What Is the Clinical Value Associated with Defining Additional Disease-Specific ‘Prognostic Indicators'?

Oncology ◽  
2016 ◽  
Vol 90 (2) ◽  
pp. 57-58
Author(s):  
Maurie Markman
Keyword(s):  
Prognostic Indicators ◽  
Clinical Value ◽  
Disease Specific

scholarly journals Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroaki Saito ◽  
Shota Shimizu ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
Tomoyuki Matsunaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Significance ◽  
Prognostic Indicators ◽  
Red Cell ◽  
Cell Distribution ◽  
Disease Specific Survival ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Disease Specific

Abstract Background Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC). Methods We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries. Results According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P <  0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P <  0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator. Conclusions The prognosis of GC patients can be precisely predictable by using both PDW and RDW.

scholarly journals Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Piotr Andrzejewski ◽  
Georg Wengert ◽  
Thomas H. Helbich ◽  
Heinrich Magometschnigg ◽  
Dietmar Georg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Correlation Analysis ◽  
Estrogen Receptor Status ◽  
Prognostic Indicators ◽  
Breast Cancer Patients ◽  
Prognostic Information ◽  
Receptor Status ◽  
Clinical Endpoints ◽  
Disease Specific

The aim of this study was to assess whether sequential multiparametric 18[F]fluoro-desoxy-glucose (18[F]FDG)/[18F]fluoromisonidazole ([18F]FMISO) PET-MRI in breast cancer patients is possible, facilitates information on tumor heterogeneity, and correlates with prognostic indicators. In this pilot study, IRB-approved, prospective study, nine patients with ten suspicious breast lesions (BIRADS 5) and subsequent breast cancer diagnosis underwent sequential combined [18F]FDG/[18F]FMISO PET-MRI. [18F]FDG was used to assess increased glycolysis, while [18F]FMISO was used to detect tumor hypoxia. MRI protocol included dynamic breast contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI). Qualitative and quantitative multiparametric imaging findings were compared with pathological features (grading, proliferation, and receptor status) and clinical endpoints (recurrence/metastases and disease-specific death) using multiple correlation analysis. Histopathology was the standard of reference. There were several intermediate to strong correlations identified between quantitative bioimaging markers, histopathologic tumor characteristics, and clinical endpoints. Based on correlation analysis, multiparametric criteria provided independent information. The prognostic indicators proliferation rate, death, and presence/development of recurrence/metastasis correlated positively, whereas the prognostic indicator estrogen receptor status correlated negatively with PET parameters. The strongest correlations were found between disease-specific death and [18F]FDGmean (R=0.83, p<0.01) and between the presence/development of metastasis and [18F]FDGmax (R=0.79, p<0.01), respectively. This pilot study indicates that multiparametric [18F]FDG/[18F]FMISO PET-MRI might provide complementary quantitative prognostic information on breast tumors including clinical endpoints and thus might be used to tailor treatment for precision medicine in breast cancer.

scholarly journals Designing Disease-Specific mHealth Apps for Clinical Value

2022 ◽  
Author(s):  
Karim Keshavjee ◽  
Dustin Johnston-Jewell ◽  
Brian Lee ◽  
Robert Kyba
Keyword(s):  
Use Case ◽  
Health And Wellness ◽  
Clinical Value ◽  
Potential Growth ◽  
Patient Health ◽  
Continued Use ◽  
App Design ◽  
Patient Use ◽  
Mhealth Apps ◽  
Disease Specific

mHealth apps for patient use are promising but continue to face a plateau in usage. Current apps work for a limited segment of the patient population, i.e., those who enjoy tracking for intrinsic rewards. There are many opportunities to support patient care in between health care provider visits that are not currently being met for many diseases and patient types (personas). This is an area of great potential growth for mHealth apps and could contribute greatly to patient health and wellness. In this chapter, we propose a framework for how to think about the between-visit needs of patients that would motivate continued use of mhealth apps. We view the app design process from the following perspectives: 1) disease-specific needs, 2) non-disease specific needs, 3) behavioral theoretical aspects of app usage and 4) app-intrinsic usage motivators. Myasthenia gravis serves as the use case for illustrating these perspectives and how to use them in designing a disease-specific mHealth app.

scholarly journals NDRG2 combined with EGFR improved its prognostic value for lung adenocarcinoma

2019 ◽  
Author(s):  
Bo Yang ◽  
Xiao-Ping Li ◽  
Hong-Gang Zhou ◽  
Tao Jiang ◽  
Ting Xiao ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Cox Regression ◽  
Growth Factor Receptor ◽  
Prognostic Indicators ◽  
Clinicopathological Parameters ◽  
Clinical Value ◽  
Cox Regression Analysis ◽  
Egfr Expression ◽  
Serum Carcinoembryonic Antigen ◽  
Prediction Of Prognosis

Abstract Background N-Myc downstream-regulated gene2 (NDRG2) plays an important role in lung adenocarcinoma (LUAD). Epidermal growth factor receptor (EGFR) mutation has significantly improved prognosis in patients with adenocarcinoma. We aimed to elucidate the clinical value of NDRG2/EGFR as a prediction of prognosis in patients with lung adenocarcinoma.Materials and Methods Immunohistochemistry and western blot analysis were conducted to detect the expression of NDRG2 protein. Association between NDRG2/EGFR expression and clinicopathological parameters of the patients were examined. Serum Carcinoembryonic antigen (CEA) level was examined prior to treatment in patients with LUAD. Patients’ survival rate was assessed by Kaplan–Meier. Candidates for independent prognostic biomarkers were analyzed using a COX proportional hazard model.Results NDRG2 levels were significantly decreased in patients with lung adenocarcinoma. NDRG2 levels were positively correlated with CEA and EGFR. Advanced stages were significantly associated with low expression of NDRG2. Patients with NDRG2-high combined with EGFR-positive expression had the best prognosis during the 5-year follow-up period. Meanwhile, COX regression analysis showed that the conjoined expressions of NDRG2-low/EGFR-positive, NDRG2-high/EGFR-positive and vascular invasion were independent prognostic indicators for lung adenocarcinoma.Conclusion NDRG2 is of more prognosis value as the biomarker for lung adenocarcinoma when analyzed combined with the EGFR expression.

Abstract 207: Assessing the Clinical Value of Frailty as a Prognostic Indicator to Aid Decision-Making in Cardiac Surgery

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Emma Wilson-Pease ◽  
George Kephart ◽  
Ryan Gainer ◽  
Paige Moorhouse ◽  
Ansar Hassan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
Prognostic Indicator ◽  
Adverse Outcomes ◽  
Prognostic Models ◽  
Nutritional Deficiencies ◽  
Prognostic Indicators ◽  
Clinical Value ◽  
Cumulative Score ◽  
All Cause Mortality

Background: In North America, octogenarians are the fastest growing demographic. Chronological age of a patient is not always the same as their biological age, and their biological status can vary from robust to frail. Frail patients are predisposed to falls, institutionalization, hospitalization, and mortality. In the realm of cardiac surgery, there is little research examining frailty as a prognostic factor for cardiac surgical intervention. Purpose: The objective of the current study is to explore whether frailty provides additional information as a risk factor regarding patient prognosis over and above that of the comprehensive risk analysis scale, EuroSCORE II, used to determine suitability for cardiac surgery. Methods: This non-interventional study uses hospital patient files and questionnaire interviews, which assesses the patient’s frailty using the Frailty Assessment for Care-Planning Tool (FACT). From the documented EuroSCORE II from patient files, predictive modeling was used to consider frailty as a prognostic indicator for three adverse outcomes, discharge to an institution, major adverse cardiac events (MACE), and all-cause mortality + MACE. Furthermore, the sensitivity and specificity of the FACT will be evaluated using the area under the ROC curve for significant models. Results: Prognostic models determined that AUROC values provide improved prediction for two adverse outcomes, MACE and all-cause mortality + MACE. Using a cumulative score that involves all four domains (usual mobility, daily tasks, social function, and memory), higher discrimination with good calibration is achieved. Conclusions: Certain aspects of frailty, as measured by the FACT, have clinical value as prognostic indicators. These models are the first, to our knowledge, to investigate the relationship between the EuroSCORE II and MACE +/- all-cause mortality using the FACT. Traditional risk assessment scores such as the EuroSCORE II will benefit from having frailty included as a risk factor. Implications: This study will assist in educating future heart surgery patients about their possible risks by predicting adverse outcomes with better predictive ability. It is hoped that patients who possess more knowledge about their personal risks will be able to make more informed decisions about their surgery. Strategies to address and reduce frailty by increasing mobility and cognitive function and reducing nutritional deficiencies could use this information to inform future work.

scholarly journals Management of Temporal Bone Malignancy in Ireland

2019 ◽  
Vol 81 (06) ◽  
pp. 680-685
Author(s):  
Robbie S. R. Woods ◽  
Anel Naude ◽  
John Barry O'Sullivan ◽  
Daniel Rawluk ◽  
Mohsen Javadpour ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Outcome Measures ◽  
Middle Ear ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Prognostic Indicators ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Tertiary Referral Center ◽  
Disease Specific

Abstract Objectives Lateral temporal bone malignancy remains a challenging rare disease. We report 17 years of multidisciplinary care of these tumors with univariate and multivariate analyses of key prognostic indicators for consideration in contemporary oncological management. Design This is a retrospective cohort study. Setting This is set at a tertiary referral center. Participants All patients presenting with histopathologically newly diagnosed cases of temporal bone malignancy between 2000 and 2017 were included. Main Outcome Measures The main outcome measures are disease-specific and recurrence-free survival rates. Results In this study, 48 cases of temporal bone malignancy were diagnosed. Median age at diagnosis was 69 years (range: 5–88). Fourteen patients were female. Squamous cell carcinoma was the predominant malignancy in 34 cases (71%). Surgical treatment was undertaken in 37 patients. Mean length of follow-up was 32 months (range: 0.7–117). Overall 5-year disease-specific survival was 52.4%, while overall 5-year recurrence-free survival was 53.5%. On univariate analysis, significantly worse survival was seen in females (p = 0.008), those with distant metastatic disease (p = 0.041), and in middle ear involvement (p = 0.012) with no difference for involvement of the external auditory canal (p = 0.98) or mastoid (p = 0.78). Only middle ear involvement remained significant on multivariate analysis. Conclusion A wide variety of malignant pathology may present in the temporal bone. Recurrence-free survival is equivalent to international data; however, this figure is low. This emphasizes the need to treat these tumors appropriately with radical resection, where possible, at first presentation. Therefore, multidisciplinary surgical input is recommended. Middle ear involvement was a negative prognosticator for disease-specific and recurrence-free survivals.

scholarly journals The High Ratio of the Plasma miR-96/miR-99b Correlated With Poor Prognosis in Patients With Metastatic Colorectal Cancer

2022 ◽  
Vol 8 ◽  
Author(s):  
Yi Chen ◽  
Haizhou Liu ◽  
Shufang Ning ◽  
Changhong Wei ◽  
Jilin Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cell Lines ◽  
Prognostic Model ◽  
Cox Regression ◽  
Clinical Stage ◽  
Interaction Network ◽  
High Ratio ◽  
Prognostic Indicators ◽  
Clinical Value ◽  
Significant Differential Expression

Object: This study aims to clarify the expression of plasma miRNA in CRC patients, and to clarify the potential use of these miRNAs in diagnosis and prognosis, and to establish a prognostic model to initially explore its clinical value.Methods: We detected the expression of 6 miRNAs in normal colon epithelial cell lines and colorectal cancer cell lines by qRT-PCR and they were validated in the tissues of three subtypes: 20 healthy subjects, 41 pCRC and 49 mCRC patients. COX regression and ROC analyses use to evaluate the diagnostic and prognostic efficacy of candidate miRNAs. Subsequently, we initially established a nomogram prognostic model. MiRNA is also used to construct miRNA-mRNA interaction network and PPI network modules.Results: Five miRNAs showed significant differential expression in pCRC, mCRC patients and normal groups. ROC analysis showed that CEA, miR-96, miR-99b and miR-96/miR-99b are distinguishable from pCRC and mCRC patients, with AUC ranging from 0.65 to 0.91; among them, the ratio of miR-96/miR-99b is stronger than any diagnostic indicators, such as CEA and CA125. Multivariate survival analysis identified miR-96, miR-99b, N stage, M stage and clinical stage as independent prognostic indicators of mCRC. The nomogram based on these 5 characteristics has satisfactory prognostic values.Conclusion: Our data indicate that plasma miR-96/miR-99b can be used as a promising biomarker for early detection of mCRC patients; our nomogram has a promising evaluation value.

Metastatic cutaneous squamous cell carcinoma of the parotid gland: prognostic factors

2017 ◽  
Vol 132 (3) ◽  
pp. 264-269 ◽  
Author(s):  
A C Coombs ◽  
A Butler ◽  
R Allison
Keyword(s):  
Squamous Cell Carcinoma ◽  
Survival Rate ◽  
Parotid Gland ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Locoregional Control ◽  
Prognostic Indicators ◽  
Disease Specific Survival ◽  
Disease Specific

AbstractBackground:Metastatic cutaneous squamous cell carcinoma is the most common parotid malignancy in Australasia. Prognostic indicators are not clearly defined and the extent of surgical resection required is controversial.Methods:A retrospective analysis was conducted of 63 patients who underwent surgery for metastatic cutaneous squamous cell carcinoma of the parotid gland at a tertiary hospital over a 10-year period.Results:The five-year overall survival rate was 53 per cent, the disease-specific survival rate was 78 per cent and the locoregional control rate was 72 per cent. Immunosuppression and no adjuvant radiotherapy were associated with a significant reduction in disease-specific survival. None of the factors analysed had a significant effect on locoregional control rates.Conclusion:More extensive surgery, including lateral temporal bone resection, may improve local control rates in cases of more advanced disease. The reduced survival of immunocompromised patients must be considered when planning their management.

scholarly journals Combination of preoperative fibrinogen and neutrophil to lymphocyte ratio is a predictive prognostic factor in ESCC and AEG systematic review

2019 ◽  
Vol 39 (10) ◽  
Author(s):  
Guo Tianxing ◽  
Pan Xiaojie ◽  
Zhu Lihuan ◽  
Huang Yangyun
Keyword(s):  
Cancer Progression ◽  
Tumor Size ◽  
Esophagogastric Junction ◽  
Neutrophil To Lymphocyte Ratio ◽  
Prognostic Indicators ◽  
Pathological Stage ◽  
Clinical Value ◽  
Curative Surgery ◽  
Lymphocyte Ratio ◽  
Prognosis Indicator

Abstract Objective: Cancer-associated systemic inflammation response and hyperfibrinogenemia play crucial roles in cancer progression and prognosis. In the present study, we assessed the clinical value of the preoperative fibrinogen and the neutrophil to lymphocyte ratio (NLR) in patients with esophageal squamous cell carcinoma (ESCC) and adenocarcinoma of the esophagogastric junction (AEG). Methods: Three hundred and fifty-six patients who underwent curative surgery were retrospectively analyzed. Univariate and Multivariate Cox analyses were performed to evaluate the prognostic indicators for overall survival (OS). The optimization cut-off values for fibrinogen and the NLR were 3.09 g/l and 1.89, respectively. The fibrinogen and the NLR (F-NLR) index was 2 for patients with high fibrinogen (≥3.09 g/l) and elevated NLR (≥1.89), whereas those with one or neither were indexed as 1 or 0, respectively. Results: The F-NLR score was significantly associated with tumor size (P&lt;0.001), and pathological stage (P=0.010). The 5-year OS rates in F-NLR groups 0, 1 and 2 were 69.1, 42.6, and 31.9%, respectively (P&lt;0.001). Multivariate analysis showed that the tumor size (P&lt;0.001), pathological stage (P&lt;0.001), and F-NLR (P&lt;0.001) were independent prognostic factors for OS. Conclusions: The preoperative F-NLR score is an independent prognosis indicator for patients with ESCC and AEG.

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