scholarly journals Prognostic Factors and Clinical Characteristics of Patients with Primary Duodenal Adenocarcinoma: A Single-Center Experience from China

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Qing-Long Jiang ◽  
Xiang-Hui Huang ◽  
Ying-Tai Chen ◽  
Jian-Wei Zhang ◽  
Cheng-Feng Wang
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Vascular Invasion ◽  
Curative Resection ◽  
Cox Regression ◽  
Early Stage ◽  
Palliative Surgery ◽  
Duodenal Adenocarcinoma ◽  
Cox Regression Analysis ◽  
Survival Difference

Aim. To evaluate the clinical risk factors influencing overall survival of patients with duodenal adenocarcinoma after potentially curative resection. Methods. A series of 201 patients with primary duodenal adenocarcinoma who underwent surgery from 1999 to 2014 at Chinese Medical Academic Cancer Hospital were studied by retrospective chart review and subsequent telephone follow-up. Results. Resectional surgery was performed in 138 of the 201 patients to attempt curative treatment, while 63 patients were treated with palliative surgery. Median survival of patients who underwent resectional operation was 57 months, whereas that of patients who had palliative surgery was shorter, 7 months (p<0.001). For patients who underwent radical resection, the overall 1-, 3-, and 5-year survival rates were 87.3, 59.1, and 44.1%, respectively. Multivariate Cox regression analysis revealed that lymph node metastasis (HR 31.76, 2.14 to 470.8; p=0.012) and vascular invasion (HR 3.75, 1.24 to 11.38; p=0.020) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups treated by the pancreaticoduodenectomy (n=20) and limited resection (n=10) for early-stage duodenal adenocarcinoma (p=0.704). Conclusions. Duodenal adenocarcinoma is a rare disease. Curative resection is the best treatment for appropriate patients. Lymph node metastases and vascular invasion are negative prognostic factors.

scholarly journals Prognostic Factors and Clinical Characteristics of Duodenal Adenocarcinoma With Survival: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Huapeng Sun ◽  
Yi Liu ◽  
Long Lv ◽  
Jingwen Li ◽  
Xiaofeng Liao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Curative Resection ◽  
Tumor Resection ◽  
Margin Status ◽  
High Expression ◽  
Duodenal Adenocarcinoma ◽  
Gastric Type ◽  
Duodenal Carcinoma

BackgroundTo evaluate the clinical risk factors that influence the overall survival in patients with duodenal adenocarcinoma (DA) after tumor resection.MethodsThis study retrospectively analyzed 188 patients who underwent tumor resection for DA between January 2005 and June 2020 at Xiangyang Central Hospital.ResultsThe median survival of the patients who underwent resectional operation was 54 months, longer than of those who underwent palliative surgery (20.8 months) (2,916.17; 95% CI, 916.3−9,280.5; p &lt; 0.001). Survival of non-ampullary duodenal carcinoma patients (50.3 months; 95% CI, 39.7−61.8) was similar to that of ampullary duodenal carcinoma patients (59.3 months; 95% CI, 38.6−66.7) but was significantly better than that of papillary adenocarcinoma patients (38.9 months; 95% CI, 29.8−54.8; p = 0.386). Those with intestinal-type ductal adenocarcinomas had a longer median overall survival than those with the gastric type (61.8 vs. 46.7 months; p &lt; 0.01) or pancreatic type (32.2 months; p &lt; 0.001). Clinical DA samples had significantly diverse expressions of ATG12, IRS2, and IGF2. Higher expressions of the ATG12 and IRS2 proteins were significantly correlated with worse survival. Multivariate Cox regression analysis revealed that lymph node metastasis (hazard ratio (HR), 6.44; 95% CI, 3.68−11.27; p &lt; 0.0001), margin status (HR, 4.94; 95% CI, 2.85−8.54; p &lt; 0.0001), and high expression of ATG12 (HR, 1.89; 95% CI, 1.17−3.06; p = 0.0099) were independent prognostic factors negatively associated with survival in patients undergoing curative resection. There was no survival difference between the groups with ampullary, non-ampullary, and papillary adenocarcinomas treated with adjuvant chemotherapy (p = 0.973).ConclusionGastric/pancreatic type, high expression of ATG12, lymph node metastases, and margin status were negative prognosticators of survival in patients with DAs than in those with tumor anatomical location. Curative resection is the best treatment option for appropriate patients.

Prognostic factors in adenocarcinoma of the gastric cardia: pathologic stage analysis and multivariate regression analysis.

1997 ◽  
Vol 15 (5) ◽  
pp. 2015-2021 ◽  
Author(s):  
Y Kajiyama ◽  
M Tsurumaru ◽  
H Udagawa ◽  
K Tsutsumi ◽  
Y Kinoshita ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cox Regression ◽  
Venous Invasion ◽  
Muscle Layer ◽  
Tumor Location ◽  
Additional Treatment ◽  
Gastric Cardia ◽  
Cox Regression Analysis

PURPOSE To clarify the pathologic stages of adenocarcinoma of the gastric cardia in which the prognosis is worse than in adenocarcinoma of the middle or distal part of the stomach, and to determine prognostic factors in these stages by multivariate analysis. PATIENTS AND METHODS We analyzed 2,536 cases of surgically resected gastric adenocarcinoma of all pathologic stages. Four hundred seventy-two cases of gastric carcinoma, in which cumulative survival of gastric cardia was poor, were subjected to Cox regression analysis for prognostic factors, and to logistic regression analysis for factors influencing venous or lymphatic invasion. RESULTS The prognosis of adenocarcinoma of the gastric cardia was inferior when compared with similarly staged carcinomas of the middle or lower part of the stomach when there was invasion of proper muscle layer or subserosal layer, with no lymph node metastasis or with only adjacent (group 1) lymph nodes metastases (T2N0 or T2N1, according to the Japanese classification). In these stages, the prognostic factors were age, histologic type, venous invasion, and location of the tumor in the upper part of the stomach. Tumor location in the upper stomach was also a predictor for the presence of venous invasion. CONCLUSION The prognosis of adenocarcinoma of the gastric cardia is poor in patients with T2 tumors with no or few lymph node metastases. Additional treatment after surgery may be necessary to improve the survival of this population.

scholarly journals Endoscopic Versus Surgical Therapy for Early Esophagogastric Junction Adenocarcinoma Based on Lymph Node Metastasis Risk: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua Ye ◽  
Ping Chen ◽  
Yi-Fan Wang ◽  
Xiu-Jun Cai
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Tumor Size ◽  
Esophagogastric Junction ◽  
Cox Regression ◽  
Radical Surgery ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Poor Differentiation

BackgroundIn this study, we aimed to compare the prognosis and lymph node metastasis (LNM) risk in patients with early-stage esophagogastric junction (EGJ) adenocarcinoma after endoscopic treatment (ET) or radical surgery.MethodsWe collected data from eligible patients based on the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. Logistic regression analysis was used to determine independent predictors of LNM (examination of at least 16 lymph nodes). Cox regression analysis and propensity score-matched (PSM) analysis were subsequently utilized to compare the overall survival (OS) and cancer-specific survival (CSS) of patients treated with ET or radical surgery.ResultsIn total, 3708 patients were identified. Among them, 856 patients had greater than or equal to 16 examined lymph nodes (LNs) (LNE≥16). The LNM rates were 18.8% in all patients 8.3% in T1a patients and 24.6% in T1b patients. Independent predictors of LNM were submucosal invasion, tumor size ≥3cm and decreasing differentiation (P&lt;0.05). The LNM rate decreased to approximately 5.3% in T1b tumors with well differentiation and tumor size &lt;3cm. However, the LNM incidence increased to 17.9% or 33.3% in T1a tumors with poor differentiation or with both tumor size≥3cm and poor differentiation. Cox regression analysis demonstrated CSS was not significantly different in early-stage EGJ adenocarcinoma patients undergoing ET and those treated with radical surgery (HR= 1.004, P=0.974), which were robustly validated after PSM analysis. Moreover, subgroup analysis stratified by T1a and T1b showed similar results.ConclusionsThe findings of this study indicated ET as an alternative to radical surgery in early EGJ adenocarcinoma.

scholarly journals The Clinicopathological Features and Overall Survival of Patients With Gastric Neuroendocrine Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110553
Author(s):  
Bin Xu ◽  
Yuxin Chu ◽  
Qinyong Hu ◽  
Qibin Song
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Cox Regression ◽  
Early Stage ◽  
Large Population ◽  
Clinicopathological Features ◽  
Retrospective Case ◽  
Cox Regression Analysis ◽  
Gastric Neuroendocrine Carcinoma

Objectives: Gastric neuroendocrine carcinoma (GNEC) is a class of rare histological subtypes in gastric cancer (GC). This retrospective case-control study aimed to explore the clinicopathological features and overall survival (OS) of patients with GNEC. Methods: A large population of GNEC and intestinal-type GC (IGC) patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The 1:1 propensity score matching (PSM) analysis was initiated to adjust the confounders between GNEC and IGC cohorts. Kaplan-Meier (KM) plots with log-rank tests were used to compare the survival differences in GNEC versus IGC. Additionally, Cox proportional hazard regression models were adopted to characterize the prognostic factors relevant to OS of the GNEC patients. Results: An entity of 4596 patients were collected, including 3943 (85.8%) IGC patients and 653 (14.2%) GNEC patients. The PSM analysis well-balanced all confounders in GNEC versus IGC (all P > .05). The KM plots showed that GNEC had significantly superior OS to IGC both before and after PSM analysis. Before PSM, the median OS was 52 (33.6-70.4) months in GNEC versus 32 (29.3-34.7) months in IGC ( P  =  .0015). After PSM, the median OS was 26 (18.3-33.7) months in GNEC versus 21 (17.7-24.3) months in IGC ( P  =  .0039). Stratified analysis indicated that GNEC had superior survivals to IGC in early stage patients and those who received surgery. In Cox regression analysis, age ≥ 60, tumor size > 50 mm, stage II-IV, T2, and N3 were independent risk factors for the GNEC patients (hazard ratio [HR]>1, P < .05). By contrast, year 2010 to 2015, female, and surgery were independent protective factors for these patients (HR < 1, P < .05). Conclusions: GNEC has unique clinicopathological features quite different from IGC and may have a superior survival to IGC in early stage patients. The prognostic factors identified here may assist the clinicians to more individually treat these patients.

Extended lymphadenectomy and adjuvant chemotherapy in muscle-invasive bladder cancer treated by radical cystectomy.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 287-287
Author(s):  
Peter J. Bostrom ◽  
Tuomas Mirtti ◽  
Martti Nurmi ◽  
Matti Laato ◽  
Bas W.G. Van Rhijn ◽  
...  
Keyword(s):  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Dissection ◽  
Cox Regression ◽  
Interaction Model ◽  
Node Dissection ◽  
Cox Regression Analysis ◽  
Survival Difference ◽  
Significant Difference ◽  
The University

287 Background: Level 1 evidence is weak for adjuvant chemotherapy (AC) after cystectomy, but surveys indicate physicians refer patients for AC more frequently than for neoadjuvant chemotherapy (NC). The exact benefit of an extended pelvic lymph node dissection (ePLND) remains debated. We addressed the issue of AC and ePLND analyzing two academic centers RC databases with opposite approaches, one using ePLND and AC, the other performing a limited lymph node dissection and no AC. Methods: Two ethics approved RC databases including consecutive BC patients undergoing RC at the University Health Network, Canada and the University of Turku, Finland were studied. Excluding non-urothelial cases and patients receiving NC, 563 patients were available for analysis. Clinicopathological variables, rate and extent of PLND and rate of adjuvant cisplatin-based chemotherapy were analyzed using the χ2-test. Kaplan-Meier method and multivariate Cox regression analysis were used to analyze survival. Results: In Toronto, patients had more extensive PLNDs (>10 nodes removed, 58% vs. 8%, p<0.001), higher rate of nodal metastases (26% vs. 7%, p<0.001), and received more often AC (21% vs. 1%, p<0.001). Positive margin rates were similar (4% in both centers). No BC specific survival difference was demonstrated in ≤ pT2a or in pT4a tumors. There was a trend for improved survival in pT2b tumors (10y BC specific survival 65% vs. 42%, p=0.23) and a significant difference favouring the Toronto cohort in pT3a and pT3b tumors (55% vs. 31%, p=0.025; 43% vs. 28% p=0.06, respectively). In multivariate analysis, N-stage (HR 2.5, 95% CI 1.5-4.1; p<0001) and ePLND (HR 0.53, 95% CI 0.31-0.93, p=0.026) significantly affected disease specific survival. The benefit of AC did not reach significance (HR 0.61, 95% CI 0.36-1.05, p=0.072). An interaction model combining ePLND and AC was significantly related to improved outcome (HR 0.49, 95% CI 0.26-0.92, p=0.026). Conclusions: Despite not being randomized, using 2 study cohorts that received completely opposite managements in terms of ePLND and AC, our results support that ePLND and AC may offer a survival advantage in T2b and especially in T3 BC treated with RC.

scholarly journals Development and Validation of Prognostic Nomogram for Primary Peritoneal Serous Carcinoma Compared With FIGO Staging System: A Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Ming Chen ◽  
Zhenzhen Wen ◽  
Zhengwei Qi ◽  
Min Gao
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cox Regression ◽  
Staging System ◽  
Serous Carcinoma ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Figo Staging ◽  
Gynecology And Obstetrics

BackgroundPrimary peritoneal serous carcinoma (PPSC) is a rare tumor that lacks a prognostic prediction model. Our study aims to develop a nomogram to predict overall survival (OS) of PPSC patients.MethodsPatients confirmed to have PPSC between 2004 and 2012 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. LASSO and multivariate Cox regression analyses were used to screen for meaningful independent prognostic factors to construct a nomogram model for 3-, 5-, and 10-year OS among patients with PPSC. The nomogram compared the discrimination, calibration, and net benefits with the International Federation of Gynecology and Obstetrics (FIGO) staging system of PPSC patients.ResultsEight variables were selected to establish the nomogram for PPSC. The established nomogram performed significantly better than the FIGO staging system (p &lt; 0.05). The 3-, 5-, and 10-year OS of PPSC was 0.498, 0.306, and 0.152, respectively. Patients of old age, widowed marital status, grade high, FIGO IIIB, IIIC, or IV, lymph node metastasis, no lymphadenectomy, no surgery, and no chemotherapy got higher score which corresponds with higher risk and lower OS. In the multivariate Cox regression analysis, age, histological grade, FIGO staging, lymph node metastasis, and lymphadenectomy (four or more) were identified as independent prognostic factors for PPSC.ConclusionsPPSC patients have distinct characteristics with respect to their presentation and survival outcomes. A prognostic nomogram constructed by various clinical indicators can provide better and more accurate predictions for patients with PPSC.

scholarly journals Combining Sarcopenia and [18F] FDGPET/CT Derived Metabolic Parameters in Patients with Adenocarcinoma Esophageal Cancer Might Improve Outcome Prediction

2021 ◽  
Author(s):  
Reut Anconina ◽  
Claudia Ortega ◽  
Ur Metser ◽  
Zhihui Amy Liu ◽  
Chihiro Suzuki ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Value ◽  
Cox Regression ◽  
Early Stage ◽  
Metabolic Parameters ◽  
Skeletal Muscle Index ◽  
Cox Regression Analysis ◽  
Pet Ct ◽  
Esophagogastric Cancer ◽  
N Staging

Abstract Purpose To determine the prognostic value of sarcopenia measurements done on staging [18F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment. Methods Patients with early stage, surgically treated esophageal adenocarcinoma and available pre-treatment PET/CT were included. The standard uptake value (SUV) and SUV normalized by lean body mass (SUL) were recorded. Skeletal muscle index (SMI) was measured at the L3 level on the CT component of the PET/CT. Sarcopenia was defined as SMI < 34.4cm2/m2 in women and < 45.4cm2/m2 in men. Results Of the included 145 patients. 30% were sarcopenic at baseline. On the univariable Cox proportional hazards analysis, ECOG, surgical T and N staging, Lymphovascular Invasion (LVI) positive lymph nodes and sarcopenia were significant prognostic factors concerning RFS, and OS. On multivariable Cox regression analysis, surgical N staging (p = 0.025) and sarcopenia (p = 0.022) remained significant poor prognostic factors for OS and RFS. Combining the clinical parameters with the imaging derived nutritional evaluation of the patient but not metabolic parameters of the tumor showed improved predictive ability for OS and RFS. Conclusion Combining the patients’ imaging derived sarcopenic status with standard clinical data, but not metabolic parameters offered an overall improved prognostic value concerning OS and RFS.

Endoscopic versus surgical therapy for early esophagogastric junction adenocarcinoma based on lymph node metastasis risk：a population-based analysis

2021 ◽  
Author(s):  
Hua Ye ◽  
Ping Chen ◽  
yi-fan Wang ◽  
Xiu-Jun Cai
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Tumor Size ◽  
Esophagogastric Junction ◽  
Cox Regression ◽  
Radical Surgery ◽  
Early Stage ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Poor Differentiation

Abstract Background In this study, we aimed to compare the prognosis and lymph node metastasis (LNM) risk in patients with early-stage esophagogastric junction (EGJ) adenocarcinoma after endoscopic treatment (ET) or radical surgery. Methods We collected data from eligible patients based on Surveillance, Epidemiology, and End Results database between 2004 and 2016. Logistic regression analysis was used to determine independent predictors of LNM (examination of at least 16 lymph nodes). Cox regression analysis and propensity score-matched (PSM) analysis were subsequently utilized to compare overall survival (OS) and cancer-specific survival (CSS) of patients treated with ET or radical surgery . Results In total, 5266 patients were identified. Among them, 856 patients had greater than or equal to 16 examined lymph nodes (LNs) (LNE ≥ 16). The LNM rates were 18.8% in: all patients 8.3% in T1a patients and 24.6% in T1b patients. Independent predictors of LNM were submucosal invasion, tumor size ≥ 3cm and decreasing differentiation (P < 0.05). The LNM rate decreased to approximately 5.3% in T1b tumors with well differentiation and tumor size < 3cm. However, the LNM incidence increased to 17.9% or 33.3% in T1a tumors with poor differentiation or with both tumor size ≥ 3cm and poor differentiation. Cox regression analysis demonstrated CSS was not significantly different in early-stage EGJ adenocarcinoma patients undergoing ET and those treated with radical surgery (HR = 0.830, P = 0.062), which were robustly validated after PSM analysis. Moreover, subgroup analysis stratified by T1a and T1b showed similar results. Conclusions Consequently, our findings indicated ET as an alternative to radical surgery in early EGJ adenocarcinoma.

Meta-analysis of prognostic factors for recurrence of resected well-differentiated pancreatic neuroendocrine tumors

2020 ◽  
Author(s):  
Yuan-Liang Li ◽  
Guohui Fan ◽  
Fuhuan Yu ◽  
Chao Tian ◽  
Huang-Ying Tan
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Vascular Invasion ◽  
Curative Resection ◽  
Perineural Invasion ◽  
Resection Margin ◽  
Positive Lymph Node ◽  
Pancreatic Neuroendocrine Tumors ◽  
Well Differentiated ◽  
Surgical Resection Margin

Well-differentiated pancreatic neuroendocrine tumors (WDPNETs) are a group of rare and heterogeneous tumors. However, the prognostic factors for recurrence after curative resection still remain controversial. We aim to illustrate the prognostic factors for recurrence of resected WDPNETs. All relevant articles published through June 2020 were identified via PubMed, Embase, Web of Science and the Cochrane Library. Articles that examined the prognostic factors of WDPNETs were enrolled. 10 articles were finally included in this study. From 1993 to 2018, 2863 patients underwent curative resection and 358 patients had recurrence, the combined recurrence rate was 13%. Furthermore, the pooled data indicated that patients with G2, positive lymph node and surgical resection margin, vascular invasion and perineural invasion had a decreased disease free survival for WDPNETs. However, gender, function, and tumor size had no significant relationship with WDPNETs recurrence. These findings demonstrated that G2, positive lymph node and surgical resection margin, vascular invasion and perineural invasion could be prognostic factors for recurrence of resected WDPNETs, indicating that patients with these high-risk factors need closer postoperative follow-up, and may benefit from adjuvant therapy.

scholarly journals Identification of Prognostic RBPs in Osteosarcoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Bei Li ◽  
Long Fang ◽  
Baolong Wang ◽  
Zengkun Yang ◽  
Tingbao Zhao
Keyword(s):  
Regression Analysis ◽  
Prognostic Factors ◽  
Differential Expression ◽  
Ribosome Biogenesis ◽  
Rna Binding ◽  
Cox Regression ◽  
Rna Binding Proteins ◽  
Malignant Tumors ◽  
Differential Expression Analysis ◽  
Cox Regression Analysis

Osteosarcoma often occurs in children and adolescents and causes poor prognosis. The role of RNA-binding proteins (RBPs) in malignant tumors has been elucidated in recent years. Our study aims to identify key RBPs in osteosarcoma that could be prognostic factors and treatment targets. GSE33382 dataset was downloaded from Gene Expression Omnibus (GEO) database. RBPs extraction and differential expression analysis was performed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to explore the biological function of differential expression RBPs. Moreover, we constructed Protein-protein interaction (PPI) network and obtained key modules. Key RBPs were identified by univariate Cox regression analysis and multiple stepwise Cox regression analysis combined with the clinical information from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Risk score model was generated and validated by GSE16091 dataset. A total of 38 differential expression RBPs was identified. Go and KEGG results indicated these RBPs were significantly involved in ribosome biogenesis and mRNA surveillance pathway. COX regression analysis showed DDX24, DDX21, WARS and IGF2BP2 could be prognostic factors in osteosarcoma. Spearman’s correlation analysis suggested that WARS might be important in osteosarcoma immune infiltration. In conclusion, DDX24, DDX21, WARS and IGF2BP2 might play key role in osteosarcoma, which could be therapuetic targets for osteosarcoma treatment.

Sign in / Sign up

Export Citation Format

Share Document