• Title/Summary/Keyword: Prognostic factors

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Treatment Outcome and Prognostic Factors for Malignant Skin Melanoma Treated with Radical Surgery

  • Majewski, Wojciech;Stanienda, Karolina;Wicherska, Katarzyna;Ulczok, Rafal;Wydmanski, Jerzy
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5709-5714
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    • 2015
  • Aim: To assess the treatment outcome in patients with malignant skin melanoma and prognostic factors for distant metastases (DM), disease-free survival (DFS) and overall survival (OS). Materials and Methods: A retrospective analysis was conducted on 113 patients with malignant skin melanoma (60 females, 53 males, average age-55 years) who were treated surgically. Primary treatment consisted of local excision. In 12 cases, it was accompanied by lymph node excision. In 93 (82%) cases, radicalization was necessary, which was either local only (19 cases) or accompanied by lymph node surgery/biopsy (74 cases). Possible prognostic factors such as Clark's stage and Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases (pN+), gender, tumor location and primary excision margins were considered. Results: In 51 (45%) cases, treatment failure occurred. The 5-year DM rate was 47%, the 5-year DFS was 38%, and the 5-year OS was 56%. In the univariate analysis, the important factors with respect to at least one endpoint included Clark's stage, Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases, gender and primary tumor localization. The presence of metastasic nodes was the most important prognostic factor, with a 5-year DM rates of 30% for pN(-) and 76% for pN(+) and a 5-year DFS and OS of 56% and 76% for pN(-) and 13% and 24% for pN(+), respectively. The average tumor dimension was independently significant for DFS and OS, with 5-year rates of 69% and 80% for ${\leq}1cm$, 28% and 53% for 1-2 cm, and 18% and 30% for >2 cm, respectively. Tumor location was also significant for DM and OS, with 5-year rates of 69% vs 33% and 41% vs 66% for trunk vs other locations, respectively. Conclusions: The natural course of a malignant skin melanoma treated radically is disadvantageous, with unsuccessful outcome in nearly half of the cases. Common clinical factors, such as Clark's tumor stage, Breslow's depth of invasion and the presence of metastatic nodes, have high prognostic significance. The size and location of the primary lesion may be considered independent prognostic factors. The most important negative prognostic factor is the presence of metastatic regional lymph nodes. Only one quarter of patients with metastases in lymph nodes survive 5 years from primary surgery.

Assessment of prognostic factors in dogs with mammary gland tumors: 60 cases (2014-2020)

  • Moon, Chang-Hwan;Kim, Dae-Hyun;Yun, Sung-Ho;Lee, Hae-Beom;Jeong, Seong-Mok
    • Korean Journal of Veterinary Research
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    • v.62 no.1
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    • pp.9.1-9.6
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    • 2022
  • Canine mammary gland tumors are the most common neoplasms in intact female dogs. Approximately half of all mammary tumors are malignant, and there is a risk of metastasis, which is associated with a poor prognosis. This study was to evaluate the prognostic factors of canine mammary gland tumors and the risk factors associated with the development of malignant tumors. From 2014 to 2020, 60 dogs with mammary gland tumors that underwent surgical treatment were evaluated in this retrospective study. Tumor size, TNM stage, and histopathological results were prognostic factors for 2-year survival after surgery. Every 10 mm increase in tumor size, increased the risk of death within 2 years after surgery 1.213 times. Dogs with TNM stage IV or V had 8.667 fold risk of death within 2 years after surgery. The 2-year survival rate for dogs with benign tumors was 90.2% and for malignant tumors was 67.3%. Tumor size is the most important prognostic factor for canine mammary gland tumors. As tumor size increased by 10 mm, the risk for development of malignant tumors increased by 1.487 times. Tumors larger than 30 mm are highly likely to be malignant, and metastatic evaluation and wide resection should be considered.

A Study of Prognostic Factors of Conservative Treatment in Plantar Fasciitis (족저 근막염 환자의 보존적 치료시 예후 인자 연구)

  • Park, Hyun-Woo;Chu, In-Tak;Hwang, Sung-Su
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.57-61
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    • 2007
  • Purpose: We analyzed to find out prognostic factors in the conservative treatment for the plantar fasciitis. Materials and Methods: The data were collected from 145 patients, 159 feet (M:F = 51:108) with conservative treatment and analyzed for possible prognostic factors : sex, age of onset, the duration of symptom before treatment, pain score before treatment, the duration for symptom remission, medication period, calcaneal pitch angle, and presence of calcaneal spur. Results: The duration of symptom before conservative treatment is affected to the prognosis, and the borderline of the effective period was about 6 months. Conclusion: With the conservative treatment of the plantar fasciitis, we found that (1) the duration of symptom before the conservative treatment was a prognostic factor, and (2) if the period before the conservative treatment was more than 6 months, the other treatment option such as surgery should be considered for this chronic group.

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Relationship between HER2 Proto-oncogene Status and Prognostic Factors of Breast Cancer in the West of Iran

  • Amirifard, Nasrin;Sadeghi, Edris;Payandeh, Mehrdad;Mohebbi, Hossain;Sadeghi, Masoud;Choubsaz, Mansour
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.295-298
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    • 2016
  • Background: Breast cancer is a very common health problem in Iranian women. The HER2-neu gene is a transmembrane receptor tyrosine kinase with homology to members of the EGF receptor family. The aim of this study was to investigate the association between HER2-neu oncogene status with prognostic factors of breast cancer in Kermanshah province, Iran. Materials and Methods: Relationship between HER2-neu and prognostic factors of 130 cases of breast cancer were evaluated during two years in Imam Reza hospital in Kermanshah, Iran. Data were analyzed using descriptive statistics and the T-test and Mann-Whitney U non-parametric test using SPSS 19. Results: The mean age for the patients was $46.0{\pm}8.0years$, all being female. Among the predictive factors for breast cancer were family history, stage of disease, involvement of the lymphovascular system, number of involved lymph nodes in axillaries, grading and hormone receptor status with HER2-neu oncogene had direct correlation and between factors, tumor location, patient age and histological characteristics and HER2-neu oncogene had no significant relationship. We found significant correlation between HER2 with ER and PR and also HER2 with ER, PR negative. Conclusions: HER2-neu is risk factor that can be a good prognostic and also predictive factor. For these reasons, we recommend that it be evaluated for all types of BC.

Acute lymphoblastic leukemia in children: past, present and future (소아 급성 림프모구 백혈병: 과거, 현재, 미래)

  • Kang, Hyoung Jin;Shin, Hee Young;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.601-605
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    • 2007
  • The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.

Perineural Invasion Independent Prognostic Factors in Patients with Gastric Cancer Undergoing Curative Resection

  • Selcukbiricik, Fatih;Tural, Deniz;Buyukunal, Evin;Serdengecti, Suheyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3149-3152
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    • 2012
  • Objective: The prognostic significance of perineural invasion (PNI) in gastric cancer has been previously investigated but not clearly clarified. The objective of our study was to investigate the role of PNI as prognostic factor in patients undergoing curative surgical resection and without distant metastasis in comparison with other clinicopathological factors. Methods: Between 2001 and 2010, 287 cases of gastric adenocarcinoma underwent radical gastrectomy recorded in hospital based registries. PNI was assessed as positive when cancer cells were seen in the perinerium or neural fascicles intramurally. Categorical and continuous variables were summarized using descriptive statistics and compared using chi-square and Mann-Whitney U tests, respectively. Cancer related survival rates were estimated by the Kaplan-Meier method. Results: PNI was positive in 211 of 287 cancers (73%), with a positive relation to lymph node metastases and advanced stage (p=0.0001, p=0.0001, respectively), mural invasion, and lymphatic and blood vessel invasion (p=0.0001, p=0.0001, respectively). The median survival of the PNI positive patients was significantly shorter than that of their PNI negative counterparts (24.1 versus 38.2 months, p=0.008). In the multivariate analysis, we detected PNI was an independent prognostic factor (p=0.025, HR=1.21, 95% CL 1.08-2.3) along with classical clinicopathological variables such as lymph node involvement (p=0.001), pT stage (p=0.03), and LVI (p=0.017), but not age, gender, tumour localization, stage, histologic type, and surgery procedure. Conclusions: PNI positivity in gastric cancers was related mural invasion, lymph node involvement, advanced stage and lymphatic and venous blood vessels. The presence of PNI appeared as an independent prognostic factor on survival on multivariate analysis, not influenced by tumor stage, lymph node metastases and other classical factors.

Prognostic Factors in Stage III Non-Small-Cell Lung Cancer Patients

  • Urvay, Semiha Elmaci;Yucel, Birsen;Erdis, Eda;Turan, Nedim
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4693-4697
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    • 2016
  • Aim: The objective of this study is to investigate prognostic factors affecting survival of patients undergoing concurrent or sequential chemoradiotherapy (CRT) for stage III non-small-cell lung cancer (NSCL). Methods and materials: We retrospectively reviewed the clinical records of 148 patients with advanced, inoperable stage III NSCLC, who were treated between 2007 and 2015. Results: The median survival was found to be 19 months and 3-year overall survival was 27%. Age (<65 vs ${\geq}65years$, p=0.026), stage (IIIA vs IIIB, p=0.033), dose of radiotherapy (RT) (<60 vs ${\geq}60Gy$, p=0.024) and treatment method (sequential chemotherapy+RT vs concurrent CRT, p=0.023) were found to be factors affecting survival in univariate analyses. Gender, histological subtype, weight loss during CRT, performance status, induction/consolidation chemotherapy and presence of comorbidities did not affect survival (p>0.050). Conclusion: Young age, stage IIIA, radiotherapy dose and concurrent chemoradiotherapy may positively affect survival in stage III NSCL cases.

Diagnosis and Treatment of Gastric Neuroendocrine Tumors (위 신경내분비종양의 진단과 치료)

  • Soo In Choi
    • Journal of Digestive Cancer Research
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    • v.10 no.1
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    • pp.1-8
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    • 2022
  • The incidence of gastric neuroendocrine tumors (NET) has been increased with the improvement of endoscopy accessibility. The World Health Organization classified NET of low (G1), intermediate (G2), high (G3) grade and neuroendocrine carcinoma with poor differentiation by mitotic count and Ki-67 labeling index. Gastric NET are divided into three subtypes based on the pathophysiology, and treatment is determined according to the subtype and prognostic factors of tumor. For diagnosis, endoscopy with biopsy, endoscopic ultrasonography, abdominal pelvis computed tomography, and serum gastrin level measure are required. In general, type 3, size > 2 cm, deep submucosal infiltration, high histological grade, lymphovascular invasion and metastasis are poor prognostic factors. Type 1 or 2 without these factors are treated by endoscopic resection, and other tumors needs surgery. Endoscopic resection of early type 3 or type 1 and 2 tumors with poor prognostic factors still remains a challenge.

A Prognostic Model To Predict Survival In Stage III Colon Cancer Patients Based on Histological Grade, Preoperative Carcinoembryonic Antigen Level and the Neutrophil Lymphocyte Ratio

  • Wuxiao, Zhi-Jun;Zhou, Hai-Yan;Wang, Ke-Feng;Chen, Xiao-Qin;Hao, Xin-Bao;Lu, Yan-Da;Xia, Zhong-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.747-751
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    • 2015
  • Background: Stage III colon cancer patients demonstrate diverse clinical outcomes. The aim of this study was to develop a prognostic model in order to better predict their survival. Materials and Methods: From 2004 to 2010, 548 patients were retrospectively analyzed, among whom 328 were defined as the study group and the remaining 220 served as a validation group. Clinico-pathologic features, including age, gender, histological grade, T stage, number of positive lymph nodes, number of harvest lymph nodes, pretreatment carcinoembryonic antigen (CEA) levels and pretreatment neutrophil lymphocyte ratio (NLR), were collected. Kaplan-Meier survival curves were used to detect prognostic factors and multivariate analysis was applied to identify independent examples on which to develop a prognostic model. Finally, the model was further validated with the validation group. Results: Histological grade (p=0.002), T stage (p=0.011), number of positive lymph nodes (p=0.003), number of harvested lymph nodes (p=0.020), CEA (p=0.005), and NLR (p<0.001) were found as prognostic factors while histological grade [RR(relative risk):0.632, 95%CI (Confidence interval) 0.405~0.985, p=0.043], CEA (RR:0.644, 95%CI:0.431~0.964, p=0.033) and NLR (RR:0.384, 95%CI:0.255~0.580, p<0.001) levels were independent. The prognostic model based on these three factors was able to classify patients into high risk, intermediate and low risk groups (p<0.001), both in study and validation groups. Conclusions: Histological grade, pretreatment CEA and NLR levels are independent prognostic factors in stage III colon cancer patients. A prognostic model based on these factors merits attention in future clinical practice.