• 제목/요약/키워드: Poor prognostic patients

검색결과 526건 처리시간 0.023초

Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

  • Boeun Lee;Young Jun Choi;Seon-Ok Kim;Yoon Se Lee;Jung Yong Hong;Jung Hwan Baek;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • 제20권8호
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    • pp.1266-1274
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    • 2019
  • Objective: To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Materials and Methods: The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. Results: Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis (p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72-9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. Conclusion: Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.

Low Expression of Tyrosine-protein Phosphatase Nonreceptor Type 12 is Associated with Lymph Node Metastasis and Poor Prognosis in Operable Triple-negative Breast Cancer

  • Wu, Min-Qing;Hu, Pan;Gao, Jie;Wei, Wei-Dong;Xiao, Xiang-Sheng;Tang, Hai-Lin;Li, Xing;Ge, Qi-Dong;Jia, Wei-Hua;Liu, Ren-Bin;Xie, Xiao-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.287-292
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    • 2013
  • Background: Low tyrosine-protein phosphatase nonreceptor type 12 (PTPN12) expression may be associated with breast cancer growth, proliferation, and metastasis. However, the prognostic value of PTPN12 in breast cancer has not been clearly identified. Patients and Methods: 51 triple-negative breast cancer (TNBC) patients and 83 non-TNBC patients with a histopathology diagnosis from October 2001 to September 2006 were included in this study. Immunohistochemical staining for PTPN12 on tissue microarrays was conducted. Results: High PTPN12 expression was seen in 39.2% of TNBC and 60.2 % of non-TNBC cases. Low PTPN12 expression was associated with lymph node status (p = 0.002) and distant metastatic relapse (p = 0.002) in TNBC patients. Similarly, low PTPN12 expression in non-TNBC patients was significantly correlated with lymph node status (p = 0.002), stage (p = 0.002) and distant metastatic relapse (p = 0.039). The high PTPN12 expression group was associated with longer DFS and OS compared with low PTPN12 expression group only in TNBC cases (p = 0.005, p = 0.015), according to univariate Cox regression analysis. Conclusion: These findings provide evidence that low expression of PTPN12 is associated with worse prognosis and may be used as a potential prognostic biomarker in TNBC patients.

Relationship between erb-B2 mRNA Expression in Blood and Tissue of Invasive Ductal Carcinoma Breast Cancer Patients and Clinicopathological Characteristics of the Tumors

  • Moazzezy, Neda;Ebrahimi, Fatemeh;Sisakht, Mahsa Mollapour;Yahyazadeh, Hossein;Bouzari, Saeid;Oloomi, Mana
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.249-254
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    • 2016
  • Molecular detection methods such as RT-PCR for detecting breast cancer-associated gene expression in the peripheral blood have the potential to modify breast cancer (BC) staging and therapy. In this regard, we evaluated the potential of erb-B2 molecular marker in BC detection and analyzed the expression of erb-B2 mRNA in the peripheral blood and fresh tissue samples of 50 pretreated female BC patients and 50 healthy females by reverse transcription-PCR (RT-PCR) method. We also assessed the correlation of erb-B2 mRNA marker positivity in peripheral blood and tumor tissue samples with clinical and pathological factors in BC patients in order to evaluate its prognostic value. It was shown that there is a significant difference between healthy females and BC patients with expression of the erb-B2 molecular marker (p<0.01). A significant difference between the expression of erb-B2 in the peripheral blood and tissue samples of BC patients (p<0.01) and the frequency of circulating erb-B2 mRNA expression in peripheral blood and in tissue was detected by RT-PCR. No correlation was found between erb-B2 mRNA expression in blood or tumor tissue samples and lymph node, tumor grade, tumor stage, tumor size, patient's age, ki67, estrogen receptor (ER), progesterone receptor (PGR), P53, and HER-2 status. However, in a small subset of 31 BC patients we found that expression of erb-B2 in peripheral blood or in both peripheral blood and tumor tissue was directly correlated with lympho-vascular invasion and perineural invasion as poor prognostic features. The highest rates of erb-B2 expression in peripheral blood or tumor tissue were in the ER and PR negative and HER-2 positive group. This study suggests that the application of the RT-PCR and immunohistochemical methods for erb-B2 molecular marker detection would provide a higher detection rate, especially in early stage BC.

Salvage Treatment Experience in Advanced Synovial Sarcoma: a Multicenter Retrospective Analysis of the Anatolian Society of Medical Oncology

  • Yetisyigit, Tarkan;Arpaci, Erkan;Seber, Erdogan Selcuk;Kucukoner, Mehmet;Kos, Fatma Tugba;Sonmez, Ozlem Uysal;Alici, Suleyman;Akman, Tulay;Aktas, Bilge;Yildiz, Ramazan;Gunaydin, Yusuf;Inanc, Mevlude;Demirci, Umut;Alkis, Necati;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5185-5188
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    • 2013
  • Background: We aimed to evaluate prognostic factors and response rates to various treatment approaches to patients with synovial sarcoma in an advanced setting. Materials and Methods: We retrospectively reviewed the medical records of 55 patients (18 pts; 32.7% women) diagnosed with synovial sarcomas. Twenty had metastatic disease at the time of diagnosis while the remainder of the study group consisted of patients who developed metastatic or inoperable locally advanced disease during follow up. Results: The median follow up time was 15 months (range: 1-53). Regarding outcomes for the 55 patients, 3 and 5 year overall survival rates were 26% and 14%, respectively. In univariate analyses among demographic factors female gender was associated with a better outcome (p=0.030). Patients with early progressing disease (<2 years) had a worse prognosis when compared to patient group with late relapse, but this difference did not reach statistical significance (p=0.056). According to multivariate Cox regression analysis patients who had undergone metastasectomy had a significant survival advantage (p=0.044). The overall response rate to different salvage chemotherapy regimens given as second line treatment was around 42.9-53.9% for all regimes. There were no statistically significant differences between chemotherapy regimens given in either second or third line settings in terms of overall survival. Conclusions: We observed no major differences in terms of response rate and survival between different salvage chemotherapy regimens. Although metastatic disease still carries a poor prognosis, metastasectomy was found to be associated with improved survival.

The long-term prognostic impact of sentinel lymph node biopsy in patients with primary cutaneous melanoma: a prospective study with 10-year follow-up

  • Portinari, Mattia;Baldini, Gabriele;Guidoboni, Massimo;Borghi, Alessandro;Panareo, Stefano;Bonazza, Simona;Dionigi, Gianlorenzo;Carcoforo, Paolo
    • Annals of Surgical Treatment and Research
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    • 제95권5호
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    • pp.286-296
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    • 2018
  • Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely accepted for staging of melanoma patients. It has been shown that clinico-pathological features such as Breslow thickness, ulceration, age, and sex are better predictors of relapse and survival than SLN status alone. The aims of this study were to evaluate the long-term (10-year) prognostic impact of SLNB and to determine predictive factors associated with SLN metastasis, relapse, and melanoma specific mortality (MSM). Methods: This was a prospective observational study on 289 consecutive patients with primary cutaneous melanoma who underwent SLNB from January 2000 to December 2007, and followed until January 2014, at an Italian academic hospital. Results: SLN was positive in 64 patients (22.1%). The median follow-up was 116 months (79-147 months). Tenyear disease-free survival and melanoma specific survival were poor in patients with positive SLN (58.7% and 66.4%, respectively). Only the increasing Breslow thickness resulted independently associated to an increased risk of SLN metastasis. Cox regression analysis showed that a Breslow thickness >2 mm was an independent predictor of relapse, and male sex and Breslow thickness >2 mm was a predictor of MSM. At 10 years, SLN metastasis was not significantly associated to either relapse or MSM. Conclusion: After the fifth year of follow-up, SLN metastasis is not an independent predictive factor of relapse or mortality which are mainly influenced by the characteristics of the primary tumor and of the patient. Patients with a Breslow thickness >2 mm regardless of the SLN status should be considered at high risk for 10-year relapse and mortality.

Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis

  • Ch'ng, Ewe Seng;Sharif, Sharifah Emilia Tuan;Jaafar, Hasnan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4445-4452
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    • 2012
  • Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.

만성 외측 발목 불안정 (Chronic Lateral Ankle Instability)

  • 김대욱;성기선
    • 대한족부족관절학회지
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    • 제22권2호
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    • pp.55-61
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    • 2018
  • Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

초기설암치료시 예방적 경부곽청술의 의의 (THE IMPORTANCE OF THE PROPHYLACTIC NECK DISSECTION IN THE EARLY-STAGE TONGUE CANCER)

  • 홍창수;김진수;장현중;이상한
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권1호
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    • pp.73-81
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    • 1995
  • The poor survival rates of patients with carcinoma of a tongue, despite of modern therapy, is well recognized. One of the most important prognostic factors is status of the cervical lymph nodes. There have been a long-standing debate about the treatment of cervical lymph nodes in early-stage tongue cancer. There are two major treatment opinion. The one is surgical excision of primary tumor with prophylactic neck dissection, simultaneously, and the other is to delay the cervical therapy until cervical lymph node is palpable. Recently we have experienced the early cervical metastasis in three patients who had been diagnosed as a carcinoma of the tongue. They were T1, T2 lesion and no palpable node was found. But histopathologic examination showed the occult metastasis or delayed cervical metastasis was occured. By the review of literature and clinical experience, we could conclude the prophylactic neck dissection offers a better chance for success than therapeutic neck dissection of palpable lymph nodes, in case of oral tongue cancer.

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MicroRNAs May Serve as Emerging Molecular Biomarkers for Diagnosis and Prognostic Assessment or as Targets for Therapy in Gastric Cancer

  • Mu, Yong-Ping;Sun, Wen-Jie;Lu, Chuan-Wen;Su, Xiu-Lan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4813-4820
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    • 2015
  • Gastric cancer (GC) is one of the most common cancers, with high incidences in East Asia countries. Most GC patients have been reported with low early diagnosis rate and show extremely poor prognosis. Therefore, it is necessary to develop novel and more sensitive biomarkers to improve early diagnosis and therapy in order to provide longer survival and better quality of life for gastric cancer patients. MicroRNAs (miRNAs) play crucial roles in GC development and progression. miRNAs have emerged as a novel molecular biomarker for cancer diagnosis, prognosis and therapy with surprising stability in tissues, serum or other body fluids. This review summarizes major advances in our current knowledge about potential miRNA biomarkers for GC that have been reported in the past two years.

Generation of Whole-Genome Sequencing Data for Comparing Primary and Castration-Resistant Prostate Cancer

  • Park, Jong-Lyul;Kim, Seon-Kyu;Kim, Jeong-Hwan;Yun, Seok Joong;Kim, Wun-Jae;Kim, Won Tae;Jeong, Pildu;Kang, Ho Won;Kim, Seon-Young
    • Genomics & Informatics
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    • 제16권3호
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    • pp.71-74
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    • 2018
  • Because castration-resistant prostate cancer (CRPC) does not respond to androgen deprivation therapy and has a very poor prognosis, it is critical to identify a prognostic indicator for predicting high-risk patients who will develop CRPC. Here, we report a dataset of whole genomes from four pairs of primary prostate cancer (PC) and CRPC samples. The analysis of the paired PC and CRPC samples in the whole-genome data showed that the average number of somatic mutations per patients was 7,927 in CRPC tissues compared with primary PC tissues (range, 1,691 to 21,705). Our whole-genome sequencing data of primary PC and CRPC may be useful for understanding the genomic changes and molecular mechanisms that occur during the progression from PC to CRPC.