Longitudinal Melanonychia: Differences in Etiology Are Associated with Patient Age at Diagnosis

Dermatology ◽  
2017 ◽  
Vol 233 (6) ◽  
pp. 446-455 ◽  
Author(s):  
Yi-Teng Tseng ◽  
Cher-Wei Liang ◽  
Jau-Yu Liau ◽  
Koping Chang ◽  
Yu-Hsian Tseng ◽  
...  
Keyword(s):  
Age At Diagnosis ◽  
Patient Age ◽  
Patient Âgé ◽  
Longitudinal Melanonychia

scholarly journals Prognostic quality of activating TERT promoter mutations in glioblastoma: interaction with the rs2853669 polymorphism and patient age at diagnosis

2015 ◽  
Vol 17 (9) ◽  
pp. 1231-1240 ◽  
Author(s):  
Sabine Spiegl-Kreinecker ◽  
Daniela Lötsch ◽  
Bahil Ghanim ◽  
Christine Pirker ◽  
Thomas Mohr ◽  
...  
Keyword(s):  
Age At Diagnosis ◽  
Patient Age ◽  
Tert Promoter ◽  
Patient Âgé ◽  
Tert Promoter Mutations ◽  
Promoter Mutations

scholarly journals Impact of comorbidities and delay in diagnosis in elderly patients with pulmonary hypertension

2018 ◽  
Vol 4 (4) ◽  
pp. 00100-2018 ◽  
Author(s):  
Marylise Ginoux ◽  
Ségolène Turquier ◽  
Nader Chebib ◽  
Jean-Charles Glerant ◽  
Julie Traclet ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Age Groups ◽  
Young Patients ◽  
Age At Diagnosis ◽  
Very Elderly ◽  
Patient Age ◽  
Delay In Diagnosis ◽  
Patient Âgé ◽  
Time To Diagnosis

Patient age at diagnosis of pulmonary hypertension is steadily increasing. The present study sought to analyse clinical characteristics, time to diagnosis and prognosis of pulmonary hypertension in elderly and very elderly patients.A study was conducted in a French regional referral centre for pulmonary hypertension. All consecutive patients diagnosed with pre-capillary pulmonary hypertension were included and categorised according to age: <65 years (“young”), 65–74 years (“elderly”) and ≥75 years (“very elderly”).Over a 4-year period, 248 patients were included: 101 (40.7%) were young, 82 (33.1%) were elderly and 65 (26.2%) were very elderly. The median age at diagnosis among the total population was 68 years. Compared with young patients, elderly and very elderly patients had a longer time to diagnosis (7±48, 9±21 and 16±32 months, respectively; p<0.001). Patients ≥75 years also more often had group 4 pulmonary hypertension. The median overall survival was 46±1.4 months, but was only 37±4.9 months in elderly patients and 28±4.7 months in very elderly patients. Survival from the first symptoms and survival adjusted to comorbidity was similar across age groups.Patient age should be taken into account when diagnosing pulmonary hypertension as it is associated with a specific clinical profile and a worse prognosis. The difference in prognosis is likely to be related to a delay in diagnosis and a greater number of comorbidities.

scholarly journals Patient age at diagnosis is associated with the molecular characteristics of diffuse large B-cell lymphoma

Blood ◽  
2012 ◽  
Vol 119 (8) ◽  
pp. 1882-1887 ◽  
Author(s):  
Wolfram Klapper ◽  
Markus Kreuz ◽  
Christian W. Kohler ◽  
Birgit Burkhardt ◽  
Monika Szczepanowski ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Age Groups ◽  
B Cell Lymphoma ◽  
Age At Diagnosis ◽  
B Cell Lymphomas ◽  
Patient Age ◽  
Large B Cell Lymphoma ◽  
Patient Âgé ◽  
Large B Cell

Abstract Diffuse large B-cell lymphoma is the most frequent type of B-cell lymphoma in adult patients but also occurs in children. Patients are currently assigned to therapy regimens based on arbitrarily chosen age limits only (eg, 18 or 60 years) and not biologically justified limits. A total of 364 diffuse large B-cell lymphomas and related mature aggressive B-cell lymphomas other than Burkitt lymphoma from all age groups were analyzed by comprehensive molecular profiling. The probability of several biologic features previously reported to be associated with poor prognosis in diffuse large B-cell lymphoma, such as ABC subtype, BCL2 expression, or cytogenetic complexity, increases with age at diagnosis. Similarly, various genetic features, such as IRF4 translocations, gains in 1q21, 18q21, 7p22, and 7q21, as well as changes in 3q27, including gains and translocations affecting the BCL6 locus, are significantly associated with patient age, but no cut-offs between age groups could be defined. If age was incorporated in multivariate analyses, genetic complexity lost its prognostic significance, whereas the prognostic impact of ABC subtype and age were additive. Our data indicate that aging is a major determinant of lymphoma biology. They challenge current concepts regarding both prognostic biomarkers and treatment stratification based on strict age cut-offs.

Impact of age on treatment of primary melanoma patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9054-9054
Author(s):  
Nathaniel H. Fleming ◽  
Jiaying Tian ◽  
Eleazar Vega-Saenz de Miera ◽  
Heidi L. Gold ◽  
Farbod Darvishian ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Older Patients ◽  
Middle Age ◽  
Primary Melanoma ◽  
Age At Diagnosis ◽  
Age Group ◽  
Patient Age ◽  
Patient Âgé ◽  
Melanoma Patients ◽  
To Receive

9054 Background: Although patient age at diagnosis is not currently included in guidelines for treatment of primary melanoma, several lines of evidence suggest that patient age is an important, yet understudied, factor when considering treatment options. Here, we attempt to address the limited knowledge of the impact of age on primary melanoma treatment. Methods: In a prospectively enrolled and followed-up cohort of melanoma patients at NYU, we used logistic regression models to evaluate the association between patient age at diagnosis, tumor baseline characteristics, including BRAF and NRAS mutation status, and likelihood of receiving and responding to adjuvant therapy. We examined adjuvant therapy effectiveness using recurrence and melanoma-specific survival as endpoints. Results: 444 primary melanoma patients were included in the study (median follow-up: 6.3 years; age range: 19-95 years). Age was categorized into three groups spanning the range of age at presentation: younger (19-45 years; 24%), middle (46-70 years; 50%), and older (71-95 years; 26%). Older patients were significantly more likely to have advanced stage, nodular subtype (P < 0.01, both variables), and BRAF wildtype tumors (P = 0.04). Controlling for these factors as well as gender, older patients experienced a higher risk of recurrence (HR older vs. younger 3.34, 95% CI 1.53-7.25; P < 0.01). Of the 128/444 (29%) patients who were eligible for adjuvant treatment (clinical stage ≥ IIB), only 67/128 (52%) received treatment. Using a propensity score that accounts for stage at presentation, patients in the middle age group were more likely to receive adjuvant therapy than those in the older group (OR 2.61, 95% CI 1.12-6.08; P = 0.03). In addition, a trend suggesting benefit from adjuvant therapy (defined as longer melanoma-specific survival) was observed only in the middle age group (P = 0.07). Conclusions: Our data suggest that older melanoma patients, despite having a significantly worse prognosis, are less likely to receive and benefit from adjuvant therapy. Further work is needed to understand the biological variables contributing to the limited response to treatment in elderly primary melanoma.

scholarly journals Patient Age–Associated Mortality Risk Is Differentiated by BRAF V600E Status in Papillary Thyroid Cancer

2018 ◽  
Vol 36 (5) ◽  
pp. 438-445 ◽  
Author(s):  
Xiaopei Shen ◽  
Guangwu Zhu ◽  
Rengyun Liu ◽  
David Viola ◽  
Rossella Elisei ◽  
...  
Keyword(s):  
Risk Factor ◽  
Thyroid Cancer ◽  
Mortality Risk ◽  
Braf V600e Mutation ◽  
Age At Diagnosis ◽  
Braf V600e ◽  
Papillary Thyroid ◽  
Wild Type ◽  
Patient Age ◽  
Patient Âgé

Purpose For the past 65 years, patient age at diagnosis has been widely used as a major mortality risk factor in the risk stratification of papillary thyroid cancer (PTC), but whether this is generally applicable, particularly in patients with different BRAF genetic backgrounds, is unclear. The current study was designed to test whether patient age at diagnosis is a major mortality risk factor. Patients and Methods We conducted a comparative study of the relationship between patient age at diagnosis and PTC-specific mortality with respect to BRAF status in 2,638 patients (623 men and 2,015 women) with a median age of 46 years (interquartile range, 35 to 58 years) at diagnosis and a median follow-up time of 58 months (interquartile range, 26 to 107 months). Eleven medical centers from six countries participated in this study. Results There was a linear association between patient age and mortality in patients with BRAF V600E mutation, but not in patients with wild-type BRAF, in whom the mortality rate remained low and flat with increasing age. Kaplan-Meier survival curves rapidly declined with increasing age in patients with BRAF V600E mutation but did not decline in patients with wild-type BRAF, even beyond age 75 years. The association between mortality and age in patients with BRAF V600E was independent of clinicopathologic risk factors. Similar results were observed when only patients with the conventional variant of PTC were analyzed. Conclusion The long-observed age-associated mortality risk in PTC is dependent on BRAF status; age is a strong, continuous, and independent mortality risk factor in patients with BRAF V600E mutation but not in patients with wild-type BRAF. These results question the conventional general use of patient age as a high-risk factor in PTC and call for differentiation between patients with BRAF V600E and wild-type BRAF when applying age to risk stratification and management of PTC.

scholarly journals Molecular analyses of triple-negative breast cancer in the young and elderly

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Mattias Aine ◽  
Ceren Boyaci ◽  
Johan Hartman ◽  
Jari Häkkinen ◽  
Shamik Mitra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Immune Cell ◽  
Genetic Alterations ◽  
Age At Diagnosis ◽  
Patient Age ◽  
Age Related ◽  
Patient Âgé

Abstract Background Breast cancer in young adults has been implicated with a worse outcome. Analyses of genomic traits associated with age have been heterogenous, likely because of an incomplete accounting for underlying molecular subtypes. We aimed to resolve whether triple-negative breast cancer (TNBC) in younger versus older patients represent similar or different molecular diseases in the context of genetic and transcriptional subtypes and immune cell infiltration. Patients and methods In total, 237 patients from a reported population-based south Swedish TNBC cohort profiled by RNA sequencing and whole-genome sequencing (WGS) were included. Patients were binned in 10-year intervals. Complimentary PD-L1 and CD20 immunohistochemistry and estimation of tumor-infiltrating lymphocytes (TILs) were performed. Cases were analyzed for differences in patient outcome, genomic, transcriptional, and immune landscape features versus age at diagnosis. Additionally, 560 public WGS breast cancer profiles were used for validation. Results Median age at diagnosis was 62 years (range 26–91). Age was not associated with invasive disease-free survival or overall survival after adjuvant chemotherapy. Among the BRCA1-deficient cases (82/237), 90% were diagnosed before the age of 70 and were predominantly of the basal-like subtype. In the full TNBC cohort, reported associations of patient age with changes in Ki67 expression, PIK3CA mutations, and a luminal androgen receptor subtype were confirmed. Within DNA repair deficiency or gene expression defined molecular subgroups, age-related alterations in, e.g., overall gene expression, immune cell marker gene expression, genetic mutational and rearrangement signatures, amount of copy number alterations, and tumor mutational burden did, however, not appear distinct. Similar non-significant associations for genetic alterations with age were obtained for other breast cancer subgroups in public WGS data. Consistent with age-related immunosenescence, TIL counts decreased linearly with patient age across different genetic TNBC subtypes. Conclusions Age-related alterations in TNBC, as well as breast cancer in general, need to be viewed in the context of underlying genomic phenotypes. Based on this notion, age at diagnosis alone does not appear to provide an additional layer of biological complexity above that of proposed genetic and transcriptional phenotypes of TNBC. Consequently, treatment decisions should be less influenced by age and more driven by tumor biology.

scholarly journals Patient Age Is Significantly Related to Distant Metastasis of Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Hui Huang ◽  
Siyuan Xu ◽  
Xiaolei Wang ◽  
Shaoyan Liu ◽  
Jie Liu
Keyword(s):  
Distant Metastasis ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Age At Diagnosis ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Middle Aged ◽  
Patient Age ◽  
Thyroid Microcarcinoma ◽  
Patient Âgé

ObjectiveDistant metastasis in papillary thyroid microcarcinoma (PTMC) is rare but fatal, and its relationship with patient age remains unclear. The objective of this study was to examine the association between age at diagnosis and metachronous distant metastasis in PTMC.MethodsConsecutive patients who underwent thyroidectomy for PTC measuring 10 mm or less at a tertiary hospital from January 2000 to December 2016 were enrolled. Patients who had evidence of distant metastasis at diagnosis or underwent postoperative radioiodine (RAI) ablation were excluded. A Cox proportional hazards model with restricted cubic splines (RCS) was applied to examine the association between age at diagnosis and distant metastasis.ResultsA total of 4,749 patients were evaluated. The median age was 44 years (range, 8–78 years), and 3,700 (78%) were female. After a median follow-up of 65 months, 21 distant metastases (20 lung, 1 liver) were recognized. A univariate Cox proportional model using a 5-knot RCS revealed a significant overall (p = 0.01) and a potential nonlinear association (p = 0.08) between distant metastasis and age at diagnosis. In multivariate analysis, age at diagnosis, extrathyroidal extension (ETE), and lymph node metastasis (pN+) were independent risk factors for distant metastasis. Compared with the middle-aged group (30–45 years old), younger and older patients had a higher risk of distant metastasis [HR, 95% CI, p-value, age ≤ 30, 4.54 (0.91–22.60), 0.06, age &gt; 45, 6.36 (1.83–22.13), &lt;0.01].ConclusionAge at diagnosis is associated with metachronous distant metastasis of PTMC, and patients with younger or older age have a higher risk of distant metastasis than middle-aged patients.

A New Subtype of Excellent Prognosis Identified by GEP in Childhood BCP-ALL Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2513-2513
Author(s):  
Elena Vendramini ◽  
Marco Giordan ◽  
Silvia Bresolin ◽  
Luca Trentin ◽  
Andrea Zangrando ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Stratification ◽  
Prognostic Markers ◽  
Risk Group ◽  
Age At Diagnosis ◽  
Functional Evaluation ◽  
Patient Age ◽  
Patient Âgé ◽  
Standard Risk

Abstract A number of clinical and biological prognostic factors are currently used for B-cell precursor Acute Lymphoblastic Leukemia (BCP-ALL) patient risk stratification into (standard risk) SR, (medium risk) MR and (high risk) HR treatment protocols. In spite of careful stratification patients stratified in the same risk class may respond differently to therapy suggestive of a need for additional prognostic markers in BCP-ALL. Here we analyzed gene expression profiles (GEP) of BCP-ALL patients at diagnosis in search for correlations with the diverse responses to therapy among these patients. We specifically searched for expression signatures that predict relapse or the absence of relapse in BCP-ALL. Among BCP-ALL 50% of patients are characterized by recurrent genomic aberrations that are strong indicators for risk stratification of which BCR/ABL and MLL rearrangements have a HR to relapse; TEL/AML1 and hyperdiploid have a standard risk to relapse. BCPALL patients without these aberrations form a heterogeneous risk group in which new prognostic markers will be very important to help stratify these patients. A GEP data set of 86 BCP-ALL patients (47 males; 39 females) without known aberrations was obtained using Affymetrix HG-U133Plus2.0 arrays that were analyzed using Partek and R software packages. Patients were treated according to AIEOP ALL 2000 protocols. Nine out of 86 patients relapsed of which 6 within 24 months; the minimum follow-up time was 24 months. For each probe set the variance among patients was computed and 10 % of the probe sets with the major variance were selected for further analysis. Unsupervised hierarchical cluster analysis separated patients in two groups: one group of 19 patients that were all in complete remission (CR) and a second group of 67 patients in which all patients that eventually relapsed (14%) and CR patients (86%) cluster together. The median follow-up time in the first group of patients was 40 months and the median patient age at diagnosis was 7 years. In the second group median follow-up was 29 months and median patient age at diagnosis was 5.5 years. The separation of patients into two groups was not related to risk group (SR, MR or HR), gender, age or response to induction therapy. A t-test (multiplicity corrections were adopted to control for false positives) was used to find probe sets that were differentially expressed between the two groups. Functional evaluation of the top 200 probe sets of this analysis established 3 major biological categories according to the GO database and revealed differential expression of genes involved in cell adhesion, signal transduction and immune response. We identified a subtype of patients with a gene expression signature that is correlated with excellent prognosis using GEP analysis on BCP-ALL patients that present no recurrent known genomic aberrancies. The signature of excellent prognosis involves about 20% of BCP-ALL patients without common genotypic aberrations and 8% of all BCP-ALL patients and is independent of currently applied prognostic risk factors.

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