Subject(s)
Immune Checkpoint Inhibitors , Immunoglobulins, Intravenous , Methylprednisolone , Mycophenolic Acid , Myocarditis , Humans , Myocarditis/chemically induced , Myocarditis/immunology , Myocarditis/drug therapy , Myocarditis/diagnosis , Methylprednisolone/administration & dosage , Mycophenolic Acid/administration & dosage , Immune Checkpoint Inhibitors/adverse effects , Immune Checkpoint Inhibitors/administration & dosage , Immunoglobulins, Intravenous/administration & dosage , Male , Treatment Outcome , Middle Aged , Female , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Drug Therapy, Combination/methodsABSTRACT
Whether sentinel lymph node biopsy status is a prognostic factor or effective in determining treatment strategies in extramammary Paget disease remains unclear. This study aimed to investigate the significance of sentinel lymph node biopsy in extramammary Paget disease. We retrospectively reviewed the clinical information of previously untreated patients with invasive extramammary Paget disease who underwent wide local excision of the primary tumor and sentinel lymph node biopsy at our hospital between April 2008 and March 2021. Clinical data including the baseline neutrophil-to-lymphocyte ratio and recurrence-free survival were analyzed. Sentinel lymph node metastases were classified as macrometastases and micrometastases, with a cut-off value for sentinel lymph node tumor burden of 2 mm. Univariate and multivariate analyses of factors affecting sentinel lymph node biopsy positivity and recurrence-free survival rates were performed. Overall, 85 patients were included in the analysis. Patients in the sentinel lymph node biopsy-positive group (n = 26) had a significantly higher invasion level and neutrophil-to-lymphocyte ratio. According to multivariate analyses, invasion level and a high neutrophil-to-lymphocyte ratio were independent predictive factors for sentinel lymph node biopsy positivity, and the sentinel lymph node biopsy status was an independent prognostic factor for recurrence-free survival. In conclusion, sentinel lymph node biopsy provides an accurate risk classification and clinical indication for postoperative follow-up in patients with invasive extramammary Paget disease.
Subject(s)
Paget Disease, Extramammary , Sentinel Lymph Node , Skin Neoplasms , Humans , Sentinel Lymph Node Biopsy , Retrospective Studies , Paget Disease, Extramammary/diagnosis , Paget Disease, Extramammary/surgery , Paget Disease, Extramammary/pathology , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/pathology , Sentinel Lymph Node/surgery , Sentinel Lymph Node/pathology , Lymph Nodes/pathology , Prognosis , Lymph Node Excision , Skin Neoplasms/diagnosis , Skin Neoplasms/surgeryABSTRACT
The neutrophil-to-lymphocyte ratio (NLR) is a useful prognostic biomarker for many cancer types. However, the prognostic value of NLR in patients with extramammary Paget disease (EMPD) remains unclear. This study aimed to determine whether NLR is associated with overall survival (OS) in patients with EMPD. In this single-center retrospective case series, we analyzed data of 109 patients with previously untreated EMPD who presented to our hospital. Data on age, sex, primary tumor site, invasion level, presence of lymph node and distant metastases, baseline NLR, and OS were analyzed. The enrolled patients were classified into the metastatic or non-metastatic EMPD groups. The metastatic EMPD group had higher invasion level and NLR value (p < 0.001 and p = 0.005, respectively) compared with the non-metastatic EMPD group. Cox proportional hazards model analysis showed invasion level (p = 0.0093) and NLR value (p = 0.019) to be independent prognostic factors for OS. Notably, multivariate analysis revealed that invasion level (p = 0.045) and NLR value (p = 0.036) were independent prognostic factors for OS in the metastatic EMPD group. The limitations of this study include the small number of participants and its retrospective nature. In conclusion, since NLR can be routinely assessed with high feasibility, it might be a useful biomarker for predicting prognosis in patients with EMPD.
Subject(s)
Lymphocytes , Neutrophils , Paget Disease, Extramammary , Humans , Lymphocytes/pathology , Neutrophils/pathology , Paget Disease, Extramammary/diagnosis , Paget Disease, Extramammary/pathology , Paget Disease, Extramammary/therapy , Prognosis , Retrospective Studies , Leukocyte Count , Lymphocyte Count , Biomarkers, Tumor/bloodABSTRACT
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a known prognostic biomarker for survival and is predictive of sentinel lymph node (SLN) positivity in some cancers. However, its usefulness as a prognostic biomarker for cutaneous squamous cell carcinoma (cSCC) has not been fully investigated. OBJECTIVE: Our objective was to investigate the relationship between the NLR and the disease-specific survival and SLN positivity in patients with cSCC. METHODS: In this single-center retrospective case series, we analyzed patients with cSCC who underwent blood tests prior to the initiation of treatment at our oncology hospital. The relationship between the patients' clinical characteristics (including the NLR) and the disease-specific survival and SLN positivity was evaluated using univariate and multivariate analyses. RESULTS: An elevated NLR was an independent prognostic factor for poor disease-specific survival and a predictive factor for SLN positivity. LIMITATIONS: Limitations include the small number of participants and selection bias due to the large proportion of high-risk cases in our patient population. CONCLUSION: NLR is a useful biomarker in cSCC because it is simple to measure and can predict prognosis.
