Evaluation of the Estimation of Physiologic Ability and Surgical Stress Score as a Prognostic Indicator for Older Patients with Gastric Cancer

2019 ◽  
Vol 37 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Yuki Murakami ◽  
Hiroaki Saito ◽  
Shota Shimizu ◽  
Yusuke Kono ◽  
Yuji Shishido ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Score ◽  
Surgical Stress ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Prognostic Indicator ◽  
Histopathological Diagnosis ◽  
Receiver Operating Characteristic Curves ◽  
Auc Value ◽  
Stress Score

Background: The incidence of gastric cancer (GC) among the older adults is increasing. Therefore, determining postoperative age-associated prognostic factors is clinically important. This present study retrospectively investigated the prognostic significance of the estimation of physiologic ability and surgical stress (E-PASS) of such patients with GC. Methods: We enrolled 136 patients aged ≥75 years with a histopathological diagnosis of gastric adenocarcinoma who underwent gastrectomy. Results: Receiver operating characteristic curves were generated to evaluate survival, and AUC values were compared to assess the discriminatory ability of carcinoembryonic antigen, the perioperative risk score, the surgical stress score, and the comprehensive risk score (CRS) of E-PASS. The AUC value of CRS was of the highest AUC value as a function of overall survival (OS) and disease-specific survival. The 5-year OS rates of CRSHigh and CRSLow groups were 50.6 and 76.9% (p = 0.0007) respectively. The 5-year DSS rates of the CRSHigh and CRSLow groups were 78.8 and 95.2% (p = 0.028) respectively. Further, the 5-year survival rates unrelated to cancer of the CRSHigh and CRSLow groups were 64.2 and 80.9% (p = 0.0096) respectively. Multivariate analysis identified that CRS was an independent prognostic indicator. Conclusions: E-PASS was a useful prognostic indicator for older GC patients.

Estimation of Physiological Ability and Surgical Stress Score Is a Useful Prognostic Indicator for Elderly Patients with Colorectal Cancer

2019 ◽  
Vol 37 (2) ◽  
pp. 145-153 ◽  
Author(s):  
Manabu Yamamoto ◽  
Hiroaki Saito ◽  
Chihiro Uejima ◽  
Akimitsu Tanio ◽  
Yoichiro Tada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Surgical Stress ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Prognostic Indicator ◽  
Histopathological Diagnosis ◽  
Characteristic Analysis ◽  
Curative Surgery ◽  
The Difference

Background: The incidence of colorectal cancer (CRC) among the elderly has been increasing. Therefore, determining postoperative prognosis factors in elderly CRC patients has clinical importance. This study retrospectively investigated the prognostic significance of the estimation of physiological ability and surgical stress (E-PASS) in elderly CRC patients. Methods: This study enrolled 166 elderly patients aged 75 or more with a histopathological diagnosis of colorectal adenocarcinoma who underwent curative surgery. Results: According to the results of receiver operating characteristic analysis, the patients were divided into the following 2 groups based on the comprehensive risk score (CRS): CRS of ≥0.05 (CRSHigh) and CRS of < 0.05 (CRSLow). The 5-year overall survival rates of CRSHigh group and CRSLow group were 51.1 and 89.6%, respectively, and the difference was statistically significant (p < 0.001). Furthermore, 5-year disease-specific survival rates of CRSHigh group and CRSLow group were 81.4 and 96.3%, respectively, and the difference was statistically significant (p = 0.017). Also, multivariate analysis indicated that CRS was an independent prognostic indicator in elderly CRC patients. With regard to the cause of death, both recurrence and cancer-unrelated deaths were observed significantly more in the CRSHigh group than in the CRSLow group. Conclusions: E-PASS was a useful prognostic indicator in elderly CRC patients.

Prognostic Significance of Pre- and Postoperative Lymphocyte Counts in Patients with Gastric Cancer

2018 ◽  
Vol 36 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Hiroaki Saito ◽  
Yusuke Kono ◽  
Yuki Murakami ◽  
Yuji Shishido ◽  
Hirohiko Kuroda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
Lymphocyte Count ◽  
Operating Characteristic ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Venous Invasion ◽  
Prognostic Indicator ◽  
Characteristic Analysis ◽  
Patient Prognosis

Background: Although preoperative lymphopenia is reportedly a prognostic factor in cancer patients, the association between postoperative lymphopenia and patient prognosis has not been widely studied. Methods: We enrolled 352 patients who underwent surgery for gastric cancer (GC) between January 2005 and April 2013 to analyze correlations among pre- and postoperative lymphocyte counts (LCs) and prognosis in GC patients. Results: Pre- and postoperative (obtained 1 day after surgery) LCs were significantly correlated (r = 0.496, p < 0.0001). Pre- and postoperative LCs of elderly patients were significantly lower than those of non-elderly patients. Postoperative lymphocyte count was significantly lower in patients with a differentiated tumor than in those with an undifferentiated tumor. Based on the results of receiver operating characteristic analysis, patients were classified into subgroups as: preoperative LC ≥1,676 (pre-LCHigh), preoperative LC <1,676 (pre-LCLow); and as postoperative LC ≥855 (post-LCHigh), and postoperative LC <855 (post-LCLow). Five-year overall survival rates significantly differed between pre-LCHigh (82.5%) and pre-LCLow (71.6%) groups (p = 0.023); and also between the post-LCHigh (81.5%) and post-LCLow (69.5%) groups (p = 0.0072). The 5-year disease specific survival rates were 91.3 and 82.4% in patients with post-LCHigh and those with post-LCLow, respectively, and differences were statistically significant (p = 0.015). Multivariate analysis indicated that postoperative lymphocyte count was an independent prognostic indicator, along with age, gender, tumor size, lymph node metastasis, and venous invasion. Conclusions: Postoperative lymphocyte count is a useful predictive factor for prognosis in GC patients.

Prognostic significance of ADAM17 expression in patients with gastric cancer who underwent curative gastrectomy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 60-60
Author(s):  
Ahmet Bilici ◽  
Dincer Aydin ◽  
Dilek Yavuzer ◽  
Hatice Odabas ◽  
Ozlem Ercelep ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Molecular Marker ◽  
Cancer Progression ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Prognostic Indicator ◽  
Curative Gastrectomy ◽  
Prognostic Importance ◽  
Gastric Cancer Patients

60 Background: Tumor invasion and metastasis are complex processes, involving regulation at the molecular level of adhesive molecules, proteolitic enzymes, and cell growth and angiogenesis factors. A Disintegrin and Metalloproteinase (ADAM)17 has been indicated to be indispensable regulator of celular event from proliferation to migration.Although prognostic importance of ADAM17 expression has been investigated in several tumors, its clinical utility as a useful prognostic molecular marker remains unclearin gastric cancer.In the present study, we evaluated the expression of ADAM17 and its prognostic significance in gastric cancer patients after surgery. Methods: Prognostic significance of ADAM17 expression was analyzed by immunohistochemically in 158 patients with gastric cancer and the relationship between its expression and clinicopathological factors was also evaluated. Results: High expression of ADAM17 was detected in 81 patients(51%),while low expression was found in 77 cases (49%). There was significant correlation between gender, histology, lymph node metastasis, vascular invasion, the presence of recurrence and high ADAM17 expression. Recurrence in patients with high ADAM17 expression was significantly higher than that for patients with low ADAM17 expression(p=0.032). The median disease-free survival (DFS) time for patients with high ADAM17 expressed tumors were worse than those of patients with low ADAM17 expressed tumor (16.6 vs. 44.2 months, p=0.004).In addition, patients with low ADAM17 expression had a higher median overall survival (OS)interval than those of high ADAM17 expressed patients (49.6 vs. 26.9 months, p=0.019). Multivariate analysis indicated that the rate of ADAM17 expression was an independent prognostic factor for DFS, in addition to known important clinicopathological prognostic indicator for DFS. But its' prognostic importance could not be proved by multivariate analysis for OS. Conclusions: The potential value of ADAM17 expression as a useful molecular marker in gastric cancer progression should be evaluated comprehensively,it may predict recurrence and poor prognosis in patients with gastric cancer after curative resection.

scholarly journals Clinical significance of conversion surgery for gastric cancer with peritoneal dissemination: A retrospective study

2020 ◽  
Author(s):  
Takaaki Arigami ◽  
Daisuke Matsushita ◽  
Keishi Okubo ◽  
Takashi Kijima ◽  
Masataka Shimonosono ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Retrospective Study ◽  
Progressive Disease ◽  
Tumor Response ◽  
Peritoneal Dissemination ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Distant Metastases ◽  
Conversion Surgery ◽  
Response To Chemotherapy

Abstract Background: Although chemotherapy has been clinically recommended as the initial treatment for patients with peritoneal dissemination of gastric cancer, poor prognosis has been noted among the same patients. However, the prognostic significance of conversion surgery after chemotherapy remains unclear. The present study therefore aimed to assess the clinical impact of conversion surgery among patients with peritoneal dissemination of gastric cancer.Methods: A total of 93 patients with peritoneal dissemination of gastric cancer undergoing chemotherapy between February 2002 and October 2019 were retrospectively enrolled and subsequently divided into progressive disease (PD) and non-PD groups based on tumor response to chemotherapy.Results: Among the included patients, 17 developed distant metastases at another site besides peritoneal dissemination. Based on tumor response, 24 and 69 patients were determined to have PD and non-PD, respectively, with the former having significantly poorer prognosis than the latter (p < 0.0001). A total of 19 patients underwent conversion surgery after chemotherapy, with the presence or absence of conversion surgery being significantly correlated with age, first-line chemotherapy regimen, and tumor response (p = 0.0134, 0.0337, and 0.0024, respectively). Patients in the non-PD group who underwent conversion surgery or chemotherapy alone had 3-year overall survival rates of 55.6% and 6.6%, respectively. Multivariate analysis identified conversion surgery alone as an independent prognostic factor in the non-PD group (p < 0.0001).Conclusion: Our retrospective study demonstrated that conversion surgery for gastric cancer with peritoneal dissemination might improve the prognosis of responders who developed no peritoneal dissemination after chemotherapy.

Eight-gene prognostic signature associated with hypoxia and ferroptosis for gastric cancer with general applicability

Epigenomics ◽  
2021 ◽  
Author(s):  
Junyu Huo ◽  
Liqun Wu ◽  
Yunjin Zang
Keyword(s):  
Gastric Cancer ◽  
Regression Analysis ◽  
Risk Score ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cancer Genome ◽  
The Cancer Genome Atlas ◽  
Cox Regression Analysis ◽  
Cancer Genome Atlas ◽  
Genome Atlas

Aims: To investigate the prognostic significance of hypoxia- and ferroptosis-related genes for gastric cancer (GC). Materials & methods: We extracted data on 259 hypoxia- and ferroptosis-related genes from The Cancer Genome Atlas and identified the differentially expressed genes between normal (n = 32) and tumor (n = 375) tissues. A risk score was established by univariate Cox regression analysis and LASSO penalized Cox regression analysis. Results: The risk score contained eight genes showed good performance in predicting overall survival and relapse-free survival in GC patients in both the training cohort (The Cancer Genome Atlas, n = 350) and the testing cohorts (GSE84437, n = 431; GSE62254, n = 300; GSE15459, n = 191; GSE26253, n = 432). Conclusion: The eight-gene signature may help to the improve the prognostic risk classification of GC.

Expression of Estrogen Receptor-α as a Prognostic Factor in Patients With Uterine Serous Carcinoma

2014 ◽  
Vol 24 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Tomoko Sho ◽  
Toru Hachisuga ◽  
Thuy Thi Nguyen ◽  
Rie Urabe ◽  
Tomoko Kurita ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Prognostic Factor ◽  
Multivariate Analyses ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Prognostic Indicator ◽  
Estrogen Receptor Α ◽  
Endometrial Biopsy ◽  
Serous Carcinoma ◽  
Uterine Serous Carcinoma

ObjectivesAlthough the expression of estrogen receptor (ER) is usually found in uterine endometrioid adenocarcinomas, it has recently been reported to be found in some uterine serous carcinomas (USCs). This report describes the clinicopathologic features of USC with an expression of ER-α, with special reference to the prognostic significance of ER-α.MethodsThe immunohistochemical expression of ER-α was examined in 33 USCs. Greater than 10% staining was defined as an overexpression of ER-α. Cox univariate and multivariate analyses for USCs were performed.ResultsA total of 7 USCs (21.2%) exhibited an expression of ER-α. All tumors were pure-type USCs and strongly demonstrated an overexpression of p53. The cancer-specific 5-year survival rates of patients with USC without an expression of ER-α and USC with an expression of ER-α were 54.5% and 0.0%, respectively (P= 0.04). The univariate analyses showed an expression of ER-α to be a significant prognostic indicator in patients with USC (P< 0.05). However, multivariate analyses for USCs showed that the surgical stage was an independent prognostic factor, whereas the significance of ER immunoreactivity disappeared.ConclusionsUterine serous carcinoma with an expression of ER-α was associated with advanced-staged tumors and a significantly worse prognosis than that without an expression of ER-α. When an endometrial biopsy specimen reveals USC with an expression of ER-α and an overexpression of p53, the presence of an extrauterine lesion is suggested.

Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery

2014 ◽  
Vol 20 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Jun Hirose ◽  
Takuya Taniwaki ◽  
Toru Fujimoto ◽  
Tatsuya Okada ◽  
Takayuki Nakamura ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Risk Score ◽  
Severity Score ◽  
Spinal Surgery ◽  
Surgical Stress ◽  
Morbidity Rate ◽  
Preoperative Risk ◽  
Operative Severity Score ◽  
Postoperative Risk ◽  
Stress Score

Object The Estimation of Physiological Ability and Surgical Stress (E-PASS) and Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) systems are surgical risk scoring systems that take into account both the patient's preoperative condition and intraoperative variables. While they predict postoperative morbidity and mortality rates for several types of surgery, spinal surgeries are currently not included. The authors assessed the usefulness of E-PASS and POSSUM algorithms and compared the predictive ability of both systems in patients with spinal disorders considered for surgery. Methods The E-PASS system includes a preoperative risk score, a surgical stress score, and a comprehensive risk score that is determined by both the preoperative risk score and surgical stress score. The POSSUM system is composed of a physiological score and an operative severity score; its total score is based on both the physiological score and operative severity score. The authors calculated the E-PASS and POSSUM scores for 601 consecutive patients who had undergone spinal surgery and investigated the relationship between the individual scores of both systems and the incidence of postoperative complications. They also assessed the correctness of the predicted morbidity rate of both systems. Results Postoperative complications developed in 64 patients (10.6%); there were no in-hospital deaths. All EPASS scores (p ≤ 0.001) and the operative severity score and total score of the POSSUM (p < 0.03) were significantly higher in patients with postoperative complications than in those without postoperative complications. The morbidity rates correlated linearly and significantly with all E-PASS scores (p ≤ 0.001); their coefficients (preoperative risk score, ρ = 0.179; surgical stress score, ρ = 0.131; and comprehensive risk score, ρ = 0.198) were higher than those for the POSSUM scores (physiological score, ρ = 0.059; operative severity score, ρ = 0.111; and total score, ρ = 0.091). The area under the receiver operating characteristic curve for the predicted morbidity rate was 0.668 for the E-PASS and 0.588 for the POSSUM system. Conclusions As E-PASS predicted morbidity more correctly than POSSUM, it is useful for estimating the postoperative risk of patients considered for spinal surgery.

scholarly journals Increased regulatory B cells are involved in immune evasion in patients with gastric cancer

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yuki Murakami ◽  
Hiroaki Saito ◽  
Shota Shimizu ◽  
Yusuke Kono ◽  
Yuji Shishido ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
T Cells ◽  
B Cells ◽  
Immune Evasion ◽  
Survival Rates ◽  
Prognostic Indicator ◽  
Interleukin 10 ◽  
Regulatory B Cells ◽  
Carboxyfluorescein Succinimidyl Ester

Abstract Accumulating evidence has indicated that immune regulatory cells are involved in the establishment of tumoral immune evasion. However, the role of regulatory B cells (Bregs) in this remains unclear. Here, we identified a role for Bregs in immune evasion in gastric cancer (GC) patients. The frequency of peripheral Bregs was significantly higher in GC patients than in healthy controls (P = 0.0023). Moreover, the frequency of CD19+CD24hiCD27+ B cells in GC tissue was significantly higher than in peripheral blood and healthy gastric tissue. Carboxyfluorescein succinimidyl ester labeling revealed that CD19+CD24hiCD27+ B cells could suppress the proliferation of autologous CD4+ T cells. Moreover, CD19+CD24hiCD27+ B cells inhibited the production of interferon-gamma by CD4+ T cells. Double staining immunohistochemistry of interleukin-10 and CD19 revealed 5-year overall survival rates of 65.4% and 13.3% in BregLow and BregHigh groups, respectively (P < 0.0001). Multivariate analysis indicated that the frequency of Bregs was an independent prognostic indicator in GC patients. Taken together, our results show the existence of Bregs in GC tissue, and indicate that they are significantly correlated with the prognosis of GC patients.

scholarly journals Aberrant Expression of The Esophageal Carcinoma Related Gene 4 As A Prognostic Signature For Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Yanjie You ◽  
Shengjuan Hu ◽  
Yanghong Deng ◽  
Fangrui Hu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
Prognostic Indicator ◽  
Prognostic Impact ◽  
Related Gene ◽  
Aberrant Expression ◽  
Free Survival ◽  
Cancer Related Gene

Abstract Background. Hepatocellular carcinoma (HCC) is a lethal cancer with increasing incidence, yet the molecular biomarkers that have strong prognostic impact and also hold great therapeutic promise remain elusive. Methods. Data mining approaches with a set of publicly accessible databases and immunohistochemistry were used to provide a novel insight into the expression pattern and prognostic significance of the esophageal cancer-related gene (ECRG) family members in HCC. Results. We found that elevated mRNA expression levels of ECRG factors were correlated with better overall survival, relapse-free survival and progression-free survival rates in patients with HCC. Subgroup analyses showed significant associations between ECRG expression and survival outcome in select HCC patients. In addition, immunohistochemical and multivariate analysis confirmed increased ECRG4 expression as an independent prognostic indicator for survival. Conclusion. Our data suggest that ECRG factors have significant impacts on the survival of HCC patients. The expression of ECRG factors may be involved in HCC progression and could serve as novel biomarkers for predicting more accurate prognosis.

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