High preoperative neutrophile-lymphocyte ratio predicts poor prognosis of patients undergoing radical cystectomy for nonurothelial carcinoma of the bladder / 现代泌尿外科杂志

【Objective】 To investigate the predictive value of high preoperative neutrophile-lymphocyte ratio (NLR) for the prognosis of nonurothelial carcinoma of the bladder (NUBC) after radical cystectomy (RC). 【Methods】 Clinical and follow-up data of NUBC patients undergoing RC during Jan.2005 and Dec.2020 were collected. The optimal cut-off value of NLR was determined with the receiver operating characteristic (ROC) curve. The survival curve was drawn with Kaplan-Meier method to compare the differences in cancer specific survival (CSS) and overall survival (OS) between the high-NLR and low-NLR groups. The independent risk factors of CSS and OS were screened with Cox proportional hazard regression model. 【Results】 Of the 62 eligible cases,34 (54.8%) were diagnosed with adenocarcinoma,17 (27.4%) with squamous cell carcinoma, 6 (9.7%) with small cell carcinoma and 5 (8.1%) with sarcoma. Kaplan-Meier analysis results showed high NLR was associated with poor CSS (P=0.001) and OS (P<0.001). Cox regression results indicated that high NLR (HR=2.42, 95%CI: 1.12-5.23, P=0.025) and advanced pathologic tumor stage (HR=3.21, 95%CI:1.53-6.74,P=0.002) were independent risk factors of unfavorable CSS. Similarly, high NLR (HR=2.75, 95%CI: 1.35-5.56, P=0.005) and advanced pathologic tumor stage (HR=2.81, 95%CI:1.43-5.57, P=0.003) were independent risk factors of unfavorable OS. 【Conclusion】 As an independent risk factor of unfavorable CSS and OS in NUBC patients undergoing RC, high preoperative NLR is of great value in the prediction of long-term prognosis and may help to optimize individualized treatment.

Effect of surgical resection on the survival of patients with CNLC stage Ⅱ hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To evaluate the effect of surgical resection on the prognosis of patients with China Liver Cancer Staging (CNLC)-Ⅱ hepatocellular carcinoma.Methods:Patients with CNLC-Ⅱ hepatocellular carcinoma between 2004 and 2015 from the SEER database were included. A total of 3 764 patients were enrolled, with the age (64±11)(18-93) years, including 2 935 males and 829 females. Among them, 2 825 patients underwent non-surgery treatment (NST), 510 patients underwent liver resection (LR), and 429 patients underwent local ablation (LA). The effects of different treatment modalities on overall survival (OS) and cancer-specific survival (CSS) were evaluated by using Kaplan-Meier analysis, propensity score matching analysis, and subgroup analysis. Cox regression were used to analyze the prognosis.Results:The 1-, 3- and 5-year overall survival rates of LR group were 76.3%, 51.9% and 34.0% respectively, which were significantly higher than those in LA group (71.7%, 34.8% and 24.9%, χ 2=18.50, P<0.001), and those in NST group (46.8%, 16.1% and 8.4%, χ 2=276.00, P<0.001). Similarly, the 1-, 3-, and 5-year cancer-related survival rates of LR group were 80.2%, 58.9%, and 41.8% respectively, which were significantly higher than those in LA group (75.9%, 42.8%, and 32.6%, χ 2=15.20, P<0.001), and those in NST group (52.3%, 21.5% and 12.7%, χ 2=245.00, P<0.001). Cox regression analysis showed that age, tumor size, chemotherapy, pathological grade, AFP levels, and surgical modalities were independent prognostic factors (all P<0.05). Propensity score matching analysis further showed that the prognosis of LR patients was significantly better than NST group [median OS: 52 months (95% CI: 38-60) vs. 10 months (95% CI: 7-16), P<0.001; median CSS: 59 months (95% CI: 44-77) vs. 11 months (95% CI: 8-18), P<0.001]. However, subgroup analysis showed no clinical benefit from surgical resection when the tumor size exceeded 10.0 cm. Conclusions:It was suggested that surgical resection could improve the OS and CSS of patients with CNLC-Ⅱ hepatocellular carcinoma.

Development and validation of a prognostic model based on SEER data for patients with esophageal carcinoma after esophagectomy / 南方医科大学学报

OBJECTIVE@#To develop a nomogram to predict the long-term survival of patients with esophageal cancer following esophagectomy.@*METHODS@#We collected the data of 7215 patients with esophageal carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database during the period from 2004 and 2016. Of these patients, 5052 were allocated to the training cohort and the remaining 2163 patients to the internal validation cohort using bootstrap resampling, with another 435 patients treated in the Department of Cardiothoracic Surgery of Jinling Hospital between 2014 and 2016 serving as the external validation cohort.@*RESULTS@#In the overall cohort, the 1-, 3-, and 5-year cancer-specific mortality rates were 14.6%, 35.7% and 41.6%, respectively. Age (≥80 years vs < 50 years, P < 0.001), gender (male vs female, P < 0.001), tumor site (lower vs middle segment, P=0.013), histology (EAC vs ESCC, P=0.012), tumor grade (poorly vs well differentiated, P < 0.001), TNM stage (Ⅳ vs Ⅰ, P < 0.001), tumor size (> 50 mm vs 0-20 mm, P < 0.001), chemotherapy (yes vs no, P < 0.001), and LNR (> 0.25 vs 0, P < 0.001) were identified as independent risk factors affecting long-term survival of the patients. The nomograms established based on the model for predicting the survival probability of the patients at 1, 3 and 5 years after operation showed a C-index of 0.726 (95% CI: 0.714-0.738) for predicting the overall survival (OS) and of 0.735 (95% CI: 0.727-0.743) for cancer-specific survival (CSS) in the training cohort. In the internal validation cohort, the C-index of the nomograms was 0.752 (95% CI: 0.738-0.76) for OS and 0.804 (95% CI: 0.790-0.817) for CSS, as compared with 0.749 (95% CI: 0.736-0.767) and 0.788 (95%CI: 0.751-0.808), respectively, in the external validation cohort. The nomograms also showed a higher sensitivity than the TNM staging system for predicting long-term prognosis.@*CONCLUSION@#This prognostic model has a high prediction efficiency and can help to identify the high-risk patients with esophageal carcinoma after surgery and serve as a supplement for the current TNM staging system.

The indications, efficacy and safety of endoscopic treatment of upper urinary tract urothelial carcinoma / 中华泌尿外科杂志

Objective:To summarize the preliminary clinical experience of endoscopic treatment of upper urinary tract urothelial carcinoma, and to analyze its indications and efficacy.Methods:The clinical data of 14 patients underwent endoscopic treatment for upper urinary tract urothelial carcinoma in our hospital from December 2014 to December 2019 were retrospectively analyzed. Among them, there were 5 males and 9 females, with a median age of 75.5(44-84) years. There were 11 patients with hematuria, 2 patients with flank pain and one asymptomatic patient. Five patients had a history of bladder cancer and one had a history of contralateral UTUC. There were 4 patients with solitary kidney, 3 patients with renal insufficiency, 1 patient with bilateral renal pelvis carcinoma, 4 patients prohibitory to nephroureterectomy because of poor general condition (American Society of Anesthesiologists score ≥3), and 2 patients were pathologically diagnosed as low-grade non-invasive urothelial carcinoma and requested renal preservation therapy. A total of 15 renal units included. The main tumor sites were renal pelvis in 6 renal units, upper calyx in 4 renal units, middle calyx in 3 renal units, and lower calyx in 2 renal units. The median tumor diameter was 2.0 (0.8-4.0) cm. All patients were diagnosed with urothelial carcinoma by preoperative computed tomography (CT/CTU), magnetic resonance imaging (MRI), and cytological or pathological biopsy. In 13 patients, ultrasond-guided percutaneous renal access and tract dilation were performed to establish a F24 standard tract. The tumor tissues were vaporized by 1470 semiconductor laser (60-80 W) or thulium laser (15-20 W) under nephroscopy, and electrocoagulation was used to coagulate the bleeding when necessary. Two patients were treated with felxible ureteroscope, under which tumor ablation was performed with 200 μm holmium laser fiber, and neodymium laser was used for hemostasis. The range of tumor vaporization ablation included 0.5-1.0 cm normal renal pelvis mucosa around the tumor, deep to the fatty layer of renal sinus. Biopsy was taken again at the base of the wound after vaporization ablation when necessary.Results:In this study, six sites were pathological high grade, 9 sites were pathological low grade tumors. Eight were in pathological T a stage, 5 in T 1 stage, and 2 in T 2 stage. The median blood loss was 20.0 (2-50) ml. There were 5 postoperative complications, including one patient with fever (body temperature >38.5℃) and 4 patients with hemorrhage requiring blood transfusion (postoperative hemoglobin <70 g/L) with 2-4 U suspended red blood cells.No patient underwent embolization. The median follow-up time were 31(11-70)months. Ten patients experienced recurrence, and the median time to recurrence was 11.3 (4-41) months. Four of them received conservative treatment after recurrence, including immunotherapy and radiotherapy in 1 patient, systemic chemotherapy in 1 patient, and watchful waiting in 2 patients. Three of them received repeated endoscopic treatment after recurrence, including 2 patients with percutaneous nephroscopic laser ablation and 1 patient with transurethral resection of bladder tumor, all of them survived during the follow-up period. Three patients underwent full-length nephroureterectomy after recurrence, 2 died and 1 survived during the follow-up period. Six patients eventually died, and the median time of death after surgery was 21(9-33) months. Five of them died from tumor-specific death and one died from gastric perforation. The median tumor-free survival interval were11 (4-41) months during the follow-up period. The 2-year tumor-specific survival rate was 78.6%, 50% for high-grade patients and 100% for low-grade patients. Conclusions:In patients who were in early stage (≤T 2) and intolerant to the nephroureterectomy, or with solitary kidney, renal insufficiency, or bilateral tumors, endoscopic treatment could be used as an alternative treatment approach for upper urinary tract epithelial carcinoma, especially for low-grade non-invasive patients.

Development and validation of a nomogram for predicting cancer-specific survival in pediatric melanoma / 中华内分泌外科杂志

Objective:To identify prognosis factors and construct a nomogram for the prediction of cancer-specific survival in surgically resected pediatric melanoma.Methods:A total of 912 patients aged 0-19 years were extracted from the Surveillance, Epidemiology, and SEER database and randomly divided into training cohort (n=640) and validation cohort (n=272) (A ratio of 70:30) . Univariable and multivariable cox analysis were used to determine prognostic factors, and these factors were used to construct a nomogram for predicting cancer-specific survival in patients with resected pediatric melanoma. Model performance was evaluated by Harrell’s concordance index (C-index) ,the area under the time-dependent receiver operating characteristic curve (AUC) and calibration plots.Results:As revealed by the multivariable cox analysis, age, tumor location, ulceration, and lymph node status were all associated with melanoma-specific survival in pediatric patients. On the basis of these factors, a nomogram was constructed. Both the training cohort and the validation cohort had a concordance index of 0.9, which validated the accuracy of our nomogram. The nomogram showed significant discriminative power in both training cohort (3-year AUC: 0.87, 5-year AUC: 0.88, 10-year AUC: 0.85) and validation cohort (3-year AUC: 0.87, 5-year AUC: 0.87, 10-year AUC: 0.89) . Also, the nomogram displayed a good calibration.Conclusions:These results suggest that the new model has superior predictive performance in predicting cancer-specific survival of pediatric melanoma. This individualized prediction model can provide reference for tailoring treatment and clinical counseling of pediatric melanoma.

Impacts of postoperative radiotherapy on long-term survival of patients with locally advanced biliary tract cancers——a propensity score-matched analysis based on the SEER database / 中华放射医学与防护杂志

Objective:To explore the impacts of postoperative radiotherapy on long-term survival of the patients with resectable locally advanced (T 3-4and/or N +) biliary tract cancers (BTCs) and to analyze the prognostic factors. Methods:The patients with locally advanced gallbladder cancer ( n=1 922) and the patients with extrahepatic biliary duct cancer ( n=3 408) who received surgical resection during 2006-2016 were selected from the Surveillance, Epidemiology, and End Result (SEER) database. They were grouped according to different treatment schemes (only surgery and surgery + radiation). The propensity score matching (PSM) method was employed to adjust the differences in baseline prognostic characteristics between patients who received only surgery and those treated with surgery+ radiation. The role of the two treatment schemes on the survival of the patients was analyzed using the Kaplan-Meier method and the prognosis factors were assessed using the Cox regression. Results:The 1 174 patients with gallbladder cancers and the 2 144 patients with extrahepatic biliary duct cancer were respectively matched according to propensity scores. The postoperative radiotherapy showed a significant advantage in 5-year cancer-specific survival (CSS) compared to only surgery for both the patients with gallbladder cancer ( χ2=35.73, P< 0.001) and those with extrahepatic biliary duct cancer ( χ2=9.878, P=0.002). After adjusting related covariates, independent prognostic factors for all the patients included pathological grading, T status, N status, treatment pattern, and age. For the patients with extrahepatic biliary duct cancer, independent prognostic factors also included race and year of diagnosis. The benefits of postoperative radiotherapy were observed in various clinicopathologic characteristics except for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of Ⅰ-Ⅱ and N 0 status or with age ≥ 70. Conclusions:Long-term survival benefits can be gained through postoperative radiotherapy for the patients with resectable locally advanced (T 3-4 and/or N+ ) BTCs. However, adjuvant radiation should be cautiously adopted for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of I-Ⅱ and N 0 status or with age ≥70.

US-guided percutanous microwave ablation for early-stage hepatocellular carcinoma in elderly patients is as effective as in younger patients: A 10-year experience

Objective: To compare the overall survival (OS), disease-free survival (DFS) and liver-cancer-specific survival (LCSS) of elderly (≥65 years) and younger patients (< 65 years) with early-stage hepatocellular carcinoma (HCC) using ultrasound-guided percutaneous microwave ablation (US-PMMA). Materials and Methods: From January 2002 to December 2017, 510 elderly and 1053 younger patients were diagnosed with early-stage HCC according to the Milan criteria. All of these patients were treatment-naïve to US-PMMA. Baseline characteristics were collected to identify any risk factors to determine the survival outcomes. OS, DFS, and LCSS probabilities were calculated with the Kaplan-Meier method and compared using the Log-rank test. Results: Complete ablation was achieved in all patients. Elderly patients were more likely to be, hepatitis C virus infection, comorbidities, cirrhosis, larger tumors, poor liver functional reservation, more ablation points, longer ablation time, longer hospital stays, and higher hospitalization costs (P < 0.05). Over the follow-up period (12–156 months), no significant differences were detected in OS, DFS, and LCSS between the two groups ( P = 0.092, 0.318, and 0.183). r-GT, ALB and ablation session were significant factors for OS, r-GT and ALB for LCSS, and cirrhosis, tumor number, AFP and ablation points for RFS in the multivariate analysis, respectively. No treatment-related deaths occurred in the two groups. Any complications were treated as appropriate. Conclusions: Although advanced age and comorbidities are intrinsic factors in elderly HCC patients, similar survival outcomes were obtained in elderly and younger HCC patients treated by US-PMWA, despite elderly patients having more comorbidities

A novel prognostic index in patients with resectable esophageal squamous cell carcinoma: fibrinogen/prealbumin ratio

ABSTRACT Background: Fibrinogen (Fib) to albumin (ALB) fibrinogen-to-albumin ratio as a prognostic index for esophageal cancer has been confirmed. A novel prognostic index was initially proposed with fibrinogen to prealbumin ratio (FPR) in patients with resectable esophageal squamous cell carcinoma (ESCC). Objective: The objective of the study was to study the prognostic role of the novel prognostic index (FPR) in patients with resectable ESCC without any neoadjuvant treatment. Methods: In this retrospective study, a total of 372 resectable ESCC patients without any neoadjuvant treatment were included. The best cutoff values were selected by the receiver operating characteristic curves. Two Cox regression analyses with forward stepwise (one for categorical variables and the other for continuous variables) were used to evaluate the overall survival (OS) and cancer-specific survival (CSS). Results: The best cutoff point was 0.014 for FPR. Patients with lower levels of FPR (≤0.014) had better CSS (50.7% vs. 18.0%, p < 0.001) and OS (48.0% vs. 17.6%, p < 0.001) than patients with higher levels of FPR (> 0.014). Multivariate Cox analyses (categorical and continuous) demonstrated that FPR was an independent prognostic factor in CSS (categorical: hazard ratio [HR]: 2.014, 95% confidence interval [CI]: 1.504-2.697, p < 0.001; continuous per 0.01: HR: 1.438, 95% CI: 1.154-1.793, p = 0.001) and OS (categorical: HR: 1.964, 95% CI: 1.475-2.617, p < 0.001; continuous per 0.01: HR: 1.429, 95% CI: 1.146-1.781, p = 0.002). Conclusions: Our study indicated that FPR served as an independent prognostic factor in patients with resectable ESCC.

Evaluation of clinical prognosis of liver transplant recipients of hepatocellular carcinoma complicated with microvascular invasion / 器官移植

Objective To investigate the clinical prognosis of the liver transplant recipients diagnosed with hepatocellular carcinoma (HCC) complicated with microvascular invasion (MVI). Methods Clinical data of 3 447 HCC recipients undergoing liver transplantation were extracted from Surveillance, Epidemiology, and End Results (SEER) database of American National Cancer Institute. According to the incidence of MVI, all recipients were divided into MVI (n=376) and non-MVI groups (n=3 071). The clinical prognosis of liver transplant recipients was statistically compared between two groups by analyzing the 1-, 3- and 5-year overall survival (OS) and liver cancer specific survival (LCSS). Relevant clinical data including age, gender, race, pathological staging, tumor size, lymph node metastasis, distant metastasis, tumor-node-metastasis (TNM) staging and MVI were recorded in two groups. The independent risk factors of clinical prognosis of HCC recipients undergoing liver transplantation were analyzed by multivariate Cox regression model. The nomogram for predicting the clinical prognosis of the recipients was delineated. The accuracy of the prediction model was evaluated by the consistency index. Results In the non-MVI group, the 1-, 3-, 5-year OS and LCSS were 93.5%, 82.1%, 75.3% and 98.3%, 93.8%, 90.7%, significantly higher than 88.8%, 72.1%, 68.4% and 95.3%, 83.1%, 80.4% in the MVI group (all P < 0.05). Multivariate regression analysis showed that pathological staging, tumor size, lymph node metastasis, distant metastasis, TNM staging and MVI were the independent risk factors of OS and LCSS in HCC recipients undergoing liver transplantation (all P < 0.05). The nomogram consistency index was calculated as 0.624 (0.602-0.648). Conclusions MVI is an independent risk factor of the clinical prognosis of HCC recipients undergoing liver transplantation, which is significantly correlated with poor prognosis of the recipients. The nomogram based on MVI can predict the clinical prognosis of these recipients.

Surgical complexity and prognostic outcome of small volume renal cell carcinoma with high-level venous tumor thrombus and large volume renal cell carcinoma with low-level thrombus / 中华医学杂志(英文版)

Background@#Radical nephrectomy with thrombectomy is one of the most difficult and complicated urological operations. But the roles of renal tumor volume and thrombus level in surgical complexity and prognostic outcome are not clear. This study aimed to evaluate the surgical complexity and prognostic outcome between the volume of renal cell carcinoma (RCC) and the level of venous tumor thrombus.@*Methods@#The clinical data of 67 RCC cases with renal vein or inferior vena cava (IVC) tumor thrombus from January 2015 to May 2018 were retrospectively analyzed. Among these 67 cases, 21 (31.3%) were small tumors with high-level thrombus (tumor ≤7 cm in diameter and thrombus Neves Level II–IV), while 46 (68.7%) were large tumors with low-level thrombus group (tumor >7 cm in diameter and thrombus Level 0–I). Clinical features, operation details, and pathology data were collected. Univariable and multivariable logistic regression analyses were applied to evaluate the risk factors for small tumor with high-level thrombus.@*Results@#Patients with small tumors and high-level thrombus were more likely to have longer operative time (421.9 ± 135.1 min vs. 282.2 ± 101.9 min, t = 4.685, P < 0.001), more surgical bleeding volume (1200 [325, 2900] mL vs. 500 [180, 1000] mL, U = 270.000, P = 0.004), more surgical blood transfusion volume (800 [0, 1400] mL vs. 0 [0, 800] mL, U = 287.500, P = 0.004), more plasma transfusion volume (0 [0, 800] mL vs. 0 [0, 0] mL, U = 319.000, P = 0.004), higher percentage of open operative approach (76.2% vs. 32.6%, χ2 = 11.015, P = 0.001), higher percentage of IVC resection (33.3% vs. 0%, χ2 = 17.122, P < 0.001), and higher percentage of post-operative complications (52.4% vs. 19.6%, χ2 = 7.415, P = 0.010) than patients with large tumors and low-level thrombus. In multivariate analysis, decreased hemoglobin (Hb) (odds ratio [OR]: 0.956, 95% confidence interval [CI]: 0.926–0.986, P = 0.005) and non-sarcomatoid differentiation (OR: 0.050, 95% CI: 0.004–0.664, P = 0.023) were more likely to form small tumors with high-level tumor thrombus rather than large tumor with small tumor thrombus. The estimated mean cancerspecific survival times of small tumor with high-level thrombus and large tumor with low-level thrombus were 31.6 ± 3.8 months and 32.5 ± 2.9 months, without statistical significance (P = 0.955). After univariate and multivariate Cox proportional hazard survival regression analyses, only distant metastasis (hazard ratio [HR]: 3.839, P = 0.002), sarcomatoid differentiation (HR: 7.923, P < 0.001), alkaline phosphatase (HR: 2.661, P = 0.025), and severe post-operative complications (HR: 10.326, P = 0.001) were independent predictors of prognosis.@*Conclusions@#The level of the tumor thrombus was more important than the diameter of the primary kidney tumor in affecting the complexity of surgery. In the same T3 stage, neither the renal tumor diameter nor the tumor thrombus level was an independent risk factor for prognosis.

Clinical, pathological features and prognosis of renal carcinoma: A single-center analysis of 4167 cases / 解放军医学杂志

Objective: To analyze the clinical characteristics, pathological features and prognosis of 4167 patients with renal carcinoma. Methods: The clinical data of 4167 patients with renal carcinoma were retrospectively studied who were admitted and received renal cancer surgery in the First Medical Center of Chinese PLA General Hospital from Jan. 2008 to Sep. 2016. All the cases were followed up for 40(2-99) months. The general data, pathological features, tumor-node-metastasis (TNM) stage, tumor diameter, surgical and postoperative clinical indicators, postoperative metastasis of renal carcinoma, and postoperative mortality and survival of patients were analyzed. Results: The male-female ratio of the 4167 cases was 72.2%(3010 cases) and 27.8%(1157 cases) (2.6:1), age of ill onset was 0.3-86(52.4 ± 12.4) years old, high incidence age was 45-65 years old. Case load diagnosed with and without symptom was 20.7% (863 cases) and 79.3% (3304 cases), respectively. In pathological diagnosis, 3670 cases of suprarenal epithelioma accounted for 88.1% in all cases. Minimally invasive surgery was 3821 cases (91.7%), nephron sparing surgery (NSS) was 1698 cases (40.7%), radical nephrectomy (RN) was 2466 cases (59.2%), open surgery was 346 cases (8.3%), transperitoneal approach rate was 16.9% (705 cases) and retroperitoneal approach rate was 83.1% (3462 cases). The overall survival rate at 1, 3 and 5 year post-operation was 98.1%, 94.8% and 92.0%, respectively. Cancer specific survival rate (1, 3, 5 year) was 98.6%, 96.2% and 94.6%, respectively. Tumor-free survival rate was 96.4%, 92.8% and 90.7%, respectively. Conclusions: The high incidence age of renal cancer is about 50 years old, the prevalence rate of men is 2.6 times higher than that of women. The main pathological type of renal cancer is suprarenal epithelioma. The rate of asymptomatic consultation rate has increased significantly. Minimally invasive surgery is the main treatment method for kidney cancer. The 5-year overall survival rate of renal cell carcinoma has exceeded 91%, and the long-term prognosis is better.

Prognostic Value of Body Mass Index in Korean Patients with Castration-Resistant Prostate Cancer

PURPOSE: We investigated the correlation between body mass index (BMI) and the prognosis of castration-resistant prostate cancer (CRPC) in patients who received docetaxel treatment. MATERIALS AND METHODS: A retrospective study was conducted of 55 patients who were diagnosed with CRPC and received docetaxel treatment between 2003 and 2009 at our institution. Patients with a normal or lower BMI ( or =23.0 kg/m2) were categorized as group II. Clinicopathological features and survival rates were evaluated by using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: On the basis of BMI, 27 patients (49.1%) belonged to group I and 28 (50.9%) patients belonged to group II. Mean follow-up periods were 30 months and 34.2 months, respectively (p=0.381). There were no significant differences between the two groups in terms of age, prostate-specific antigen (PSA), Gleason score, Eastern Cooperative Oncology Group Performance Status, hemoglobin level, alkaline phosphatase level, distant metastasis, radiation treatments, or performance of radical prostatectomy (p>0.05). In the univariate analysis for predicting survival rates, BMI (p=0.005; hazard ratio [HR], 0.121), logPSA (p=0.044; HR, 2.878), and alkaline phosphatase level (p=0.039; HR, 8.582) were significant factors for prediction. In the multivariate analysis, BMI (p=0.005; HR, 0.55), logPSA (p=0.008; HR, 7.836), Gleason score (p=0.018; HR, 6.434), hemoglobin (p=0.006; HR, 0.096), alkaline phosphatase level (p=0.005; HR, 114.1), and metastasis to the internal organs (p=0.028; HR, 5.195) were significant factors for prediction. CONCLUSIONS: Better effects on the cancer-specific survival rate were observed in cases with higher BMI.

Prognostic Value of Body Mass Index in Korean Patients with Castration-Resistant Prostate Cancer

PURPOSE: We investigated the correlation between body mass index (BMI) and the prognosis of castration-resistant prostate cancer (CRPC) in patients who received docetaxel treatment. MATERIALS AND METHODS: A retrospective study was conducted of 55 patients who were diagnosed with CRPC and received docetaxel treatment between 2003 and 2009 at our institution. Patients with a normal or lower BMI ( or =23.0 kg/m2) were categorized as group II. Clinicopathological features and survival rates were evaluated by using the Kaplan-Meier method and Cox proportional hazards models. RESULTS: On the basis of BMI, 27 patients (49.1%) belonged to group I and 28 (50.9%) patients belonged to group II. Mean follow-up periods were 30 months and 34.2 months, respectively (p=0.381). There were no significant differences between the two groups in terms of age, prostate-specific antigen (PSA), Gleason score, Eastern Cooperative Oncology Group Performance Status, hemoglobin level, alkaline phosphatase level, distant metastasis, radiation treatments, or performance of radical prostatectomy (p>0.05). In the univariate analysis for predicting survival rates, BMI (p=0.005; hazard ratio [HR], 0.121), logPSA (p=0.044; HR, 2.878), and alkaline phosphatase level (p=0.039; HR, 8.582) were significant factors for prediction. In the multivariate analysis, BMI (p=0.005; HR, 0.55), logPSA (p=0.008; HR, 7.836), Gleason score (p=0.018; HR, 6.434), hemoglobin (p=0.006; HR, 0.096), alkaline phosphatase level (p=0.005; HR, 114.1), and metastasis to the internal organs (p=0.028; HR, 5.195) were significant factors for prediction. CONCLUSIONS: Better effects on the cancer-specific survival rate were observed in cases with higher BMI.