radical cystectomy in overall survival in the SYSUCC cohort.
CONCLUSION
The perivesical fat invasion pattern could predict prognosis and clinically different chemotherapeutic survival outcomes in patients with T3 stage bladder cancer after radical cystectomy.
Topics: Humans; Prognosis; Neoplasm Staging; Neoplasm Invasiveness; Urinary Bladder Neoplasms; Cystectomy; Chemotherapy, Adjuvant
PubMed: 37286409
DOI: 10.1016/j.clgc.2023.05.005