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Thoracic Cancer Jun 2023In non-small-cell lung cancer, ground-glass opacity on computed tomography imaging reflects pathological noninvasiveness and is a favorable prognostic factor. However,...
MAIN PROBLEMS
In non-small-cell lung cancer, ground-glass opacity on computed tomography imaging reflects pathological noninvasiveness and is a favorable prognostic factor. However, the significance of pathological noninvasive areas (NIAs) has not been fully revealed. In this study, we aimed to elucidate the prognostic impact of NIAs on lung adenocarcinoma.
METHODS
We analyzed 402 patients with pathological stage (p-Stage) IA lung adenocarcinoma who underwent surgery in 2013-2016 at two institutions and examined the association of the presence of NIAs with clinicopathological factors and prognosis. Furthermore, after using propensity-score matching to adjust for clinicopathological factors, such as age, sex, smoking history, pathological invasive area size, pathological T factor (p-T), p-Stage, and histological subtype (lepidic predominant adenocarcinoma [LPA] or non-LPA), the prognostic impact of NIAs was evaluated.
RESULTS
Patients were divided into NIA-present (N = 231) and NIA-absent (N = 171) groups. Multivariable analysis showed that NIA-present was strongly associated with earlier p-T, earlier p-Stage, LPA, and epidermal growth factor receptor mutation. Kaplan-Meier survival analysis showed that the NIA-present group displayed a better prognosis than the NIA-absent group in disease-free survival (DFS) and overall survival (OS) (5-year DFS 94.6% vs. 87.2%, 5-year OS 97.2% vs. 91.1%). However, after adjusting for clinicopathological factors by propensity score matching, no significant differences in prognosis were identified between the NIA-present and NIA-absent groups (5-year DFS 92.4% vs 89.6%, 5-year OS 95.6% vs 94.3%).
CONCLUSIONS
Our current study suggests that the prognostic impact of the presence of NIAs on lung adenocarcinoma is due to differences in clinicopathological factors.
Topics: Humans; Prognosis; Lung Neoplasms; Adenocarcinoma; Carcinoma, Non-Small-Cell Lung; Neoplasm Staging; Retrospective Studies; Adenocarcinoma of Lung
PubMed: 37105937
DOI: 10.1111/1759-7714.14910 -
Cancer Imaging : the Official... Oct 2007Tumour volume is a significant prognostic factor in the treatment of malignant head and neck tumours. Studies of laryngeal and pharyngeal tumours have shown tumour... (Review)
Review
Tumour volume is a significant prognostic factor in the treatment of malignant head and neck tumours. Studies of laryngeal and pharyngeal tumours have shown tumour volume to be an important predictor for tumour recurrence. Some studies (for instance nasopharyngeal carcinoma) have shown through multivariate modelling that tumour volume is a dominant covariate that overwhelms T stage, N stage and stage group. The results of these studies have prompted several investigators to suggest the inclusion of tumour volume as an additional prognostic factor in future revisions of the TNM staging system. This paper briefly reviews the TNM system as a staging tool, the measurement of tumour volume and how tumour volume could possibly be incorporated in the system or used as an additional prognostic factor.
Topics: Diagnosis, Computer-Assisted; Diagnostic Imaging; Head and Neck Neoplasms; Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Predictive Value of Tests; Prognosis
PubMed: 17921082
DOI: 10.1102/1470-7330.2007.9002 -
Cancer Medicine Mar 2023To explore the factors affecting the prognosis of cervical cancer (CC), and to construct and evaluate predictive nomograms to guide individualized clinical treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To explore the factors affecting the prognosis of cervical cancer (CC), and to construct and evaluate predictive nomograms to guide individualized clinical treatment.
METHODS
The clinicopathological and follow-up data of CC patients from June 2013 to December 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively analyzed. Log-rank test was used for univariate survival analysis, and Cox multivariate regression was used to identify independent prognostic factors, based on which nomogram models were established and evaluated in multiple aspects.
RESULTS
Patients were randomly assigned into the training (n = 746) and validation sets (n = 329). Survival analysis of the training set identified cervical myometrial invasion, parametrial involvement, and malignant tumor history as prognosticators of postoperative DFS and pathological type, cervical myometrial invasion, and history of STD for OS. C-index was 0.799 and 0.839 for the nomograms for DFS and OS, respectively. Calibration curves and Brier scores also indicated high performance. Importantly, decision curve analysis suggested great clinical applicability of these nomograms.
CONCLUSIONS
In this study, we analyzed a cohort of 1075 CC patients and identified DFS- or OS-associated clinicohistologic characteristics. Two nomograms were subsequently constructed for DFS and OS prognostication, respectively, and showed high performance in terms of discrimination, calibration, and clinical applicability. These models may facilitate individualized treatment and patient selection for clinical trials. Future investigations with larger cohorts and prospective designs are warranted for validating these prognostic models.
Topics: Female; Humans; Nomograms; Prognosis; Retrospective Studies; Uterine Cervical Neoplasms; Survival Analysis
PubMed: 36394197
DOI: 10.1002/cam4.5335 -
World Neurosurgery Aug 2023Mutations in isocitrate dehydrogenase 1 (IDH1) induce extensive transcriptional alterations to promote glioma development. However, IDH1 mutation contributes the better...
BACKGROUND
Mutations in isocitrate dehydrogenase 1 (IDH1) induce extensive transcriptional alterations to promote glioma development. However, IDH1 mutation contributes the better clinical outcomes of glioma. Further understanding the transcriptional and DNA methylation changes mediated by IDH1 mutation will provide new therapeutic targets for glioma.
METHODS
Public glioma cohorts were collected and processed using R software. The transcriptional changes mediated by IDH1 mutation were determined and presented using heatmap. The differentially expressed genes in IDH1 mutant glioma were overlapped using TBtools. The prognostic effects of IDH1 regulated genes were determined by Kaplan-Meier survival analysis.
RESULTS
Retinoic acid receptor responder 2 (RARRES2) was upregulated in IDH1 wild type lower-grade glioma (LGG) patients, and higher expression levels of RARRES2 were associated with worse clinical outcomes of LGG. Moreover, IDH1 wild type LGG patients with higher expression levels of RARRES2 had even worse overall survival. Compared with LGG, RARRES2 was upregulated in grade IV glioma (glioblastoma multiforme, GBM). Also, RARRES2 represented an unfavorable prognostic factor of glioma. In GBM, RARRES2 was also associated with IDH1 mutation. In both LGG and GBM, IDH1 mutation induced extensive DNA hypermethylation, and more than half genes that were downregulated in IDH1 mutant glioma were contributed by DNA hypermethylation. RARRES2 was also hypermethylated in IDH1 mutant LGG or GBM patients. Furthermore, RARRES2 hypomethylation was an unfavorable prognostic factor in patients with LGG.
CONCLUSIONS
RARRES2 was downregulated by IDH1 mutation and served as an unfavorable prognostic factor in glioma.
Topics: Humans; Brain Neoplasms; DNA; Glioma; Isocitrate Dehydrogenase; Mutation; Prognosis
PubMed: 37271257
DOI: 10.1016/j.wneu.2023.05.109 -
Thoracic Cancer Sep 2022The histological subtype has been introduced in invasive lung adenocarcinoma. The predominant micropapillary and solid subtypes are categorized as high-grade patterns...
BACKGROUND
The histological subtype has been introduced in invasive lung adenocarcinoma. The predominant micropapillary and solid subtypes are categorized as high-grade patterns and provide a worse prognosis. However, the prognostic analysis of high-grade patterns has not previously been fully investigated. Thus, this study aimed to investigate the prognostic role of high-grade patterns in pathological stage I lung adenocarcinoma.
METHODS
Patients with stage I lung adenocarcinoma and micropapillary or solid components were reviewed. Clinicopathological features and clinical course were compared in these subtypes, and prognostic factors were analyzed in high-grade patterns.
RESULTS
The patients were classified into five groups based on the presence of micropapillary or solid subtypes, namely, micropapillary predominant, solid predominant, both nonpredominant subtypes, only minor micropapillary subtype, and only minor solid subtype present. Disease-free interval was significantly different, and the micropapillary predominant group showed worse disease-free interval (p = 0.001). Contrastingly, the solid predominant group showed significantly worse overall survival among high-grade patterns (p = 0.035). The multivariate analysis revealed an association between smoking, micropapillary predominant, blood vessel invasion, and visceral pleural invasion with recurrence and more association between solid predominant and visceral pleural invasion with overall survival.
CONCLUSIONS
Clinical results were different in stage I high-grade adenocarcinoma. The predominant micropapillary subtype is the independent prognostic factor for recurrence. However, the solid subtype is the significant factor for overall survival. Furthermore, the predominant subtype is the most valuable and independent prognostic factor for predicting recurrence or survival.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Humans; Lung Neoplasms; Neoplasm Staging; Prognosis; Retrospective Studies
PubMed: 35820717
DOI: 10.1111/1759-7714.14578 -
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 -
Medicine Aug 2020The present study aimed to investigate the prognostic implication of distance from tumor to nipple according to clinicopathological factors with known prognostic... (Observational Study)
Observational Study
The present study aimed to investigate the prognostic implication of distance from tumor to nipple according to clinicopathological factors with known prognostic value.We retrospectively identified 961 patients of invasive breast cancer from January 2000 to April 2016. Clinicopathological information was extracted from hospital database and distance from tumor to nipple was objectively measured during surgeries. Overall survival (OS) and disease-free survival (DFS) were compared among patients with tumor-nipple distance ≤2, 2 to 5, and >5 cm. Subgroup analyses were performed according to age at diagnosis (≤35 vs >35), tumor size, histological features, treatment, axillary nodal metastasis and lymphovascular invasion.A total of 627 cases were included in statistical analysis. There was no difference detected in OS or DFS among patients with different tumor-nipple distance. Better OS was associated with greater tumor-nipple distance in old patients (HR = 0.582, 95%CI: 0.345-0.982, P = 0.042), while the association between OS and tumor-nipple distance was not observed in young patients. DFS was influenced by tumor-nipple distance in both young (HR = 5.321, 95%CI: 1.151-24.595, P = 0.032) and old (HR = 0.593, 95%CI: 0.385-0.913, P = 0.018) patients with opposite effects.Tumor-nipple distance can be adopted as a prognostic factor of breast cancer and it functions oppositely in young and old patients. Multicenter prospective studies with larger sample size are needed to validate the result.
Topics: Adult; Age Factors; Breast Neoplasms; Female; Humans; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Nipples; Prognosis; Retrospective Studies; Survival Rate
PubMed: 32769875
DOI: 10.1097/MD.0000000000021461 -
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 -
Cancer Radiotherapie : Journal de La... May 2022The coronavirus disease 2019 (COVID-19) pandemic has caused a global upheaval in our health care system. Our hospital facilities have been subjected to a major influx of... (Review)
Review
The coronavirus disease 2019 (COVID-19) pandemic has caused a global upheaval in our health care system. Our hospital facilities have been subjected to a major influx of patients and the prevention of cross-contamination has been a key issue in the spread of the virus. New recommendations for good hygiene practice and new recommendations for disease management have emerged to limit the spread of the virus and reorganize the provision of care in key services. Many studies have attempted to identify factors that contribute to poor prognosis for COVID-19 infection. Among them, cancer patients, were considered more at risk of developing severe forms of COVID-19. In this article, we provide an overview of the current state of the pandemic as well as new recommendations for disease management that have emerged in oncology and radiation therapy in particular. In this article, we will try to provide some answers through a review of the literature to the question: is cancer a prognostic factor for severe COVID-19?
Topics: Breast Neoplasms; COVID-19; Female; Humans; Pandemics; Prognosis; SARS-CoV-2
PubMed: 34274225
DOI: 10.1016/j.canrad.2021.06.015 -
Arquivos Brasileiros de Cardiologia Nov 2022
Topics: Female; Humans; Brazil; ST Elevation Myocardial Infarction; Prognosis
PubMed: 36453761
DOI: 10.36660/abc.20220688