scholarly journals Combination of Strong MMP-2 and Weak TIMP-2 Immunostainings Is a Significant Prognostic Factor in Endometrial Carcinoma

2013 ◽  
Vol 35 ◽  
pp. 261-266 ◽  
Author(s):  
Maria Honkavuori-Toivola ◽  
Markku Santala ◽  
Ylermi Soini ◽  
Taina Turpeenniemi-Hujanen ◽  
Anne Talvensaari-Mattila
Keyword(s):  
Endometrial Carcinoma ◽  
Cox Regression ◽  
Endometrioid Adenocarcinoma ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Tissue Samples ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Relative Risk Of Death

Objective. The aim of this study was to evaluate the combined effects of MMP-2 and TIMP-2 protein immunoreactivities on the prognosis in endometrial carcinoma.Methods. Paraffin-embedded tissue samples from 225 primary endometrioid adenocarcinomas and 13 histologies other than endometrioid adenocarcinoma were immunohistochemically stained for MMP-2 and TIMP-2.Results. In Kaplan-Meier analysis, the 5-year cancer-specific survival rate of the endometrioid adenocarcinoma patients with negative MMP-2 and positive TIMP-2 staining was 100%, whereas only 78% of patients presenting with positive MMP-2 and negative TIMP-2 staining results were alive at that time. In Cox regression analysis, patients with positive MMP-2 and negative TIMP-2 immunostaining had a 4.7-fold relative risk of death from endometrial carcinoma compared to the group of patients with negative MMP-2 and positive or negative TIMP-2 immunoreaction.Conclusions. MMP-2 seems to be the main metalloproteinase determining the prognosis in endometrial carcinoma. Combination of strong MMP-2 and weak TIMP-2 immunostainings was the most potent prognostic marker for poor survival.

scholarly journals Fast-Track Programs in Total Hip and Knee Replacement at Swedish Hospitals—Influence on 2-Year Risk of Revision and Mortality

2021 ◽  
Vol 10 (8) ◽  
pp. 1680
Author(s):  
Urban Berg ◽  
Annette W-Dahl ◽  
Anna Nilsdotter ◽  
Emma Nauclér ◽  
Martin Sundberg ◽  
...  
Keyword(s):  
Fast Track ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Total Hip ◽  
Total Knee Replacements ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty ◽  
Total Knee

Purpose: We aimed to study the influence of fast-track care programs in total hip and total knee replacements (THR and TKR) at Swedish hospitals on the risk of revision and mortality within 2 years after the operation. Methods: Data were collected from the Swedish Hip and Knee Arthroplasty Registers (SHAR and SKAR), including 67,913 THR and 59,268 TKR operations from 2011 to 2015 on patients with osteoarthritis. Operations from 2011 to 2015 Revision and mortality in the fast-track group were compared with non-fast-track using Kaplan–Meier survival analysis and Cox regression analysis with adjustments. Results: The hazard ratio (HR) for revision within 2 years after THR with fast-track was 1.19 (CI: 1.03–1.39), indicating increased risk, whereas no increased risk was found in TKR (HR 0.91; CI: 0.79–1.06). The risk of death within 2 years was estimated with a HR of 0.85 (CI: 0.74–0.97) for TKR and 0.96 (CI: 0.85–1.09) for THR in fast-track hospitals compared to non-fast-track. Conclusions: Fast-track programs at Swedish hospitals were associated with an increased risk of revision in THR but not in TKR, while we found the mortality to be lower (TKR) or similar (THR) as compared to non-fast track.

scholarly journals De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor in Patients Undergoing Radical Cystectomy with Bladder Urothelial Carcinoma: A Propensity Score-Matched Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Hyeong Dong Yuk ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
Ja Hyeon Ku
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Radical Cystectomy ◽  
Cox Regression ◽  
Alanine Transaminase ◽  
Significant Prognostic Factor ◽  
Aspartate Transaminase ◽  
Cancer Specific Survival ◽  
T Stage ◽  
Kaplan Meier

Introduction. To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase (AST)/alanine transaminase (ALT)) and postoperative outcome in patients with urothelial cell carcinoma (UC) treated with radical cystectomy. Materials and Methods. We analyzed the clinical and pathological data of 771 patients who underwent radical cystectomy for bladder UC. Patients were divided into two groups according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed using the Kaplan–Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS). In addition, propensity score matching of 1 : 1 was performed between the two groups. Results. Median follow-up was 84.0 (36–275) months. Mean age was 64.8±10.0 years. According to the receiver operating characteristic (ROC) analysis, the optimal threshold of the AST/ALT ratio was 1.1. In Kaplan–Meier analyses, the high AST/ALT group showed worse outcomes in CSS and OS (all P<0.001). Also, RFS (P=0.001) in the Cox regression models of clinical and pathological parameters was used to predict CSS, OS, and AST/ALT ratio (HR 2.15, 95% CI 1.23-3.73, P=0.007) and pathological T stage (HR 4.80, 95% CI 1.19-19.28, P=0.003). To predict OS and AST/ALT ratio (HR 2.05, 95% CI 1.65–2.56, P<0.001), pathological T stage (HR 2.96, 95% CI 0.57–17.09, P=0.037) and positive lymph node (HR 1.71, 95% CI 1.50–1.91, P=0.021) were determined as independent prognostic factors. Conclusion. Preoperative AST/ALT ratio could be an independent prognostic factor in patients with UC treated with radical cystectomy.

scholarly journals Low Expression of RILPL2 Predicts Poor Prognosis and Correlates With Immune Infiltration in Endometrial Carcinoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinhui Liu ◽  
Mengting Xu ◽  
Zhipeng Wu ◽  
Yan Yang ◽  
Shuning Yuan ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Endometrial Carcinoma ◽  
Immune Cell ◽  
Cox Regression ◽  
Critical Role ◽  
Enrichment Analysis ◽  
The Cancer Genome Atlas ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Promising Target

Increasing numbers of biomarkers have been identified in various cancers. However, biomarkers associated with endometrial carcinoma (EC) remain largely to be explored. In the current research, we downloaded the RNA-seq data and corresponding clinicopathological features from the Cancer Genome Atlas (TCGA) database. We conducted an expression analysis, which resulted in RILPL2 as a novel diagnostic biomarker in EC. The dysregulation of RILPL2 in EC was also validated in multiple datasets. The correlations between clinical features and RILPL2 expression were assessed by logistic regression analysis. Then, Kaplan-Meier analysis, univariate and multivariate Cox regression analysis were performed to estimate prognostic values of RILPL2 in the TCGA cohort, which revealed that increased level of RILPL2 was remarkably associated with better prognosis and could act as an independent prognostic biomarker in patients with EC. Moreover, correlation analysis of RILPL2 and tumor-infiltrating immune cells (TIICs) indicated that RILPL2 might play a critical role in regulating immune cell infiltration in EC and is related to immune response. Besides, high methylation level was a significant cause of low RILPL2 expression in EC. Subsequently, weighted gene co-expression network analysis (WGCNA) and enrichment analysis were conducted to explore the RILPL2-involved underlying oncogenic mechanisms, and the results indicated that RILPL2 mainly regulated cell cycle. In conclusion, our findings provided evidence that downregulation of RILPL2 in EC is an indicator of adverse prognosis and RILPL2 may act as a promising target for the therapeutics of EC.

The effect of marital status on endometrial cancer-related diagnosis and prognosis: a Surveillance Epidemiology and End Results database analysis

2019 ◽  
Vol 15 (34) ◽  
pp. 3963-3976 ◽  
Author(s):  
Jia Dong ◽  
Qinjin Dai ◽  
Fan Zhang
Keyword(s):  
Endometrial Cancer ◽  
Marital Status ◽  
Cox Regression ◽  
Significant Prognostic Factor ◽  
Cox Regression Analysis ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
Risk Of Mortality ◽  
The Relationship ◽  
End Results

Aim: Marital status has been proved a significant prognostic factor for diagnosis and prognosis in various cancers, but the effect in endometrial cancer (EMC) is controversial. The research was designed to clarify the relationship between marital status and EMC. Methods: We identified 39,387 patients with EMC between 2004 and 2010 from the Surveillance Epidemiology and End Results database. Patients were categorized into four groups according to marital status. We used the logistic regression, the Kaplan–Meier method and Cox regression analysis to analyze the effect of marital status on EMC-related diagnosis and prognosis. Results: The study suggests that marriage benefits the diagnosis and prognosis of EMC. Widowed and unmarried patients had higher risk of mortality than other marital status.

Impact of cytoreductive surgery on outcomes of metastatic appendiceal carcinoma: a real-world, population-based study

2020 ◽  
Vol 9 (6) ◽  
pp. 431-439
Author(s):  
Omar Abdel-Rahman
Keyword(s):  
Overall Survival ◽  
Regression Analysis ◽  
Metastatic Disease ◽  
Cytoreductive Surgery ◽  
Mucinous Adenocarcinoma ◽  
Cox Regression ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Appendiceal Carcinoma

Aim: To evaluate the impact of cytoreductive surgery on the outcomes of patients with metastatic appendiceal carcinoma. Methods: Surveillance, Epidemiology and End Results (SEER) database was accessed and patients with metastatic appendiceal carcinoma diagnosed (2010–2015) were reviewed. Kaplan–Meier survival estimates/log-rank testing were then used to assess overall survival outcomes according to cytoreductive surgery. Multivariable Cox regression analysis was then used to evaluate factors affecting cancer-specific survival. Factors included in this model were age, race, sex, stage and histology and cytoreductive surgery. Results: A total of 1339 patients with metastatic appendiceal carcinoma were included in the current study. Using Kaplan–Meier survival estimates to evaluate overall survival, patients with surgery for metastatic disease have better overall survival compared with patients without surgery for metastatic disease (p < 0.001). Stratifying survival analysis according to histology, the overall survival benefit from surgery for the metastases seems to be limited to patients with mucinous adenocarcinoma (p = 0.002) rather than patients with nonmucinous adenocarcinoma (p = 0.401). Multivariable Cox regression analysis was then conducted to evaluate factors predicting cancer-specific survival. The following factors were associated with worse cancer-specific survival: African-American race (hazard ratio [HR]: 1.356; 95% CI: 1.036–1.774; p = 0.026), more advanced stage (HR: 3.910; 95% CI: 2.735–5.588; p < 0.001), nonmucinous adenocarcinoma (HR for signet ring carcinoma vs mucinous adenocarcinoma: 2.119; 95% CI: 1.674–2.683; p < 0.001) and no surgical resection of metastatic disease (HR: 1.273; 95% CI: 1.067–1.519; p < 0.001). Conclusion: The current study suggests that among patients with metastatic appendiceal carcinoma, surgical cytoreduction of metastatic disease is associated with improved outcomes for patients with mucinous adenocarcinoma but not in patients with nonmucinous adenocarcinoma.

Chemoradiation-related lymphopenia and its association with survival in patients with anal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 3-3
Author(s):  
Grace Lee ◽  
Daniel W. Kim ◽  
Vinayak Muralidhar ◽  
Devarati Mitra ◽  
Nora Horick ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Anal Cancer ◽  
Cox Regression ◽  
Cox Model ◽  
Rank Test ◽  
Anal Squamous Cell Carcinoma ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Increased Risk

3 Background: While treatment-related lymphopenia (TRL) is common and associated with poorer survival in multiple solid malignancies, little data exists for anal cancer. We evaluated TRL and its association with survival in anal cancer patients treated with chemoradiation (CRT). Methods: A retrospective analysis of 140 patients with non-metastatic anal squamous cell carcinoma (SCC) treated with definitive CRT was performed. Total lymphocyte counts (TLC) at baseline and monthly intervals up to 12 months after initiating CRT were analyzed. Multivariable Cox regression analysis was performed to evaluate the association between overall survival (OS) and TRL, dichotomized by G4 TRL ( < 0.2k/μl) two months after initiating CRT. Kaplan-Meier and log-rank tests were used to compare OS between patients with versus without G4 TRL. Results: Median time of follow-up was 55 months. Prior to CRT, 95% of patients had a normal TLC ( > 1k/μl). Two months after initiating CRT, there was a median of 71% reduction in TLC from baseline and 84% of patients had TRL: 11% G1, 31% G2, 34% G3, and 8% G4. On multivariable Cox model, G4 TRL at two months was associated with a 3.7-fold increased risk of death (p = 0.013). On log-rank test, the 5-year OS rate was shorter in the cohort with versus without G4 TRL at two months (32% vs. 86%, p < 0.001). Conclusions: TRL is common and may be another prognostic marker of OS in anal cancer patients treated with CRT. The association between TRL and OS supports the hypothesis that host immunity plays an important role in survival among patients with anal cancer. These results support ongoing efforts of randomized trials underway to evaluate the potential role of immunotherapy in localized anal cancer.

scholarly journals Clinical Significance of Pre-to-Postoperative Dynamics of Aspartate Transaminase/Alanine Transaminase Ratio in Predicting the Prognosis of Renal Cell Carcinoma after Surgical Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Minyong Kang ◽  
Seung Jea Shin ◽  
Hyun Hwan Sung ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factor ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Cox Regression ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Group 2

Background. This study is aimed at examining the prognostic role of pre-to-postoperative dynamics of De Ritis ratio (aspartate aminotransaminase (AST)/alanine aminotransaminase (ALT)) in patients with nonmetastatic renal cell carcinoma (RCC) following radical nephrectomy. Methods. We retrospectively reviewed the records of 670 patients who underwent radical nephrectomy for nonmetastatic RCC between 1996 and 2012 at our institution. The cutoff points for preoperative (=1.0) and postoperative AST/ALT ratios (=1.12) were assigned based on the median values. We categorized patients into four groups according to the dynamics of AST/ALT ratios: group 1 (lower (≤1.0) ⟶ lower (≤1.12)), group 2 (lower (≤1.0) ⟶ higher (>1.12)), group 3 (higher (>1.0) ⟶ lower (≤1.12)), and group 4 (higher (>1.0) → higher (>1.12)). Results. When grouped by a preoperative AST/ALT ratio alone, the groups were not statistically different in cancer-specific survival (CSS) or overall survival (OS). In contrast, in Kaplan-Meier analysis, CSS (P=0.0296) and OS (P=0.0324) were both significantly shorter with an increased postoperative AST/ALT ratio. According to the pre-to-postoperative dynamics of the AST/ALT ratio, group 2 (lower (≤1.0) ⟶ higher (>1.12)) had a significantly lower CSS (P=0.0028) and OS (P=0.0194) than the other groups. On multivariate Cox regression analysis, the pre-to-postoperative dynamics of the AST/ALT ratio were a significant prognostic factor for CSS (hazard ratio, HR=3.45) and OS (HR=2.18). Conclusion. This study is the first to suggest that the dynamics of the pre-to-postoperative De Ritis ratio represent an independent prognostic factor for RCC patients following nephrectomy.

With versus Without Primary Tumor Radiotherapy in Patients with Unresectable Stage IV Rectal or Rectosigmoid Cancer: A Propensity Score Matching Analysis for Survival

2020 ◽  
Author(s):  
Gang Wang ◽  
Ling Wen Wang ◽  
Jie Hai Jin ◽  
min Hong Dong ◽  
wei Wei Chen ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Primary Tumor ◽  
Cox Regression ◽  
Stage Iv ◽  
Rectosigmoid Cancer ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
The Impact

Abstract Background: To evaluate the impact of primary tumor radiotherapy on survival in patients with unresectable metastatic rectal or rectosigmoid cancer. Methods: Form September 2008 to September 2017, 350 patients with unresectable metastatic rectal or rectosigmoid cancer were retrospectively reviewed in our center. All patients received at least 4 cycles of chemotherapy, and were divided into two groups according to with primary tumor radiotherapy or without. 163 patients received primary tumor radiotherapy, and the median radiation dose was 56.69Gy(50.4-60). Survival curves were estimated from the Kaplan–Meier procedure to roughly compare survival among two groups. Subsequently, 18-month survival was used as the outcome variable for this study. This study mainly evaluated the impact of primary tumor radiotherapy on survival of these patients through a series of multivariate Cox regression analyses after propensity score matching (PSM). Results: The median follow-up time was 21 months. All 350 patients received a median of 7 cycles of chemotherapy (range 4-12), 163 (46.67%) patients received primary tumor radiotherapy for local symptoms. The Kaplan–Meier survival curves showed a significant overall survival (OS) advantage for primary tumor radiotherapy group to without radiotherapy (20.07 vs 17.33 months; P=0.002). In this study, multivariate Cox regression analysis after adjusted covariates, multivariate Cox regression analysis after PSM, and inverse probability of treatment weighting (IPTW) analysis and propensity score (PS)-adjusted model analysis consistently showed that primary tumor radiotherapy could effectively reduce the risk of death for these patients at 18 months (HR: 0.62, 95% CI 0.40-0.98; HR:0.79, 95% CI:0.93-1.45; HR: 0.70, 95% CI 0.55-0.99 and HR: 0.74, 95% CI:0.59-0.94). Conclusion: Compared with patients with stage IV rectal or rectosigmoid cancer who did not receive primary tumor radiotherapy, received primary tumor radiotherapy reduced the risk of death in these patients. The radical doses（59.4Gy/ 33 fractions or 60Gy/ 30 fractions） of radiation for primary tumors might be considered for unresectable metastatic rectal or rectosigmoid cancer, not just for relieve symptoms. Keywords: Stage IV Rectal cancer, primary tumor radiotherapy, propensity score matching.

Kleinzelliges Lungenkarzinom: Interdisziplinär für oder wider eine Operation entscheiden

2020 ◽  
Vol 8 (6) ◽  
pp. 322-323
Author(s):  
Khosro Hekmat
Keyword(s):  
Lung Cancer ◽  
Tumor Size ◽  
Cox Regression ◽  
Population Based ◽  
Kleinzelliges Lungenkarzinom ◽  
Matched Cohort ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Patient Groups

<b>Background:</b> The role of surgery for small cell lung cancer (SCLC) is not clear. We aimed to evaluate this issue using a population-based database. <b>Methods:</b> Patients diagnosed between 2004 and 2014 with SCLC staged T1–4 N0–2 M0 disease were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM) was used to reduce bias between the surgical and nonsurgical patient groups. The Kaplan-Meier method and Cox regression analysis were used to compare overall survival (OS) for the matched patients. <b>Results:</b> A total of 8,811 patients were retrieved, including 863 patients who underwent surgical resection. After 1: 1 PSM, a matched cohort with 1,562 patients was generated. In the matched cohort, surgery was associated with 5-year OS improvement (from 16.8 to 36.7%, <i>p</i> &#x3c; 0.001) and lung cancer-specific survival improvement (from 21.6 to 43.2%, <i>p</i> &#x3c; 0.001). Survival benefits of surgery were significant in all subgroups, including N1–2 disease, except for patients with a tumor size &#x3e;5.0 cm or T3 disease. <b>Conclusions:</b> Patients with SCLC of limited stage can benefit from surgery, including N1–2 disease. However, patients with a tumor size &#x3e;5.0 cm or advanced T stage may be unable to benefit from surgery.

scholarly journals Survival among cancers screened at the first stage of Dispanserization of certain groups of the adult population: a population-based epidemiological analysis

2021 ◽  
Vol 67 (4) ◽  
pp. 501-510
Author(s):  
Ludmila Valkova ◽  
Vakhtang Merabishvili ◽  
Aleksandra Pankratyeva ◽  
Anna Agaeva ◽  
Anton Ryzhov ◽  
...  
Keyword(s):  
Cox Regression ◽  
Cox Model ◽  
Adult Population ◽  
Treatment Method ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Before And After

Objective: to evaluate trends of survival in nine index malignant neoplasms (iMNs), which are screened at the first stage of the Dispanserization of certain groups of the adult population (DCGAP), on data of the Arkhangelsk regional cancer registry over a period 2006-2019. Materials and methods. We compared two seven-year periods 2006-2012 and 2013-2019, before and after the introduction of the DCGAP. The 1- and 5-year cancer-specific survival (CSS) rate was calculated using the life table and Kaplan-Meier methods with an assessment of the differences by log-rank. Cox regression analysis with sequential input was used to identify possible causes of differences in survival between periods and independent prognostic factors. Results. 37197 cases were selected for analysis. 5-year CSS estimates in 2013-2019 compared with the previous seven-year period significantly increased for all nine iMNs, by from 2.5% [2006-2012, 12.5% ​​(95% confidence interval (CI) 11.4-13.6%) vs 2013-2019, 15.0 (95% CI 13.7-16.5%)] in lung cancer up to 12.6% [2006-2012, 31.0% (95% CI 28.6-33.4%) vs 2013-2019, 43.6 (95% CI 40.8-46.2%)]. Correction for the stage (possible effect of screening) in the Cox model has led to a decrease in the hazard ratio (HR) of death from cancer of the colon, rectum, breast, kidney by 38-64%, no change for other iMNs; while for cervical cancer, it has increased. Adjustment for the variable "treatment method" led to a 34-100% decrease in the HR in the Cox model for all iMNs, except for prostate cancer. Conclusion. The increase in survival estimates for nine iMNs in 2013-2019 can be explained to a large extent by improved access to cancer-directed treatment and its quality; the contribution of DCGAP is possible in renal, breast and colorectal cancer. Key words: malignant neoplasms, screening, dispensarization of certain groups of the adult population, survival

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