• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2369-2374
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• 2016

Background: Differentiated thyroid cancer (DTC) is a cancer group that shares molecular and cellular origin but shows different clinical courses and prognoses. Several prognostic factors have been reported for predicting recurrence for individual patients. This literature review aimed to evaluate prognostic scores for predicting recurrence of DTC. Materials and Methods: A search of the MEDLINE database for articles published until December 2015 was carried out using the terms "thyroid neoplasms AND (recurrent OR persistent) AND (score OR model OR nomogram)". Studies were eligible for review if they indicated the development of prognostic scoring models, derived from a group of independent prognostic factors, in predicting disease recurrence in DTC patients. Results: Of the 308 articles obtained, five were eligible for evaluation. Two scoring models were developed for DTC including both papillary and follicular carcinoma, one for papillary carcinoma, and the other two for papillary microcarcinoma. The number of patients included in the score development cohort ranged from 59 to 1,669. The number of evaluated potential prognostic factors ranged from 4 to 25. Tumor-related factors were the most common factors included in the final scores, with cervical lymph node metastases being the most common. Only two studies showed internal validation of the derived score. Conclusions: There is a paucity of prognostic scores for predicting disease recurrence in patients with DTC, in particular for follicular thyroid carcinoma. Several limitations of the created scores were found. Performance of the scores has not been adequately studied. Comprehensive validation in multiple cohorts is recommended before widespread use.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2805-2810
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• 2016

Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

• Journal of Korean Traditional Oncology
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• v.17 no.1
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• pp.1-7
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• 2012

Objective : The association of cancer survival and components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (modified Glasgow Prognostic Score (GPS), Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio) is reviewed in this article. Methods and Results : With extensive research of papers in the PubMed, there is good evidence that preoperative measures of the systemic inflammatory response predict cancer survival, independent of tumor stage, in primary operable cancer. GPS also shows its prognostic value as a predictor of survival, independent of tumor stage, performance status and treatment in a variety of advanced cancer. GPS is associated with chemotherapy related toxicities as well as response to treatment and C-reactive protein shows its clinical value as a monitor of chemotherapy response. The systemic inflammatory response is closely related to cachexia and may be suitable measure for the clinical definition of cancer cachexia. Conclusion : Anticipated survival using the inflammation-based prognostic score is a major factor to be taken into consideration when deciding whether active intervention including surgery and chemotherapy or palliation therapy including acupuncture and herb medication is appropriate.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6255-6259
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• 2015

Purpose: To evaluate the prognostic value of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) in gallbladder cancer (GBC). Materials and Methods: Serum ALP and GGT levels and clinicopathological parameters were retrospectively evaluated in 199 GBC patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of ALP and GGT. Then, associations with overall survival were assessed by multivariate analysis. Based on the significant factors, a prognostic score model was established. Results: By ROC curve analysis, $ALP{\geq}210U/L$ and $GGT{\geq}43U/L$ were considered elevated. Overall survival for patients with elevated ALP and GGT was significantly worse than for patients within the normal range. Multivariate analysis showed that the elevated ALP, GGT and tumor stage were independent prognostic factors. Giving each positive factor a score of 1, we established a preoperative prognostic score model. Varied outcomes would be significantly distinguished by the different score groups. By further ROC curve analysis, the simple score showed great superiority compared with the widely used TNM staging, each of the ALP or GGT alone, or traditional tumor markers such as CEA, AFP, CA125 and CA199. Conclusions: Elevated ALP and GGT levels were risk predictors in GBC patients. Our prognostic model provides infomration on varied outcomes of patients from different score groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.305-311
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• 2017

Objectives: TNM staging, especially for lymph node metastasis, is the scoring system most widely used among prognostic factors for cancer survival. Several biomarkers have been studied as serologic markers, but their specificity is low and clinical applications are difficult. This study aimed to establish a scoring system for patients with oral squamous cell carcinoma (OSCC) using platelet (PLT) and mean platelet volume (MPV) levels measured postoperatively and to evaluate their significance as prognostic factors. Materials and Methods: We studied 40 patients admitted to the Department of Oral and Maxillofacial Surgery of Dankook University Hospital who were diagnosed with primary OSCC histopathologically between May 2006 and May 2012. Clinical pathological information obtained from the medical records of each patient included age, sex, height, weight, tumor location, degree of differentiation, tumor diameter, lymph node metastasis, TNM stage, and other test values including white blood cell, MPV, PLT, C-reactive protein (CRP), and albumin obtained through a test conducted within 7 days before surgery. Count of platelet (COP)-MPV Score: Patients with both PLT and MPV values below the cut-off values were defined as score 0 (group A). Patients with at least one of the two higher than the cut-off value were defined as score 1 (group B). Results: Univariate analyses showed N-metastasis, COP-MPV (A vs B), PLT, platelet-lymphocyte ratio, and CRP were statistically significant prognostic factors. A multivariate Cox proportional hazards model showed N-metastasis (hazard ratio [HR] 6.227, P=0.016) and COP-MPV (A vs B) (HR 18.992, P=0.013) were independent prognostic factors with a significant effect on survival. Conclusion: COP-MPV score is a simple and cost-effective test method and is considered a more effective prognostic factor than other considered factors in predicting the prognosis of OSCC patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.5
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• pp.243-250
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• 2016

Objectives: Many studies have examined histopathological factors and various prognostic scores related to inflammation to predict outcomes. Here, we examined the prognostic value of the C-reactive protein/albumin (CRP/alb) ratio in oral squamous cell carcinoma (OSCC). Materials and Methods: This retrospective study included 40 patients with OSCC. Using univariate and multivariate analyses, we focused on the correlation of the CRP/alb ratio with clinicopathological characteristics and with overall survival. We then compared five inflammation-based prognostic scores, CRP/alb ratio, modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), based on receiver operating characteristic (ROC) curves. Results: The optimal cut-off value for the CRP/alb ratio was 0.085. The group with a high CRP/alb ratio had a high TNM clinical stage (P=0.002) and larger primary tumors (P=0.029), with statistically significant differences in lymph node metastasis and distant metastasis. In addition, when the CRP/alb ratio was high, multivariate analysis showed a lower survival rate (P=0.002; hazard ratio=6.078), and the ROC curve showed more outstanding discriminatory ability regarding overall survival compared to other inflammation-based prognostic scores. Conclusion: The CRP/alb ratio can be an independent prognostic factor when predicting prognosis in OSCC and has good prognostic ability.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7909-7911
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• 2014

Gastric cancer is the fourth most common malignancy worldwide. Poor prognosis in gastric cancer is linked with hypoalbuminemia. Previous studies demonstrated relationships between gastric cancer and chronic inflammation. The aim of this study was to assess the prognostic value of preoperative inflammation-based prognostic scores regarding hospital mortality after gastrectomy. Unlike other recent articles on the same topic; we could only verify prognostic value of prognostic nutritional index for in hospital mortality after surgery.

• Gut and Liver
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• v.12 no.6
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• pp.714-721
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• 2018

Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p<0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4677-4680
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• 2016

Background: The Glasgow Prognostic Score (GPS) is calculated from measured CRP and albumin levels. We here evaluated the significance of the GPS in patients with resected pulmonary adenocarcinoma. Materials and Methods: The present study included 156 patients with lung adenocarcinoma who underwent lobectomy at Kanazawa Medical University between 2002 and 2012. Classification was into three groups: those with normal albumin (>=3.5 g/dl) and C-reactive protein (CRP) (<=1.0 mg/dl) levels were classified as GPS 0 (n =136), those with low albumin (<3.5 g/dl) or elevated CRP (>1.0 mg/dl) levels as GPS 1 (n = 16), and those with low albumin (<3.5 g/dl) and elevated CRP (>1.0 mg/dl) levels as GPS 2 (n = 4). We retrospectively investigated relationships between the patient characteristics including the GPS, and disease-free survival and cancer-specific survival. Results: The pathological stages of the patients were as follows: IA (n=78, 50%), IB (n=31, 19.9%), IIA (n=20.0, 12.8%), IIB (n=9.0, 5.7%), and IIIA (n=18.0, 11.5%). Lobectomy was performed in all cases. The average GPS was 0.15 (0-2) and showed significant relationships with stage and tumor size. The 2-year survival rates in patients with GPS0, 1 and 2 were 81.4%, 38.4%, and 25.0%, respectively. Clear correlations were noted with both cancer-specific survival and disease-free survival. Furthermore, multivariate analysis revealed that GPS was a significant prognostic factor. Conclusions: The GPS could be a prognostic factor for patients with resected pulmonary adenocarcinoma.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.82-88
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• 2011

Background: The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examination and to analyze factors associated with the prognosis for blunt abdominal trauma with small bowel perforation. Methods: The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed. Results: A total of 83 patients met the inclusion criteria: The male was 81.9%. The mean age was 45.6 years. The mean APACHE II score was 5.75. The mean time interval between injury and surgery was 395.9 minutes. The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patients suffered from complications. Conclusion: The patient's age and the APACHE II score on admission were important prognostic factors that effected a patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.