• Title/Summary/Keyword: Multivariate survival analysis

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Gallbladder Carcinoma: Analysis of Prognostic Factors in 132 Cases

  • Wang, Rui-Tao;Xu, Xin-Sen;Liu, Jun;Liu, Chang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2511-2514
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    • 2012
  • Objective: To evaluate the prognostic factors of gallbladder carcinoma. Methods: Presentation, operative data, complications, and survival outcome were examined for 132 gallbladder carcinoma patients who underwent gallbladder surgery in our unit during 2002-2007, and follow-up results were obtained from every patient for univariate and multivariate survival analysis. Results: The univariate analysis showed that gallbladder lesion history, tumor cell differentiation, Nevin staging, preoperative lymph node metastasis and the surgical approach significantly correlated with the prognosis of the patients (p<0.05). The results of the multivariate analysis (Cox regression) showed that gallbladder lesion history, Nevin staging and the surgical approach were independent predicators with relative risks of 6.9, 4.4, 2.8, respectively (p=0.002, 0.003, 0.008). Conclusion: Gallbladder lesion history, Nevin staging and the surgical approach are independent prognostic factors for gallbladder carcinoma, a rapidly fatal disease. Therefore, early diagnosis, anti-infective therapy and radical surgery are greatly needed to improve the prognosis of gallbladder carcinoma.

Prognostic Significance of the Mucin Component in Stage III Rectal Carcinoma Patients

  • Wang, Meng;Zhang, Yuan-Chuan;Yang, Xu-Yang;Wang, Zi-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8101-8105
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    • 2014
  • Background: Although mucinous adenocarcinoma has been recognized for a long time, whether it is associated with a poorer prognosis in colorectal cancer patients is still controversial. Many studies put emphasis on mucinous adenocarcinoma containing mucin component ${\geq}50%$. Only a few studies have analyzed cases with a mucin component <50%. Objectives: This study aimed to analyze the prognostic value of different mucin component proportions in patients with stage III rectal cancer. Materials and Methods: Clinical, pathological and follow-up data of 136 patients with the stage III rectal cancer were collected. Every variable was analyzed by univariate analysis, then multivariate analysis and survival analysis were further performed. Results: Univariate analysis showed pathologic T stage, lymphovascular invasion, and histological subtype were statistically significant for DFS. Pathologic T stage was significant for OS. Histological subtype and lymphovascular invasion were independent prognostic factors in multivariate analysis for DFS, and histological subtype was the only independent prognostic factor for OS. Survival curves showed the survival time of mucinous adenocarcinoma (MUC) was shorter than non-MUC (adenocarcinomas with a mucin component <50% and without mucin component). Conclusions: Histological subtype (tumor with different mucin component) was an independent prognostic factor for both DFS and OS. Patients with MUC had a worse prognosis than their non-MUC counterparts with stage III rectal carcinoma.

Assessing the Impact of Socio-economic Variables on Breast Cancer Treatment Outcome Disparity

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7133-7136
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    • 2013
  • Background: We studied Surveillance, Epidemiology and End Results (SEER) breast cancer data of Georgia USA to analyze the impact of socio-economic factors on the disparity of breast cancer treatment outcome. Materials and Methods: This study explored socio-economic, staging and treatment factors that were available in the SEER database for breast cancer from Georgia registry diagnosed in 2004-2009. An area under the receiver operating characteristic curve (ROC) was computed for each predictor to measure its discriminatory power. The best biological predictors were selected to be analyzed with socio-economic factors. Survival analysis, Kolmogorov-Smirnov 2-sample tests and Cox proportional hazard modeling were used for univariate and multivariate analyses of time to breast cancer specific survival data. Results: There were 34,671 patients included in this study, 99.3% being females with breast cancer. This study identified race and education attainment of county of residence as predictors of poor outcome. On multivariate analysis, these socio-economic factors remained independently prognostic. Overall, race and education status of the place of residence predicted up to 10% decrease in cause specific survival at 5 years. Conclusions: Socio-economic factors are important determinants of breast cancer outcome and ensuring access to breast cancer treatment may eliminate disparities.

Multivariate Analysis of the Prognosis of 37 Chondrosarcoma Patients

  • Yang, Zheng-Ming;Tao, Hui-Min;Ye, Zhao-Ming;Li, Wei-Xu;Lin, Nong;Yang, Di-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1171-1176
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    • 2012
  • Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

High Preoperative Fibrinogen and Systemic Inflammation Response Index (F-SIRI) Predict Unfavorable Survival of Resectable Gastric Cancer Patients

  • Gao, Weiwei;Zhang, Fei;Ma, Tai;Hao, Jiqing
    • Journal of Gastric Cancer
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    • v.20 no.2
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    • pp.202-211
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    • 2020
  • Purpose: This study was to investigate the prognostic significance of the preoperative fibrinogen and systemic inflammation response index (F-SIRI) in a Chinese cohort of resectable gastric cancer. Materials and Methods: Baseline characteristics, preoperative fibrinogen levels and peripheral neutrophil, monocyte, and lymphocyte counts were retrospectively reviewed in 240 patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and SIRI were defined as 4.0 g/L and 1.2. Then patients with hyperfibrinogenemia (≥4.0 g/L) and high SIRI (≥1.2) were assigned with an F-SIRI of 2 (both of these hematological abnormalities), 1 (one of these abnormalities), and 0 (neither abnormality), respectively. The prognostic value was examined by univariate and multivariate survival analysis. Results: Preoperative F-SIRI was significantly correlated with tumor size, fibrinogen level, and adjuvant chemotherapy. Whereas there was no significant difference in age, gender, tumor location or other characteristics between groups. In addition, high preoperative F-SIRI was significantly associated with worse disease-free survival (DFS) (hazard ratio [HR], 2.299; 95% confidence interval [CI], 1.482-3.566; P<0.001) and overall survival (OS) (HR, 2.461; 95% CI, 1.584-3.824; P<0.001) by univariate survival analysis. Moreover, it remained an independent predictor for impaired DFS (HR, 2.023; 95% CI, 1.273-3.215; P=0.003) and OS (HR, 2.341; 95% CI, 1.480-3.705; P<0.001) in multivariate Cox regression analysis. Conclusions: Preoperative F-SIRI could serve as a significantly prognostic marker for long-term survival in Chinese patients who underwent radical gastrectomy.

Analysis of Survival and Prognostic Factors in Soft Tissue Sarcomas (연부 조직 육종의 생존 및 예후 인자 분석)

  • Kim, Han-Soo;Seong, Sang-Cheol;Choi, In-Ho;Chung, Chin-Youb;Cho, Tae-Joon;Kim, Sang-Rim;Jeong, Jin-Young;Han, Il-Kyu;Lee, Han-Koo;Lee, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.4
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    • pp.208-215
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    • 1999
  • The purpose of this study was to identify the independent clinicopathologic prognostic factors of soft tissue sarcoma affecting local recurrence, metastasis and survival. Retrospectively collected data from 130 patients with soft tissue sarcoma were analyzed. Patient, tumor and pathologic factors were analyzed by univariate and multivariate methods for the endpoints of local recurrence, metastasis and survival. In univariate analysis, wide surgical margin, adjuvant radiotherapy and age younger than 40 years reduced local recurrence. Tumor size larger than 5cm was related with a higher rate of metastasis. Patients with metastasis at initial presentation and with a large tumor size had a low survival rate. In multivariate analysis, adjuvant radiotherapy and young age were significantly correlated with a low local recurrence rate. In conclusion, patients with metastasis at initial presentation and a large tumor size had a reduced survival rate. Independent adverse prognostic factors for local recurrence were old age and not undergoing adjuvant therapy.

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The Prognostic Value of 18F-Fluorodeoxyglucose PET/CT in the Initial Assessment of Primary Tracheal Malignant Tumor: A Retrospective Study

  • Dan Shao;Qiang Gao;You Cheng;Dong-Yang Du;Si-Yun Wang;Shu-Xia Wang
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.425-434
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    • 2021
  • Objective: To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. Materials and Methods: An analysis of FDG PET/CT findings in 37 primary tracheal malignant tumor patients with a median follow-up period of 43.2 months (range, 10.8-143.2 months) was performed. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18F-FDG PET/CT parameters, other clinic-pathological factors, and overall survival (OS). A risk prognosis model was established according to the independent prognostic factors identified on multivariate analysis. A survival curve determined by the Kaplan-Meier method was used to assess whether the prognosis prediction model could effectively stratify patients with different risks factors. Results: The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p < 0.001). Conclusion: This study shows that 18F-FDG PET/CT can predict the survival of patients with primary tracheal malignant tumors. Patients with an MTV > 5.19, a TLG > 16.94 on PET/CT scans, squamous cell carcinoma, and non-E1 were more likely to have a reduced OS.

Clinicopathologic correlation with MUC expression in advanced gastric cancer

  • Kim, Kwang;Choi, Kyeong Woon;Lee, Woo Yong
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.89-94
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    • 2018
  • Purpose: To investigate the relationship between MUC expression and clinicopathologic factors in advanced gastric cancer. Methods: A total of 237 tumor specimens were assessed for MUC expression by immunohistochemistry. The clinicopathologic factors were investigated with MUC1, MUC2, MUC5AC, and MUC6. Results: MUC1, MUC2, MUC5AC, and MUC6 expression was identified in 148 of 237 (62.4%), 141 of 237 (59.5%), 186 of 237 (78.5%), and 146 of 237 (61.6%) specimens, respectively. MUC1 expression was correlated with age, human epidermal growth factor receptor 2 (HER2) status, lymphatic invasion, Lauren classification and histology. Further multivariate logistic regression analysis revealed a significant correlation between MUC1expression and lymphatic invasion, diffuse type of Lauren classification. MUC5AC expression was correlated with HER2 status, Lauren classification and histology. Further multivariate logistic regression analysis revealed a significant correlation between MUC5AC expression and HER2 status, diffuse and mixed type of Lauren classification. MUC2 and MUC6 expression were not correlated with clinicopathologic factors. The patients of MUC1 expression had poorer survival than those without MUC1 expression, but MUC2, MUC5AC or MUC6 were not related to survival. In an additional multivariate analysis that used the Cox proportional hazards model, MUC1 expression was not significantly correlated with patient survival independent of age, N-stage, and venous invasion. Conclusion: When each of these four MUCs expression is evaluated, in light of clinicopathologic factors, MUC1 expression may be considered as a prognostic factor in patients with advanced gastric cancer. Therefore, careful follow-up may be necessary because the prognosis is poor when MUC1 expression is present.

Greater Lymph Node Retrieval Improves Survival in Node-Negative Resected Gastric Cancer in the United States

  • Mirkin, Katelin A.;Hollenbeak, Christopher S.;Wong, Joyce
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.306-318
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    • 2017
  • Purpose: Guidelines in Western countries recommend retrieving ${\geq}15$ lymph nodes (LNs) during gastric cancer resection. This study sought to determine whether the number of examined lymph nodes (eLNs), a proxy for lymphadenectomy, effects survival in node-negative disease. Materials and Methods: The US National Cancer Database (2003-2011) was reviewed for node-negative gastric adenocarcinoma. Treatment was categorized by neoadjuvant therapy (NAT) vs. initial resection, and further stratified by eLN. Kaplan-Meier and Weibull models were used to analyze overall survival. Results: Of the 1,036 patients who received NAT, 40.5% had ${\leq}10eLN$, and most underwent proximal gastrectomy (67.8%). In multivariate analysis, greater eLN was associated with improved survival (eLN 16-20: HR, 0.71; P=0.039, eLN 21-30: HR, 0.55; P=0.001). Of the 2,795 patients who underwent initial surgery, 42.5% had ${\leq}10eLN$, and the majority underwent proximal gastrectomy (57.2%). In multivariate analysis, greater eLN was associated with improved survival (eLN 11-15: HR, 0.81; P=0.021, eLN 16-20: HR, 0.73; P=0.004, eLN 21-30: HR, 0.62; P<0.001, and eLN >30: HR, 0.58; P<0.001). Conclusions: In the United States, the majority of node-negative gastrectomies include suboptimal eLN. In node-negative gastric cancer, greater LN retrieval appears to have therapeutic and prognostic value, irrespective of initial treatment, suggesting a survival benefit to meticulous lymphadenectomy.

Prognostic Factors for Second-line Treatment of Advanced Non-small-cell Lung Cancer: Retrospective Analysis at a Single Institution

  • Inal, Ali;Kaplan, M. Ali;Kucukoner, Mehmet;Urakci, Zuhat;Karakus, Abdullah;Isikdogan, Abdurrahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1281-1284
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    • 2012
  • Background: Platinum-hased chemotherapy for advanced non-small cell lung cancer (NSCLC) is still considered the first choice, presenting a modest survival advantage. However, the patients eventually experience disease progression and require second-line therapy. While there are reliable predictors to identify patients receiving first-line chemotherapy, very little knowledge is available about the prognostic factors in patients who receive second-line treatments. The present study was therefore performed. Methods: We retrospectively reviewed 107 patients receiving second-line treatments from August 2002 to March 2012 in the Dicle University, School of Medicine, Department of Medical Oncology. Fourteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Result: The results of univariate analysis for overall survival (OS) were identified to have prognostic significance: performance status (PS), stage, response to first-line chemotherapy response to second-line chemotherapy and number of metastasis. PS, diabetes mellitus (DM), response to first-line chemotherapy and response to second-line chemotherapy were identified to have prognostic significance for progression-free survival (PFS). Multivariate analysis showed that PS, response to first-line chemotherapy and response to second-line chemotherapy were considered independent prognostic factors for OS. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. Conclusion: In conclusion, PS, response to first and second-line chemotherapy were identified as important prognostic factors for OS in advanced NSCLC patients who were undergoing second-line palliative treatment. Furthermore, PS and response to second-line chemotherapy were considered independent prognostic factors for PFS. It may be concluded that these findings may facilitate pretreatment prediction of survival and can be used for selecting patients for the correct choice of treatment.