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Background: Nasopharyngeal carcinoma (NPC) is relatively rare worldwide but exhibits a higher prevalence in specific geographic regions, particularly Southeast Asia and the North-Eastern states of India. In this study, we present a comprehensive analysis of a decade抯 worth of data involving 117 patients with NPC at the Regional Institute of Medical Sciences, Imphal, Manipur, India. Methods: We retrospectively reviewed data from 117 newly diagnosed NPC patients spanning from 2012 to 2022. Key demographic parameters such as age, gender, presenting symptoms, and disease stage were meticulously documented. Survival outcomes were assessed using Kaplan-Meier survival curves. Results: Our analysis encompassed 117 patients. The median age at presentation was 54 years. Undifferentiated carcinoma emerged as the predominant histological subtype. Notably, patients with type 1 keratinizing carcinoma, cranial nerve involvement, and advanced disease stages exhibited significantly poorer overall survival outcomes. Conclusions: This retrospective analysis of nasopharyngeal carcinoma in the North-Eastern region of India highlights the critical significance of implementing early detection and intervention strategies for NPC in this specific geographical area, with the potential to improve patient outcomes.
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Diagnosis and treatment of locally advanced rectal cancer(LARC)must be completed by a collaborative model of a multi-disciplinary team.The neoadjuvant chemoradiotherapy significantly reduced the local recurrence rate of LARC,but did not affect the occurrence of distant metastases and overall survival.Total neoadjuvant therapy(TNT),by strengthening the intensity of chemotherapy and extending the time from radiotherapy to surgery,can improve the tumor response rate as well as disease-free survival rate and metastasis-free survival rate.It offers advantages such as enhancing the compliance with chemotherapy,maximizing tumor regression,improving survival and increasing the chance of organ preservation.TNT is a promising treatment model for LARC patients with high risk of distant metastasis or strong desire for organ preservation.With the application of immunotherapy in the field of TNT,the mode of TNT continues to expand.And the exploration of therapeutic predictive markers will help to provide a personalized treatment for patients.
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Objective:To develop and verify a nomogram to predict disease-free survival(DFS)and overall survival(OS)for patients undergoing cervical cancer surgery,which may provide reference for evaluating the prognosis of cervical cancer patients undergoing surgery.Methods:The clinical,pathological and follow-up data of patients who underwent radical operation for cervical cancer in Xijing Hospital,Air Force Medical University from March 2013 to October 2018 were analyzed retrospectively.Based on Cox regression analysis,Bayesian Informa-tion Criterion(BIC)backward stepwise selection method and R square screening variables,Net Reclassification Index(NRI)and Integrated Discrimination Improvement(IDI)were used to compare the predictive efficiency of the model,and a nomogram with better predictive efficiency was selected.The consistency index(C-index)and the receiver operating characteristic curve(ROC)were used to test the efficiency of the nomogram.Results:A total of 950 patients with cervical cancer were enrolled in this study.The risk factors for constructing the DFS nomogram were FIGO stage(2018),parametrium invasion,invasion depth,and maximum tumor diameter.The C-index for DFS in the training cohort and the verification cohort were 0.754 and 0.720,respectively.The area under ROC of the training cohort for 1-,3-and 5-years was 0.74(95%CI 0.65-0.82),0.77(95%CI 0.71-0.83)and 0.79(95%CI0.74-0.85),and the areas under ROC of verification cohort 1-,3-and 5-years were 0.72(95%CI 0.58-0.87),0.75(95%CI 0.64-0.86)and 0.72(95%CI 0.61-0.84),respectively.The risk factors for con-structing the OS nomogram were FIGO stage(2018),histological type,LVSI,parametrium invasion,surgical mar-gin,and invasion depth.The C-index for OS in the training cohort and the verification cohort were 0.737 and 0.759,respectively.The area under ROC of the 3-and 5-year training cohort were 0.76(95%CI 0.69-0.83)and 0.78(95%CI 0.72-0.84),and the areas under ROC of verification cohort 3-and 5-years were 0.76(95%CI 0.65-0.87)and 0.79(95%CI 0.69-0.88),respectively.Conclusions:This study is based on real-world big data to construct nomogram of DFS for 1,3,and 5 years and OS for 3,and 5 years for cervical cancer,which have ideal predictive effects and help clinical physicians correctly evaluate the prognosis of cervical cancer surgery patients.It provides strong reference basis for diagnosis,treatment,and prognosis evaluation.
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ObjectiveTo investigate whether severe myelosuppression after chemotherapy is associated with prognosis in patients with breast cancer. MethodsTriple negative breast cancer （TNBC） patients who received chemotherapy at the Second Affiliated Hospital of Nanchang University from May 2， 2013 to May 2， 2018 were divided into a control group （no/mild myelosuppression） and a case group （severe myelosuppression）. In this study， 251 patients with TNBC met the inclusion and exclusion criteria， including 125 patients in the control group （20 patients with grade 0 myelosuppression， 43 patients with grade I myelosuppression， 62 patients with grade Ⅱ myelosuppression）， 126 patients in the case group （114 patients with grade Ⅲ myelosuppression， 12 patients with grade Ⅳ myelosuppression）. The general clinicopathological data of the patients in the two groups， including age， pathological type of tumor， tumor T stage， tumor N stage， tumor Nottingham grade， intravascular cancer thrombus， were analyzed using the χ2 test. The disease-free survival （DFS） and overall survival （OS） of the two groups were analyzed using the Kaplan-Meier method. A Cox proportional hazards regression model with multiple factors was used to analyze the impact of post-chemotherapy severe myelosuppression on disease-free survival （DFS） and overall survival （OS） in patients with TNBC. ResultsThe differences in general clinicopathologic data between the two groups of patients were not statistically significant （all P＞0.05）. The 5-year disease-free survival （DFS） rate was significantly lower in the control group compared with the case group （75.2% vs. 85.7%， P=0.027）. However， there was no statistically significant difference in the 5-year overall survival （OS） rate between the two groups （88.8% vs. 95.2%， P=0.057）. The analysis of the multifactorial Cox proportional hazards regression model revealed that post-chemotherapy severe myelosuppression was an independent protective factor for disease-free survival （DFS） （HR=0.332， 95% CI： 0.173-0.638， P=0.001） and overall survival （OS） （HR=0.193， 95% CI： 0.062-0.602， P=0.005） in TNBC patients. ConclusionOur results show that TNBC patients with severe myelosuppression after chemotherapy have longer disease-free survival （DFS） than those with no/mild myelosuppression， and overall survival （OS） also tend to be prolonged compared with those with no/mild myelosuppression， and severe myelosuppression after chemotherapy can be used as an independent predictor of a good prognosis in breast cancer.
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Background and purpose:Follow-up data of 6 737 patients undergoing surgery for gastric cancer were collected based on hospital registration,and the 1-,3-and 5-years observed overall survival(OS)rates and disease-free survival(DFS)rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China.Methods:A total of 6 737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was November 30,2023.Kaplan-Meier method was applied in evaluating the 1-,3-and 5-year OS rate and DFS rate,and survival data were described by different subgroups including age group,gender,treatment period,tumor staging,and pathological characteristics.Results:With a median follow-up time of 50.99 months,the 5-year OS rate of surgically resected gastric cancer patients was 70.37%,and 5-year DFS rate in Ⅰ-Ⅲ stage cases was 69.46%.The 5-year OS rates of stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 94.32%,82.56%,51.01%and 23.97%,respectively.The differences in survival among patients with different age,tumor location,gross classification,Borrmann classification and Laurence classification were significant.Conclusion:Staging is an important factor directly affecting the survival of gastric cancer patients.Screening and early diagnosis and treatment in large population,especially high-risk group,should be strengthened to further improve the patients'survival.
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SUMMARY OBJECTIVE: Patients with residual disease after neoadjuvant chemotherapy have a relative risk of developing recurrence. This study investigates the risk factors for recurrence in locally advanced breast cancer patients with residual disease and evaluates survival analysis. METHODS: This is a retrospective, single-center study. Breast cancer patients who failed to achieve a pathological complete response after neoadjuvant chemotherapy were included. Demographic, clinicopathological, and treatment characteristics were evaluated to identify predictive factors of recurrence and survival analysis. RESULTS: We included 205 patients in this study. After a median of 31 months of follow-up, 10 patients died, and 20 developed distant metastasis. Disease-free survival and disease-specific survival were 73.8% and 83.1%, respectively. Lymphovascular invasion and non-luminal subtype were independent predictors of locoregional recurrence. In situ carcinoma, lymphovascular invasion, ypTIII stage, and non-luminal molecular subtypes were independent predictors of disease-free survival. The only independent factor affecting disease-specific survival was cNII-III. The number of involved lymph nodes was an independent predictor of disease-free survival in patients without complete axillary response. CONCLUSION: Factors affecting disease-specific survival and disease-free survival were cNII-III and the number of involved lymph nodes, respectively. Patients with non-luminal, large residual tumors with in situ carcinoma, lymphovascular invasion, clinically positive axilla, and residual nodal involvement have a high relative risk for recurrence and may benefit from additional treatments.
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Objectives: Muscle Invasive Bladder Cancer (MIBC) remains a lethal disease, despite aggressive local and systemic therapies with Radical Cystectomy (RC) ± Neo-Adjuvant Chemotherapy (NACT). The 5-year Overall Survival (OS) in advanced cases was around 32%. So novel treatment modalities are required. Our aim is to study the impact of adding Postoperative Radiotherapy (PORT) to standard chemotherapy on local control, survival outcomes and toxicity pattern. Methods: In this study, 123 MIBC patients’ medical records were reviewed and classified into 3 groups according to their treatment modalities; A (RC Chemotherapy), B (RC Radiotherapy), and C (RC Chemo and Radiotherapy). Results: Over a median follow-up of 18.5 months, the 5-year disease free survival (DFS) of group B was significantly higher (80.4%) compared to groups A and C (41.1% & 29.9% respectively; p= 0.0073). Additionally, the 5-year OS was higher in group B (77%) compared to groups A (33.9%) and C (28.5%), (p=0.041). However, the median Local Recurrence Free Survival (LRFS) for the whole group was 69.03 months (95% CI: 69.03 to 69.03), with no significant difference among the 3 groups (p=0.067). Conclusion: Our results suggest that the addition of adjuvant radiotherapy improved the Disease-Free Survival (DFS) and OS in MIBC patients. Although NACT remains the standard of care, incorporation of PORT should be considered in the future management of these cases.
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【Objective】 To construct an easy-to-use individual survival prognostic tool based on competing risk analyses to predict the risk of 1-, 2- and 3- year recurrence for patients with non-muscle invasive bladder cancer (NMIBC). 【Methods】 The follow-up data of 419 NMIBC patients were obtained. The patients were randomly divided into training cohort (n=293) and validation cohort (n=126). The variables included age at diagnosis, sex, history of smoking, tumor number, tumor size, histolo-gic grade, pathological stage, and bladder perfusion drug. The cumulative incidence function (CIF) of recurrence was estimated using all variables in the training cohort and potential prognostic variables were determined with Gray’s test. The Fine-Gray subdistribution proportional hazard approach was used as a multivariate competitive risk analysis to identify independent pro-gnostic variables. A competing risk nomogram was developed to predict the recurrence. The performance of the competing risk model was evaluated with the area under the receiver operating characteristic curve (AUC), calibration curve, and Brier score. 【Results】 Five independent prognostic factors including age, number of tumors, tumor size, histologic grade and pathological stage were used to construct the competing risk model. In the validation cohort, the AUC of 1-, 2- and 3- year recurrence were 0.895 (95%CI: 0.831-0.959), 0.861(95%CI: 0.774-0.948) and 0.827(95%CI: 0.721-0.934), respectively, indicating that the model had a high predictive performance. 【Conclusion】 We successfully constructed a competing risk model to predict the risk of 1-, 2- and 3-year recurrence for NMIBC patients. It may help clinicians to improve the postoperative management of patients.
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Objective:To investigate the role of prophylactic cranial irradiation (PCI) in non-small cell lung cancer (NSCLC) by meta-analysis.Methods:Studies published from January 1, 1980 to August 30, 2021 were searched systematically in PubMed, Embase, Cochrane Systematic Review database and China National Knowledge Infrastructure Database. The searching keywords included "non-small cell lung cancer", "randomized controlled trial", "prophylactic cranial irradiation" and "clinical trial". The data extracted from the above studies were analyzed using Review Manager 5.3 and Stata 12.0 software. Outcomes included the development of brain metastases (BM), overall survival (OS), disease-free survival (DFS), toxicity, and quality of life (QoL).Results:Ten trials, including 2005 NSCLC patients, met the inclusion criteria. Patients who underwent PCI had a significantly lower risk of BM than those who did not ( OR=0.29, 95% CI: 0.22-0.40, P<0.001). Compared with non-PCI group, DFS in PCI group was significantly increased ( HR=0.75, 95% CI: 0.63-0.89, P=0.001). However, there was no significant difference in OS ( OR=0.90, 95% CI: 0.69-1.18, P=0.45). In addition, the incidence of fatigue was significantly increased in the PCI group ( OR=2.64, 95% CI: 1.58-4.40, P<0.001). There was no significant difference in cognitive impairment between the PCI and non-PCI groups ( OR=3.60, 95% CI: 0.97-13.32, P=0.06). Conclusions:PCI is the standard treatment for NSCLC. Compared with non-PCI, PCI significantly reduces the incidence of BM and prolongs the DFS of NSCLC patients. The effect of PCI-related toxicity on the QoL and long-term OS needs further study.
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Objective:To investigate the relationship between long non-coding RNA (lncRNA) DHRS4-AS1 and disease-free survival in osteosarcoma patients and the mechanisms of its effect on proliferation and migration of osteosarcoma cells in vitro.Methods:The data of DHRS4-AS1 transcriptome levels and survival status of osteosarcoma patients in GEPIA database were collected since the database was established, and the patients were divided into high DHRS4-AS1 expression group and low DHRS4-AS1 expression group based on the median DHRS4-AS1 transcriptome level, with 59 cases in each group, and the Kaplan-Meier method was used to analyze the disease-free survival of the two groups. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of DHRS4-AS1 in osteosarcoma cell lines MG-63, HOS, 143B, U-2OS, Saos2 and normal osteoblast cell line hFOB1.19, and the osteosarcoma cell line with the lowest DHRS4-AS1 expression level was selected for subsequent experiments. The plasmid carrying DHRS4-AS1 sequence and the plasmid carrying negative control sequence were transfected into the selected osteosarcoma cells as DHRS4-AS1 group and control group. CCK-8 method was used to detect the proliferation of each group of cells, and the absorbance value was used as the cell proliferation ability; cell scratch assay was used to detect the migration of each group of cells. The bioinformatics website starBase V2.0 was used to predict the target genes of DHRS4-AS1, and the dual luciferase reporter gene assay was used to verify the targeting relationship between DHRS4-AS1 and the target genes. The expression levels of target genes and downstream genes of osteosarcoma cells in control group and DHRS4-AS1 group were detected by qRT-PCR and Western blotting.Results:Survival analysis showed that the disease-free survival of osteosarcoma patients in the high DHRS4-AS1 expression group in GEPIA database was superior to that of the low DHRS4-AS1 expression group ( P < 0.001). Compared with normal osteoblastic hFOB1.19 cells, the expression level of DHRS4-AS1 was low in all osteosarcoma cells (all P < 0.01), with the lowest expression level of DHRS4-AS1 in U-2OS cells ( P < 0.001). Cell proliferation ability was reduced in U-2OS cells of the DHRS4-AS1 group after 1, 2, 3 and 4 d of culture compared with the control group (all P < 0.05). The migration rate of U-2OS cells in the DHRS4-AS1 group was lower than that in the control group [(31±6)% vs. (63±4)%, t = 4.38, P = 0.005]. starBase V2.0 website predicted that DHRS4-AS1 complementarily bound to miRNA-411-3p (miR-411-3p); dual luciferase reporter gene assay showed that miR-411-3p overexpression reduced the luciferase activity of the wild-type DHRS4-AS1 reporter gene ( P < 0.001), but had no effect on the luciferase activity of the mutant DHRS4-AS1 reporter gene ( P > 0.05). qRT-PCR showed that the relative expression of miR-411-3p in U-2OS cells of the DHRS4-AS1 group was low (0.22±0.06 vs. 1.06±0.23, t = 3.55, P = 0.012) and the relative expression of metastasis suppressor MTSS1 mRNA was high (5.58±1.03 vs. 1.06±0.22, t = 4.28, P = 0.005) compared with the control group; Western blotting showed that MTSS1 expression was elevated, and the expression levels of cell proliferation phenotype proteins CDK3 and cyclin C and cell migration phenotype proteins ZEB2 and KLF8 were low. Conclusions:Osteosarcoma patients with high expression of lncRNA DHRS4-AS1 have better disease-free survival, and its expression is low in osteosarcoma cell lines. DHRS4-AS1 may promote MTSS1 gene expression and inhibit cell proliferation and migration by targeting and down-regulating miR-411-3p expression in osteosarcoma cells.
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@#Introduction: Non-epithelial is a rare type of ovarian cancer but the most common ovarian neoplasm in reproductive age. This study analyzed the correlation of clinical characteristics to disease-free survival (DFS) and 3-year survival in non-epithelial ovarian cancer. Methods: A cohort analysis of medical records of 30 patients with non-epithelial ovarian cancer from 2016 to 2017 at Dr. Soetomo General Academic Hospital. Survival analysis was performed using Kaplan–Meier test, log-rank test, and Cox regression to determine the correlation of characteristics including age, stage, tumor size, tumor residue, histopathology type and chemotherapy status as prognostic factors for recurrence and mortality. Results: DFS was significantly affected by stage (p=0.049), tumor residue (p<0.0001), and chemotherapy (p=0.005). Stage I, no residual disease, and adequate chemotherapy had the highest DFS and mean DFS rates (94.1% and 35.6 months; 95.5% and 35.7 months; 75% and 31.94 months, respectively). Highest recurrence rates were found in patients with unstaged disease (hazard ratio [HR]=10.08), residue >0 cm (HR=23.13), and inadequate chemotherapy (HR=6.55). Three-year survival was significantly affected by stage (p=0.001), tumor residue (p<0.0001), and chemotherapy (p<0.0001). Stage I, no residual disease, and adequate chemotherapy had the highest 3-year survival rate and mean survival time (94.1% and 35.47 months; 95.5% and 35.7 months; 87.5% and 33 months). The highest mortality were found in patients with unstaged disease (HR=19.99), residue >0 cm (HR=11.33), and inadequate chemotherapy (HR=11.71). Conclusion: Stage, tumor residue, and chemotherapy status in patients with non-epithelial ovarian cancer are significant prognostic factors for DFS and 3-year survival.
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Objective To analyze the expression of targeting protein for xenopus kinesin-like protein 2(TPX2) in hepatocellular carcinoma (HCC) and its clinical prognostic significance. Methods First, the expression levels, survival prognosis and correlation of TPX2 in HCC were analyzed using UALCAN, K-PLOT and HPA databases. Secondly, the TIMER, GEPIA, and SangerBox databases were used to analyze the immune cell infiltration of TPX2, its correlation with TP53 mutation, and the mutation landscape map. Finally, the co-expressed genes of TPX2 in HCC and their prognostic value were analyzed by HCCDB database, and the co-expressed genes were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) were analyzed by the HCCDB database. Results TPX2 was highly expressed in HCC and was not conducive to overall survival(OS), disease-specific survival(DSS), progression-free survival(PFS), and recurrence free survival(RFS) of HCC patients; and its presence in HCC was significantly correlated with tumor cell purity and multiple immune cells (B cells, CD4
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Objective To investigate the correlation between pan-immune inflammatory values(PIV)and clinicopathological char-acteristics of breast cancer patients,and analyze its value in predicting prognosis.Methods The case data of 107 patients with breast cancer admitted to Wuhan Maternal and Child Healthcare Hospital from August 2017 to August 2019 were retrospectively analyzed.The patients were followed up for 3 years,preoperative peripheral blood results were designated as cohort 1 and peripheral blood results ob-tained between 2 and 3 years after postoperative adjuvant therapy were designated as cohort 2;the optimal cut-off values for PIV were de-termined using receiver operator characteristic curve(ROC curve)for cohort 1 and cohort 2,respectively,and 107 patients were divided into PIV high-value group and PIV low-value group,and pathological characteristics were compared and analyzed between groups.Uni-variate analysis was performed and survival curves were plotted by Kaplan-Meier method and Log-rank test to analyze the value of PIV in evaluating the prognosis of breast cancer patients.Results The preoperative PIV was related to tumor size,TNM stage,vascular inva-sion,histological grade,systemic immune-inflammation index before and after operation and systemic inflammation response index(SI-RI)before operation(P＜0.05),and the postoperative PIV was significantly related to lymph node metastasis,TNM stage,histological grade,SII before and after operation and SIRI before and after operation(P＜0.05).TNM stage and histological grade in the patients of PIV high-value group were higher than those of PIV low-value group,overall survival(OS)and disease-free survival(DFS)were lower than those of PIV low-value group.Conclusion The postoperative PIV can be a predictor of OS and DFS in patients with breast cancer,the preoperative PIV can not be an independent factor for predicting OS in patients with breast cancer,but can be a predictor of DFS.
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Objective:To investigate the risk factors of non-alcoholic fatty liver disease (NAFLD) in patients with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) breast cancer (HR+/HER2-BC) and the impact of NAFLD on the survival of patients.Methods:54 HR+BC patients were enrolled in this study. The liver fat accumulation was examined by magnetic resonance imaging (MRI). The patients were divided into two groups: non-NAFLD and NAFLD. Student's t test or Fisher's test was used to analyze the clinical indicators of the two groups. Logistic univariate and multivariate tests were used to analyze the clinical risk factors related to NAFLD. Receiver operating characteristic curve (ROC curve) was used to further analyze the sensitivity of clinical risk factors to predict the diagnosis of NAFLD. The Disease-free survival (DFS) and Overall survival (OS) of the two groups were analyzed by Log-rank (Mantel-Cox) test. Results:There were 22 NAFLD patients and 32 non-NAFLD patients diagnosed by MRI. Student's t test or Fisher's test showed that BMI, waist circumference, AST, ALT, GGT, TG, LDL and HDL were statistically different between the two groups (all P<0.05). Logistic univariate and multivariate analysis showed that AST ( OR=1.05, 95% CI: 1.02-1.10, P=0.007), GGT ( OR=1.04, 95% CI: 1.01-1.09, P=0.038), TG ( OR=1.03, 95% CI: 1.01-1.06, P=0.011) and HDL ( OR=1.06, 95% CI: 1.01-1.12, P=0.037) were the risk factors associated with NAFLD. ROC curve analysis showed that the combination of AST, GGT, TG and HDL had high sensitivity in predicting NAFLD (AUC=0.869, P<0.05). There was no difference in DFS ( HR=1.830, 95% CI: 0.983-3.409, P=0.057) or OS ( HR=2.482, 95% CI: 0.761-8.093, P=0.132) between the two groups. Conclusion:AST, GGT, TG and HDL are the independent risk factors for NAFLD in HR+BC patients during treatment, but concurrent NAFLD has no significant effect on DFS or OS.
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SUMMARY OBJECTIVE: The aim of this study was to assess the effect of lymphovascular space invasion on recurrence and disease-free survival in patients with low-risk endometrial cancer. METHODS: The study included patients with stage 1A, grade 1-2 endometrioid endometrial cancer who underwent a total hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Independent prognostic predictors of endometrial cancer recurrence were assessed using the Cox regression model. Binary logistic regression analysis was used to identify the predictors of distant recurrence. Kaplan-Meier analysis was used to describe survival curves, and the log-rank test was used to compare the differences in survival curves. RESULTS: A total of 189 patients met the inclusion criteria, of whom 24 (12.7%) had lymphovascular space invasion. The median follow-up time was 60 (3-137) months. Distant recurrence was present in 11 of 22 patients who developed recurrence. Kaplan-Meier survival analysis showed that the 5-year disease-free survival rates of patients with lymphovascular space invasion(+) and lymphovascular space invasion(-) were 62.5 and 91.9%, respectively, which were significantly lower (p<0.001). In multivariate Cox regression analysis, the presence of lymphovascular space invasion (p<0.001) and age ≥60 years (p=0.017) remained as prognostic factors for reduced disease-free survival. In binary logistic regression analysis, only lymphovascular space invasion (adjusted OR=13, 95%CI=1.456-116.092, p=0.022) was a prognostic factor for distant recurrence. CONCLUSION: lymphovascular space invasion is a prognostic risk factor for recurrence and distant metastasis and also a predictor of poorer disease-free survival outcomes in low-risk endometrial cancer.
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Abstract Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients.
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Abstract Introduction New evidence suggests that the ratio of neutrophils to lymphocytes is associated with the prognosis of other carcinoma, but the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma remains controversial. Objective The objective of this meta-analysis was to clarify the prognostic effectiveness of the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma. Methods According to the meta-analysis of the free guide, we searched EMBASE, Pubmed, the Cochrane Library databases. The ratio of neutrophils to lymphocytes of laryngeal squamous cell carcinoma patients was evaluated using mean standard vehicle and confidence interval. The overall survival, disease-free survival and progression free survival of patients with laryngeal squamous cell carcinoma were expressed by standard mean carrier method and confidence interval. The risk ratio of 95% confidence interval was used as an evaluation index for patients with laryngeal squamous cell carcinoma. Results Eight studies, including 1780 patients, used a variety of different end values to classify the ratio of neutrophils to lymphocytes (range 1.78-4.0). Among the eight studies that reported risk ratio of the overall survival, the higher median value was 2.72, and 2 of 4 studies reported disease-free survival results. The critical value of ratio of neutrophils to lymphocytes and overall survival deterioration (risk ratio = 1.68, 95% confidence interval 1.43-1.99, p< 0.001), disease-free survival (risk ratio = 2.09, 95% confidence interval 1.62-2.6, p< 0.001) and progression free survival (risk ratio = 1.92, 95% confidence interval 1.75-2.10, p< 0.001) was associated with with laryngeal aquamous cell carcinoma. The ratio of neutrophils to lymphocytes had prognostic value for laryngeal squamous cell carcinoma. Conclusion The results of this meta-analysis showed that the increase of neutrophils to lymphocytes ratio was related to poor prognosis of laryngeal squamous cell carcinoma. The neutrophils to lymphocytes ratio may serve as a cost-effective prognostic biomarker of poor prognosis of laryngeal squamous cell carcinoma. More high-quality prospective trials are needed to assess the practicability of evaluating the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma.
Resumo Introdução Novas evidências sugerem que a relação neutrófilo-linfócito está associada ao prognóstico de vários carcinomas, mas a relação neutrófilo-linfócito no carcinoma espinocelular da laringe ainda permanece controversa. Objetivo Esclarecer a eficácia prognóstica da relação neutrófilo-linfócito no carcinoma espinocelular de laringe. Método De acordo com as diretrizes de metanálise, conduzimos uma busca nas bases de dados Embase, PubMed, e Cochrane Library. A relação neutrófilo-linfócito de pacientes com carcinoma espinocelular de laringe foi avaliado com a diferença de médias padronizadas e intervalo de confiança. A sobrevida global, sobrevida livre de doença e sobrevida livre de progressão de pacientes com carcinomaespinocelular de laringe foram expressas pelo método da diferença de médias padronizadas e intervalo de confiança. A razão de risco do intervalo de confiança 95% foi usada como um índice de avaliação para pacientes com carcinoma espinocelular de laringe. Resultados Oito estudos, que incluíram 1.780 pacientes, usaram uma variedade de valores finais diferentes para classificar a relação neutrófilo-linfócito (intervalo de 1,78-4,0). Entre os oito estudos que relataram a razão de risco de sobrevida global, o maior valor médio foi de 2,72 e 2 de 4 estudos relataram resultados com sobrevida livre de doença. O valor crítico de relação neutrófilo-linfócito e deterioração da sobrevida global (razão de risco = 1,68, intervalo de confiança 95% 1,43-1,99, p ˂ 0,001), sobrevida livre de doença (razão de risco = 2,09, intervalo de confiança 95% 1,62-2,6, p ˂ 0,001) e sobrevida livre de progressão (razão de risco = 1,92, intervalo de confiança 95% 1,75-2,10, p ˂ 0,001) foi associado com carcinoma espinocelular de laringe. A relação neutrófilo-linfócito tem valor prognóstico para carcinoma espinocelular de laringe. Conclusão Os resultados da metanálise mostraram que o aumento da relação neutrófilo-linfócito estava relacionado ao mau prognóstico do carcinoma espinocelular de laringe. A relação neutrófilo-linfócito pode servir como um biomarcador custo-efetivo de prognóstico do carcinoma espinocelular de laringe. Entretanto, mais estudos prospectivos de alta qualidade são necessários para avaliar a sua praticabilidade.
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Background : Over half the patients of Oral Tongue Cancers in India present with locally advanced disease and Nodal Metastasis. Additionally many of them avoid surgical intervention due to fear or belief that Cancer is a Death Sentence.Materials and Methods : A Retrospective analysis of all Oral Tongue Cancer patients treated at Mahavir Cancer Sansthan from 1998 to 2017 was done. The primary aim was to find the Disease Free Survival (DFS) rates of these patients. The secondary aim was to examine if surgical excision improved DFS rates. Results : The mean DFS for all stages was 51 months varying from 90 months in stage 1 to 30 months in stage 4. One in every three patients survived without recurrence of disease for more than five years. The addition of surgical excision at any stage of Cancer, when possible, resulted in a significant increase in DFS.
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Objective@#To clarify the prognostic value of the neutrophil to lymphocyte ratio (NLR) in oral squamous cell carcinoma (OSCC) patients.@*Methods@#literature on the correlation between NLR and the prognosis and clinicopathological features of OSCC was searched in PubMed, Web of Science, Cochrane and Embase. The outcome indicators, including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), tumor size, cervical lymph node metastasis, tumor stage, extracapsular lymph node invasion and peripheral nerve invasion, were analyzed by RevMan5.3 software@*Results @# In total, 6 180 patients were included in 23 studies. The analysis showed that NLR was significantly negatively correlated with OS [HR=1.62, 95%CI(1.38, 1.91), P < 0.001], DFS [HR=1.48, 95%CI(1.24, 1.77), P < 0.001] and DSS [HR=1.87, 95%CI(1.60, 2.20), P < 0.001]. In addition, higher NLR values were positively correlated with tumor size [OR=2.68, 95%CI (1.84, 3.90), P < 0.001], cervical lymph node metastasis [OR=1.59, 95%CI (1.35, 1.88), P < 0.001], tumor stage [OR=2.85, 95%CI (2.35, 3.47), P < 0.001], extralymphatic invasion [OR=1.72, 95%CI (1.23, 2.40), P=0.001], and peripheral nerve invasion [OR=1.70, 95%CI (1.29, 2.24), P < 0.001]. However, there was no significant correlation with age [OR=0.96, 95%CI (0.71, 1.29), P=0.77], sex [OR=1.08, 95%CI (0.88, 1.33), P=0.55], or degree of differentiation [OR=1.15, 95%CI (0.92, 1.43), P=0.22]@*Conclusion @#Elevated NLR was significantly associated with the prognosis and clinicopathological features of OSCC and might be an independent prognostic factor.
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Objective: To investigate the postoperative prognostic factors of non-metastatic colorectal cancer (non-mCRC), and construct a prognostic prediction model. Methods: A total of 846 patients with colorectal cancer who were admitted to the Cancer Hospital, Chinese Academy of Medical Sciences from July 1, 2014 to December 31, 2016 were included in the study. There were 314 patients in the metastatic colorectal cancer (mCRC) group and 532 patients in the non-mCRC group. The data of clinical characteristics, preoperative blood routine and common serum tumor markers for CRC tests were collected retrospectively. The disease-free survival time (DFS) data of patients in non-mCRC group were obtained by follow-up. Univariate and multivariate Cox regression analyses were used to clarify the independent risk factors of DFS, and then these factors were included to construct a nomogram prediction model. The concordance index (C index), receiver operating characteristic curve (ROC) and calibration curve were used to evaluate the performance of the model. Results: Platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 242 (CA242) in the mCRC group were higher than those of the non-mCRC group, while the lymphocyte/monocyte ratio (LMR) was lower than that of the non-mCRC group (P<0.05). ROC analysis showed that the area under curve (AUC) of CEA, CA19-9, CA242, NLR, LMR and PLR for the diagnosis of mCRC were 0.775, 0.716, 0.712, 0.607, 0.591 and 0.556, respectively. Multivariate Cox regression analysis demonstrated that age, perineural invasion, pN stage and preoperative CA242 level were independent risk factors for DFS of non-mCRC patients (P<0.05). Based on this, a nomogram prediction model predicting 3 years of DFS for non-mCRC patients was constructed, its C index and AUC for non-CRC prognostic prediction were 0.710 and 0.733, respectively, higher than 0.696 and 0.701 of AJCC 7th edition TNM staging system. The calibration curve of nomogram showed that the predicted DFS rate was consistent with the actual DFS rate. Conclusions: Age, perineural invasion, pN stage and preoperative CA242 level are independent risk factors for 3-year DFS of non-mCRC patients. The nomogram prediction model constructed based on these four indictors has a good predictive performance and may provide prognosis evaluation reference for the patients with non-mCRC.