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In Vivo (Athens, Greece) 2022The purpose of this study was to examine the impact of clinicopathological prognostic factors on tumor resectability, perioperative complications, and 5-year survival...
BACKGROUND/AIM
The purpose of this study was to examine the impact of clinicopathological prognostic factors on tumor resectability, perioperative complications, and 5-year survival rates in patients with gastric cancer treated surgically.
PATIENTS AND METHODS
A cohort of 834 patients operated on for gastric cancer between 2007 and 2016 was analyzed.
RESULTS
Patients over 70 years of age manifested a significantly higher rate of overall complications, systemic complications, surgical complications, perioperative mortality, and a worse 5-year survival. The diffuse type according to the Lauren classification was an independent prognostic factor for perioperative mortality. TNM stage significantly influenced resectability and 5-year survival rates. Furthermore, the presence of distant metastases (M1 stage) significantly increased the rates of overall complications, systemic complications, and perioperative mortality.
CONCLUSION
Although TNM stage was the most important prognostic factor for resectability, perioperative complications and 5-year survival, other clinicopathological prognostic factors, such as age, and Lauren type also significantly affected treatment outcomes in gastric cancer surgery.
Topics: Humans; Aged; Aged, 80 and over; Stomach Neoplasms; Gastrectomy; Prognosis; Treatment Outcome; Survival Rate; Neoplasm Staging; Retrospective Studies
PubMed: 36309397
DOI: 10.21873/invivo.13035 -
Nihon Rinsho. Japanese Journal of... Apr 2011
Review
Topics: Colorectal Neoplasms; Humans; Neoplasm Staging; Prognosis
PubMed: 22213955
DOI: No ID Found -
BMC Gastroenterology Apr 2023It has previously been observed that the prognostic value of tumor size varied according to different stages patients enrolled in gastric cancer. We aimed to investigate...
BACKGROUND
It has previously been observed that the prognostic value of tumor size varied according to different stages patients enrolled in gastric cancer. We aimed to investigate the influence of T stage on the prognostic and predicting value of tumor size.
MATERIAL AND METHODS
A total of 13,585 patients with stage I-III gastric cancer were selected from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and multivariate cox regression analysis stratified by T stage were performed. C-index and time-dependent receiver operating characteristic curve (ROC) curve were applied to assess discrimination ability of tumor size and other factors. Nomograms were constructed to further assess the performance of tumor size in a specific model. Calibration ability, discrimination ability, reclassification ability and clinical benefits were executed to judge the performance of models.
RESULTS
Stratified analyses according to T stage illustrated that with the increase of T stage, the effect of tumor size on overall survival (OS) and cancer-specific survival (CSS) significantly decreased. Moreover, tumor size showed superior discrimination ability in T1 gastric cancer, outperformed other prognostic factors in predicting both CSS (C-index: 0.666, AUC: 0.687) and OS (C-index: 0.635, AUC: 0.660). The cox regression model included tumor size showed better performance than the model excluded tumor size in every aspect.
CONCLUSION
T stage had a negative impact on the predicting value of tumor size. Tumor size showed significant prognostic value in T1 gastric cancer, which may be effective in clinical practice.
Topics: Humans; Prognosis; Stomach Neoplasms; Databases, Factual; Multivariate Analysis; Nomograms; Neoplasm Staging
PubMed: 37046218
DOI: 10.1186/s12876-023-02737-z -
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 -
Journal of Thoracic Oncology : Official... Jan 2022Because several articles have reported a prognostic association with the radiologic features of ground-glass opacity, we explored whether the histologic presence of a...
INTRODUCTION
Because several articles have reported a prognostic association with the radiologic features of ground-glass opacity, we explored whether the histologic presence of a lepidic component had similar significance.
METHODS
We retrospectively evaluated 380 consecutive surgically resected lung adenocarcinomas (ADCs) of pathologic (p)stage IA. The tumors were classified into lepidic-positive and lepidic-negative ADCs. Clinicopathologic characteristics, radiographic ground-glass opacity status, and disease-free survival were compared between lepidic-positive and lepidic-negative ADCs and between part-solid and solid nodules on computed tomography images.
RESULTS
Of the 380 cases, 176 (46.3%) were lepidic-positive ADCs. Of the overall patients with pT1, lepidic-positive ADCs were found to have significantly better recurrence-free survival (5 y, 95.4% versus 87.0%, p = 0.005), but this significance was not reproduced in pT1 subcategories (pT1a, pT1b, and pT1c). Furthermore, the presence of the lepidic component was not an independent prognostic factor in the multivariate analysis (hazard ratio = 0.46 [95% confidence interval: 0.19-1.14], p = 0.09). We also analyzed the extent of the lepidic component with 10% incremental valuables. Although we found that a 10% or greater extent of lepidic component made the recurrence-free survival difference the largest, a clear prognostic impact was not obtained with this cutoff point.
CONCLUSIONS
Although lepidic-positive ADCs tended to have a favorable outcome, the lepidic component was not a clear independent prognostic factor in pstage I ADC.
Topics: Adenocarcinoma; Humans; Lung Neoplasms; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Retrospective Studies
PubMed: 34634451
DOI: 10.1016/j.jtho.2021.09.006 -
Cancer Oct 1997
Topics: Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasms; Predictive Value of Tests; Prognosis
PubMed: 9338458
DOI: 10.1002/(sici)1097-0142(19971015)80:8<1363::aid-cncr1>3.0.co;2-g -
Annals of Surgical Oncology Oct 2022
Topics: Fibrinogen; Humans; Prognosis; Tumor Microenvironment
PubMed: 35717519
DOI: 10.1245/s10434-022-12040-y -
Digestive Surgery 2020Various inflammatory markers have been investigated for a prognostic role in patients with resectable pancreatic cancer. However, the value of preoperative platelet to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Various inflammatory markers have been investigated for a prognostic role in patients with resectable pancreatic cancer. However, the value of preoperative platelet to lymphocyte ratio (PLR) remains controversial. We performed a systematic review and meta-analysis of PLR as a preoperative prognostic factor for resectable pancreatic cancer.
MATERIAL AND METHODS
Systematic literature search was conducted for studies assessing PLR influence as a preoperative prognostic factor in resectable pancreatic cancer patients. Random-effects model was applied for pooling hazard ratios and 95% confidence intervals related to overall survival (OS) and disease-free survival (DFS).
RESULTS
Fourteen articles with 2,743 patients were included in the study. According to the analysis, high PLR had no correlation with decreased OS. Due to high heterogeneity among studies, subgroup analysis was performed. Better OS was associated with low PLR in Asian patients, patients with mixed type of operation performed, and patients with preoperative PLR ≤150. Low PLR was associated with significantly better DFS.
CONCLUSIONS
PLR is a predictive factor of better DFS in patients with resectable pancreatic cancer. However, available evidence does not support PLR as a reliable prognostic factor for OS.
Topics: Disease-Free Survival; Humans; Lymphocyte Count; Pancreatic Neoplasms; Platelet Count; Preoperative Period; Prognosis; Survival Rate
PubMed: 32690855
DOI: 10.1159/000508444 -
Current Opinion in Urology Nov 2003There are limited independent predictors of survival in patients with renal cell carcinoma. Factors related to the tumor, host and treatment may help us to predict... (Review)
Review
PURPOSE OF REVIEW
There are limited independent predictors of survival in patients with renal cell carcinoma. Factors related to the tumor, host and treatment may help us to predict prognosis to a certain extent. Prognostic indicators would enable selection of patients who can benefit from adjuvant therapy and thus should be enrolled in clinical trials. This review highlights developments in the identification of current prognosticators for patients with renal cell carcinoma.
RECENT FINDINGS
Tumor stage, grade and patient-performance status are the known prognostic indicators in renal cell carcinoma. Besides these parameters, many molecular and cytogenetic markers were evaluated recently. Unfortunately, none of these parameters appear to be a better predictive prognostic factor than the usual staging and grading. Therefore, efforts to identify new markers for tumor proliferation and progression are still ongoing. It was recently reported that low carbonic anhydrase 9 staining may be an independent poor prognostic factor in patients with renal cell carcinoma. Moreover, there is increasing interest in prognostic indices and predictive algorithms for survival. Staging systems that combine the pathological features with additional prognostic variables have been constructed to predict outcome. The UCLA Integrated Staging System seems to be superior to staging alone in differentiating patients' survival.
SUMMARY
Although the literature reviewed contains numerous promising clinical, histological, molecular and cytogenetic parameters, none of them has yet been shown to have an independent prognostic value
Topics: Adult; Age Factors; Aged; Algorithms; Biomarkers, Tumor; Carcinoma, Renal Cell; Female; Genetic Markers; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Staging; Neovascularization, Pathologic; Prognosis; Sex Factors
PubMed: 14560134
DOI: 10.1097/00042307-200311000-00002 -
International Journal of Colorectal... Feb 2024Sidedness has emerged as a prognostic factor for metastatic colorectal cancer treated with modern systemic therapies. This study investigates whether it is also relevant...
Sidedness is not a prognostic factor in an unselected cohort of patients with colon cancer but prognosis for caecal carcinoma is worse - A multivariate analysis of a large single institution database.
PURPOSE
Sidedness has emerged as a prognostic factor for metastatic colorectal cancer treated with modern systemic therapies. This study investigates whether it is also relevant for an unselected patient cohort including all stages.
METHODS
All consecutive patients admitted with colon cancer between 1995 and 2018 were retrieved from an institution-held database. Patients were divided into two cohorts. The first cohort included patients without distant metastases who were able to undergo curative resection. The second cohort presented with distant metastases (stage IV). Potentially prognostic factors were subjected to multivariate Cox Regression analysis.
RESULTS
Overall, 1,606 patients met the inclusion and exclusion criteria. An R0-resection was achieved in 1,222 patients without distant metastases. Five-year cause-specific survival rate was 89.3% for this group. There was no difference between right- and left-sided cancers (88.2% vs. 90.1%, p = 0.220). However, prognosis of caecal carcinoma was significantly worse than that of all other sites combined (83.5% vs. 90.2%, p = 0.007). In multivariate analysis, pT-category, pN-category, grading, vascular invasion, emergency operation, adjuvant chemotherapy, and caecal carcinoma remained as independent prognostic factors. In the 384 patients with stage IV-disease, 3-year overall survival for right- vs. left-sided cancers differed only in univariate analysis (17.7% vs. 28.6%, p = 0.013).
CONCLUSION
In non-metastatic colon cancer, location in the caecum is an independent prognostic factor. In unselected patients with stage IV colon cancer, sidedness was not found to be a prognostic factor. Differentiation into right- and left-sided tumors may be simplistic, and further studies on the biological behavior of different colonic sites are warranted.
Topics: Humans; Prognosis; Colonic Neoplasms; Cecal Neoplasms; Multivariate Analysis; Carcinoma
PubMed: 38349566
DOI: 10.1007/s00384-023-04590-8