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Massaad E, Smith WJ, Bradley J, Esposito E, Gupta M, Burns E, Burns R, Velarde JK, Berglar IK, Gupta R, Martinez-Lage M, Dietrich J, Lennerz JK, Dunn GP, Jones PS, Choi BD, Kim AE, Frosch M, Barker FG, Curry WT, Carter BS, Nahed BV, Cahill DP, Shankar GM. Radical surgical resection with molecular margins is associated with improved survival in IDH wildtype GBM. Neuro Oncol 2024:noae073. [PMID: 38581292 DOI: 10.1093/neuonc/noae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Survival is variable in patients with glioblastoma IDH wild-type (GBM), even after comparable surgical resection of radiographically-detectable disease, highlighting the limitations of radiographic assessment of infiltrative tumor anatomy. The majority of post-surgical progressive events are failures within 2cm of the resection margin, motivating supramaximal resection strategies to improve local control. However, which patients benefit from such radical resections remains unknown. METHODS We developed a predictive model to identify which IDH wild-type GBM are amenable to radiographic gross total resection (GTR). We then investigated whether GBM survival heterogeneity following GTR is correlated with microscopic tumor burden a by analyzing tumor cell content at the surgical margin with a rapid qPCR-based method for detection of TERT promoter mutation. RESULTS Our predictive model for achievable GTR, developed on retrospective radiographic and molecular data of GBM patients undergoing resection, had an AUC of 0.83, sensitivity of 62%, and specificity of 90%. Prospective analysis of this model in 44 patients found 89% of patients were correctly predicted to achieve a RV<4.9cc. Of the 44 prospective patients undergoing rapid qPCR TERT promoter mutation analysis at the surgical margin, 7 had undetectable TERT mutation, of which 5 also had a gross total resection (RV<1cc). In these 5 patients at 30 months follow up, 75% showed no progression, compared to 0% in the group with TERT mutations detected at the surgical margin (p=0.02). CONCLUSIONS These findings identify a subset of patients with GBM that may derive local control benefit from radical resection to undetectable molecular margins.
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Affiliation(s)
- Elie Massaad
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - William J Smith
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Joseph Bradley
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Eric Esposito
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Mihir Gupta
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
- Dept of Neurosurgery, Yale New Heaven Health, New Haven, CT
| | - Evan Burns
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
- Jacobs School of Medicine, University of Buffalo, Buffalo, NY
| | - Ryan Burns
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
- Boston College, Newton, MA
| | - José K Velarde
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Inka K Berglar
- Dept of Radiology, Massachusetts General Hospital, Boston, MA
| | - Rajiv Gupta
- Dept of Radiology, Massachusetts General Hospital, Boston, MA
| | | | - Jorg Dietrich
- Dept of Neurology, Massachusetts General Hospital, Boston, MA
| | | | - Gavin P Dunn
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Pamela S Jones
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Bryan D Choi
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Albert E Kim
- Dept of Neurology, Massachusetts General Hospital, Boston, MA
| | - Matthew Frosch
- Dept of Pathology, Massachusetts General Hospital, Boston, MA
| | - Fred G Barker
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - William T Curry
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Bob S Carter
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Brian V Nahed
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Daniel P Cahill
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
| | - Ganesh M Shankar
- Dept of Neurosurgery, Massachusetts General Hospital, Boston, MA
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Pang S, Wang W, Zhou J, Jiang X, Lin R. Inverse association between age and risk of lymph node metastasis in patients with early gastric cancer: a surveillance, epidemiology, and end results analysis. J Cancer 2024; 15:2829-2836. [PMID: 38577611 PMCID: PMC10988299 DOI: 10.7150/jca.94542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
Background: Recent studies have shown that young patients with gastric cancer are at a more advanced stage and have poor survival, but the cause is still unclear. The prognosis of gastric cancer is closely related to LNM, but the relationship between age and LNM in early gastric cancer (EGC) is currently unclear. Therefore, we aimed to study the relationship between age and the risk of LNM in EGC. Materials and Methods: We screened out patients with EGC who underwent surgery from the SEER research database from 1975 to 2016, and retrospectively analyzed the proportion of LNM in different age groups. We grouped age into 18-39, 40-49, 50-59, 60-69, 70-79, and ≥ 80 years old, and used univariate analysis and multivariate logistic regression to analyze the correlation between age and LNM. Results: We included 9231 patients with EGC, with LNM rates of 20.3%, 23.3%, 21.0%, 19.8%, 18.1%, and 13.2% in the age groups of 18-39 years old (2.3%), 40-49 (6.1%), 50-59 years old (15.7%), 60-69 years old (24.8%), 70-79 years old (27.2%) and ≥80 years old (23.9%), respectively. We found that when older than 39 years old, the risk of LNM and postoperative survival time of EGC patients decrease (p<0.001). Multivariate analysis results showed that age, tumor size, the number of retrieved lymph nodes (rN), tumor grade, and tumor location were related to LNM. Conclusions: This study found that age in patients with EGC was inversely related to the risk of LNM, and positively correlated with postoperative survival. For older patients with EGC, endoscopic treatment is more appropriate. For young patients with EGC, LNM should be considered when choosing endoscopic treatment.
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Affiliation(s)
| | | | | | | | - Rong Lin
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Sun X, Wang Y, Ge H, Chen C, Han X, Sun K, Wang M, Wei X, Ye M, Zhang Q, Liang T. Development and Validation of Novel Models Including Tumor Micronecrosis for Predicting the Postoperative Survival of Patients with Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1181-1194. [PMID: 37521028 PMCID: PMC10386864 DOI: 10.2147/jhc.s423687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023] Open
Abstract
Background The heterogeneity of hepatocellular carcinoma (HCC) leads to the unsatisfying predictive performance of current staging systems. HCC patients with pathological tumor micronecrosis have an immunosuppressive microenvironment. We aimed to develop novel prognostic models by integrating micronecrosis to predict the survival of HCC patients after hepatectomy more precisely. Methods We enrolled 765 HCC patients receiving curative hepatic resection. They were randomly divided into a training cohort (n= 536) and a validation cohort (n = 229). We developed two prognostic models for postoperative recurrence-free survival (RFS) and overall survival (OS) based on independent factors identified through multivariate Cox regression analyses. The predictive performance was assessed using the Harrell concordance index (C-index) and the time-dependent area under the receiver operating characteristic curve, compared with six conventional staging systems. Results The RFS and OS nomograms were developed based on tumor micronecrosis, tumor size, albumin-bilirubin grade, tumor number and prothrombin time. The C-indexes for the RFS nomogram and OS nomogram were respectively 0.66 (95% CI, 0.62-0.69) and 0.74 (95% CI, 0.69-0.79) in the training cohort, which was significantly better than those of the six common staging systems (0.52-0.61 for RFS and 0.53-0.63 for OS). The results were further confirmed in the validation group, with the C-indexes being 0.66 and 0.77 for the RFS and OS nomograms, respectively. Conclusion The two nomograms could more accurately predict RFS and OS in HCC patients receiving curative hepatic resection, thereby aiding in formulating personalized postoperative follow-up plans.
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Affiliation(s)
- Xuqi Sun
- Department of Medical Oncology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Yangyang Wang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Hongbin Ge
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Cao Chen
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Xu Han
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Ke Sun
- Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Meng Wang
- Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Xiaobao Wei
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Mao Ye
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Qi Zhang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang University Cancer Center, Hangzhou, People’s Republic of China
- Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou, People’s Republic of China
| | - Tingbo Liang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Zhejiang University Cancer Center, Hangzhou, People’s Republic of China
- Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou, People’s Republic of China
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Kong W, Wang H, Chen Y, Xie J, Huang B, Fang L, Chen W, Shao W, Zhang J. Association between length of stay and postoperative survival in patients with lung cancer: a propensity score matching analysis based on National Cancer Database. J Thorac Dis 2023; 15:1785-1793. [PMID: 37197503 PMCID: PMC10183490 DOI: 10.21037/jtd-23-407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/21/2023] [Indexed: 05/19/2023]
Abstract
Background Postoperative complications tend to result in prolonged hospitalization. The aim of this study was to investigate whether prolonged postoperative length of stay (LOS) can predict patient survival, particularly long-term survival. Methods All patients undergoing lung cancer surgery between 2004 and 2015 were identified in the National Cancer Database (NCDB). The highest quintile of LOS (more than 8 days) was defined as prolonged length of stay (PLOS). We performed 1:1 propensity score matching (PSM) between the groups with and without PLOS (Non-PLOS). Excluding confounding factors, postoperative LOS was used as a surrogate for postoperative complications. Kaplan-Meier and Cox proportional hazards survival analyses were performed to analyze survival. Results A total of 88,007 patients were identified. After matching, 18,585 patients were enrolled in the PLOS and Non-PLOS groups, respectively. Before and after matching, 30-day rehospitalization rate and 90-day mortality in the PLOS group were significantly higher than they were in the Non-PLOS group (P<0.001), indicating a potential worse short-term postoperative survival. After matching, the median survival of the PLOS group was significantly lower than that of the Non-PLOS group (53.2 vs. 63.5 months, P<0.0001). Multivariable analysis revealed that PLOS is independent negative predictor of overall survival [OS; hazard ratio (HR) =1.263, 95% confidence interval (CI): 1.227 to 1.301, P<0.001]. In addition, age (<70 or ≥70), gender, race, income, year of diagnosis, surgery type, pathological stage, and neoadjuvant therapy also were independent prognostic factors of postoperative survival for patients with lung cancer (all P<0.001). Conclusions Postoperative LOS could be taken as the quantitative indicator of postoperative complications of lung cancer in NCDB. In this study, PLOS predicted worse short-term and long-term survival independent of other factors. Avoiding PLOS could be considered to benefit patient survival after lung cancer surgery.
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Affiliation(s)
- Weicheng Kong
- Department of Thoracic Surgery, Putuo District People’s Hospital, Zhoushan, China
| | - Haoran Wang
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanyan Chen
- Division of Pulmonary, SinoUnited Health, Shanghai, China
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Juntao Xie
- Department of Surgery, Shanghai Putuo District People’s Hospital, Shanghai, China
| | - Binhao Huang
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Liang Fang
- Department of General Medicine, Xinzhou District Second People’s Hospital, Shangrao, China
| | - Wenjuan Chen
- Department of Intensive Care Unit, Putuo District People’s Hospital, Zhoushan, China
| | - Wei Shao
- Department of Interventional Therapy, Putuo District People’s Hospital, Zhoushan, China
| | - Jie Zhang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Xu Q, Lu X. Development and validation of an XGBoost model to predict 5-year survival in elderly patients with intrahepatic cholangiocarcinoma after surgery: a SEER-based study. J Gastrointest Oncol 2022; 13:3290-3299. [PMID: 36636060 PMCID: PMC9830368 DOI: 10.21037/jgo-22-1238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background Nomograms have been established to predict survival in postoperative or elderly intrahepatic cholangiocarcinoma (ICC) patients. There are no models to predict postoperative survival in elderly ICC patients. Extreme gradient boosting (XGBoost) can adjust the errors generated by existing models. This retrospective cohort study aimed to develop and validate an XGBoost model to predict postoperative 5-year survival in elderly ICC patients. Methods The Surveillance, Epidemiology, and End Results (SEER) program provided data on elderly ICC patients aged 60 years or older and undergoing surgery. The median follow-up time was 20 months. Totally 1,055 patients were classified as training (n=738) and testing (n=317) sets at a ratio of 7:3. The outcome was postoperative 5-year survival. Demographic, tumor-related and treatment-related variables were collected. Variables were screened using the XGBoost model. The predictive performance of the model was assessed by the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Kaplan-Meier curve. Cox regression analysis was conducted to estimate the risk of death in the predicted populations. The predictive abilities of the XGBoost model and the American Joint Commission on Cancer (AJCC) system (7th edition) were compared. Results The XGBoost model achieved an AUC of 0.811, a sensitivity of 0.573, a specificity of 0.890, and a PPV of 0.849 in the training set. In the testing set, the model had an AUC of 0.713, a sensitivity of 0.478, a specificity of 0.814, and a PPV of 0.726. The 5-year mortality risk of patients predicted to die was 2.91 times that of patients predicted to survive [hazard ratio (HR) =2.91, 95% confidence interval (CI): 2.42-3.50]. The XGBoost model showed a better predictive performance than the AJCC staging system both in the training and testing sets. AJCC stage, multiple (satellite) tumors/nodules, tumor-node-metastasis (TNM) stage, more than one lobe invaded, direct invasion of adjacent organs, tumor size, and radiotherapy were relatively important features in survival prediction. Conclusions The XGBoost model exhibited some predictive capacity, which may be applied to predict postoperative 5-year survival for elderly ICC patients.
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Affiliation(s)
- Qiuping Xu
- Department of Oncology, Suzhou Wuzhong People’s Hospital, Suzhou, China
| | - Xiaoling Lu
- Department of Oncology, Affiliated Zhangjiagang Hospital, Soochow University, Suzhou, China
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Lei LL, Song X, Zhao XK, Xu RH, Wei MX, Sun L, Wang PP, Yang MM, Hu JF, Zhong K, Han WL, Han XN, Fan ZM, Wang R, Li B, Zhou FY, Wang XZ, Zhang LG, Bao QD, Qin YR, Chang ZW, Ku JW, Yang HJ, Yuan L, Ren JL, Li XM, Wang LD. Long-term effect of hospital volume on the postoperative prognosis of 158,618 patients with esophageal squamous cell carcinoma in China. Front Oncol 2022; 12:1056086. [PMID: 36873301 PMCID: PMC9978392 DOI: 10.3389/fonc.2022.1056086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/16/2022] [Indexed: 02/18/2023] Open
Abstract
Background The impact of hospital volume on the long-term survival of esophageal squamous cell carcinoma (ESCC) has not been well assessed in China, especially for stage I-III stage ESCC. We performed a large sample size study to assess the relationships between hospital volume and the effectiveness of ESCC treatment and the hospital volume value at the lowest risk of all-cause mortality after esophagectomy in China. Aim To investigate the prognostic value of hospital volume for assessing postoperative long-term survival of ESCC patients in China. Methods The date of 158,618 patients with ESCC were collected from a database (1973-2020) established by the State Key Laboratory for Esophageal Cancer Prevention and Treatment, the database includes 500,000 patients with detailed clinical information of pathological diagnosis and staging, treatment approaches and survival follow-up for esophageal and gastric cardia cancers. Intergroup comparisons of patient and treatment characteristics were conducted with the X2 test and analysis of variance. The Kaplan-Meier method with the log-rank test was used to draw the survival curves for the variables tested. A Multivariate Cox proportional hazards regression model was used to analyze the independent prognostic factors for overall survival. The relationship between hospital volume and all-cause mortality was assessed using restricted cubic splines from Cox proportional hazards models. The primary outcome was all-cause mortality. Results In both 1973-1996 and 1997-2020, patients with stage I-III stage ESCC who underwent surgery in high volume hospitals had better survival than those who underwent surgery in low volume hospitals (both P<0.05). And high volume hospital was an independent factor for better prognosis in ESCC patients. The relationship between hospital volume and the risk of all-cause mortality was half-U-shaped, but overall, hospital volume was a protective factor for esophageal cancer patients after surgery (HR<1). The concentration of hospital volume associated with the lowest risk of all-cause mortality was 1027 cases/year in the overall enrolled patients. Conclusion Hospital volume can be used as an indicator to predict the postoperative survival of ESCC patients. Our results suggest that the centralized management of esophageal cancer surgery is meaningful to improve the survival of ESCC patients in China, but the hospital volume should preferably not be higher than 1027 cases/year. Core tip Hospital volume is considered to be a prognostic factor for many complex diseases. However, the impact of hospital volume on long-term survival after esophagectomy has not been well evaluated in China. Based on a large sample size of 158,618 ESCC patients in China spanning 47 years (1973-2020), We found that hospital volume can be used as a predictor of postoperative survival in patients with ESCC, and identified hospital volume thresholds with the lowest risk of death from all causes. This may provide an important basis for patients to choose hospitals and have a significant impact on the centralized management of hospital surgery.
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Affiliation(s)
- Ling-Ling Lei
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Song
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue-Ke Zhao
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui-Hua Xu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Meng-Xia Wei
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Lin Sun
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Pan-Pan Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Miao-Miao Yang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Jing-Feng Hu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Kan Zhong
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Wen-Li Han
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue-Na Han
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Zong-Min Fan
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ran Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei Li
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Fu-You Zhou
- Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, Henan, China
| | - Xian-Zeng Wang
- Department of Thoracic Surgery, Linzhou People's Hospital, Linzhou, Henan, China
| | - Li-Guo Zhang
- Department of Thoracic Surgery, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Qi-De Bao
- Department of Oncology, Anyang District Hospital, Anyang, Henan, China
| | - Yan-Ru Qin
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Chang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jian-Wei Ku
- Department of Gastroenterology, The Second Affiliated Hospital of Nanyang Medical College, Nanyang, Henan, China
| | - Hai-Jun Yang
- Department of Pathology, Anyang Tumor Hospital, Anyang, Henan, China
| | - Ling Yuan
- Department of Radiotherapy, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, Henan, China
| | - Jing-Li Ren
- Department of Pathology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xue-Min Li
- Department of Pathology, Hebei Provincial Cixian People's Hospital, Cixian, Hebei, China
| | - Li-Dong Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
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Beetz O, Timrott A, Weigle CA, Schroeter A, Cammann S, Klempnauer J, Vondran FWR, Oldhafer F. Proposal of a New Definition of "Very Early" Intrahepatic Cholangiocarcinoma-A Retrospective Single-Center Analysis. J Clin Med 2021; 10:jcm10184073. [PMID: 34575181 PMCID: PMC8468271 DOI: 10.3390/jcm10184073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022] Open
Abstract
Intrahepatic cholangiocarcinoma (ICC) is a rare disease with poor outcome, despite advances in surgical and non-surgical treatment. Recently, studies have reported a favorable long-term outcome of “very early” ICC (based on tumor size and absence of extrahepatic disease) after hepatic resection and liver transplantation, respectively. However, the prognostic value of tumor size and a reliable definition of early disease remain a matter of debate. Patients undergoing resection of histologically confirmed ICC between February 1996 and January 2021 at our institution were reviewed for postoperative morbidity, mortality, and long-term outcome after being retrospectively assigned to two groups: “very early” (single tumor ≤ 3 cm) and “advanced” ICC (size > 3 cm, multifocality or extrahepatic disease). A total of 297 patients were included, with a median follow-up of 22.8 (0.1–301.7) months. Twenty-one (7.1%) patients underwent resection of “very early” ICC. Despite the small tumor size, major hepatectomies (defined as resection of ≥3 segments) were performed in 14 (66.7%) cases. Histopathological analyses revealed lymph node metastases in 5 (23.8%) patients. Patients displayed excellent postoperative outcome compared to patients with “advanced” disease: intrahospital mortality was not observed, and patients displayed superior long-term survival, with a 5-year survival rate of 58.2% (versus 24.3%) and a median postoperative survival of 62.1 months (versus 25.3 months; p = 0.013). In conclusion, although the concept of a “very early” ICC based solely on tumor size is vague as it does not necessarily reflect an aggressive tumor biology, our proposed definition could serve as a basis for further studies evaluating the efficiency of either surgical resection or liver transplantation for this malignant disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Felix Oldhafer
- Correspondence: ; Tel.: +49-511-532-6534; Fax: +49-511-532-4010
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Sugita A, Ikeuchi H, Funayama Y, Futami K, Iiai T, Itabashi M, Suzuki Y. Postoperative Survival in Colitis-associated Colorectal Cancer With Ulcerative Colitis in Japan: A Multicenter Analysis. Anticancer Res 2021; 41:2681-2688. [PMID: 33952499 DOI: 10.21873/anticanres.15049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The aim of the study was to analyze the postoperative survival of colitis-associated colorectal cancer (CAC) with ulcerative colitis (UC), and the risk factors affecting it. PATIENTS AND METHODS A questionnaire including postoperative survival was sent to 88 hospitals that reported CAC patients in the literature up until January, 2006 and to members of the Research Group of Intractable Inflammatory Bowel Disease. RESULTS The 5-year postoperative overall survival (OS) of 170 CAC patients was 74.2% which was similar to sporadic colorectal cancer in Japan (72.1%). Pathologic TNM stage, histological type, type of surgical procedure (proctocolectomy, segmental resection), and preoperative cancer surveillance were statistically significant factors for OS. By Cox regression analysis, pathologic TNM stage and proctocolectomy were statistically significant prognostic factors for OS. CONCLUSION In CAC with UC, the postoperative OS was similar to sporadic colorectal cancer. Pathologic TNM stage and proctocolectomy were confirmed as important prognostic factors.
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Affiliation(s)
- Akira Sugita
- Department of Inflammatory Bowel Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan;
| | - Hiroki Ikeuchi
- Surgical Department of Inflammatory Bowel Disease, Hyogo Medical University, Nishinomiya, Japan
| | - Yuuji Funayama
- Department of Colorectal Surgery, Sendai Red Cross Hospital, Sendai, Japan
| | - Kitaro Futami
- Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Tsuneo Iiai
- Department of Surgery, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Michio Itabashi
- Department of Digestive Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuo Suzuki
- Department of Gastroenterology, Toho University Sakura Hospital, Sakura, Japan
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9
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Asplund J, Gottlieb-Vedi E, Leijonmarck W, Mattsson F, Lagergren J. Prognosis after surgery for gastric adenocarcinoma in the Swedish Gastric Cancer Surgery Study (SWEGASS). Acta Oncol 2021; 60:513-520. [PMID: 33502275 DOI: 10.1080/0284186x.2021.1874619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Most studies examining prognostic factors after gastrectomy come from selected patients and non-Western populations. This nationwide population-based cohort study aims to identify prognostic factors after surgery for gastric adenocarcinoma in an unselected Western cohort. METHODS This study included 98% of patients who underwent gastrectomy for gastric adenocarcinoma in Sweden in 2006-2015, with follow-up through 2019. Data were collected from medical records and national registries. Exposures were sex, age, education, comorbidity, tumor sub-localization, tumor stage, calendar period, and pre-operative chemotherapy. Outcomes were 3-year all-cause and disease-specific mortality. Cox regression produced hazard ratios (HRs) with 95% confidence intervals (95% CIs), adjusted for the other study exposures. RESULTS Among all 2154 patients, 3-year all-cause mortality was 53.3%. Factors influencing 3-year all-cause mortality after multivariable adjustment were tumor stage (stage IV vs. stage 0-I: HR 8.72, 95% CI 6.77-11.24), comorbidity (Charlson comorbidity score ≥2 vs. 0: HR 1.63, 95% CI 1.39-1.90), age (>75 vs. <65 years: HR 1.48, 95% CI 1.24-1.78), and calendar period (2006-2010 vs. 2011-2015: HR 0.83, 95% CI 0.73-0.95). No independent prognostic influence was found for sex (women vs. men: HR 1.01, 95% CI 0.85-1.09), pre-operative chemotherapy (yes vs. no: HR 0.92, 95% CI 0.78-1.08), tumor sub-localization (non-cardia vs. cardia: HR 1.01, 95% CI 0.83-1.22), or education (≥13 vs. ≤9 years: HR 0.89, 95% CI 0.74-1.07). The results were similar for 3-year disease-specific mortality. CONCLUSION Survival after gastrectomy for gastric adenocarcinoma needs further improvement. Tumor stage, comorbidity, age, and calendar period were independently prognostic, while sex, pre-operative chemotherapy, tumor sub-localization, and education were not.
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Affiliation(s)
- Johannes Asplund
- Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Eivind Gottlieb-Vedi
- Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Wilhelm Leijonmarck
- Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Mattsson
- Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jesper Lagergren
- Department of Molecular Medicine and Surgery, Upper Gastrointestinal Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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10
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Liu S, Zhou X, Song A, Yao S, Wang M, Niu T, Gao C, Huo Z, Liu Y, Wang Y. A Single-Center, 10-Year Retrospective Study on Surgical Treatment and Prognosis Analysis of Differentiated Thyroid Carcinoma with Spinal Metastasis. Cancer Manag Res 2020; 12:9893-9904. [PMID: 33116847 PMCID: PMC7555321 DOI: 10.2147/cmar.s275176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 09/18/2020] [Indexed: 11/23/2022] Open
Abstract
Objective Metastatic spinal differentiated thyroid carcinoma (MSDTC) is relatively rare in the clinic and often overlooked. The objective of the current study is to analyze the clinical characteristics and prognosis of patients with MSDTC who underwent surgical treatment to determine the prognostic factors that affect survival. Methods This study retrospectively analyzed the clinical data and postoperative follow-up results of MSDTC patients who underwent spinal surgery at the Orthopedic Department of Peking Union Medical College Hospital from January 2010 to January 2020. Clinical data and survival time were analyzed by Kaplan–Meier analysis. Results Eleven patients were included, and the average age was 58.3 years (range 37‒74). The average time from the initial surgery to the discovery of spinal metastasis was 42.9 months (range 0‒132), and the average follow-up time was 21.8 months (range 3‒80). Progression was identified in seven patients, and 10 patients (90.9%) died during the follow-up period. Kaplan–Meier analysis showed that extraosseous visceral metastasis (p=0.012), revised Tokuhashi score (p=0.035), Tomita score (p=0.038), and surgical method (p=0.028) were associated with overall survival (OS). In addition, skeletal visceral metastasis (p=0.017), revised Tokuhashi score (p=0.028), Tomita score (p=0.038), and surgical method (p=0.049) were associated with progression-free survival (PFS). Conclusion Surgical treatment is an effective method for treating MSDTC and leads to pain relief, restored function and increased spinal stability. Based on our single-center experience, extraosseous visceral metastasis, revised Tokuhashi score, Tomita score, and surgical methods may be potential prognostic factors for OS whilst visceral metastasis, revised Tokuhashi score, Tomita score, and surgical methods may be potential prognostic factors for PFS.
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Affiliation(s)
- Shuzhong Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xi Zhou
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - An Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China
| | - Siyuan Yao
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Muchuan Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Tong Niu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Chengao Gao
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China
| | - Yong Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yipeng Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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11
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Overmann AL, Clark DM, Tsagkozis P, Wedin R, Forsberg JA. Validation of PATHFx 2.0: An open-source tool for estimating survival in patients undergoing pathologic fracture fixation. J Orthop Res 2020; 38:2149-2156. [PMID: 32492213 DOI: 10.1002/jor.24763] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 02/04/2023]
Abstract
Treatment decisions in patients with metastatic bone disease rely on accurate survival estimation. We developed the original PATHFx models using expensive, proprietary software and now seek to provide a more cost-effective solution. Using open-source machine learning software to create PATHFx version 2.0, we asked whether PATHFx 2.0 could be created using open-source methods and externally validated in two unique patient populations. The training set of a well-characterized, database records of 189 patients and the bnlearn package within R Version 3.5.1 (R Foundation for Statistical Computing), was used to establish a series of Bayesian belief network models designed to predict survival at 1, 3, 6, 12, 18, and 24 months. Each was externally validated in both a Scandinavian (n = 815 patients) and a Japanese (n = 261 patients) data set. Brier scores and receiver operating characteristic curves to assessed discriminatory ability. Decision curve analysis (DCA) evaluated whether models should be used clinically. DCA showed that the model should be used clinically at all time points in the Scandinavian data set. For the 1-month time point, DCA of the Japanese data set suggested to expect better outcomes assuming all patients will survive greater than 1 month. Brier scores for each curve demonstrate that the models are accurate at each time point. Statement of Clinical Significance: we successfully transitioned to PATHFx 2.0 using open-source software and externally validated it in two unique patient populations, which can be used as a cost-effective option to guide surgical decisions in patients with metastatic bone disease.
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Affiliation(s)
- Archie L Overmann
- Orthopaedics, USU-Walter Reed Department of Surgery, Bethesda, Maryland
| | - DesRaj M Clark
- Orthopaedics, USU-Walter Reed Department of Surgery, Bethesda, Maryland
| | - Panagiotis Tsagkozis
- Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Rikard Wedin
- Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Jonathan A Forsberg
- Orthopaedics, USU-Walter Reed Department of Surgery, Bethesda, Maryland.,Section of Orthopaedics and Sports Medicine, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
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12
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Zhang J, Wang X, Zhang L, Yao L, Xue X, Zhang S, Li X, Chen Y, Pang P, Sun D, Xu J, Shi Y, Chen F. Radiomics predict postoperative survival of patients with primary liver cancer with different pathological types. Ann Transl Med 2020; 8:820. [PMID: 32793665 PMCID: PMC7396247 DOI: 10.21037/atm-19-4668] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Radiomics can be used to determine the prognosis of liver cancer, but it might vary among cancer types. This study aimed to explore the clinicopathological features, radiomics, and survival of patients with hepatocellular carcinoma (HCC), mass-type cholangiocarcinoma (MCC), and combined hepatocellular-cholangiocarcinoma (CHCC). Methods This was a retrospective cohort study of patients with primary liver cancer operated at the department of hepatobiliary surgery of the First Affiliated Hospital of Zhejiang University from 07/2013 to 11/2015. All patients underwent preoperative liver enhanced MRI scans and diffusion-weighted imaging (DWI). The radiomics characteristics of DWI and the enhanced equilibrium phase (EP) images were extracted. The mRMR (minimum redundancy maximum relevance) was applied to filter the parameters. Results There were 44 patients with MCC, 59 with HCC, and 33 with CHCC. Macrovascular invasion, tumor diameter, positive ferritin preoperatively, positive AFP preoperatively, positive CEA preoperatively, Correlation, Inverse Difference Moment, and Cluster Prominence in model A (DWI and clinicopathological parameters) were independently associated with overall survival (OS) (P<0.05). Lymphadenopathy, gender, positive ferritin preoperatively, positive AFP preoperatively, positive CEA preoperatively, Uniformity, and Cluster Prominence in model B (EP and clinicopathological parameters) were independently associated with OS (P<0.05). Macrovascular invasion, lymphadenopathy, gender, positive ferritin preoperatively, positive CEA preoperatively, Uniformity_EP, GLCMEnergy_DWI, and Cluster Prominence_EP in model C (image texture and clinicopathological parameters) were independently associated with OS (P<0.05). Those factors were used to construct three nomograms to predict OS. Conclusions Clinicopathological and radiomics features are independently associated with the OS of patients with primary liver cancer.
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Affiliation(s)
- Jiahui Zhang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Radiology, Hangzhou Third Hospital, Hangzhou, China
| | - Xiaoli Wang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lixia Zhang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Linpeng Yao
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xing Xue
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Siying Zhang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Li
- GE China Medical Life Sciences Division Core Image Senior Application Team, Guangzhou, China
| | - Yuanjun Chen
- GE China Medical Life Sciences Division Core Image Senior Application Team, Guangzhou, China
| | - Peipei Pang
- GE China Medical Life Sciences Division Core Image Senior Application Team, Guangzhou, China
| | | | - Juan Xu
- Medical Big Data, AliHealth, Hangzhou, China
| | - Yanjun Shi
- Department of Hepatobiliary and Pancreas Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Chen
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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13
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Wang Z, Yuan C, Huang Y, Liu Z, Yu X, Lv C, Su Z. Decreased expression of apoptosis-inducing factor in renal cell carcinoma is associated with poor prognosis and reduced postoperative survival. Oncol Lett 2019; 18:2805-2812. [PMID: 31452759 PMCID: PMC6676395 DOI: 10.3892/ol.2019.10630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 04/26/2019] [Indexed: 12/19/2022] Open
Abstract
Apoptosis-inducing factor (AIF) serves a crucial role in cell death and is involved in several types of cancer, including kidney cancer. The present study aimed to explore the association between AIF expression and patient survival based on tumor grades. AIF expression in 96 patients with renal cell carcinoma (RCC) was investigated using immunohistochemistry. Negative AIF expression was determined in 80 patients (83.3%). mRNA expression of AIF was analyzed in RCC and adjacent tissue samples from 15 patients. AIF mRNA expression in RCC tissues were significantly lower compared with that in adjacent tissues. Analysis of histopathological grades revealed that AIF expression was negatively associated with RCC grade, with AIF expression in Grade II tumors being lower than Grade I types, but higher than Grade III. Finally, 68 patients were followed up for 6-118 months, and it was revealed that the overall postoperative survival rate of patients with negative AIF expression was significantly lower compared with those those with positive AIF expression. These results suggest that decreased AIF expression could be associated with worsening RCC grade. Therefore, reduced AIF expression may potentially help diagnose RCC and distinguish tumor grades.
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Affiliation(s)
- Zhaoxing Wang
- Department of Urology, Affiliated Haikou Hospital of Xiangya Medical School of Central South University, Haikou, Hainan 570208, P.R. China
| | - Chao Yuan
- Hubei Key Laboratory for Kidney Disease Pathogenesis and Intervention, Hubei Polytechnic University School of Medicine, Huangshi, Hubei 435000, P.R. China.,Clinical Laboratory, Huangshi Central Hospital of The Edong Healthcare Group, Huangshi, Hubei 435000, P.R. China
| | - Yuan Huang
- Department of Neurology, Affiliated Haikou Hospital of Xiangya, Medical School of Central South University, Haikou, Hainan 570208, P.R. China
| | - Zhenxiang Liu
- Department of Urology, Affiliated Haikou Hospital of Xiangya Medical School of Central South University, Haikou, Hainan 570208, P.R. China
| | - Xin Yu
- Hubei Key Laboratory for Kidney Disease Pathogenesis and Intervention, Hubei Polytechnic University School of Medicine, Huangshi, Hubei 435000, P.R. China.,Clinical Laboratory, Huangshi Central Hospital of The Edong Healthcare Group, Huangshi, Hubei 435000, P.R. China
| | - Cai Lv
- Department of Urology, Affiliated Haikou Hospital of Xiangya Medical School of Central South University, Haikou, Hainan 570208, P.R. China
| | - Zhenhong Su
- Hubei Key Laboratory for Kidney Disease Pathogenesis and Intervention, Hubei Polytechnic University School of Medicine, Huangshi, Hubei 435000, P.R. China.,Clinical Laboratory, Huangshi Central Hospital of The Edong Healthcare Group, Huangshi, Hubei 435000, P.R. China.,Clinical Laboratory, Huangshi Fourth People Hospital, Huangshi, Hubei 435000, P.R. China
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14
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Guo Y, Qin X, Chai B, Jia J, Yi J, Wang K, Hou X. The prognostic value of homeobox B7 expression in patients with hepatocellular carcinoma. Int J Clin Exp Pathol 2019; 12:2682-2690. [PMID: 31934098 PMCID: PMC6949547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/23/2019] [Indexed: 06/10/2023]
Abstract
The prognostic role of homeobox B7 (HOXB7) in hepatocellular carcinoma (HCC) is not clearly established. The present study aimed to evaluate the associations among the clinicopathological characteristics, HOXB7 expression, and the overall survival (OS) of patients with HCC. An immunohistochemical analysis was used to detect the expression level of HOXB7. In addition, the association between the expression of HOXB7 and the clinicopathological characteristics of HCC was analyzed. The Kaplan-Meier method was used to calculate the survival rates, and the COX proportional hazards model was used to investigate univariate and multivariate analyses. A total of 80 patients were enrolled in this study. Of the 80 HCC samples, HOXB7 was up-regulated in 28 samples (35.0%). The high HOXB7 expression was significantly associated with OS by univariate Cox regression analysis (HR = 2.0; 95% CI = 1.1-3.4, P = 0.016). The median survival with high HOXB7 expression and low HOXB7 expression was 12.5 months ± 3.7 months versus 32.5 months ± 4.7 months, respectively, as visualized on Kaplan-Meier curves (P = 0.014). After adjusting for possible factors related to survival time after HCC resection, the results suggested that survival time was negatively correlated with high HOXB7 expression (HR = 2.592, 95% CI = 1.283-5.239, P = 0.008). The present data indicate that the HOXB7 expression was negatively associated with survival time after HCC resection. As HOXB7 was a common and readily available measurement in the clinical setting, it was a convenient and feasible way to identify those patients who were at high risk and who had a poor prognosis.
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Affiliation(s)
- Yarong Guo
- Department of Oncology, The First Clinical Hospital of Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Xiaojiang Qin
- School of Public Health, Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Bao Chai
- Department of Pharmacology, Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Junmei Jia
- Department of Oncology, The First Clinical Hospital of Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Jiahong Yi
- Department of Oncology, The First Clinical Hospital of Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Kang Wang
- Department of Oncology, The First Clinical Hospital of Shanxi Medical UniversityTaiyuan, Shanxi Province, China
| | - Xiaomin Hou
- Department of Gastroenterology and Hepatology, Shanxi Academy of Medical Sciences Shanxi DAYI HospitalTaiyuan, Shanxi Province, China
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15
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Kuboki A, Kanaya H, Nakayama T, Konno W, Goto K, Nakajima I, Kashiwagi T, Hirabayashi H, Haruna SI. Prognostic value of C-reactive protein/albumin ratio for patients with hypopharyngeal and laryngeal cancer undergoing invasive surgery involving laryngectomy. Head Neck 2018; 41:1342-1350. [PMID: 30552844 DOI: 10.1002/hed.25565] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/19/2018] [Accepted: 11/20/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The C-reactive protein/albumin (CRP/Alb) ratio has been recently established as a prognostic indicator in various cancer types. However, few reports regarding the prognostic value of the CRP/Alb ratio in head and neck cancer exist. This study aimed to investigate the significance of the CRP/Alb ratio in clinical outcomes after invasive surgery involving laryngectomy for hypopharyngeal and laryngeal cancer. METHODS We evaluated 56 patients who underwent total laryngectomy or total pharyngolaryngectomy between 2003 and 2012. Univariate and multivariate analyses were retrospectively performed to examine the prognostic value of the CRP/Alb ratio in these patients. RESULTS The optimal cutoff value of the CRP/Alb ratio was 0.32. Multivariate analysis showed that the CRP/Alb ratio was a significant and independent predictor of poor overall and disease-free survival. CONCLUSION The CRP/Alb ratio may be a novel and useful indicator for predicting postoperative outcomes in patients with hypopharyngeal and laryngeal cancer.
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Affiliation(s)
- Akihito Kuboki
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan.,Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Kanaya
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Tsuguhisa Nakayama
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan.,Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Wataru Konno
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Kazutaka Goto
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Itsuo Nakajima
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Takashi Kashiwagi
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hideki Hirabayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Shin-Ichi Haruna
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan
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16
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Shimizu T, Ishizuka M, Shibuya N, Tanaka G, Abe A, Aoki T, Kubota K. Preoperative globulin-to-albumin ratio predicts outcome after curative resection in patients with gastric cancer. Ann Gastroenterol Surg 2018; 2:367-375. [PMID: 30238078 PMCID: PMC6139717 DOI: 10.1002/ags3.12200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/05/2018] [Accepted: 06/21/2018] [Indexed: 12/26/2022] Open
Abstract
AIM The globulin-to-albumin ratio (GAR) is useful for prognostication of patients with various cancers. However, the significance of GAR in gastric cancer (GC) remains unclear. Our purpose was to investigate the relationship between the GAR and outcome after curative resection in GC patients. METHODS Three-hundred and seventy-six patients who had undergone curative resection for GC were retrospectively reviewed. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS), and their cut-off values were identified using receiver operating characteristic (ROC) curve analyses. Kaplan-Meier analysis and log-rank test were used for comparison of OS and relapse-free survival (RFS). RESULTS Multivariate analysis using 17 clinical characteristics selected by univariate analyses revealed that GAR (>0.80/≤0.80) was significantly associated with OS (hazard ratio [HR], 2.305; 95% CI, 1.122-4.735; P = 0.023), as well as lymph node metastasis (presence/absence) (HR, 2.417; 95% CI, 1.077-5.426; P = 0.032), neutrophil-to-lymphocyte ratio (>2.7/≤2.7) (HR, 2.368; 95% CI, 1.138-4.930; P = 0.002), and serosal invasion (presence/absence) (HR, 3.443; 95% CI, 1.048-11.31; P = 0.042). Kaplan-Meier analysis and log-rank test demonstrated that the OS and RFS of patients with a high GAR (>0.80) were significantly poorer than those with low GAR (≤0.80). CONCLUSIONS The GAR is a useful predictor of postoperative outcome among GC patients undergoing curative resection.
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Affiliation(s)
- Takayuki Shimizu
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Mitsuru Ishizuka
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Norisuke Shibuya
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Genki Tanaka
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Akihito Abe
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Taku Aoki
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Keiichi Kubota
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
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17
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Ma Q, Liu W, Jia R, Long H, Zhang L, Lin P, Zhao H, Ma G. Alcohol and survival in ESCC: prediagnosis alcohol consumption and postoperative survival in lymph node-negative esophageal carcinoma patients. Oncotarget 2018; 7:38857-38863. [PMID: 27095577 PMCID: PMC5122435 DOI: 10.18632/oncotarget.8754] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 03/31/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The association between esophageal cancer and prediagnosis alcohol consumption is well established. However, evidence that prediagnosis alcohol consumption affects postoperative survival in patients with lymph node-negative esophageal squamous cell carcinoma (ESCC) is lacking. We conducted a retrospective study on the effect of prediagnosis alcohol consumption on the postoperative survival of patients with lymph node-negative ESCC in China. METHODS We enrolled 643 ESCC patients with negative lymphatic metastasis who had undergone esophagectomy between 1990 and 2005 at the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China, and reviewed their demographic, pathologic, preoperative, and cancer outcome data obtained from medical records. These data were analyzed using life table and Kaplan-Meier analyses and multivariate Cox regression. RESULTS There was a significant reduction in 3- and 5-year survival in drinkers with lymph node-negative ESCC. For drinkers, 3- and 5-year survival rates were 43% and 36% respectively, whereas, for nondrinkers, the corresponding values were 63% and 58%, respectively (p < 0.05). Multivariate Cox regression showed that drinking (p = 0.001, relative risk =1.583) was an independent factor for survival in patients with lymph node-negative ESCC. Striated analysis revealed that drinking was an independent factor for survival in patients with stage II A (p = 0.008, relative risk =1.679), stage IB (p = 0.044, relative risk=1.517), and well (p=0.011, relative risk =1.783) and moderately (p = 0.002, relative risk = 1.915) differentiated ESCC. CONCLUSIONS Prediagnosis alcohol consumption is an independent prognostic factor for postoperative survival in patients with lymph node-negative ESCC.
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Affiliation(s)
- Qilong Ma
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wengao Liu
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ran Jia
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hao Long
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lanjun Zhang
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Peng Lin
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hongyun Zhao
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Guowei Ma
- Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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Zhang J, Chen Q, Li ZM, Xu XD, Song AF, Wang LS. Association of body mass index with mortality and postoperative survival in renal cell cancer patients, a meta-analysis. Oncotarget 2018; 9:13959-13970. [PMID: 29568408 PMCID: PMC5862629 DOI: 10.18632/oncotarget.24210] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/05/2017] [Indexed: 01/12/2023] Open
Abstract
Obesity is one of the major risk factors of cancer. However, how body mass index (BMI) influences the prognosis of renal cell cancer (RCC) patient is unclear. In this work, we have performed a meta-analysis to elucidate the role of abnormal weight in RCC mortality and postoperative survival. Articles related to BMI and RCC mortality as well as postoperative survival has been identified by searching PUBMED and ENBASE. Totally, 19 articles have been selected for this meta-analysis, 5 articles for RCC mortality and 14 for postoperative survival. Compared to normal weight, the estimated relative risks of RCC mortality are 0.71 (95% CI: 0.34–1.49), 1.19 (95% CI: 1.05–1.35) and 1.71 (95% CI: 1.27–2.00) respectively for the underweight, overweight and obesity patients. The risk of RCC mortality increase 5% for each 1 kg/m2 increment of BMI. However, the estimated hazard ratios of cancer specific postoperative survival are 2.62 (95% CI: 1.67–4.11), 0.72 (95% CI: 0.63–0.83) and 0.66 (95% CI: 0.49–0.89) respectively for underweight, overweight and obesity RCC patients. The risk of hazard ratio decrease 5% for each 1 kg/m2 increment of BMI. In addition, the hazard ratios of postoperative overall survival show a similar tendency. These results indicate an opposite association of BMI with mortality and postoperative survival in renal cell cancer patients.
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Affiliation(s)
- Jiao Zhang
- Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, ShanghaI 201199, China.,School of Public Health Taishan Medical University, Taian, Shandong 271000, China
| | - Qiang Chen
- School of Public Health Taishan Medical University, Taian, Shandong 271000, China
| | - Zhan-Ming Li
- Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, ShanghaI 201199, China
| | - Xu-Dong Xu
- Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, ShanghaI 201199, China
| | - Ai-Fang Song
- Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, ShanghaI 201199, China
| | - Li-Shun Wang
- Institute of Fudan-Minhang Academic Health System, Minhang Hospital, Fudan University, ShanghaI 201199, China.,School of Public Health Taishan Medical University, Taian, Shandong 271000, China
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19
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Yu L, Wang G, Zhang Q, Gao L, Huang R, Chen Y, Tang Q, Liu J, Liu C, Wang H, Wang X. Karyopherin alpha 2 expression is a novel diagnostic and prognostic factor for colorectal cancer. Oncol Lett 2017; 13:1194-1200. [PMID: 28454233 PMCID: PMC5403343 DOI: 10.3892/ol.2017.5579] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 04/15/2016] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is the fourth most common cancer and the second leading cause of cancer-associated mortality in Western countries. CRC treatment is dependent on the preoperative and postoperative condition of patients. At present, the prognostic value of conventional parameters for the estimation of patient prognosis is limited. The aim of the present study was to investigate the expression of karyopherin α2 (KPNA2) in cancerous and healthy colon tissues and to evaluate the prognostic factors for patients with primary CRC. KPNA2 expression in CRC and paired normal tissues was analyzed by immunohistochemistry and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, serum KPNA2 expression was evaluated by enzyme-linked immunosorbent assay. Subsequently, the association between KPNA2 expression in CRC tissues and patient clinicopathological features was analyzed. Kaplan-Meier analysis was utilized to investigate the prognostic value of KPNA2 expression on overall survival rates following radical surgery for the treatment of CRC. Immunohistochemistry and RT-qPCR revealed that KPNA2 expression was significantly increased in CRC tissues compared with paired normal tissues. Serum KPNA2 expression was significantly increased in CRC patients compared with healthy individuals. Furthermore, KPNA2 expression was observed to positively correlate with Tumor-Node-Metastasis stage, lymph node involvement, tumor differentiation, infiltration depth, lymphovascular invasion and perineural invasion, which are factors known to affect the prognosis of CRC patients following surgery. In addition, increased KPNA2 expression was associated with decreased overall survival and disease-free survival rates. Patients not suited for surveillance regimens may be identified at initial biopsy test with a positive KPNA2 immunohistochemistry. Increased serum expression of KPNA2 may be utilized as a diagnostic factor for patients with CRC. High nuclear KPNA2 expression may serve as a novel predictor of survival following radical colorectal surgery in CRC patients. The results of the present study may improve individualized risk stratification, leading to the optimization of therapies for CRC patients.
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Affiliation(s)
- Lei Yu
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Guiyu Wang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qian Zhang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Li Gao
- Department of Oral Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Rui Huang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Yinggang Chen
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qingchao Tang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Pathology, Colorectal Cancer Institute of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Jin Liu
- Department of Pathology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Chunjia Liu
- Department of Histology and Embryology, Basic Medical Science College, Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Hongwei Wang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Xishan Wang
- Department of Colorectal Surgery, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing 100021, P.R. China
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20
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Rohloff J, Zinke J, Schoppmeyer K, Tannapfel A, Witzigmann H, Mössner J, Wittekind C, Caca K. Heparanase expression is a prognostic indicator for postoperative survival in pancreatic adenocarcinoma. Br J Cancer 2002; 86:1270-5. [PMID: 11953884 PMCID: PMC2375333 DOI: 10.1038/sj.bjc.6600232] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2001] [Revised: 02/04/2002] [Accepted: 02/11/2002] [Indexed: 12/31/2022] Open
Abstract
Pancreatic ductal adenocarcinoma has a median survival of less than 6 months from diagnosis. This is due to the difficulty in early diagnosis, the aggressive biological behaviour of the tumour and a lack of effective therapies for advanced disease. Mammalian heparanase is a heparan-sulphate proteoglycan cleaving enzyme. It helps to degrade the extracellular matrix and basement membranes and is involved in angiogenesis. Degradation of extracellular matrix and basement membranes as well as angiogenesis are key conditions for tumour cell spreading. Therefore, we have analysed the expression of heparanase in human pancreatic cancer tissue and cell lines. Heparanase is expressed in cell lines derived from primary tumours as well as from metastatic sites. By immunohistochemical analysis, it is preferentially expressed at the invading edge of a tumour at both metastatic and primary tumour sites. There is a trend towards heparanase expression in metastasising tumours as compared to locally growing tumours. Postoperative survival correlates inversely with heparanase expression of the tumour reflected by a median survival of 34 and 17 month for heparanase negative and positive tumours, respectively. Our results suggest, that heparanase promotes cancer cell invasion in pancreatic carcinoma and could be used as a prognostic indicator for postoperative survival of patients.
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Affiliation(s)
- J Rohloff
- Department of Medicine II, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
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