Background: The Glasgow Prognostic Score (GPS) is calculated from measured CRP and albumin levels. We here evaluated the significance of the GPS in patients with resected pulmonary adenocarcinoma. Materials and Methods: The present study included 156 patients with lung adenocarcinoma who underwent lobectomy at Kanazawa Medical University between 2002 and 2012. Classification was into three groups: those with normal albumin (>=3.5 g/dl) and C-reactive protein (CRP) (<=1.0 mg/dl) levels were classified as GPS 0 (n =136), those with low albumin (<3.5 g/dl) or elevated CRP (>1.0 mg/dl) levels as GPS 1 (n = 16), and those with low albumin (<3.5 g/dl) and elevated CRP (>1.0 mg/dl) levels as GPS 2 (n = 4). We retrospectively investigated relationships between the patient characteristics including the GPS, and disease-free survival and cancer-specific survival. Results: The pathological stages of the patients were as follows: IA (n=78, 50%), IB (n=31, 19.9%), IIA (n=20.0, 12.8%), IIB (n=9.0, 5.7%), and IIIA (n=18.0, 11.5%). Lobectomy was performed in all cases. The average GPS was 0.15 (0-2) and showed significant relationships with stage and tumor size. The 2-year survival rates in patients with GPS0, 1 and 2 were 81.4%, 38.4%, and 25.0%, respectively. Clear correlations were noted with both cancer-specific survival and disease-free survival. Furthermore, multivariate analysis revealed that GPS was a significant prognostic factor. Conclusions: The GPS could be a prognostic factor for patients with resected pulmonary adenocarcinoma.
Byun, Sang Jun;Kim, Jin Hee;Oh, Young Kee;Kim, Byung Hoon
Radiation Oncology Journal
/
v.33
no.4
/
pp.294-300
/
2015
Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent. Materials and Methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months). Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS. Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.
Unal, Olcun Umit;Oztop, Ilhan;Assoc, Tugba Kos;Turan, Nedim;Kucukoner, Mehmet;Helvaci, Kaan;Berk, Veli;Sevinc, Alper;Yildiz, Ramazan;Cinkir, Havva yesil;Tonyali, Onder;Demirci, Umut;Aktas, Bilge;Balakan, Ozan;Yilmaz, Ahmet Ugur
Asian Pacific Journal of Cancer Prevention
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v.15
no.22
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pp.9687-9692
/
2014
Background: Biliary tract cancers are rare, and surgical resection is the standard treatment at early stages. However, reports on the benefits of adjuvant treatment following surgical resection are conflicting. This study aimed to evaluate the factors affecting survival and adjuvant treatments in patients with surgically treated biliary tract cancers. Materials and Methods: Patient clinical features, adjuvant treatments, and efficacy and prognostic factor data were evaluated. Survival analyses were performed using SPSS 15.0. Results: The median overall survival was 30.7 months (95% confidence interval [CI], 18.4-42.9 months). Median survival was 19 months (95% CI, 6-33) for patients treated with fluorouracil based chemotherapy and 53 months (95% CI, 33.2-78.8) with gemcitabine based chemotherapy(p=0.033). On univariate analysis, poor prognostic factors for survival were galbladder localization, perineural invasion, hepatic invasion, a lack of adjuvant chemoradiotherapy treatment, and a lack of lymph node dissection. On multivariate analysis, perineural invasion was a poor prognostic factor (p=0.008). Conclusions: Biliary tract cancers generally have poor prognoses. The main factors affecting survival are tumour localization, perineural invasion, hepatic invasion, adjuvant chemoradiotherapy, and lymph node dissection. Gemcitabine-based adjuvant chemotherapy is more effective than 5-fluorouracil-based chemotherapy.
Purpose: Vascular endothelial growth factor (VEGF)-C and its tyrosine kinase receptor, VEGF receptor (VEGFR)-3 are recently known to have lymphangiogenic activities in various tumor types. In this study, we determined whether the expression of lymphangiogenic factors correlate with nodal metastasis or survival in a nude mouse model of oral squamous cell carcinoma (OSCC). Methods: Three OSCC cells (KB, SCC4, SCC9) were xenografted into the right mandibular gland of athymic nude mice. The mice were followed for tumor development and growth, and the mice were sacrificed when they had lost more than 20% of their initial body weight, or the diameter of the induced tumor exceeds 20 mm. After necropsy, the murine tumors were examined histologically and radiologically (micro-positron emission tomography computed tomography) for regional or distant metastasis. We performed immunohistochemical assays with anti-VEGF-C, VEGFR-3, CD105, and D2-40 antibodies. Immunofluorescence double staining for LYVE-1/CD31 was also performed. To quantify the VEGF-C and VEGFR-3 level in the cancer tissue, Western blotting was performed. Finally, we determined the correlation between the degree of expression of VEGF-C/VEGFR-3 and the mean survival time. Results: OSCC tumor cells into the mandibular gland of the nude mice successfully resulted in the formation of recapitulating orthotopic tumor. Tumor cells of the induced tumor did not express VEGF-C. VEGF-C/VEGFR-3 expression was mainly distributed in the endothelial cells of the stromal area. There were no correlation between the degree of expression of VEGF-C/VEGFR-3 and the mean survival time of mice injected with different OSCC cell lines. Conclusion: An recapitulating orthotopic model of OSCC in nude mice was established, which copies the cervical nodal metastasis of human OSCC. Overexpression of lymphangiogenic factors seems to have no effect on survival of hosts in this in vivo experiment.
Purpose : Patients with esophageal cancer treated with surgery plus postoperative radiotherapy or radiation alone were retrospectively analyzed. Method : From August 1980 to June 1992, 93 patients who were treated with 30 Gy or more in the Department of Therapeutic Radiology were evaluated. Median age was 59 years. Ninety one were male and remaining 2 were female. Patients with stage II, III and IV disease were 25, 62 and 6 respectively. Thirteen of the tumor were located in upper one third, 56 in middle one third and 24 in lower one third. Forty three patients had tumors 5cm or less in size and remaining 50 had greater than 5cm. Of those 93 patients, 41 were treated with surgery plus postoperative radiotherapy and 52 with radiation alone. Dose of radiation ranged from 34 to 66.6 Gy. Follow up period was 12 to 61 months. Results : Stage of the tumor was the most important prognostic factor of the evaluated factors. Median survival for entire group of patients was 12 months. Median survival for patients treated with surgery plus postoperative radiotherapy and radiation alone were 15 and 10 months, respectively. There was no difference of 2 year survival. Median survival was 21 months for Stage II and 10 months for Stage m disease. In Stage II disease, that was 21 months for postoperative group and 17.5 months for radiation alone group. Five year survival were $27.5\%$ and $9\%$, respectively. Conclusion : This study showed that the result of surgery plus postoperative radiotherapy was not different from that of radiation alone despite of slightly longer median survival in postoperative group. Also stage of the disease was the most important prognostic factor.
Lee, Jae Ho;Kim, Oh Lyong;Seo, Young Beom;Choi, Jun Hyuk
Journal of Korean Neurosurgical Society
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v.60
no.6
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pp.661-666
/
2017
Objective : Atypical meningioma is rare tumor and there is no accurate guide line for optimal treatment. This retrospective study analyzed the prognostic factors, the effect of different methods of treatments and the behavior of atypical meningioma. Methods : Thirty six patients were diagnosed as atypical meningioma, among 273 patients who were given a diagnosis of meningioma in the period of 2002 to 2015. Age, gender, tumor location, Ki 67, Simpson grade and treatment received were analyzed. We studied the correlation between these factors with recurrence, overall survival rate and progression free survival. Results : Median overall survival time and progression free survival time are 60 and 53 (months). Better survival rate was observed for patients less than 50 years old but with no statistical significance (p=0.322). And patients with total resection compared with subtotal resection also showed better survival rate but no statistical significance (p=0.744). Patients with a tumor located in skull base compared with patients with a tumor located in brain convexity and parasagittal showed better progression free survival (p=0.048). Total resection is associated with longer progression-free survival than incomplete resection (p=0.018). Conclusion : We confirmed that Simpson grade was significant factor for statistically affect to progression free survival in univariate analysis. In case of skull base atypical tumor, it is analyzed that it has more recurrence than tumor located elsewhere. Overall survival was not affected statistically by patient age, gender, tumor location, Ki 67, Simpson grade and treatment received in this study.
Background: Socioeconomic factors are associated with screening in terms of reducing the risk of cervical cancer. This study aimed to clearly establish the effect of screening on variation in socio-economic factor-specific survival estimates. Materials and Methods: Survival estimates were calculated using the life table method for 165 women from the routine care control arm and 67 from the visual inspection with acetic acid screening arm diagnosed with cervical cancer during 2000-2006 in rural south India. Kaplan-Meier survival curves were plotted to compare the variation in survival by socioeconomic factors. Results: Whereas there was a significant variation in survival estimates of the different categories of age at diagnosis among the screen-detected cancers with women aged<50 years having an improved survival, no significant variation was noted among women diagnosed with cervical cancer from the control arm. Compared to the variation among the cancer cases detected in the unscreened control group, screening widened the variation in survival estimates by age and type of house, and reduced the variation by education. The direction of the magnitude of the survival estimates was reversed within the different categories of occupation, marital status and household income in the screen-detected cancer cases compared to control group cancer cases. Also, women diagnosed with stage 1 disease had a very good survival. Conclusions: Screening changed the pattern of survival by socio-economic factors. We found improved survival rates in screened women aged <50 years, with no formal education, manual workers and married women.
Somatic mutations that lead to hyperactivation of epidermal growth factor receptor (EGFR) signaling are detected in approximately 50% of lung adenocarcinoma in people from the Far East population and tyrosine kinase inhibitors are now the standard first line treatment for advanced disease. They have led to a doubling of progression-free survival and an increase in overall survival by more than 2 years. However, emergence of resistant clones has become the primary cause for treatment failure, and has created a new challenge in the daily management of patients with EGFR mutations. Identification of mechanisms leading to inhibitor resistance has led to new therapeutic modalities, some of which have now been adapted for patients with unsuccessful tyrosine kinase inhibitor treatment. In this review, we describe mechanisms of tyrosine kinase inhibitor resistance and the available strategies to overcoming resistance.
Im, Won Jin;Kim, Min Gyu;Ha, Tae Kyung;Kwon, Sung Joon
Journal of Gastric Cancer
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v.12
no.3
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pp.164-172
/
2012
Purpose: The purpose of this study is to investigate the prognostic significance of tumor size for 5-year survival rate in patients with gastric cancer. Materials and Methods: A total of 1,697 patients with gastric cancer, who underwent potentially curative gastrectomy, were evaluated. Patients were divided into 4 groups as follows, according to the median size of early and advanced gastric cancer, respectively: small early gastric cancer (tumor size ${\leq}3$ cm), large early gastric cancer (tumor size >3 cm), small advanced gastric cancer (tumor size ${\leq}$ 6 cm), and large advanced gastric cancer (tumor size >6 cm). The prognostic value of tumor size for 5-year survival rate was investigated. Results: In a univariate analysis, tumor size is a significant prognostic factor in advanced gastric cancer, but not in early gastric cancer. Multivariate analysis showed that tumor size is an independent prognostic factor for 5-year survival rate in advanced gastric cancer (P=0.003, hazard ratio=1.372, 95% confidence interval=1.115~1.690). When advanced gastric cancer is subdivided into 2 groups, according to serosa invasion: Group 1; serosa negative (T2 and T3, 7th AJCC), and Group 2; serosa positive (T4a and T4b, 7th AJCC), tumor size is an independent prognostic factor in Group 1 (P=0.011, hazard ratio=1.810, 95% confidence interval=1.149~2.852) and in Group 2 (P=0.033, hazard ratio=1.288, 95% confidence interval=1.020~1.627), respectively. Conclusions: Tumor size is an independent prognostic factor in advanced gastric cancer irrespective of the serosa invasion, but not in early gastric cancer.
Background: This study hypothesized living in a poor neighborhood decreased the cause specific survival in individuals suffering from carcinoid carcinomas. Surveillance, Epidemiology and End Results (SEER) carcinoid carcinoma data were used to identify potential socioeconomic disparities in outcome. Materials and Methods: This study analyzed socioeconomic, staging and treatment factors available in the SEER database for carcinoid carcinomas. The Kaplan-Meier method was used to analyze time to events and the Kolmogorov-Smirnov test to compare survival curves. The Cox proportional hazard method was employed for multivariate analysis. Areas under the receiver operating characteristic curves (ROCs) were computed to screen the predictors for further analysis. Results: There were 38,546 patients diagnosed from 1973 to 2009 included in this study. The mean follow up time (S.D.) was 68.1 (70.7) months. SEER stage was the most predictive factor of outcome (ROC area of 0.79). 16.4% of patients were un-staged. Race/ethnicity, rural urban residence and county level family income were significant predictors of cause specific survival on multivariate analysis, these accounting for about 5% of the difference in actuarial cause specific survival at 20 years of follow up. Conclusions: This study found poorer cause specific survival of carcinoid carcinomas of individuals living in poor and rural neighborhoods.
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