ABSTRACT
Objective: To explore the prognostic factors for the breast cancer patients with spinal metastasis, and establish a prognostic scoring model. Methods: A total of 160 breast cancer patients with spinal metastasis in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2008 to January 2016 were retrospectively identified. The clinical characteristics and prognosis were analyzed by univariate and multivariate survival analysis to explore the prognostic factors. And then a prognostic scoring model was developed according to the regression coefficient for each independent prognostic factor. Results: The 160 breast cancer patients with spinal metastasis whose average age was 56.8 years (range 22-82 years) were identified, and the median follow-up was 40 (24, 55) months. The multivariate Cox analysis showed that the patients' general condition, hormone receptor expression, visceral metastasis, and serum carbohydrate antigen 125 (CA125) level significantly influenced survival (P<0.05). According to the regression coefficients, a survival prediction scoring model comprising these factors was established, which ranged from 0 to 6 points. Three risk groups with different prognoses were identified : low risk group (0-1 point), intermediate risk group (2-4 points), and high risk group (5-6 points). Conclusion: The general condition, hormone receptor expression, visceral metastasis, and serum CA125 level were independent prognostic factors for the breast cancer patients with spinal metastasis. And the prognostic scoring model comprising these four clinical factors can effectively predict the patients' prognoses.
ABSTRACT
PURPOSE: There are various lymph node-based staging systems. Nevertheless, there is debate over the use of parameters such as the number of involved lymph nodes and the lymph node ratio. As a possible option, the distribution of metastatic lymph nodes may have a prognostic significance in rectal cancer. This study is designed to evaluate the impact of distribution-weighted nodal staging on oncologic outcome in rectal cancer. MATERIALS AND METHODS: From a prospectively maintained colorectal cancer database of our institution, a total of 435 patients who underwent a curative low anterior resection for mid and upper rectal cancer between 1995 and 2004 were enrolled. Patients were divided into 3 groups according to the location of apical metastatic nodes. A location-weighted prognostic score was calculated by a scoring model using a logistic regression test for location based-statistical weight to number of lymph nodes. All cases were categorized in quartiles from lymph node I to lymph node IV using this protocol. RESULTS: The location of lymph node metastasis was an independent factor that was associated with a poor prognostic outcome (p<0.001). Based on this result, the location-weighted-nodal prognostic scoring model did not show lesser significant results (p<0.0001) in both overall survival and cancer-free survival analyses. CONCLUSION: The location of apical nodes among the metastatic nodes does not have a lesser significant impact on oncologic result in patients with advanced rectal cancer. A location-weighted prognostic scoring model, which considered the numbers of involved lymph nodes as the rate of significance according to the location, may more precisely predict the survival outcome in patients with lymph node metastasis.