• Journal of Korean Traditional Oncology
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• v.17 no.1
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• pp.1-7
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• 2012

Objective : The association of cancer survival and components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (modified Glasgow Prognostic Score (GPS), Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio) is reviewed in this article. Methods and Results : With extensive research of papers in the PubMed, there is good evidence that preoperative measures of the systemic inflammatory response predict cancer survival, independent of tumor stage, in primary operable cancer. GPS also shows its prognostic value as a predictor of survival, independent of tumor stage, performance status and treatment in a variety of advanced cancer. GPS is associated with chemotherapy related toxicities as well as response to treatment and C-reactive protein shows its clinical value as a monitor of chemotherapy response. The systemic inflammatory response is closely related to cachexia and may be suitable measure for the clinical definition of cancer cachexia. Conclusion : Anticipated survival using the inflammation-based prognostic score is a major factor to be taken into consideration when deciding whether active intervention including surgery and chemotherapy or palliation therapy including acupuncture and herb medication is appropriate.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.126-132
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• 2010

Purpose: Peritoneal carcinomatosis (PC) has a dismal prognosis and is occasionally encountered during initial exploration in patients with gastric cancer. The clinicopathological characteristics and survival were analyzed in patients with gastric cancer and PC. Materials and Methods: Among 2,083 gastric cancer patients who received surgery at the department of surgery, Hanyang University Hospital from 1992 to 2009, 130 patients revealed PC. Ten patients who were lost during follow-up were excluded. The remaining 120 patients were divided into three groups according to the type of surgery. The degree of PC was classified into P1(to the adjacent peritoneum) and P2 (to the distant peritoneum). Various other clinicopathological factors were analyzed using univariate and multivariatec survival analyses. Results: Systemic chemotherapy (SC), type of surgery, lymph node dissection, degree of PC, and presence of ascites were significant prognostic factors. However, age, gender, resection of PC, and Borrmann type were not significant prognostic factors. In a multivariate analysis, SC and the degree of PC were independent prognostic factors. The survival benefit of SC was significant without reference to the type of surgery or degree of PC. Conclusions: A gastrectomy should be considered feasible in patients with gastric cancer and PC. The independent favorable prognostic factors were SC and a low degree of PC. SC improved the prognosis regardless of operation type and degree of PC.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.133-146
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• 2001

This study was performed to predict the conservative treatment outcome of TMD patients by investigating the prognostic factors ; symptom duration, history of previous treatment, history of previous medication, history of trauma, disability of daily activity, severity of pain, noise, limitation of mouth opening(LOM) and maximum comfortable opening(MCO). Two hundreds and fifty-four subjects were selected for this study among the TMD patients who had visited the Dept. of Oral Medicine BNUH and been treated conservatively with medication, physical therapy, behavioral treatment, and splint therapy from 1991 to 2000. The subjects were divided into two groups improved or unimproved according to the treatment response following six months of conservative treatment. Those who showed less than 1 on NAS for pain, TMJ noise, and opening limitation belonged to the improved group and those who showed more than 2 on NAS belonged to the unimproved group. The two groups were compared with respect to symptom severity, number of diagnosis, history of trauma, previous treatment, previous medication, and disability of daily activity. A prognostic equation with the factors revealed to be significantly related to the prognosis of conservative treatment was obtained. The obtained results were as follows ; 1. In improved group, mean duration of history was 12 months, mean treatment duration of a patient was 4 months an mean number of treatment was about 10 times. In other words, in unimproved group, mean duration of history was 27.4 months, mean treatment duration of patient was 10.5 months and mean number of treatment was 19 times. 2. In unimproved group, multiple diagnosis, chronicity, disability of daily activity were significantly greater than that of the improved group. 3. Patients in unimproved group revealed severe noise at first visit and smaller maximum comfortable opening comparatively. 4. Prognostic factors such as duration of treatment, number of treatment, multiplicity, and chronicity and disability of daily activity showed a significant relation in prediction of improvement. 5. Prognostic equation with significant variables is as follows ; Y = 1.984 - 0.251Noise + 0.068MCO - 0.673Multiplicity. - 0.958Chronicity - 0.065Disability. Classification accuracy of 70.3 %, sensitivity of 71.4% and specificity of 66.7% were shown. 6. Prognostic equation with all factors is as follows : Y = 1.599 - 0.038Pain - 0.256Noise - 0.006Limitation + 0.068MCO - 0.580Multiplicity - 1.025Chronicity - 0.720Disability - 0.329Medication - 0.087Treatment + 0.740Trauma. Classification accuracy of 70.3 %, sensitivity of 73% and specificity of 64.3% were shown. 7. Prognostic value of the improved group with significant factors was $1.0446{\pm}1.0726$ and prognostic value of the unimproved group with significant factors was $-0.013{\pm}1.0146$. Prognostic value of the improved group with all factors was $1.0465{\pm}1.0849$ and prognostic value of the unimproved group with all factors was $-0.057{\pm}1.0611$.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5767-5772
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• 2012

Introduction: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. Methods: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. Results: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. Discussion: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.164-172
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• 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.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.210-219
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• 1995

Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3869-3872
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• 2012

Background: The majority of patients with gastric cancer in developing countries present with advanced disease. Systemic chemotherapy therefore has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyze prognostic factors for survival in advanced gastric cancer patients undergoing first-line palliative chemotherapy. Methods: We retrospectively reviewed 107 locally advanced or metastatic gastric cancer patients who were treated with docetaxel and cisplatin plus fluorouracil (DCF) as first-line treatment between June 2007 and August 2011. Twenty-eight potential prognostic variables were chosen for univariate and multivariate analyses. Results: Among the 28 variables of univariate analysis, nine variables were identified to have prognostic significance: performance status, histology, location of primary tumor, lung metastasis, peritoneum metastasis, ascites, hemoglobin, albumin, weight loss and bone metastasis. Multivariate analysis by Cox proportional hazard model, including nine prognostic significance factors evident in univariate analysis, revealed weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level to be independent variables. Conclusion: Performance status, weight loss, histology, peritoneum metastasis, ascites and serum hemoglobin level were identified as important prognostic factors in advanced gastric cancer patients. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

• 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.13 no.7
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• pp.3187-3190
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• 2012

This study evaluated the relationship between pretreatment hemoglobin (Hb) and prognostic factors in Thai patients with endometrial cancer. Medical records of 228 patients who had undergone surgery between January 2005 and December 2007 were retrospectively reviewed. Associations between clinicopathological variables and pretreatment Hb levels were described using Pearson's chi square test or two-tailed Fisher's exact test. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors, including Hb levels, in term of disease-free survival. The median duration of follow-up was 38.2 months. Eighty-nine patients (39%) had a preoperative Hb level of <12 g/dL, these having significantly higher rates of non-endometrioid histology, advanced FIGO stage, lymphovascular space invasion, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with Hb ${\geq}12$ g/dL. The 5-year disease-free and overall survival were significantly lower in patients with pretreatment Hb levels <12 g/dL compared with those with Hb ${\geq}12$ g/dL (79.3% vs. 89.2%, p=0.044 and 87.6% vs. 99.3%, p<0.001, respectively). In the multivariate analysis only histology, myometrial invasion, and lymphovascular invasion proved to be independent prognostic factors, whereas tumor grading, stage, cervical involvement, adnexal involvement, positive peritoneal cytology, lymph node involvement, and low Hb were not. In conclusion, presence of anemia before treatment may reflect poor prognostic factors in patients with endometrial cancer and low pretreatment hemoglobin level may have a prognostic impact on clinical outcome.