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PLoS Medicine 2013Prognostic factor research aims to identify factors associated with subsequent clinical outcome in people with a particular disease or health condition. In this article,... (Review)
Review
Prognostic factor research aims to identify factors associated with subsequent clinical outcome in people with a particular disease or health condition. In this article, the second in the PROGRESS series, the authors discuss the role of prognostic factors in current clinical practice, randomised trials, and developing new interventions, and explain why and how prognostic factor research should be improved.
Topics: Biomarkers; Biomedical Research; Decision Support Techniques; Disease Progression; Health Services Research; Humans; Predictive Value of Tests; Prognosis; Randomized Controlled Trials as Topic; Research Design; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 23393429
DOI: 10.1371/journal.pmed.1001380 -
Clinical and Molecular Hepatology Dec 2018
Topics: Cardiomyopathies; Humans; Liver Cirrhosis; Prognosis
PubMed: 30531663
DOI: 10.3350/cmh.2018.0098 -
Medicina (Kaunas, Lithuania) Dec 2022: Among patients with pathologically proven T2N0 oral squamous cell carcinoma (OSCC), a notable amount of patients still die from tumor recurrence although they have...
UNLABELLED
: Among patients with pathologically proven T2N0 oral squamous cell carcinoma (OSCC), a notable amount of patients still die from tumor recurrence although they have radical surgery for early stage cancers. In literature, the prognostic indicators of this specific disease entity were rarely reported. This study aims at analyzing the prognostic factors of T2N0 OSCC patients and discussing possible managements to improve the survival.
MATERIALS AND METHODS
From January 2012 to December 2017, the data of 166 pathologically proven T2N0 oral cancer patients proved by radical surgery were retrospectively collected. The clinical and pathologic factors including age, gender, tumor differentiation grade, perineural invasion (PNI), angiolymphatic invasion (ALI), margin status, and adjuvant therapy were analyzed by univariate and multivariate analysis to determine their association with disease-specific survival (DSS), and disease-free survival (DFS), which were calculated by Kaplan-Meier method.
RESULTS
After median follow up time of 43.5 months, overall 3-year rates of DSS and DFS were 86.1% and 80.1% respectively for our 166 patients. Univariate analysis showed that the 3-year DSS of 90.8% for PNI negative patients was significantly better than DSS of 57.0% for PNI positive patients ( = 0.0006). The 3-year DFS of 84.2% for PNI negative patients was also significantly better than DFS of 54.6% for PNI positive patients ( = 0.001). Further multivariate analysis revealed PNI was the only independent prognostic factor associated with both DSS (Hazard Ratio (HR) = 5.02; 95% Confidence Interval (CI) = 1.99-12.6; = 0.001), and DFS (HR = 3.92; 95% CI = 1.65-9.32; = 0.002). Nearly 10% (16) of the 166 patients had adverse pathologic feature of PNI only. In the 11 patients without adjuvant therapy, 5 patients died from OSCC. No patients had recurrence or mortality after they received adjuvant therapy with chemotherapy ± radiotherapy.
CONCLUSION
PNI was an independent prognostic factor for T2N0 oral cancer patients. Adjuvant chemotherapy and radiotherapy may benefit the survival of this specific disease entity, but further investigations are needed to elucidate the optimal regimen.
Topics: Humans; Prognosis; Carcinoma, Squamous Cell; Mouth Neoplasms; Retrospective Studies; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging
PubMed: 36557011
DOI: 10.3390/medicina58121809 -
Frontiers in Immunology 2022This study aims at investigating the potential prognostic significance of the breast immune prognostic index (BIPI) in breast cancer patients who received neoadjuvant...
OBJECTIVE
This study aims at investigating the potential prognostic significance of the breast immune prognostic index (BIPI) in breast cancer patients who received neoadjuvant chemotherapy (NACT).
METHODS
The optimal cutoff value was calculated through the receiver operating characteristic curve (ROC). The correlations between BIPI and clinicopathologic characteristics were determined by the chi-square test or Fisher's exact test. The Kaplan-Meier method was used to estimate the survival probability, and the log-rank test was used to analyze the differences in the survival probability among patients. The univariate and multivariate Cox proportional hazard regression model was used to screen the independent prognostic factors. A prognostic nomogram for disease-free survival (DFS) and overall survival (OS) was built on the basis of the multivariate analyses. Furthermore, the calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram.
RESULTS
All enrolled patients were split into three subgroups based on the BIPI score. The mean DFS and OS of the BIPI score 0 group and BIPI score 1 group were significantly longer than those of the BIPI score 2 group (42.02 vs. 38.61 vs. 26.01 months, 77.61 vs. 71.83 vs. 53.15 months; p < 0.05). Univariate and multivariate analyses indicated that BIPI was an independent prognostic factor for patients' DFS and OS (DFS, hazard ratio (HR): 6.720, 95% confidence interval (CI): 1.629-27.717; OS, HR: 8.006, 95% CI: 1.638-39.119). A nomogram with a C-index of 0.873 (95% CI: 0.779-0.966) and 0.801 (95% CI: 0.702-0.901) had a favorable performance for predicting DFS and OS survival rates for clinical use by combining immune scores with other clinical features. The calibration curves at 1-, 3-, and 5-year survival suggested a good consistency between the predicted and actual DFS and OS probability. The DCA demonstrated that the constructed nomogram had better clinical predictive usefulness than only BIPI in predictive clinical applications of 5-year DFS and OS prognostic assessments.
CONCLUSIONS
The patients with low BIPI score have better prognoses and longer DFS and OS. Furthermore, the BIPI-based nomogram may serve as a convenient prognostic tool for breast cancer and help in clinical decision-making.
Topics: Breast Neoplasms; Disease-Free Survival; Female; Humans; Neoadjuvant Therapy; Nomograms; Prognosis
PubMed: 35320931
DOI: 10.3389/fimmu.2022.831848 -
PloS One 2017Different subtypes of non-small cell lung cancer (NSCLC) have distinct sites of origin, histologies, genetic and epigenetic changes. In this study, we explored the...
Different subtypes of non-small cell lung cancer (NSCLC) have distinct sites of origin, histologies, genetic and epigenetic changes. In this study, we explored the mechanisms of ECT2 dysregulation and compared its prognostic value in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). In addition, we also investigated the enrichment of ECT2 co-expressed genes in KEGG pathways in LUAD and LUSC. Bioinformatic analysis was performed based on data from the Cancer Genome Atlas (TCGA)-LUAD and TCGA-LUSC. Results showed that ECT2 expression was significantly upregulated in both LUAD and LUSC compared with normal lung tissues. ECT2 expression was considerably higher in LUSC than in LUAD. The level of ECT2 DNA methylation was significantly lower in LUSC than in LUAD. ECT2 mutation was observed in 5% of LUAD and in 51% of LUSC cases. Amplification was the predominant alteration. LUAD patients with ECT2 amplification had significantly worse disease-free survival (p = 0.022). High ECT2 expression was associated with unfavorable overall survival (OS) (p<0.0001) and recurrence-free survival (RFS) (p = 0.001) in LUAD patients. Nevertheless, these associations were not observed in patients with LUSC. The following univariate and multivariate analysis showed that the high ECT2 expression was an independent prognostic factor for poor OS (HR: 2.039, 95%CI: 1.457-2.852, p<0.001) and RFS (HR: 1.715, 95%CI: 1.210-2.432, p = 0.002) in LUAD patients, but not in LUSC patients. Among 518 genes co-expressed with ECT2 in LUAD and 386 genes co-expressed with ECT2 in LUSC, there were only 98 genes in the overlapping cluster. Some of the genes related KEGG pathways in LUAD were not observed in LUSC. These differences might help to explain the different prognostic value of ECT2 in LUAD and LUSC, which are also worthy of further studies.
Topics: Adenocarcinoma; DNA Methylation; Disease-Free Survival; Humans; Lung Neoplasms; Prognosis; Proto-Oncogene Proteins; Survival Analysis
PubMed: 29088286
DOI: 10.1371/journal.pone.0187356 -
Asian Journal of Surgery Dec 2022Pancreatic neuroendocrine tumors (P-NETs) are highly heterogeneous with wide spectrum of biological behaviors and growth patterns. Here, we aimed to assess the impact of...
BACKGROUND/OBJECTIVE
Pancreatic neuroendocrine tumors (P-NETs) are highly heterogeneous with wide spectrum of biological behaviors and growth patterns. Here, we aimed to assess the impact of tumor grading on P-NETs prognosis and survival outcomes.
METHODS
Patients with P-NET were recruited to determine correlations between grades and clinicopathological factors, survival outcomes and prognostic factors.
RESULT
A total of 152 patients with P-NETs were enrolled. G1 P-NET were associated with significantly lower rates of perineural invasion, lymphovascular invasion, lymph node involvement and distant metastasis. The pancreatic head was the most common location of P-NETs. The 1-year, 5-year and 10-year overall survival rates of the patients were 94.4%, 89.1% and 78.8%, respectively. Majority of pancreatic neuroendocrine carcinoma (P-NEC) were unresectable (90.9%), and P-NECs patients had poor survival rates (1-year, 20% and no 5-year). Male sex, tumor size ≥2.5 cm, perineural invasion, lymph node invasion, metastasis, and advanced stage were significantly associated with poorer survival outcomes. Tumor grade and sex were independent survival predictors. Moreover, tumor grade was the most powerful prognostic factor.
CONCLUSIONS
Tumor grade, sex, perineural invasion, tumor size, lymph node involvement, metastasis, and stage are survival predictors for patients with P-NETs. Tumor grade is the most powerful independent prognostic factor.
Topics: Humans; Male; Infant, Newborn; Neuroendocrine Tumors; Pancreatic Neoplasms; Retrospective Studies; Prognosis; Neoplasm Grading
PubMed: 35246343
DOI: 10.1016/j.asjsur.2022.01.094 -
Acta Otorhinolaryngologica Italica :... Feb 2022Numerous studies have evaluated the prognostic significance of perineural invasion (PNI) in oral cancer; however, the results are inconclusive. (Review)
Review
INTRODUCTION
Numerous studies have evaluated the prognostic significance of perineural invasion (PNI) in oral cancer; however, the results are inconclusive.
PURPOSE
To identify the prognostic value of PNI in oral cancer through a metanalysis.
METHODS
A literature review was carried out, searching the MedLine databases via Pubmed, Scielo, Lilacs, Cochrane and Websco.
RESULTS
A total of 56 studies were included. The results indicate that PNI in oral cancer has an incidence of 28% (95% confidence interval (CI) 24-31%); 5-year survival with relative risk (RR) 0.67 (0.59-0.75); 5-year disease-free survival RR 0.71 (0.68-0.75); locoregional recurrence with RR 2.09 (1.86-2.35).
CONCLUSIONS
PNI is a negative prognostic factor in oral cancer.
Topics: Disease-Free Survival; Humans; Mouth Neoplasms; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Prognosis
PubMed: 35292785
DOI: 10.14639/0392-100X-N1653 -
International Journal of Surgery... Feb 2018Recently, the lymphocyte-to-monocyte ratio (LMR) has been reported to be a prognostic factor in multiple malignancies. The current study was designed to assess the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Recently, the lymphocyte-to-monocyte ratio (LMR) has been reported to be a prognostic factor in multiple malignancies. The current study was designed to assess the prognostic value of pretreatment LMR in gastric cancer (GC).
METHODS
MEDLINE, EMBASE, Cochrane, and CNKI databases were searched until April 2017. Eligible articles were defined as studies assessing the prognostic role of pretreatment LMR in GC. Pooled hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were calculated using fixed-effects or random-effects models.
RESULTS
A total of six studies comprising 4908 patients were included in the study. Pooled results showed that low LMR was significantly associated with decreased OS (HR: 0.66, 95% confidence interval [CI]: 0.54-0.82, p < .001), but not with poor DFS/RFS (HR: 0.71, 95% CI: 0.38-1.32, p = .004). The unfavorable prognostic impact of low LMR on OS was observed in patients of different disease stages and cut-off values. Moreover, low LMR was significantly related to age (>median), gender (male), CEA (>5 ng/ml), tumor size (>3 cm), TNM stage (III-IV), lymph node metastasis, and distant metastasis.
CONCLUSIONS
Low pretreatment LMR may be a significant prognostic biomarker for poor OS in patients with GC.
Topics: Age Factors; Disease-Free Survival; Humans; Leukocyte Count; Lymphatic Metastasis; Lymphocytes; Monocytes; Neoplasm Metastasis; Neoplasm Staging; Prognosis; Proportional Hazards Models; Sex Factors; Stomach Neoplasms
PubMed: 29329786
DOI: 10.1016/j.ijsu.2018.01.002 -
Biomedical Papers of the Medical... Dec 2022The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal cholangiocarcinoma (DCC) patients to identify potential...
BACKGROUND
The aim of the study was to calculate the short-term and long-term outcomes of curative-intent surgery in distal cholangiocarcinoma (DCC) patients to identify potential prognostic factors.
PATIENTS AND METHODS
A retrospective cohort study of 32 consecutive DCC patients treated with pancreaticoduodenectomy between 2009-2017. The clinicopathological and histopathological data were evaluated for prognostic factors using the univariable Cox regression analysis. The Overall Survival (OS) was estimated using the Kaplan-Meier analysis.
RESULTS
The study comprised a total of 32 patients, with a mean age of 65.8 (± 9.0) years at the time of surgery. R0 resection was achieved in 25 (86.2%) patients, 19 (65.5%) patients received adjuvant oncological therapy. The OS rates at 1, 3 and 5 years were 62.5%, 37.5% and 21.9%, respectively. The 90-day mortality was 3/32 (9.4%) accounting for one-fourth of the first-year mortality rate. The median OS was 28.5 months. The only statistically significant prognostic factor was vascular resection, which was associated with worse OS in the univariable analysis (HR: 3.644; 95%-CI: 1.179-11.216, P=0.025). An age less than 65 years, ASA grade I/II, hospital stay of fewer than 15 days, R0 resection, lymph node ratio less than 0.2 and adjuvant oncological therapy tended to be associated with better OS but without statistically significant relevance.
CONCLUSION
The main factor directly influencing the survival of DCC patients is surgical complications. Surgical mortality comprises a significant group of patients, who die in the first year following pancreaticoduodenectomy. Vascular resection is the most important negative prognostic factor for long-term survival.
Topics: Humans; Aged; Pancreaticoduodenectomy; Bile Duct Neoplasms; Retrospective Studies; Treatment Outcome; Cholangiocarcinoma; Bile Ducts, Intrahepatic; Prognosis
PubMed: 34467956
DOI: 10.5507/bp.2021.043 -
Frontiers in Immunology 2023Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide and has a poor prognosis. Thus, there is a need for an effective biomarker...
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide and has a poor prognosis. Thus, there is a need for an effective biomarker to improve and predict the prognosis of HCC.
METHODS
RNA sequencing data, simple nucleotide variation data, and clinical data of HCC patients from The Cancer Genome Atlas (TCGA) to identify mutant genes, simple nucleotide variation data, and clinical data of HCC patients from the International Cancer Genome Consortium (ICGC) to validate the prognostic value of mutant genes were the data sources of the present study. To identify the overall survival (OS)-related mutant genes, a Kaplan-Meier (KM) analysis was conducted. We carried out univariate Cox and multivariate Cox regression analyses to identify the independent prognostic factors. We also conducted a correlation analysis of immune cells and mutant genes. To explore the molecular mechanisms of mutant genes, we conducted a gene set enrichment analysis (GSEA). A nomogram was constructed to help predict the prognosis of HCC. In addition, we explored the expression profile of mutant genes in HCC based on a TCGA dataset, an ICGC dataset, and our own HCC tissue samples.
RESULTS
We identified and validated a mutant gene, dynein axonemal heavy chain 5 (), which was negatively related to the OS of HCC patients. Univariate Cox and multivariate Cox regression analyses revealed that the mutant gene could act as an independent prognostic factor for HCC. Most pathways of the mutant gene were involved in cancer development and progression based on GSEA analysis. The mutant gene was negatively correlated with monocytes, naive CD4 T cells, activated dendritic cells, and activated mast cells. In addition, the mRNA and protein levels of had a significantly higher level of expression in the tissue samples of patients with HCC. A nomogram consisting of the pathological stage, , and tumor mutation burden (TMB) performed well.
CONCLUSION
The mutant gene had a significantly higher level of expression in the tissue samples of patients with HCC, could act as an independent prognostic factor for HCC, and is a potential new immunotherapy target for HCC.
Topics: Humans; Carcinoma, Hepatocellular; Prognosis; Liver Neoplasms; Nomograms; Nucleotides; Axonemal Dyneins
PubMed: 38022557
DOI: 10.3389/fimmu.2023.1236995