• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3009-3013
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• 2012

Background: The clinical course of individual chronic lymphocytic leukemia (CLL) is highly variable and clinical staging systems do not help us to predict if and at what rate there will be disease progression in an individual patient diagnosed with early stage disease. Recently, several important observations related to other prognostic factors including lymphocyte doubling time (LDT), ${\beta}_2$-microglobulin (${\beta}_2$-MG), and percent of smudge cell in peripheral blood smears, cytogenetic and molecular analysis have been made. The aim of this study was to evaluate a range of prognostic factors in our CLL patients. Design and methods: Seventy patients with CLL were enrolled. Prognostic factors of disease including Binet staging, LDT, ${\beta}_2$-MG, ESR, LDH, percent of smudge cell in peripheral blood smear, absolute lymphocyte count, and conventional cytogenetic (CC) analysis were evaluated at diagnosis, and the patients were followed up to determine their outcome. We compared factors with each other and with Binet staging and prognosis. Results: Enrolled patients aged 37-85 years at diagnosis or during follow up. There was no relationship between serum LDH level (P=0.3), ESR (P=0.11), percent of smudge cells in peripheral blood smear (P=0.94), and absolute lymphocyte count (P=0.18) with the stage of disease and prognosis, but the ${\beta}_2$ macroglobulin level (p<0.0001), LDT (p<0.001) had direct and significant relation with staging and outcome. In 19% of patients cytogenetic alteration were seen. Conclusion: The detection of cytogenetic alteration only using the CC method is not sufficient and we need to use FISH, but because FISH study is an expensive method not available in all areas, instead we believe that ${\beta}_2$ MG can be applied in its place as a good prognostic factor for CLL at diagnosis and during follow up. We suggest to add it to Binet staging for prognostic subgrouping of CLL.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2089-2094
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• 2014

Background: Although many prognostic factors have been identified for lung cancers, new ones are needed to determine the course of the disease. Recently, a high neutrophil to lymphocyte ratio (NLR) prior to surgery or treatment has been shown to be an indicator of prognosis for cancer. The aim of this study was to investigate the value of NLR as a prognostic factor and the correlation between NLR and other probable clinical prognostic factors in non small cell lung cancer patients prior to treatment. Materials and Methods: Data of patients who were diagnosed with non-small cell lung cancer in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR was calculated before the application of any treatment. Results: A total of 299 patients, 270 (90%) males and 29 (10%) females, were included in the study. Age (p<0.001) stage (p<0.001), Eastern Cooperative Oncology Group performance status (p<0.001), weight loss (p<0.001), anemia (p<0.001), histopatology (p<0.001), NLR ${\geq}3$ (p=0.048), NLR ${\geq}4$ (p=0.025) and NLR ${\geq}5$ (p=0.018) were found to be the prognostic factors. Age, anemia, Eastern Cooperative Oncology Group performance status, the stage, NLR (${\geq}5$) were an independent prognostic factors. There was a positive correlation between NLR and the Eastern Cooperative Oncology Group performance status (0.23, p=0.001), the C reactive protein levels (r=0.36, p<0.001). Conclusions: Prior to treatment high NLR was found as an independent poor prognosis factor. Besides, NLR correlated with Eastern Cooperative Oncology Group performance status and the C reactive protein levels.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.92-96
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• 2011

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.91-98
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• 2001

Objective : The purpose of this study was to investigate the prognostic factors in patients who suffered an intracerebral hemorrhage(ICH) due to a ruptured middle cerebral artery(MCA) aneurysm. Methods : Among 148 case of ruptured MCA aneurysm, ruptured MCA aneurysm with ICH was compared with ruptured MCA aneurysm alone. According to factors, the prognosis in these two groups was analyzed. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. Prognostic factors were evaluated with Chi square test, Mann-Whitney test and ANOVA test with differences being considered significant for value less than 0.05. Results : Ruptured MCA aneurysm alone revealed better consciousness on admission and final outcome than those combined with ICH. Ruptured MCA aneurysm alone showed 74% in H-H grade I, II and 82% in GOS I, II. But ruptured MCA aneurysm with ICH showed 63% in H-H grade IV, V and 52% in GOS IV, V. Age, sex, lesion site, aneurysmal size, temoporary clipping time, interval to operation, operative approach were statistically not significant in prognosis(p>0.05). But H-H grade on admission(p<0.05), complication(esp. cerebral infarction)(p<0.05), preoperative ICH volume and site(p<0.01), preoperative midline shifting(p<0.01), remained ICH volume(p<0.05) showed significance statistically. Conclusion : Prognostic factors are helpful to neurosurgeon to estimate clinical and neurological outcome postoperatively. We suggest that the good prognostic factors in ruptured MCA aneurysm with ICH were good H-H grade on admission, cerebral infarction(-), preoperative ICH volume <25cc, temporal and intrasylvian ICH, preoperative midline shifting <5mm, remained ICH volume <10cc.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10231-10236
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• 2015

This study aimed to evaluate the prevalence of preoperative thrombocytosis and its prognostic significance in Thai patients with endometrial cancer. We retrospectively reviewed the medical records of 238 cases who had undergone surgical staging procedures between January 2005 and December 2008. Associations between clinicopathological variables and preoperative platelet counts were analyzed using Pearson's chi square or two-tailed Fisher's exact tests. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors including platelet count in terms of disease-free survival and overall survival. The mean preoperative platelet count was $315,437/{\mu}L$ (SD $100,167/{\mu}L$). Patients who had advanced stage, adnexal involvement, lymph node metastasis, and positive peritoneal cytology had significantly higher mean preoperative platelet counts when compared with those who had not. We found thrombocytosis (platelet count greater than $400,000/{\mu}L$) in 18.1% of our patients with endometrial cancer. These had significant higher rates of advanced stage, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with a normal pretreatment platelet count. The 5-year disease-free survival and overall survival were significantly lower in patients who had thrombocytosis compared with those who had not (67.4% vs. 85.1%, p=0.001 and 86.0% vs. 94.9%, p=0.034, respectively). Thrombocytosis was shown to be a prognostic factor in the univariate but not the multivariate analysis. In conclusion, presence of thrombocytosis is not uncommon in endometrial cancer and may reflect unfavorable prognostic factors but its prognostic impact on survival needs to be clarified in further studies.

• Journal of Gastric Cancer
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• v.17 no.2
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• pp.132-144
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• 2017

Purpose: To identify baseline prognostic factors for survival in patients with disease progression, during or after chemotherapy for the treatment of advanced gastric or gastroesophageal junction (GEJ) cancer. Materials and Methods: We pooled data from patients randomized between 2009 and 2012 in 2 phase III, global double-blind studies of ramucirumab for the treatment of advanced gastric or GEJ adenocarcinoma following disease progression on first-line platinum- and/or fluoropyrimidine-containing therapy (REGARD and RAINBOW). Forty-one key baseline clinical and laboratory factors common in both studies were examined. Model building started with covariate screening using univariate Cox models (significance level=0.05). A stepwise multivariable Cox model identified the final prognostic factors (entry+exit significance level=0.01). Cox models were stratified by treatment and geographic region. The process was repeated to identify baseline prognostic quality of life (QoL) parameters. Results: Of 1,020 randomized patients, 953 (93%) patients without any missing covariates were included in the analysis. We identified 12 independent prognostic factors of poor survival: 1) peritoneal metastases; 2) Eastern Cooperative Oncology Group (ECOG) performance score 1; 3) the presence of a primary tumor; 4) time to progression since prior therapy <6 months; 5) poor/unknown tumor differentiation; abnormally low blood levels of 6) albumin, 7) sodium, and/or 8) lymphocytes; and abnormally high blood levels of 9) neutrophils, 10) aspartate aminotransferase (AST), 11) alkaline phosphatase (ALP), and/or 12) lactate dehydrogenase (LDH). Factors were used to devise a 4-tier prognostic index (median overall survival [OS] by risk [months]: high=3.4, moderate=6.4, medium=9.9, and low=14.5; Harrell's C-index=0.66; 95% confidence interval [CI], 0.64-0.68). Addition of QoL to the model identified patient-reported appetite loss as an independent prognostic factor. Conclusions: The identified prognostic factors and the reported prognostic index may help clinical decision-making, patient stratification, and planning of future clinical studies.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6087-6094
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• 2014

Purpose: The aim of the present study was to invesitigate the impact of significant clinico-pathological prognostic factors on survival rates and to identify factors predictive of poor outcome in patients with ovarian carcinoma. Materials and Methods: A retrospective chart review of 74 women with pathologically proven ovarian carcinoma who were treated between January 2006 and April 2011 was performed. Patients were investigated with respect to survival to find the possible effects of age, gravida, parity, menstruel condition, pre-operative Ca-125, treatment period, cytologic washings, presence of ascites, tumor histology, stage and grade, maximal tumor diameter, adjuvan chemotherapy and cytoreductive success. Also 55 ovarian carcinoma patients were investigated with respect to prognostic factors for early 2-year survival. Results: The two-year survival rate was 69% and the 5-year survival rate was 25.5% for the whole study population. Significant factors for 2-year survival were preoperative CA-125 level, malignant cytology and FIGO clinical stage. Significant factors for 5-year survival were age, preoperative CA-125 level, residual tumor, lymph node metastases, histologic type of tumor, malignant cytology and FIGO clinical stage. Logistic regression revealed that independent prognostic factors of 5-year survival were patient age, lymph node metastasis and malignant cytology. Conclusions: We consider quality registries with prospectively collected data to be one important tool in monitoring treatment effects in population-based cancer research.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.743-746
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• 2013

Background: Some studies have indicated an inverse relationship between cancer risk and sunlight exposure. Others have reported that the prognosis of some cancers such as prostate, colon, ovarian and non melanoma skin cancer, were affected by the season in which the cancer was diagnosed. In our study, we evaluated whether season is prognostic in Turkish patients with breast cancer. Materials and Methods: A total of 517 patients from Kayseri Training and Research Hospital were analysed retrospectively. Patients were divided into 4 groups according to season of cancer diagnosis: winter, spring, summer and autumn. The prognostic factors for disease free survival and overall survival were investigated. Results: No significant differences were found among groups regarding prognostic factors overall. Only estrogen receptor status and lymphovascular invasion were independent prognostic factors (p=0.001 and p=0.001 respectively). We found significantly differences for mean disease free survival among groups (p=0.019). Winter group had better mean DFS while summer group had worse DFS. Mean overall survival was similar in the four groups (p=0.637). Conclusions: The season is not an independent predictive factor. However, due to interaction with other factors, we think that the season of cancer diagnosis is important for cancer prognosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2805-2810
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• 2016

Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.421-430
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• 2020

Purpose: Currently, there is no clear evidence to support any specific treatment as a principal therapy for stage IV gastric cancer outlet obstruction (GCOO) patients. This study evaluated the outcomes of palliative gastrectomies and survival prognostic factors in patients with stage IV resectable GCOO. Materials and Methods: We retrospectively reviewed the medical records of 48 stage IV GCOO patients who underwent palliative gastrectomies between June 2010 and December 2019. Palliative gastrectomies were performed only in patients with resectable disease. Early surgical outcomes and prognostic factors were analyzed using univariate and multivariate analyses. Results: There were no specific risk factors for postoperative complications, except for being underweight. Severe postoperative complications developed in five patients, and most of the patients underwent interventional procedures and received broad-spectrum antibiotics for intra-abdominal abscesses. The multivariate survival analysis showed that palliative chemotherapy is a positive prognostic factor, while the specific type of hematogenous and lymphatic metastasis is a negative prognostic factor. Conclusions: We recommend that the treatment method for stage IV GCOO should be selected according to each patient's physical condition and tumor characteristics. In addition, we suggest that palliative gastrectomies can be performed in stage IV resectable GCOO patients without unfavorable prognostic factors (types of hematogenous and lymphatic metastases).