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1.
Epigenetic silencing of the O6-methylguanine-DNA methyltransferase (MGMT) gene is associated with improved survival in patients with high-grade gliomas
(HGG), with varying estimates of magnitude. The objective of this meta-analysis is to determine the prognostic value of MGMT
silencing, and assess its predictive value by treatment type. MEDLINE and EMBASE databases were searched for studies relating
to gliomas and MGMT. Studies reporting overall survival (OS) by MGMT status in patients with HGG were considered potentially
eligible. We excluded studies that did not control for potential confounding variables. A meta-analysis of studies was performed
via random-effects modelling. Subgroup meta-analyses by treatment were performed according to a priori hypotheses. Twenty
studies were ultimately eligible, including 2,018 patients. In the pooled analysis, MGMT silencing was associated with improved
OS (HR = 0.436; 95% CI: 0.333–0.571; P < 0.001). The prognostic utility of MGMT status varies significantly by treatment type (P = 0.001): the HR for OS for MGMT silenced tumors is 0.190 (0.047–0.770), 0.403 (0.282–0.576), 0.743 (0.579–0.954), and 1.070
(0.722–1.585) for studies using surgery plus the addition of either: chemotherapy (CT), chemoradiotherapy (CRT), radiotherapy
(RT), and nothing (surgery alone), respectively. Epigenetic silencing of MGMT is associated with markedly improved survival
in patients with HGG who receive adjuvant therapy. MGMT silencing serves as a predictive marker, with the largest benefit
seen in patients receiving CT as a component of adjuvant treatment, an intermediate benefit in patients receiving adjuvant
RT, and no evidence to support benefit in those receiving surgery alone. 相似文献
2.
Manila Antonelli Francesca Romana Buttarelli Antonietta Arcella Sumihito Nobusawa Vittoria Donofrio Hiroko Oghaki Felice Giangaspero 《Journal of neuro-oncology》2010,99(2):209-215
The objective of this study was to evaluate, in a series of 43 pediatric high-grade gliomas (21 anaplastic astrocytoma WHO
grade III and 22 glioblastoma WHO grade IV), the prognostic value of histological grading and expression of p53 and YKL-40.
Moreover, mutational screening for TP53 and IDH1 was performed in 27 of 43 cases. The prognostic stratification for histological grading showed no difference in overall (OS)
and progression-free survival (PFS) between glioblastomas and anaplastic astrocytomas. Overexpression of YKL40 was detected
in 25 of 43 (58%) cases, but YKL-40 expression was not prognostic in terms of OS and PFS. p53 protein expression was observed
in 13 of 43 (31%) cases but was not prognostic. TP53 mutations were detected in five of 27 (18%) cases (four glioblastomas and one anaplastic astrocytoma). Patients with TP53 mutation had a shorter median OS (9 months) and PFS (8 months) than those without mutations (OS, 17 months; PFS, 16 months),
although this trend did not reach statistical significance (p = 0.07). IDH1 mutations were not detected in any of the cases analyzed. Our results suggest that in pediatric high-grade gliomas: (i) histological
grading does not have strong prognostic significance, (ii) YKL-40 overexpression is less frequent than adult high-grade gliomas
and does not correlate with a more aggressive behavior, (iii) TP53 mutations but not p53 expression may correlate with a more aggressive behavior, and (iv) IDH1 mutations are absent. These observations support the concept that, despite identical histological features, the biology of
high-grade gliomas in children differs from that in adults, and therefore different prognostic factors are needed. 相似文献
3.
Prognostic value of 18F‐fluoroazomycin arabinoside PET/CT in patients with advanced non‐small‐cell lung cancer 下载免费PDF全文
Tsuneo Saga Masayuki Inubushi Mitsuru Koizumi Kyosan Yoshikawa Ming‐Rong Zhang Katsuyuki Tanimoto Atsushi Horiike Noriko Yanagitani Fumiyoshi Ohyanagi Makoto Nishio 《Cancer science》2015,106(11):1554-1560
This study evaluated the prognostic value of positron emission tomography/computed tomography (PET/CT) using 18F‐fluoroazomycin arabinoside (FAZA) in patients with advanced non‐small‐cell lung cancer (NSCLC) compared with 18F‐fluorodeoxyglucose (FDG). Thirty‐eight patients with advanced NSCLC (stage III, 23 patients; stage IV, 15 patients) underwent FAZA and FDG PET/CT before treatment. The PET parameters (tumor‐to‐muscle ratio [T/M] at 1 and 2 h for FAZA, maximum standardized uptake value for FDG) in the primary lesion and lymph node (LN) metastasis and clinical parameters were compared concerning their effects on progression‐free survival (PFS) and overall survival (OS). In our univariate analysis of all patients, clinical stage and FAZA T/M in LNs at 1 and 2 h were predictive of PFS (P = 0.021, 0.028, and 0.002, respectively). Multivariate analysis also indicated that clinical stage and FAZA T/M in LNs at 1 and 2 h were independent predictors of PFS. Subgroup analysis of chemoradiotherapy‐treated stage III patients revealed that only FAZA T/M in LNs at 2 h was predictive of PFS (P = 0.025). The FDG PET/CT parameters were not predictive of PFS. No parameter was a significant predictor of OS. In patients with advanced NSCLC, FAZA uptake in LNs, but not in primary lesions, was predictive of treatment outcome. These results suggest the importance of characterization of LN metastases in advanced NSCLC patients. 相似文献
4.
Watanabe R Nakasu Y Tashiro H Mitsuya K Ito I Nakasu S Nakajima T 《Brain tumor pathology》2011,28(2):127-135
Expression of the O6-methylguanine-DNA methyltransferase (MGMT) gene has been shown to correlate with clinical outcomes in patients with glioblastoma
multiforme treated with alkylating agents. We evaluated MGMT protein expression in 53 primary glioblastomas by the immunohistochemistry
(IHC) and analyzed the correlation between results of immunostaining and patient outcomes. There were 28 MGMT-immunopositive
and 25 negative glioblastomas. Patients with MGMT-immunonegative glioblastomas showed significantly longer progression-free
survival (PFS) (P = 0.0032), but no statistically significant benefits on overall survival (OS) (P = 0.0825) were shown. In 41 glioblastomas treated with temozolomide (TMZ) therapy (MGMT-immunopositive: n = 22, negative: n = 19), both PFS and OS were significantly better in MGMT-immunonegative glioblastomas. (PFS: P = 0.0015, OS: P = 0.0384). We conclude that MGMT expression on immunohistochemistry (IHC) correlates with outcomes in patients with primary
glioblastoma receiving TMZ and suggest the use of MGMT-IHC as a surrogate marker for predicting tumor chemosensitivity. 相似文献
5.
《Clinical lung cancer》2019,20(6):412-419
IntroductionThe aim of the present study was to investigate the value of incorporation 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) maximum standardized uptake value (SUVmax) and neutrophil-to-lymphocyte ratio (NLR) for improving prediction of clinical outcomes of patients with locally advanced non–small-cell lung cancer (LA NSCLC).Materials and MethodsWe retrospectively enrolled 138 patients with unresectable LA NSCLC at our institution from July 2010 to August 2017. Spearman correlation analyses were used to estimate the correlations between SUVmax and NLR level. The univariate and multivariate Cox survival analyses were used to evaluate the prognostic indicators, including the incorporation of SUVmax and NLR. We defined the SUVmax and NLR grade (SNG = 0, 1, or 2) score as the number of risk factors among (1) SUVmax > 11.95 and (2) NLR > 3.82. The SNG score prognostic value was evaluated for overall survival (OS) and progression-free survival (PFS).ResultsUnivariate analysis showed that tumor stage, SUVmax, SUVmean, NLR, and SNG score were significantly associated with OS and PFS in patients with LA NSCLC. Kaplan-Meier analysis and log-rank test demonstrated significant differences in both OS and PFS among patients in SNG score (OS, P < .001; PFS, P < .001). Spearman correlation analyses showed that SUVmax had a correlation with the NLR (r = 0.237; P = .005). In subgroup analyses for patients with tumor pathologic stage IIIA/IIIB, we found that the SNG score was significantly associated with OS and PFS in each subgroup (P < .001, P < .001 for OS and P = .027, P < .001 for PFS, respectively). Multivariate analysis showed that the SNG score was a significantly independent prognostic factor for OS (hazard ratio, 1.612; 95% confidence interval, 1.157-2.246; P = .005) and PFS (hazard ratio, 2.241; 95% confidence interval, 1.486-3.379; P < .001).ConclusionIncorporation of the SUVmax and NLR improves prediction of clinical outcomes in patients with LA NSCLC. 相似文献
6.
Persistently low lymphocyte counts after FCR therapy for chronic lymphocytic leukemia are associated with longer overall survival 下载免费PDF全文
Erel Joffe N. Ariela Arad Osnat Bairey Riva Fineman Rosa Ruchlemer Naomi Rahimi‐Levene Lev Shvidel Uri Greenbaum Ariel Aviv Tamar Tadmor Andrei Braester Neta Goldschmidt Aaron Polliack Yair Herishanu 《Hematological oncology》2018,36(1):128-135
Decreased absolute lymphocyte counts (ALCs) following frontline therapy for chronic lymphocytic leukemia may be associated with disease control, even in patients without evidence of minimal residual disease. We studied the prognostic significance of ALCs during the first year following treatment with fludarabine, cyclophosphamide, and rituximab (FCR). We evaluated 99 patients who achieved a partial response without lymphocytosis (<4.0 × 103cells/μL) or better after FCR. Absolute lymphocyte counts were recorded at 3‐, 6‐, 9‐, and 12‐month posttreatment and correlated with overall survival (OS) and event‐free survival (EFS). For each time point, analyses were limited to patients without lymphocytosis, so as to avoid possible biases from undocumented disease progressions. Lymphopenia (ALC < 1.0 × 103cells/μL) at 3 m after FCR (69% of patients n = 68), was associated with a longer OS (5y OS 91% vs 64%, P = .001), as were ALC ≤ 2 × 103 cells/μL at 6 m (5y OS 85% vs 48%, P = .004) and ALC ≤ 1.8 × 103 cells/μL at 9 m (5y OS 93% vs 54%, P = .009). A normal‐range ALC (≤4 × 103 cells/μL) at 12 m was also associated with a 91% 5y OS. Higher ALCs (but without lymphocytosis) were associated with shorter EFS (median EFS 27 months for ALC > 1.8 vs not reached for ALC ≤ 0.7 at 9 months, P < .0001). In conclusion, lower ALC levels in the first few months following frontline FCR therapy were associated with longer OS and EFS. Possible explanations may be that lower ALCs reflect deeper clonal suppression or protracted Treg depletion. Absolute lymphocyte count levels may be a cheap and widely available prognostic marker, though the added value for clinical practice is the minimal residual disease era needs to be explored. 相似文献
7.
Kavita K. Mishra Sarah Squire Kathleen Lamborn Anuradha Banerjee Nalin Gupta William M. Wara Michael D. Prados Mitchel S. Berger Daphne A. Haas-Kogan 《Journal of neuro-oncology》2010,100(1):121-127
To report long-term results for children with low-grade hypothalamic/chiasmatic gliomas treated on a phase II chemotherapy
protocol. Between 1984 and 1992, 33 children with hypothalamic/chiasmatic LGGs received TPDCV chemotherapy on a phase II prospective
trial. Median age was 3.0 years (range 0.3–16.2). Twelve patients (36%) underwent STRs, 14 (42%) biopsy only, and seven (21%)
no surgery. Twenty patients (61%) had pathologic JPAs, nine (27%) grade II gliomas, and four (12%) no surgical sampling. Median
f/u for surviving patients was 15.2 years (range 5.3–20.7); 20 of the 23 surviving patients had 14 or more years of follow-up.
Fifteen-year PFS and OS were 23.4 and 71.2%, respectively. Twenty-five patients progressed, of whom 13 are NED, two are AWD,
and 10 have died. All children who died were diagnosed and first treated at age three or younger. Age at diagnosis was significantly
associated with relapse and survival (P = 0.004 for PFS and P = 0.037 for OS). No PFS or OS benefit was seen with STR versus biopsy/no sampling (P = 0.58 for PFS, P = 0.59 for OS). For patients with JPAs and WHO grade II tumors, the 15-year PFS was 18.8 and 22.2% (P = 0.95) and 15-year OS was 73.7 and 55.6% (P = 0.17), respectively. Upfront TPDCV for children with hypothalamic/chiasmatic LGGs resulted in 15-year OS of 71.2% and 15-year
PFS of 23.4%. No survival benefit is demonstrated for greater extent of resection. Age is a significant prognostic factor
for progression and survival. 相似文献
8.
Nicolas Penel Sylvie Bonvalot Marie-Cécile Le Deley Antoine Italiano Camille Tlemsani Diane Pannier Clémence Leguillette Jean-Emmanuel Kurtz Maud Toulmonde Julien Thery Daniel Orbach Pascale Dubray-Longeras Benjamin Verret François Bertucci Cécile Guillemet Lucie Laroche Armelle Dufresne Jean-Yves Blay Axel Le Cesne 《International journal of cancer. Journal international du cancer》2023,153(2):407-416
The aim of this study is to evaluate the prevalence, determinants and prognostic value of pain at diagnosis in patients with desmoid-type fibromatosis (DF). We selected patients from the ALTITUDES cohort (NCT02867033), managed by surgery, active surveillance or systemic treatments, with pain assessment at diagnosis. Patients were invited to fill QLQ-C30 questionnaire and Hospital Anxiety Depression Scale. Determinants were identified using logistic models. Prognostic value on event-free survival (EFS) was evaluated using the Cox model. Overall, 382 patients were included in the current study (median age: 40.2 years; 117 men). The prevalence of pain was 36%, without significant difference according to first-line treatment (P = .18). In the multivariate analysis, pain was significantly associated with tumor size >50 mm (P = .013) and tumor site (P < .001); pain was more frequent in the neck and shoulder locations (odds ratio: 3.05 [1.27-7.29]). Pain at baseline was significantly associated with poor quality of life (P < .001), depression (P = .02), lower performance status (P = .03) and functional impairment (P = .001); we also observed a nonsignificant association with anxiety (P = .10). In the univariate analysis, baseline pain was associated with poor EFS; the 3-year EFS was 54% in patients with pain compared to 72% in those without pain. After adjustment for sex, age, size and line of treatment, pain was still associated with poor EFS (hazard ratio: 1.82 [1.23-2.68], P = .003). One third of recently diagnosed patients with DF experienced pain, especially those with larger tumors and neck/shoulder locations. Pain was associated with unfavorable EFS after adjustment for the confounders. 相似文献
9.
Christina Chen Raymond Huang Ainsley MacLean Alona Muzikansky Srinivasan Mukundan Patrick Y. Wen Andrew D. Norden 《Journal of neuro-oncology》2013,115(2):267-276
Although bevacizumab represented an important advance in treatment of recurrent high-grade gliomas (HGG), responses occur in fewer than half of patients. There are no validated biomarkers for anti-angiogenic therapy that are available for routine clinical use. We assessed the prognostic values of imaging and molecular markers in this patient population. MRI scans from 191 patients with recurrent HGG obtained prior to initiating bevacizumab were reviewed for areas of enhancement, necrosis, T2/FLAIR abnormality, and ADC values. Serial MRI scans following the initiation of bevacizumab were evaluated for response and progression. Non-radiographic markers including EGFR and MGMT status were also assessed with respect to response and patient survival. 65 of 191 patients (34 %) showed complete or partial response at the time of their best response MRI and demonstrated longer progression free survival (PFS) and overall survival (OS) compared to the group without response (PFS: 6.9 vs 3.5 months, OS: 10.9 vs 6.1 months). Minimum ADC values within enhancing and non-enhancing regions were lower in responders compared to those of non-responders (1,099 vs 984 × 10?6 mm2/s, p = 0.006). Smaller enhancing area was associated with longer OS (HR = 1.99, p = 0.017). The ratio of T2/FLAIR to enhancing area was prognostic of OS for only the Grade III HGG subgroup (HR = 0.14, p = 0.004). Area of enhancing tumor at baseline can stratify survival in patients with recurrent HGG treated with bevacizumab. The extent of edema relative to enhancing area may have a prognostic role specific to Grade III HGG. 相似文献
10.
Sebastian Zschaeck Yimin Li Rebecca Bütof Chen Lili Wu Hua Esther C.G. Troost Marcus Beck Holger Amthauer David Kaul Jörg Kotzerke Alexander D.J. Baur Pirus Ghadjar Michael Baumann Mechthild Krause Frank Hofheinz 《International journal of cancer. Journal international du cancer》2020,147(5):1427-1436
We have investigated the prognostic value of two novel interim 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) parameters in patients undergoing chemoradiation (CRT) for esophageal squamous cell carcinoma (ESCC): one tumor parameter (maximal standardized uptake ratio rSUR) and one normal tissue parameter (change of FDG uptake within irradiated nontumor-affected esophagus ∆SUVNTO). PET data of 134 European and Chinese patients were analyzed. Parameter establishment was based on 36 patients undergoing preoperative CRT plus surgery, validation was performed in 98 patients receiving definitive CRT. Patients received PET imaging prior and during fourth week of CRT. Clinical parameters, baseline PET parameters, and interim PET parameters (rSUR and ∆SUVNTO) were analyzed and compared to event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM). Combining rSUR and ∆SUVNTO revealed a strong prognostic impact on EFS, OS, LRC and FFDM in patients undergoing preoperative CRT. In the definitive CRT cohort, univariate analysis with respect to EFS revealed several staging plus both previously established interim PET parameters as significant prognostic factors. Multivariate analyses revealed only rSUR and ∆SUVNTO as independent prognostic factors (p = 0.003, p = 0.008). Combination of these parameters with the cutoff established in preoperative CRT revealed excellent discrimination of patients with a long or short EFS (73% vs. 17% at 2 years, respectively) and significantly discriminated all other endpoints (OS, p < 0.001; LRC, p < 0.001; FFDM, p = 0.02), even in subgroups. Combined use of interim FDG-PET derived parameters ∆SUVNTO and rSUR seems to have predictive potential, allowing to select responders for definitive CRT and omission of surgery. 相似文献
11.
Xue-Qin Yang Yan Li Chuang Chen Chun-Wei Peng Shao-ping Liu Yang Liu 《Medical oncology (Northwood, London, England)》2011,28(3):789-795
To evaluate the prognostic value of preoperative serum carbohydrate antigen19-9 (CA19-9), carcinoembryonic antigen (CEA),
and carbohydrate antigen 125 (CA125) for overall survival (OS) in patients with colorectal cancer (CRC). Preoperative serum
CA19-9, CEA, and CA125 levels were detected by C12 protein chip diagnostic system in 80 patients with CRC, and the association
of their preoperative status with the patients’ OS was analyzed. Patients with positive preoperative serum CA19-9, CA125,
and CEA had a worse survival comparing with those negative patients, the difference in CA19-9 and CA125 reached statistical
significance (Log rank test, P < 0.05), but the difference of CEA did not achieve statistical significance (Log rank test, P > 0.05). The OS of patients with CRC with three positive tumor markers (TMs) <1 or 2 positive TMs < negative TM, simultaneously
positive serum CA19-9, CEA, and CA125 was the most dismal predicting factor for OS. Spearman correlations revealed that the
preoperative serum status of CA19-9 (P = 0.000), CEA (P = 0.000), and CA125 (P = 0.000) had correlations with stage; the preoperative serum CA125 status (r = −0.385, P = 0.000) and stage (r = −0.457, P = 0.000) and location (r = 0.223, P = 0.047) had correlations with OS. Multivariate analysis with Cox regression model showed that only stage (P = 0.000) and the preoperative serum CA125 status (P = 0.016) were independent prognostic factors for OS of patients with CRC. The preoperative status of serum CA19-9, CEA, and
CA125 had correlations with CRC stage. The simultaneously positive serum CA19-9, CEA, and CA125 was the most dismal predicting
factor for OS of patients with CRC. Preoperative serum CA125 status and stage were independent prognostic factors for OS of
CRC. 相似文献
12.
Chih‐Hsiang Yu Wan‐Ting Chang Shiann‐Tarng Jou Tze‐Kang Lin Ya‐Hsuan Chang Chien‐Yu Lin Kai‐Hsin Lin Meng‐Yao Lu Shu‐Huey Chen Kang‐Hsi Wu Shih‐Chung Wang Hsiu‐Hao Chang Yi‐Ning Su Chia‐Cheng Hung Dong‐Tsamn Lin Hsuan‐Yu Chen Yung‐Li Yang 《Cancer science》2020,111(1):229-238
TP53 alterations are frequent relapse‐acquired mutations in childhood acute lymphoblastic leukemia (ALL). The present study evaluated the clinical significance of relapsed childhood ALL in Taiwan. Diagnostic and/or relapsed bone marrow or peripheral blood was obtained from 111 children with relapsed ALL who were initially treated by using Taiwan Pediatric Oncology Group (TPOG) ALL protocols from January 1997 to May 2018. Mutations were detected by PCR and sequencing, as well as by multiplex ligation‐dependent probe amplification to detect copy number alterations. Copy number and/or sequence alterations of TP53 were detected in 29% (28 of 98) and in 46% (6 of 13) of patients with relapsed B‐cell and T‐cell ALL, respectively. This incidence was much higher than that in several similar studies conducted in Caucasian populations. Seventy percent of all TP53 alterations were gained at relapse in 67 matched samples by back‐tracking matched diagnostic samples. TP53 alterations were associated with lower 5‐year event‐free survival (EFS) and overall survival (OS) rates (P = .013 and P = .0002, respectively). Multivariate analysis confirmed the prognostic significance of TP53 alterations. Forty‐five patients received hematopoietic stem‐cell transplantations post‐relapse. Patients with TP53 alterations (14/45) had inferior 5‐year EFS and OS than patients without TP53 alterations after transplantation (P = .002 and P = .001, respectively). The significance of these TP53 alterations for patients who received transplantations was confirmed by multivariate analysis. In conclusion, TP53 alterations were enriched and useful as prognostic markers in relapsed childhood ALL. 相似文献
13.
Phi JH Wang KC Park SH Kim IH Kim IO Park KD Ahn HS Lee JY Son YJ Kim SK 《Journal of neuro-oncology》2012,106(3):619-626
Pediatric infratentorial ependymomas are difficult to cure. Despite the availability of advanced therapeutic modalities for
brain tumors, total surgical resection remains the most important prognostic factor. Recently, histological grade emerged
as an independent prognostic factor for intracranial ependymoma. We retrospectively reviewed the treatment outcome of 33 pediatric
patients with infratentorial ependymoma. Progression-free survival (PFS) and overall survival (OS) rates were calculated and
relevant prognostic factors were analyzed. Fourteen patients (42%) were under the age of 3 at diagnosis. Gross total resection
was achieved in 16 patients (49%). Anaplastic histology was found in 13 patients (39%). Adjuvant therapies were delayed until
progression in 12 patients (36%). Actuarial PFS rates were 64% in the first year and 29% in the fifth year. Actuarial OS rates
were 91% in the first year and 71% in the fifth year. On univariate analysis, brainstem invasion (P = 0.047), anaplastic histology (P = 0.004), higher mitotic count (P = 0.001), and higher Ki-67 index (P = 0.004) were significantly related to a shorter PFS. Gross total resection (P = 0.029) and a greater age at diagnosis (P = 0.033) were significantly related to a longer PFS. On multivariate analysis, anaplastic histology alone was significantly
related to a shorter PFS (P = 0.023). Gross total resection (P = 0.039) was significantly related to a longer overall survival (OS) on multivariate analysis. Anaplastic histology and gross
total resection were the most important clinical factors affecting PFS and OS, respectively. Anaplastic histology, mitotic
count, and Ki-67 index can be used as universal and easily available prognostic parameters in infratentorial ependymomas. 相似文献
14.
The factors that affect the prognosis of patients’ metastatic osteosarcoma are still poorly understood. In this study, we investigated a new prognostic factor, the ratio of surgically resected to radiologically detected osteosarcoma lung nodules (SR/RD), which may have predictive value.Patients and methodsData from patients with metastatic osteosarcoma who underwent metastasectomy between January 2009 and December 2020, in a single center, were reviewed. The relationships between survival and the SR/RD ratio, timing of lung metastases, number of nodules, laterality, and presence of tumor necrosis at first metastasectomy were investigated.ResultsAmong the 125 metastatic osteosarcoma patients, 80 patients had an SR/RD ratio ≤1. The median duration of follow-up was 72 months, ranging from 6 to 118 months. The five-year overall survival (OS) and postmetastasectomy event-free survival (EFS) for all patients were 36.5% and 18.1%, respectively. The five-year OS of patients with a low SR/RD ratio was 49.6% and that of patients with a high SR/RD ratio was 11.8 (P = 0.001). The two-year postmetastasectomy EFS rates of the high and low ratio groups were 24.1% and 9.4%, respectively (P = 0.001). The SR/RD ratio, number of nodules, and tumor necrosis had significant effects on OS and postmetastasectomy EFS in univariate analysis. A Cox proportional hazard model demonstrated that tumor necrosis and an SR/RD ratio >1 were associated with OS (HR = 1.8 and 2.01) and postmetastasectomy EFS (HR = 1,69 and 1.97).ConclusionsA high SR/RD ratio of greater than 1 and poor tumor necrosis were significantly associated with poor survival among patients with metastatic osteosarcoma who had lung metastasectomy. The high SR/RD ratio may be a surrogate outcome for incomplete metastatic tumor resection. 相似文献
15.
Keam B Im SA Kim HJ Oh DY Kim JH Lee SH Chie EK Han W Kim DW Cho N Moon WK Kim TY Park IA Noh DY Heo DS Ha SW Bang YJ 《Breast cancer research and treatment》2009,116(1):153-160
Purpose Neoadjuvant chemotherapy may modify the yield of involved axillary lymph nodes. The purpose of this study was to identify
the clinical significance of the involved nodal ratios in patients with stage II/III breast cancer treated with neoadjuvant
chemotherapy. Methods Two hundred and five stage II and III breast cancer patients who received neoadjuvant docetaxel/doxorubicin chemotherapy
were enrolled in this prospective study. The patients received three cycles of neoadjuvant chemotherapy followed by curative
surgery, either breast-conserving surgery or mastectomy with axillary lymph node dissection, and received three additional
cycles of docetaxel/doxorubicin chemotherapy as adjuvant. Adjuvant radiotherapy and hormonal therapy were given after adjuvant
chemotherapy when indicated. Results The median follow-up duration was 28.9 months. The overall response rate (RR) for neoadjuvant chemotherapy was 77.6%. The
mean nodal ratio was 0.29 (range, 0–1.0; nodal ratio ≤0.25, 121 [59.0%] vs. >0.25, 84 [41.0%]). Relapse free survival (RFS)
of the patients who had a nodal ratio >0.25 was significantly shorter (Hazard Ratio (HR) = 2.701, P = 0.001). A nodal ratio >0.25 was also associated with a shorter overall survival (OS) (HR = 4.109, P = 0.006). However, RFS and OS were not different according to the absolute number of involved nodes (ANIN) (P = 0.166, P = 0.248, respectively). In multivariate analysis, the nodal ratio was an independent prognostic factor for RFS and OS (HR = 4.246,
P < 0.001; HR = 7.764, P < 0.001). Conclusion Axillary nodal ratios have an independent prognostic value in stage II/III breast cancer treated with neoadjuvant chemotherapy.
Nodal ratio might be a useful tool to identify the patients at high risk of relapse in the neoadjuvant setting. 相似文献
16.
《Clinical Lymphoma, Myeloma & Leukemia》2020,20(12):e998-e1009
BackgroundUp to 55% of non-APL acute myeloid leukemias (AML) lack a molecular target suitable for standardized disease monitoring. We aimed to evaluate the prognostic significance of WT1 gene expression at early stages of intensive treatment.Patients and MethodsA total of 106 consecutive patients with intermediate and high-risk AML who had WT1 expression at diagnosis >500 copies/104 ABL and who achieved remission after 1 to 2 cycles of induction treatment were analyzed. WT1 expression was measured in peripheral blood using a standardized European LeukemiaNet method. Overexpression was defined as >50 copies/104 ABL. The median follow-up was 30 months.ResultsPatients with normal versus high WT1 expression after 2 cycles of chemotherapy had overall survival (OS) at 3 years of 66% versus 41% (P = .01); event-free survival (EFS) 45% versus 22% (P = .01). Prognostic significance of WT1 expression after 2 cycles of treatment was maintained in the group of patients treated with chemotherapy alone without hematopoietic stem cell transplantation in first line treatment (OS 70% vs. 36%, P = .02; EFS 35% vs. 0%, P = .03). Significant prognostic factors for EFS on multivariate analysis were the achievement of molecular remission (<50 copies of WT1) at any time during treatment (hazard ratio [HR] 0.47, P = .04) and increased WT1 expression after 2 cycles of chemotherapy (HR 2.0, P = .03).ConclusionIncreased WT1 expression after 2 cycles of chemotherapy is a negative prognostic factor for survival. WT1 remains a valuable molecular marker in AML without any leukemia-specific mutation, especially if next generation sequencing and/or digital polymerase chain reaction are not routinely available. 相似文献
17.
Enrique González-Billalabeitia Ricardo Hitt Jesús Fernández Esther Conde Francisco Martínez-Tello Rafael Enríquez de Salamanca Hernán Cortés-Funes E. González-Billalabeitia 《Clinical & translational oncology》2009,11(7):479-483
Background Treatment of high-grade osteosarcoma remains a challenge. The prognostic significance of the pre-treatment serum lactate dehydrogenase
(LDH) level is currently controversial.
Patients and methods We reviewed records from all patients diagnosed with conventional high-grade osteosarcoma at our institution over a 25-year
period and analysed the prognostic significance of LDH in high-grade localised extremity osteosarcomas treated with chemotherapy.
Results Between June 1977 and March 2003, 66 patients for whom follow-up was available were diagnosed with localised high-grade extremity
osteosarcoma and treated with chemotherapy. The median age was 15 years, with only 3% older than 40 years, and the median
follow-up was 100 months. The median progression-free survival (PFS) was 67 months and the median overall survival (OS) was
113 months. The absence of a response to chemotherapy was correlated with a trend toward lower PFS and OS. High serum pre-treatment
LDH level was associated in multivariate analyses with a poorer prognosis for both PFS (HR=8.623, 95%CI: 1.71–43.37; p=0.009) and for OS (HR=9.38; 95%CI: 1.73–50.74; p=0.009).
Conclusion In this series, the pre-treatment serum LDH level had an independent prognostic value for both PFS and OS in patients with
high-grade localised extremity osteosarcoma. This measurement should be included in a large prospective prognostic series. 相似文献
18.
《European journal of surgical oncology》2020,46(8):1532-1538
PurposeTo investigate the value of 18 FDG PET/CT volumetric parameters in the prediction of overall survival (OS) in patients with pancreatic cancer and also, assess their independence relative to well-established clinico-pathological variables.MethodsWe conducted a retrospective analysis of patients with a confirmed diagnosis of pancreatic cancer who underwent 18 FDG PET/CT. The tumour maximum standardised uptake value (SUVmax) in addition to SUVmean, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated. The prognostic value of 18 FDG PET/CT and clinico-pathological parameters for OS were assessed using univariate and multivariable analyses.ResultsA sum of 89 patients were analysed in this study. Median survival for patients categorised as having high TLG (≥55) and low TLG (<55) was 18 vs 5 months (p < 0.001). Similarly, the respective high vs low SUVmean, MTV and SUVmax were 18 vs 6 months (p = 0.001), 16 vs 6 months (p = 0.002) and 18 vs 6 months (p = 0.001). Univariate analysis showed SUVmax, SUVmean, MTV, TLG, tumour size, tumour differentiation and presence of distant metastasis as prognostic factors for OS. On multivariable analysis, TLG (HR 2.0, 95% CI 1.26–3.18, p = 0.004) and the presence of distant metastasis (HR 3.37, 95% CI 1.97–5.77, p < 0.001) emerged as independent prognostic factors. Subgroup analysis identified TLG as the only significant PET metric after adjusting for the presence of distant metastasis.Conclusions18 FDG PET/CT is a useful tool in the preoperative evaluation of patients with pancreatic cancer. Tumour TLG offer an independent prognostic value in both potentially operable and metastatic disease settings. 相似文献
19.
Lin Ma Lijun Sun Kaikai Zhao Zhengxin Dong Zhaoqin Huang Xiangjiao Meng 《Cancer science》2021,112(12):4968-4976
TCF1+CD8+T cells are reported to exhibit stem-like properties with the ability to self-renew and differentiate into terminal effector T cells (TCF1-CD8+T cells) to enhance antitumor response. Previous studies indicated that TCF1+CD8+ tumor-infiltrating lymphocytes (TILs) are related to response to immunotherapy. However, their role in predicting prognosis for patients with primary small cell carcinoma of the esophagus (PSCCE) remains unclear. In this study, the expression of TCF1+CD8+T was analyzed by multiplex fluorescence immunohistochemistry in tumor tissues of 79 patients with PSCCE. High infiltration of TCF1+CD8+T cells had longer overall survival (OS) than low infiltration (P = .009, hazard ratio [HR] = 0.506). High TCF1+CD8/CD8 ratio (>21%) showed superior OS compared with low ratio (≤21%) (P < .001, HR = 0.394). In the validation set (n = 20), the prognostic value of TCF1+CD8+T cells on OS was also verified. TCF1+CD8+T cells are strong prognostic predictors. 相似文献
20.
Giuseppe Minniti M. Salvati A. Arcella F. Buttarelli A. D’Elia G. Lanzetta V. Esposito S. Scarpino R. Maurizi Enrici F. Giangaspero 《Journal of neuro-oncology》2011,102(2):311-316
Epigenetic silencing of the O6-methylguanine-DNA-methyltransferase (MGMT) gene by promoter methylation is correlated with improved progression-free survival
(PFS) and overall survival (OS) in adult patients with newly diagnosed glioblastoma multiforme (GBM) who receive alkylating
agents. The aim of this study is to determine the correlation between MGMT and survival in elderly patients with GBM treated
with radiotherapy (RT) and temozolomide (TMZ). Eighty-three patients aged 70 years or older with histologically confirmed
GBM treated with RT plus TMZ between February 2005 and September 2009 were investigated in this study. The methylation status
of the MGMT promoter was determined by polymerase chain reaction analysis. Median PFS and OS were 7.5 and 12.8 months, respectively.
The MGMT promoter was methylated in 42 patients (50.6%) and unmethylated in 41 patients (49.4%). Median OS was 15.3 months
in methylated patients and 10.2 months in unmethylated patients (P = 0.0001). Median PFS was 10.5 months in methylated tumors and 5.5 months in unmethylated tumors (P = 0.0001). On multivariate analysis MGMT methylation status emerged as the strongest independent prognostic factor for OS
and PFS (P = 0.004 and P = 0.005, respectively). The results of the present study suggest that MGMT methylation status might be an important prognostic
factor associated with better OS and PFS in elderly patients with GBM treated with RT and TMZ. 相似文献