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1.
G. Lorimier B. Linot N. Paillocher D. Dupoiron V. Verrièle R. Wernert A. Hamy O. Capitain 《European journal of surgical oncology》2017,43(1):150-158
Objectives
This study describes the outcomes of patients with colorectal peritoneal carcinomatosis (PC) with or without liver metastases (LMs) after curative surgery combined with hyperthermic intraperitoneal chemotherapy, in order to assess prognostic factors.Background
Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) increases overall survival (OS) in patients with PC. The optimal treatment both for PC and for LMs within one surgical operation remains controversial.Methods
Patients with PC who underwent CRS followed by HIPEC were evaluated from a prospective database. Overall survival and disease free survival (DFS) rates in patients with PC and with or without LMs were compared. Univariate and multivariate analyses were performed to evaluate predictive variables for survival.Results
From 1999 to 2011, 22 patients with PC and synchronous LMs (PCLM group), were compared to 36 patients with PC alone (PC group). No significant difference was found between the two groups. The median OS were 36 months [range, 20–113] for the PCLM group and 25 months [14–82] for the PC group (p > 0.05) with 5-year OS rates of 38% and 40% respectively (p > 0.05). The median DFS were 9 months [9–20] and 11.8 months [6.5–23] respectively (p = 0.04). The grade III–IV morbidity and cytoreduction score (CCS) >0 (p < 0.05) were identified as independent factors for poor OS. Resections of LMs and CCS >0 impair significantly DFS.Conclusions
Synchronous complete CRS of PC and LMs from a colorectal origin plus HIPEC is a feasible therapeutic option. The improvement in OS is similar to that provided for patients with PC alone. 相似文献2.
Qingxiu Dang Hong Zhou Juan Qian Li Yang Jianfei Huang Yaping Zhang Wenyu Shi 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(11):749-754
Introduction
Lysosomal-associated membrane protein 1 (LAMP1) is a lysosomal and plasma membrane protein that contributes to tumor metastatic potential and differentiation.Patients and Methods
We performed immunohistochemical staining to investigate LAMP1 protein expression levels in 122 diffuse large B-cell lymphoma (DLBCL) tumor samples and 45 reactive hyperplasia tissues. Correlations between LAMP1 expression, various clinicopathologic features, and patient prognosis were evaluated by univariate and multivariate analyses.Results
LAMP1 expression was greater in the DLBCL tissues than in the reactive hyperplasia tissues. High LAMP1 expression was significantly associated with a high international prognostic index (score, 3-5; P = .023) and elevated lactate dehydrogenase level (P = .028). Moreover, high LAMP1 expression (P = .026), elevated serum lactate dehydrogenase level (P = .011), and high international prognostic index (P < .001) were independently associated with worse overall survival and progression-free survival.Conclusion
These data provide the first evidence that LAMP1 expression is associated with a poor prognosis in patients with DLBCL. 相似文献3.
Shidan Wang Lin Yang Bo Ci Matthew Maclean David E. Gerber Guanghua Xiao Yang Xie 《Journal of thoracic oncology》2018,13(9):1338-1348
Introduction
SCLC accounts for almost 15% of lung cancer cases in the United States. Nomogram prognostic models could greatly facilitate risk stratification and treatment planning, as well as more refined enrollment criteria for clinical trials. We developed and validated a new nomogram prognostic model for SCLC patients using a large SCLC patient cohort from the National Cancer Database (NCDB).Methods
Clinical data for 24,680 SCLC patients diagnosed from 2004 to 2011 were used to develop the nomogram prognostic model. The model was then validated using an independent cohort of 9700 SCLC patients diagnosed from 2012 to 2013. The prognostic performance was evaluated using p value, concordance index and integrated area under the (time-dependent receiver operating characteristic) curve (AUC).Results
The following variables were contained in the final prognostic model: age, sex, race, ethnicity, Charlson/Deyo score, TNM stage (assigned according to the American Joint Committee on Cancer [AJCC] eighth edition), treatment type (combination of surgery, radiation therapy, and chemotherapy), and laterality. The model was validated in an independent testing group with a concordance index of 0.722 ± 0.004 and an integrated area under the curve of 0.79. The nomogram model has a significantly higher prognostic accuracy than previously developed models, including the AJCC eighth edition TNM-staging system. We implemented the proposed nomogram and four previously published nomograms in an online webserver.Conclusions
We developed a nomogram prognostic model for SCLC patients, and validated the model using an independent patient cohort. The nomogram performs better than earlier models, including models using AJCC staging. 相似文献4.
Juan Chipollini Sharon Chaing Charles C. Peyton Pranav Sharma Laura C. Kidd Anna R. Giuliano Peter A. Johnstone Philippe E. Spiess 《Clinical genitourinary cancer》2018,16(1):e121-e127
Background
We analyzed the trends in presentation of squamous cell carcinoma (SCC) of the penis and determined the socioeconomic predictors for locally advanced (cT3-cT4) disease in the United States.Patient and Methods
The National Cancer Database was queried for patients with clinically nonmetastatic penile SCC and staging available from 1998 to 2012. Temporal trends per tumor stage were evaluated, and a multivariable logistic regression model was used to identify predictors for advanced presentation during the study period.Results
A total of 5767 patients with stage ≤ T1-T2 (n = 5423) and T3-T4 (n = 344) disease were identified. Increasing trends were noted in all stages of penile SCC with a greater proportion of advanced cases over time (P = .001). Significant predictors of advanced presentation were age > 55 years, the presence of comorbidities, and Medicaid or no insurance (P < .05 for all).Conclusion
More penile SCC is being detected in the United States. Our results have demonstrated older age, presence of comorbidities, and Medicaid or no insurance as potential barriers to early access of care in the male population. Understanding the current socioeconomic gaps could help guide targeted interventions in vulnerable populations. 相似文献5.
Young Hyo Choi Min Yong Kang Hyun Hwan Sung Hwang Gyun Jeon Byong Chang Jeong Seong Il Seo Seong Soo Jeon Chan Kyo Kim Byung Kwan Park Hyun Moo Lee 《Clinical genitourinary cancer》2019,17(1):e19-e25
Background
The purpose of the study was to compare cancer detection rates between 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and multiparametric magnetic resonance imaging (mpMRI)-guided target prostate biopsy (MRI-TBx) according to prostate-specific antigen (PSA) level in biopsy-naive patients.Patients and Methods
A retrospective study was conducted in 2009 biopsy-naive patients with suspected prostate cancer (PSA ≤20 ng/mL). Patients underwent TRUS-Bx (n = 1786) or MRI-guided target prostate biopsy (MRI-TBx; n = 223) from September 2013 to March 2017 and were stratified according to each of 4 PSA cutoffs. MRI-TBx was performed on lesions with Prostate Imaging Reporting and Data System (PI-RADS) scores of 3 to 5 on mpMRI. Clinically significant prostate cancer (csPCa) was defined as Gleason ≥7. Propensity score matching was performed using the prebiopsy variables, which included age, PSA, prostate volume, and PSA density.Results
Propensity score matching resulted in 222 patients in each group. There were significant differences between the TRUS-Bx and MRI-TBx groups in the overall detection rates of prostate cancer (41.4% vs. 55.4%; P = .003) and csPCa (30.1% vs. 42.8%; P = .005). However, across PSA cutoffs, MRI-TBx detected more prostate cancer than TRUS-Bx at PSA levels of 2.5 to <4 (29.5% vs. 56.6%; P < .001). The csPCa detection rates of TRUS-Bx and MRI-TBx did not differ significantly within the PSA cutoffs. There was a significantly higher detection rate of prostate cancer and csPCa in lesions with PI-RADS scores 4 and 5 than in those with a score of 3.Conclusion
Prebiopsy mpMRI and subsequent targeted biopsy had a higher detection rate than TRUS-Bx in patients with prostate cancer and csPCa. 相似文献6.
Jianyang Wang Shulian Wang Yu Tang Hao Jing Guangyi Sun Jing Jin Yueping Liu Yongwen Song Weihu Wang Hui Fang Hua Ren Zihao Yu Yexiong Li 《Clinical breast cancer》2018,18(5):e975-e984
Background
To investigate the superiority of breast-conserving surgery (BCS) plus radiotherapy (RT) compared with mastectomy alone for patients with stage I breast cancer in a real-world setting.Patients and Methods
The data from patients with histologically confirmed stage I breast cancer treated from 1999 to 2014 were retrospectively reviewed. The association of outcomes with the choice of treatment (BCS plus RT vs. mastectomy) was evaluated using multivariable proportional hazards regression and further confirmed using propensity score matching methods.Results
Of 6137 eligible patients in the present study, 1296 underwent BCS plus RT and 4841 underwent mastectomy plus axillary lymph node dissection without RT (mastectomy group). Multivariate analysis revealed that BCS plus RT was related to similar locoregional recurrence-free survival but greater distant metastasis-free survival (P = .003) and overall survival (P = .036) compared with mastectomy. For the 1252 pairs of patients matched using propensity score matching, the BCS plus RT groups enjoyed significantly greater 5-year overall survival (99.1% vs. 96.1%; P = .001), distant metastasis-free survival (97.0% vs. 92.2%; P < .001), and disease-free survival (95.3% vs. 90.2%; P = .001) compared with the mastectomy group.Conclusion
BCS plus RT provided better outcomes than mastectomy for eligible patients with stage I breast cancer and should be offered as a preferred treatment option. 相似文献7.
Susana Roselló Matteo Frasson Eduardo García-Granero Desamparados Roda Esther Jordá Samuel Navarro Salvador Campos Pedro Esclápez Stephanie García-Botello Blas Flor Alejandro Espí Carlotta Masciocchi Vincenzo Valentini Andrés Cervantes 《Clinical colorectal cancer》2018,17(2):104-112.e2
Background
Adjuvant chemotherapy is controversial in patients with locally advanced rectal cancer after preoperative chemoradiation. Valentini et al developed 3 nomograms (VN) to predict outcomes in these patients. The neoadjuvant rectal score (NAR) was developed after VN to predict survival. We aimed to validate these tools in a retrospective cohort at an academic institution.Patients and Methods
VN and the NAR were applied to 158 consecutive patients with locally advanced rectal cancer treated with chemoradiation followed by surgery. According to the score, they were divided into low, intermediate, or high risk of relapse or death. For statistical analysis, we performed Kaplan-Meier curves, log-rank tests, and Cox regression analysis.Results
Five-year overall survival was 83%, 77%, and 67% for low-, intermediate-, and high-risk groups, respectively (P = .023), according to VN, and 84%, 71%, and 59% for low-, intermediate-, and high-risk groups, respectively (P = .004), according to NAR. When the score was considered as a continuous variable, a significant association with the risk of death was observed (NAR: hazard ratio, 1.04; P < .001; VN: hazard ratio, 1.10; P < .001).Conclusion
We confirmed the value of these scores to stratify patients according to their individual risk when designing new trials. 相似文献8.
Objective
Compare long-term outcomes in colorectal cancer (CRC) patients with peritoneal carcinomatosis (PC) treated with peritonectomy/HIPEC using oxaliplatin versus MMC.Background
Peritonectomy and heated intraperitoneal chemotherapy (HIPEC) greatly improves patient survival in CRC PC. This procedure is not uniform across centres and the optimal choice of HIPEC chemotherapeutic is unclear. Oxaliplatin and Mitomycin C (MMC) are the most commonly used agents and comparative studies have reported varying results.Method
201 patients were retrospectively selected from the St George Hospital database, all of which had undergone peritonectomy/HIPEC for CRC PC. Oxaliplatin and MMC were used in 106 and 96 patients, respectively. Each patient's baseline characteristics, operative details, choice of chemotherapeutic agent and survival were noted.Results
The two groups did not differ significantly at baseline. Patients receiving oxaliplatin had significantly greater unadjusted median survival compared to MMC (56.0 ± 8.1 vs. 29.0 ± 3.4 months) which translated into a hazards ratio of 0.59 (95% CI 0.37–0.91, p = 0.017). Subgroup analysis further confirmed an advantage with oxaliplatin in females, moderate-well differentiated tumours, tumours without signet ring pathology and PCI 10–15.Conclusion
Our study suggests oxaliplatin offers a survival advantage over MMC when used for HIPEC in CRC PC. Further studies to understand its efficacy, complications and ideal preparation are required. A Phase III randomised control trial comparing oxaliplatin and MMC would enhance decision-making. 相似文献9.
Francesco Sanguedolce Giuseppe Petralia Heminder Sokhi Elena Tagliabue Nicola Anyamene Giles Hellawell Anwar R. Padhani 《Clinical genitourinary cancer》2018,16(2):155-163.e6
Introduction
Increasing evidence has supported the use of multiparametric magnetic resonance imaging (mpMRI) for the detection of prostate cancer. However, its role in selecting patients clinically suitable for active surveillance (AS) is still in development. We aimed to find relevant mpMRI features that might be helpful for refinement of the selection of low-risk prostate cancer patients for AS. We also evaluated the interobserver variability in reporting prostate mpMRI features.Patients and Methods
From 2008 to 2012, 135 patients were selected for AS using Epstein criteria. Baseline mpMRI studies were performed within 3 months of recruitment and reviewed by 2 radiologists who were unaware of the patients' outcomes. The radiologists recorded the mpMRI features using the Prostate Imaging Reporting and Data System (PI-RADS) guidelines. The overall likelihood of the presence of significant prostate cancer was also determined using the Likert and PI-RADS, version 2 (v2), scores. Univariate and multivariate analyses, receiver operating characteristic curves, and Kaplan-Meier survival curves were calculated for the mpMRI features with respect to patient withdrawal from the AS program and failure-free survival (FFS). The interobserver agreement was also evaluated.Results
At a median follow-up time of 31 months (range, 6-80 months), 84 patients (62.2%) were participating in the AS program. In 2 multivariate models, the variables significantly associated with outcomes for both readers were the index lesion size (hazard ratio [HR], 2.34 and 3.13, respectively) and overall PI-RADS, v2, score (HR, 2.51 and 3.21, respectively). The interobserver agreement was higher for the overall Likert and PI-RADS, v2, scores.Conclusion
Overall, the PI-RADS, v2, score and index lesion size were strongly associated with FFS. Overall, the Likert and PI-RADS, v2, scoring systems have been confirmed to be useful, although further improvements are needed. 相似文献10.
Amro M.S. El-Ghammaz Mostafa K. El-Razzaz 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(4):e183-e190
Background
Prognosis of acute leukemia patients who experience relapse after hematopoietic stem-cell transplantation (HSCT) remains poor. Identifying risk factors influencing outcome of these patients is essential.Patients and Methods
Follow-up of 234 acute leukemia patients who underwent allogeneic HSCT from matched related donor was performed for occurrence of posttransplantation relapse. Statuses of remission and survival were assessed at 6 months after treatment of relapse. Analysis of risk factors influencing postrelapse overall survival (prOS), complete remission (CR), and nonrelapse mortality (NRM) was carried out.Results
Posttransplantation relapse occurred in 43 patients (17.9%). After treatment, 11 patients (25.6%) experienced postrelapse remission, the prOS rate was 20.9% (9 patients), and the NRM rate was 25.6% (11 patients). Older age (P = .007) and failure to experience remission after relapse treatment (P = .027) were associated with lower prOS in multivariate analysis. Female sex (P = .027), posttransplantation extramedullary relapse (P = .001), and absence of postrelapse graft-versus-host disease P = .025) were associated with lower CR rate. Also, presence of extramedullary relapse (P = .011) was associated with lower risk of NRM whereas treatment of posttransplantation relapse with donor lymphocyte infusion with or without chemotherapy (P = .002) and occurrence of postrelapse graft-versus-host disease (P = .025) were associated with higher risk of NRM.Conclusion
Survival of acute leukemia patients who experience relapse after allogeneic HSCT is poor, especially in elderly patients and those who do not experience remission after relapse treatment. 相似文献11.
Jose F. Falantes Francisco J. Márquez-Malaver Cristina Calderón-Cabrera Begoña Pedrote María L. Martino Jose González Ildefonso Espigado Jose A. Pérez-Simón 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(7):469-474.e1
Background
The prognosis of patients with lower-risk myelodysplastic syndrome (LR-MDS) is very heterogeneous. In addition to survival estimates, identification of factors related to the probability of leukemic progression might help prognosis assessment.Patients and Methods
The present study is a retrospective analysis of 409 patients with primary LR-MDS. The probability of leukemic progression was estimated in the competing risk framework by the cumulative incidence method considering death without acute myeloid leukemia (AML) as a competing event.Results
Sixty-six patients (16.1%) progressed to AML. The following covariates influenced the probability of leukemic progression in a multivariate competing risk regression model: intermediate karyotype versus diploid or chromosome 5 deletion, 5% to 9% bone marrow blast percentage, platelet count <50 × 10e9/L and age younger than 75 years.Conclusion
According to these, a predictive model is proposed, which categorizes patients with different probability of leukemic progression (P < .001). Validation of these results might help prognostic refinement of patients with LR-MDS. 相似文献12.
Alexander L. Chin Kiran A. Kumar Haiwei H. Guo Peter G. Maxim Heather Wakelee Joel W. Neal Maximillian Diehn Billy W. Loo Michael F. Gensheimer 《Clinical lung cancer》2018,19(5):e581-e588
Background
Emerging data support aggressive local treatment of oligometastatic non–small-cell lung cancer (NSCLC) patients. We sought to determine whether the metabolic burden of disease found by fluorodeoxyglucose positron emission tomography at the time of high-dose radiotherapy (RT) for oligometastatic NSCLC can serve as a prognostic biomarker.Materials and Methods
We conducted a retrospective cohort study of 67 RT treatment courses in 55 patients with oligometastatic NSCLC who had undergone high-dose RT to all sites of active disease at our institution. The metabolic tumor volume, total lesion glycolysis (TLG), and maximum standardized uptake value of all lesions were measured on the pretreatment fluorodeoxyglucose positron emission tomography scans. Cox regression analysis was used to assess the influence of imaging and clinical factors on overall survival (OS).Results
On univariate analysis, a greater metabolic tumor volume and TLG were predictive of shorter OS (hazard ratio of death, 2.42 and 2.14, respectively; P = .009 and P = .004, respectively). The effects remained significant on multivariate analysis. Neither the maximum standardized uptake value nor the number of lesions was significantly associated with OS. Patients within the highest quartile of TLG values (> 86.8 units) had a shorter median OS than those within the lower 3 quartiles (12.4 vs. 30.1 months; log-rank P = .014).Conclusion
The metabolic tumor burden was prognostic of OS and might help to better select oligometastatic NSCLC patients for locally ablative therapy. 相似文献13.
Hong-Fei Gao Ci-Qiu Yang Min-Yi Cheng Teng Zhu Mei Yang Liu-Lu Zhang Kun Wang 《Clinical breast cancer》2018,18(5):e961-e966
Introduction
The prognostic value of the mesenchymal–epithelial transition (MET) in triple-negative breast cancers (TNBCs) remains controversial. A meta-analysis of the impact of MET in TNBCs was performed by searching published data.Methods
PubMed and Embase databases were searched for eligible literature. The principal outcome measures were hazard ratios (HRs) for recurrence-free survival or overall survival according to MET expression. Combined HRs were calculated using fixed- or random-effects models according to heterogeneity.Results
Six studies involving 785 patients met our selection criteria. The meta-analysis results showed that MET overexpression was associated with a 1.29-fold increased risk of recurrence (combined HR 1.29; 95% confidence interval, 1.04-1.60; P = .020) in the TNBCs. Three studies provided the related overall survival data (488 cases). The results showed that MET overexpression was associated with a 1.38-fold increased risk of mortality (HR, 1.38; 95% confidence interval, 1.08-1.76; P = .009).Conclusion
MET is an adverse prognostic marker for TNBCs. The results strengthen the rationale for targeted therapy of TNBCs using MET inhibitors in future clinical trials. 相似文献14.
Bartosz Mucha Dariusz Pytel Lukasz Markiewicz Magda Cuchra Izabela Szymczak Karolina Przybylowska-Sygut Adam Dziki Ireneusz Majsterek Lukasz Dziki 《Clinical colorectal cancer》2018,17(2):e435-e441
Background
Colorectal cancer (CRC) is leading malignant tumors to occur mainly in industrialized countries, where it exhibits one of the highest mortality rates. Up to 80% of all CRCs characterize a chromosomal instability (CIN) phenotype. The main challenge faced by scientist is to reveal the mechanism of CIN development. An often proposed model is defects in DNA repair in terms of efficiency and genetic variations that modulate the response to stimuli from the environment. The objectives of this research were to determine whether nucleotide excision repair (NER) might affect CRC risk.Materials and Methods
The first part of the study concerns NER efficiency. In the second part we selected 2 common single nucleotide polymorphisms within genes involved in NER (Xeroderma pigmentosum group C (XPC) Lys939Gln, Xeroderma pigmentosum group D (XPD) Lys751Gln) to determine the relation between them and CRC risk. The restriction fragment length polymorphism-polymerase chain reaction method was used for genotyping of 221 CRC patients vs. 270 cancer-free individuals. The isotopic labeling in vitro assay was used to evaluate NER capacity in lymphocytes and tissue protein extracts.Results
We observed a significantly decreased level of NER capacity (P = .025) in lymphocytes delivered from CRC patients compared with healthy ones. Polymorphism screening points to higher CRC risk for the Gln939Gln genotype (P = .02) and Gln allele (P = .002) of the XPC gene.Conclusion
Taken together, our findings suggest a potential role for NER in CRC. 相似文献15.
Holly Lee Peter Duggan Ahsan Chaudhry Paola Neri Jason Tay Fariborz Rashid-Kolvear Nizar J. Bahlis Victor H. Jimenez-Zepeda 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(1):e69-e75
Introduction
Multiple myeloma is a heterogeneous disease with diverse clinical courses and patient outcomes. Although the introduction of novel agents has improved the overall survival (OS) of multiple myeloma patients, reports have highlighted that a subset of patients persists who experience early relapse (ER) and whose prognosis is significantly poorer than that of patients with a longer therapy response.Methods
The purpose of the present study was to understand the effect of ER on OS and identify other predictors of OS. We analyzed the outcomes of 257 patients who had undergone novel agent-based induction and single autologous stem cell therapy at our center from 2010 to 2016.Results
ER occurred in 35 patients (13.6%), and the group had a greater percentage of high-risk cytogenetics (48.5% vs. 23.3%; P = .0001), a lower percentage of a very good partial response or better (51.4% vs. 80.5%; P = .001), and a shorter median OS (17.8 months vs. not realized; P = .0001) compared with the non-ER group. Multivariate analysis showed that the presence of ER, high-risk cytogenetics, and lactate dehydrogenase > 350 UI/L are independent prognosticators for OS (P < .05).Conclusions
Our results have demonstrated that ER is an important clinical indicator of patients at high risk. As applications of novel agents evolve, further studies are required to tailor therapy for this patient group. 相似文献16.
Yoo Jin Lee Dong Won Baek Jae-Sook Ahn Seo-Yeon Ahn Sung-Hoon Jung Deok-Hwan Yang Je-Jung Lee Hyeoung Joon Kim Ji Yeon Ham Jang Soo Suh Sang Kyun Sohn Joon Ho Moon 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(12):e529-e535
Background
The optimal number of high-dose cytarabine (HDAC) consolidation cycles before allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia is not fully standardized.Patients and Methods
This study evaluated the impact of HDAC consolidation cycles before allogeneic HCT in 194 patients with acute myeloid leukemia in first complete remission between 1998 and 2014. The patients were reclassified into 3 groups—no consolidation (C0, n = 20), 1 consolidation (C1, n = 115), and ≥ 2 consolidations (C2, n = 59)—by pre-HCT consolidation cycle.Results
The 3-year relapse-free survival rates was 45.9%, 66.9%, and 73.3% for the C0, C1, and C2 groups, respectively (P = .064), while the 3-year overall survival rates were 35.0%, 55.2%, and 67.5%, respectively (P = .106). The cumulative incidence of acute graft-versus-host disease (GVHD) was higher in the C2 group (38.7%) than in the C0 (22.2%) or C1 (17.7%) group (P = .018). However, the incidence of chronic GVHD showed no difference between the groups. Multivariate analysis for overall survival revealed the following independent factors: adverse cytogenetic risk (hazard ratio [HR] = 1.84, P = .046), C2 versus C0 (HR = 0.41, P = .037), pre-HCT status beyond CR1 versus CR1 (HR = 5.78, P < .001), and presence of chronic GVHD (HR = 0.45, P = .004).Conclusion
One or two cycles of HDAC consolidation therapy led to better subsequent HCT outcomes compared to the no–consolidation therapy group. 相似文献17.
Andrew W. Hahn Camryn Froerer Sidney VanAlstine Nityam Rathi Erin B. Bailey David D. Stenehjem Neeraj Agarwal 《Clinical genitourinary cancer》2018,16(5):365-368
Background
Vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) are a mainstay of treatment for metastatic renal-cell carcinoma. Stool microbiome composition is predictive of response to immunotherapy and cytotoxic chemotherapy. We sought to investigate whether antibiotics targeting Bacteroides species affect progression-free survival (PFS) while receiving first-line VEGF-TKI therapy.Patients and Methods
Using a retrospective cohort of intermediate- and poor-risk metastatic renal-cell carcinoma patients from the University of Utah, we categorized patients receiving first-line VEGF-TKIs by receipt of antibiotics (Bacteroides spp., non-Bacteroides spp., or none) and assessed PFS by Kaplan-Meier and Cox proportional hazard models.Results
Of 145 patients, 17 received antibiotics with Bacteroides spp. coverage and 32 patients received antibiotics without Bacteroides spp. coverage. When compared to patients not receiving antibiotics, improved PFS was seen with each additional day antibiotics were prescribed with Bacteroides spp. coverage (hazard ratio = 0.92; 95% confidence interval, 0.83-0.99; P = .04).Conclusion
Targeting stool Bacteroides spp. with antibiotics improves PFS in patients receiving first-line VEGF-TKIs in a duration-dependent manner. 相似文献18.
Shen Zhao Ding Ma Yi Xiao Yi-Zhou Jiang Zhi-Ming Shao 《European journal of surgical oncology》2018,44(4):420-428
Purpose
To examine the clinicopathologic characteristics and survival outcomes of different histologic types of triple-negative breast cancer (TNBC).Methods
We used the SEER database to identify patients with TNBC diagnosed between 2010 and 2014. Our analysis focused on the seven most prevalent histologic types. Differences were compared between invasive carcinoma of no special type (NST) and the other six types.Results
Significant differences were observed in age at diagnosis, tumor grade, size, nodal status and treatment. As tumor size increased, the number of positive lymph nodes increased markedly in invasive lobular carcinoma (ILC) and mixed NST and lobular carcinoma (NST-ILC), while in metaplastic carcinoma the number only increased slightly. In multivariate survival analyses, compared with patients with invasive carcinoma NST, breast cancer-specific survival (BCSS) and overall survival (OS) were worse for those with NST-ILC (BCSS: hazard ratio [HR] 1.81, P < .001; OS: HR 1.56, P = .005) or metaplastic carcinoma (BCSS: HR 1.95, P < .001; OS: HR 1.73, P < .001). By contrast, patients with medullary (HR 0.40, P = .010) or apocrine carcinoma (HR 0.27, P = .008) showed better BCSS. Time-dependent receiver operating characteristic (ROC) analyses indicated that T category in ILC and N category in metaplastic carcinoma were of less prognostic value.Conclusions
According to the histologic classification of TNBC, this heterogeneous disease can be divided into several entities with different clinicopathologic features and prognoses. In the era of molecular subtyping of breast cancer, the histologic classification of TNBC is still of considerable clinical significance. 相似文献19.
Vincent T. Ma Philip S. Boonstra Kamal Menghrajani Cecelia Perkins Krisstina L. Gowin Ruben A. Mesa Jason R. Gotlib Moshe Talpaz 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(5):e201-e210
Introduction
In the era before Janus kinase (JAK) inhibitors, cytogenetic information was used to predict survival in myelofibrosis patients. However, the prognostic value of cytogenetics in the setting of JAK inhibitor therapy remains unknown.Patients and Methods
We performed a retrospective analysis of 180 patients with bone marrow biopsy–proven myelofibrosis from 3 US academic medical centers. We fit Cox proportional hazards models for overall survival and transformation-free survival on the bases of 3 factors: JAK inhibitor therapy as a time-dependent covariate, dichotomized cytogenetic status (favorable vs. unfavorable), and statistical interaction between the two. The median follow-up time was 37.1 months.Results
Among patients treated with best available therapy, unfavorable cytogenetic status was associated with decreased survival (hazard ratio = 2.31; P = .025). At initiation of JAK inhibitor therapy, unfavorable cytogenetics was (nonsignificantly) associated with increased survival compared to favorable cytogenetics (hazard ratio = 0.292; P = .172). The ratio of hazard ratios was 0.126 (P = .034). These findings were similar after adjusting for standard clinical prognostic factors as well as when measured against transformation-free survival.Conclusion
The initiation of JAK inhibitor therapy appears to change the association between cytogenetics and overall survival. There was little difference in survival between treatment types in patients with favorable cytogenetics. However, the use of JAK inhibitor therapy among patients with unfavorable cytogenetics was not associated with worse survival compared to favorable cytogenetics. Our analyses suggest that initiation of JAK inhibitor therapy nullifies the negative prognostic implication of unfavorable cytogenetics established in the pre–JAK inhibitor therapy era. 相似文献20.
Kazushige Kawai Hiroaki Nozawa Keisuke Hata Toshiaki Tanaka Takeshi Nishikawa Koji Oba Toshiaki Watanabe 《Clinical colorectal cancer》2018,17(2):e163-e170