共查询到20条相似文献，搜索用时 953 毫秒
1.
Ho Won Kang Sung Pil Seo Young Joon Byun Xuan-Mei Piao Ye-Hwan Kim Pildu Jeong Yun-Sok Ha Won Tae Kim Yong-June Kim Sang-Cheol Lee Sung-Kwon Moon Yung-Hyun Choi Seok-Joong Yun Wun-Jae Kim 《Clinical genitourinary cancer》2018,16(4):274-280
Background
Pathologic T1 high-grade (pT1HG) bladder cancer (BC) is characterized by a high progression rate and constitutes an important clinical challenge; however, there is no consensus on the prediction of progression in pT1HG BC. The purpose of this study was to validate previously published molecular progression risk score (MoPRS) for predicting muscle-invasive disease in pT1HG BC.Materials and Methods
The expression of an 8-gene progression-related classifier identified from microarray data was analyzed by real-time PCR, and the MoPRS was calculated in 121 newly recruited patients with pT1HG BC. Progression was defined as muscle invasion or metastasis.Results
Overall, the disease of 28 patients (23.1%) progressed to muscle-invasive BC during the median follow-up of 63.7 (interquartile range, 17.6-96.4) months. The MoPRS was significantly higher in 1973 World Health Organization grade 3 than grade 2 tumors (P = .004). Early development of invasive BC was more prevalent in the highest quartile MoPRS group than in the lowest to 75th percentile MoPRS groups according to Kaplan-Meier analysis. Multivariate Cox regression analysis revealed that the MoPRS was an independent predictor of invasive BC, either as a continuous variable (hazard ratio, 1.624; 95% confidence interval, 1.266-2.082; P < .001) or as a categorical variable (hazard ratio, 3.089; 95% confidence interval, 1.335-7.150; P = .008).Conclusion
The MoPRS was an independent prognostic factor for identifying patients at high risk of invasive BC in patients with pT1HG BC. This scale may help identify patients who could benefit from more aggressive therapeutic intervention such as early cystectomy. 相似文献2.
Mohammad Hashemi Sara Sanaei Seyeh Mehdi Hashemi Ebrahim Eskandari Gholamreza Bahari 《Clinical breast cancer》2018,18(5):e883-e891
Introduction
The murine double minute 4 (MDM4) protein is a negative regulator of p53, and its upregulation has been observed in many tumor types. Previous literature suggested that genetic variations in the MDM4 gene are associated with risk of different cancers. The objective of the present study was to examine the effect of 3 common genetic variants of MDM4, rs4245739 A>C, rs11801299 G>A, and rs1380576 C>G, on the risk of breast cancer (BC) in a southeast Iranian population sample.Patients and Methods
A total of 265 BC patients and 221 healthy women were included in this case-control study. We used polymerase chain reaction (PCR)-restriction fragment length polymorphism and tetra amplification refractory mutation system-PCR methods for detection of MDM4 polymorphisms.Results
Our findings showed that rs1380576 C>G was associated with a reduced risk of BC using co-dominant (GC vs. CC: odds ratio [OR], 0.54; 95% confidence interval [CI], 0.34-0.84; P = .006; and GG vs. CC: OR, 0.49; 95% CI, 0.26-0.94; P = .044), dominant (CG+GG vs. CC: OR, 0.54; 95% CI, 0.35-0.82; P = .004), and allele models (G vs. C: OR, 0.74; 95% CI, 0.57-0.96; P = .025). However, our study failed to show any relationship between rs4245739 A>C and rs11801299 G>A variants and BC risk (P > .05). We also found no significant association between MDM4 variants and clinical characteristics of BC patients (P > .05).Conclusion
Our findings proposed that the MDM4 rs1380576 C>G polymorphism was a protective factor for BC risk in our population. Additional studies with larger sample sizes and diverse ethnicities are required to confirm our findings. 相似文献3.
Andrea Mari Mohammad Abufaraj Beat Foerster Mehmet ?zsoy Alberto Briganti Morgan Rouprêt Pierre I. Karakiewicz Romain Mathieu David D&#x;Andrea Daher C. Chade Shahrokh F. Shariat 《Clinical genitourinary cancer》2018,16(3):e619-e627
Introduction
The purpose of the present study was to investigate the association of smoking with biochemical recurrence (BCR) and metastasis in radiation-recurrent prostate cancer (PCa) patients undergoing salvage radical prostatectomy (SRP).Patients and Methods
A total of 214 patients treated with SRP for radiation-recurrent PCa in 5 tertiary referral centers were included from January 2007 to December 2015. Kaplan-Meier analyses were used to assess the time to BCR and metastasis. Pre- and postoperative multivariable Cox proportional hazard regression models were fitted.Results
Overall, 120 (56.1%), 49 (22.9%), and 45 (21%) patients were never, former, and current smokers, respectively. Low-, medium-, and high-cumulative smoking exposure was registered in 59.8%, 16.4%, and 23.8% of cases, respectively. Patients with high cumulative smoking exposure had a significantly greater rate of a pathologic Gleason score of ≥ 8 (P = .01) and extracapsular extension (P = .004). Smoking status, cumulative smoking exposure, intensity, and duration were significantly associated with BCR-free survival (P < .001 for all). Smoking status, cumulative smoking exposure, and smoking intensity were significantly associated with metastasis-free survival (P = .03 for all). High cumulative smoking exposure was independently associated with BCR in both pre- (hazard ratio, 2.23; P = .001) and postoperative (hazard ratio, 1.64; P = .04) multivariable models adjusted for the effects of established clinicopathologic features. Smoking cessation did not affect either BCR- or metastasis-free survival (P = .56 and P = .40, respectively).Conclusion
High cumulative smoking exposure was associated with the biologic and clinical aggressiveness of PCa in patients treated with SRP for radiation-recurrent disease. Smoking is a modifiable risk factor that detrimentally affected the outcomes, even in patients with advanced PCa. 相似文献4.
P. Zhang C.-Z. Li C.-T. Wu G.-M. Jiao F. Yan H.-C. Zhu X.-P. Zhang 《European journal of surgical oncology》2017,43(2):285-293
Background
The purpose of this study was to compare patient outcomes between immediate breast reconstruction (IBR) after mastectomy and mastectomy alone.Methods
We conducted a comprehensive literature search of PUBMED, EMBASE, Web of Science, and Cochrane Library. The primary outcomes evaluated in this review were overall survival, disease-free survival and local recurrence. Secondary outcome was the incidence of surgical site infection. All data were analyzed using Review Manager 5.3.Results
Thirty-one studies, involving of 139,894 participants were included in this paper. Pooled data demonstrated that women who had IBR after mastectomy were more likely to experience surgical site infection than those treated with mastectomy alone (risk ratios 1.51, 95% CI: 1.22–1.87; p = 0.0001). There were no significant differences in overall survival (hazard ratios 0.92, 95% CI: 0.80–1.06; p = 0.25) and disease-free survival (hazard ratios 0.96, 95% CI: 0.84–1.10; p = 0.54) between IBR after mastectomy and mastectomy alone. No significant difference was found in local recurrence between two groups (risk ratios 0.92, 95% CI: 0.75–1.13; p = 0.41).Conclusions
Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of breast cancer. Besides, no evidence shows that IBR after mastectomy increases the frequency of local recurrence. 相似文献5.
Introduction
The purpose of this study was to investigate the impact of single nucleotide polymorphisms (SNPs) in the acylphosphatase 2 gene and the SNP-SNP interactions on breast cancer (BC) risk in Chinese Han women.Patients and Methods
A logistic regression model was used to examine the association between SNPs and BC risk. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Generalized multifactor dimensionality reduction was employed to analyze the SNP-SNP interaction.Results
Logistic regression analysis showed that BC risk was significantly higher in carriers with the rs1682111-A allele than those with the TT genotype (TA + AA vs. TT; adjusted OR, 1.47; 95% CI, 1.21-1.92). In addition, we also found that BC risk was significantly higher in carriers with the rs10439478-C allele than those with the AA genotype (AC + CC vs. AA); adjusted OR, 1.67; 95% CI, 1.29-2.11. We found a significant 2-locus model (P = .0010) involving rs1682111 and rs10439478; the cross-validation consistency of this model was 10 of 10, and the testing accuracy was 60.11%. Participants with the TA or AA of rs1682111 and the AC or CC of rs10439478 genotype have the highest BC risk, compared with subjects with the TT of rs1682111 and the AA of rs10439478 genotype (OR, 2.52; 95% CI, 1.67-3.44), after covariate adjustment for gender, age, age at menarche, number of children, and body mass index.Conclusions
Minor allele of rs1682111 and rs10439478 and its interaction were associated with increased BC risk. 相似文献6.
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7.
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8.
W.J. Choi J.H. Cha H.H. Kim H.J. Shin E.Y. Chae K.H. Jung J.-H. Ahn S.-B. Kim B.H. Son S.H. Ahn 《Clinical oncology (Royal College of Radiologists (Great Britain))》2017,29(10):653-661
Aims
To investigate whether preoperative magnetic resonance imaging (MRI) in patients with primary breast cancer is predictive of disease-free (DFS) and overall survival and to determine the prognostic factors indicating survival.Materials and methods
This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. From 2009 to 2010, 828 women with primary breast cancer and preoperative MRI were matched with 1613 women without such imaging. Patients were matched with regards to 25 patient and tumour-related covariates. A Cox proportional hazards model was used to investigate the time to recurrence and to estimate the hazard ratio for preoperative MRI. Log-rank tests and Cox proportional hazards survival analysis were carried out on total recurrence DFS and overall survival in the unmatched datasets.Results
In total, 799 matched pairs were available for survival analysis. The MRI group showed a tendency towards better survival outcome; however, there were no significant differences in DFS and overall survival. Age at diagnosis (DFS hazard ratio = 0.98; overall survival hazard ratio = 1.04), larger tumour size (DFS hazard ratio = 1.01; overall survival hazard ratio = 1.02), triple negative breast cancer (DFS hazard ratio = 2.64; overall survival hazard ratio = 3.44) and the presence of lymphovascular invasion (DFS hazard ratio = 2.12; overall survival hazard ratio = 2.70) were independent significant variables for worse DFS and overall survival.Conclusion
Preoperative MRI did not result in an improvement in a patient's outcome. Age at diagnosis, tumour size, molecular subtype and lymphovascular invasion were significant independent factors affecting both DFS and overall survival. 相似文献9.
Alona Zer Mor Moskovitz David M. Hwang Anat Hershko-Klement Ludmila Fridel Grzegorz J. Korpanty Elizabeth Dudnik Nir Peled Tzippy Shochat Natasha B. Leighl Geoffrey Liu Ronald Feld Ronald Burkes Mira Wollner Ming-Sound Tsao Frances A. Shepherd 《Clinical lung cancer》2017,18(2):156-161
Background
Patients with lung cancer are at increased risk for venous thromboembolism (VTE), particularly those receiving chemotherapy. It is estimated that 8% to 15% of patients with advanced non–small-cell lung cancer (NSCLC) experience a VTE in the course of their disease. The incidence in patients with specific molecular subtypes of NSCLC is unknown. We undertook this review to determine the incidence of VTE in patients with ALK (anaplastic lymphoma kinase)-rearranged NSCLC.Patients and Methods
We identified all patients with ALK-rearranged NSCLC diagnosed and/or treated at the Princess Margaret Cancer Centre (PM CC) in Canada between July 2012 and January 2015. Retrospective data were extracted from electronic medical records. We then included a validation cohort comprising all consecutive patients with ALK-rearranged NSCLC treated in 2 tertiary centers in Israel.Results
Within the PM CC cohort, of 55 patients with ALK-rearranged NSCLC, at a median follow-up of 22 months, 23 (42%) experienced VTE. Patients with VTE were more likely to be white (P = .006). The occurrence of VTE was associated with a trend toward worse prognosis (overall survival hazard ratio = 2.88, P = .059). Within the validation cohort (n = 43), the VTE rate was 28% at a median follow-up of 13 months. Combining the cohorts (n = 98), the VTE rate was 36%. Patients with VTE were younger (age 52 vs. 58 years, P = .04) and had a worse Eastern Cooperative Oncology Group performance status (P = .04). VTE was associated with shorter overall survival (hazard ratio = 5.71, P = .01).Conclusion
The rate of VTE in our ALK-rearranged cohort was 3- to 5-fold higher than previously reported for the general NSCLC population. This warrants confirmation in larger cohorts. 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.
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12.
John V. Hegde Xiaoyan Wang Deanna J. Attai Maggie L. DiNome Amy Kusske Anne C. Hoyt Sara A. Hurvitz Joanne B. Weidhaas Michael L. Steinberg Susan A. McCloskey 《Clinical breast cancer》2018,18(2):e205-e218
Introduction
Contralateral prophylactic mastectomy (CPM) rates are rising, with fear implicated as a contributing factor. This study used a contralateral breast cancer (CBC) risk stratification tool to assess whether the selection of CPM is reflective of future CBC risk.Patients and Methods
This retrospective study evaluated 404 women with unilateral breast cancer treated with breast conservation, unilateral mastectomy, or bilateral mastectomy within a single multidisciplinary clinic. Women were evaluated by the Manchester risk tool to calculate lifetime CBC risk. Logistic regression analysis was used to evaluate whether CBC risk was associated with CPM, and the clinical rationale for prophylactic mastectomy justification was recorded.Results
Sixty-two percent underwent breast conservation, 18% unilateral mastectomy, and 20% bilateral mastectomy. In the CPM cohort, 36% had > 20% calculated lifetime CBC risk. In the invasive cohort, younger age (odds ratio 2.65, P < .0001) and genetic mutation positivity (odds ratio 35.39, P = .019) independently predicted CPM. Other contributing factors included benign contralateral breast findings (29%) and recommendations against breast conservation due to disease burden (28%). Six percent selected CPM as a result of an unsubstantiated fear regarding breast cancer.Conclusion
The majority of women (63%) who selected CPM had < 20% CBC risk. In these lower-risk women selecting CPM, factors increasing reasonable fear dominated surgical choice (81% of this subset). 相似文献13.
B.A. Wan V. Ganesh L. Zhang P. Sousa L. Drost J. Lorentz D. Vesprini J. Lee E. Rakovitch F.-I. Lu A. Eisen C. Yee H. Lam E. Chow 《Clinical oncology (Royal College of Radiologists (Great Britain))》2018,30(6):354-365
Aims
Male breast cancer is a rare disease with limited evidence-based guidelines for treatment. This study aimed to identify demographic, pathological and clinical factors associated with its prognosis.Materials and methods
A retrospective review of 161 male breast cancer patients diagnosed at a single institution from 1987 to June 2017 was conducted. Patient demographics, disease characteristics, treatment and outcome were extracted and included in competing-risk analysis and the univariate Cox proportional hazard model for univariate analysis. Factors with P < 0.10 were included in multivariable analysis.Results
The mean age at diagnosis was 67 years (standard deviation = 11.2) and the median follow-up duration was 5.3 years (range 0–25 years). There were 48 deaths, including 23 cancer-specific deaths. The actuarial median survival was 19.9 years. In multivariable analysis, factors associated with overall survival were size of tumours (hazard ratio 2.0; 95% confidence interval 1.4–2.7, P < 0.0001) and diagnosis of metastatic disease (hazard ratio 8.7; 95% confidence interval 1.9–40.6; P = 0.006). Of 138 patients without metastases at diagnoses, 11 had local-regional recurrence and 26 had distant metastases. In the multivariable model for local-regional recurrence, a more recent year of diagnosis was associated with reduced risk (hazard ratio 0.9, 95% confidence interval 0.8–1.0, P = 0.008), whereas more positive lymph nodes was associated with higher risk (hazard ratio 2.2, 95% confidence interval 1.2–4.0, P = 0.01). A higher risk of metastases was associated with more positive lymph nodes (hazard ratio 1.9; 95% confidence interval 1.1–3.3; P = 0.03) and tumour size (hazard ratio 1.8; 95% confidence interval 1.1–2.9; P = 0.01). A higher risk of any recurrence or metastases was associated with the number of positive nodes (hazard ratio 1.9; 95% confidence interval 1.2–3.0; P = 0.005) and tumour size (hazard ratio 1.6; 95% confidence interval 1.1–2.2; P = 0.01).Conclusion
In general, tumour size and more positive lymph nodes were associated with worse prognosis. Larger powered studies are needed to identify prognostic factors with smaller effect sizes. 相似文献14.
Naoya Niwa Kazuhiro Matsumoto Hiroki Ide Hirohiko Nagata Mototsugu Oya 《Clinical genitourinary cancer》2018,16(3):e655-e661
Purpose
To investigate the relationship between albumin-to-globulin ratio (AGR) and oncologic outcomes in patients with non–muscle-invasive bladder cancer (NMIBC).Patients and Methods
We identified 364 patients with primary NMIBC who underwent transurethral surgery between 2000 and 2015. The association between pretreatment AGR and clinicopathologic variables, including oncologic outcomes, was statistically evaluated.Results
One hundred twenty patients (33.0%) experienced at least one tumor recurrence, and 23 (6.3%) developed muscle-invasive disease. The median (interquartile range) pretreatment AGR was 1.73 (1.53-1.89). The Kaplan-Meier curve revealed that tumor recurrence was strongly predicted in patients with pretreatment AGR < 1.6, and similar results were observed for disease progression (P < .01 and P < .01, respectively). On multivariate analysis, we found that pretreatment AGR < 1.6 is an independent risk factor for tumor recurrence (hazard ratio, 0.53; P < .01). On univariate analysis, pretreatment AGR < 1.6 was also associated with disease progression (hazard ratio, 0.24; P < .01).Conclusion
Low pretreatment AGR is an independent risk factor for tumor recurrence and is one risk factor for disease progression in NMIBC patients. This inexpensive and easily accessible biomarker may become useful in selecting patients with NMIBC with higher risk of recurrence and progression. 相似文献15.
Andrea Prochowski Iamurri Martina Ponziani Marco Macchini Marco Fogante Mirco Pistelli Mariagrazia De Lisa Rossana Berardi Gian Marco Giuseppetti 《Clinical breast cancer》2018,18(2):e231-e235
Introduction
The purpose of this study was to evaluate whether diagnostic performance of breast magnetic resonance imaging (MRI) for detection of multifocality and multicentricity (MFMC) of breast cancer (BC) can be influenced by different histotypes or immunophenotypes in newly diagnosed patients with breast cancer.Materials and Methods
In this institutional review board-approved retrospective study, 289 patients who underwent both preoperative breast MRI and radical or modified mastectomy in our institution because of primary BCs were selected. Patients were stratified based on the pathologic report in 2 main histotypes and 5 immunophenotypes. By matching the radiologic report with the corresponding pathologic report for each patient, breast MRI performance for detection of MFMC were obtained in each histotype and immunophenotype and subsequently compared.Results
Overall breast MRI sensitivity for MFMC detection was 88.1%, specificity was 80.0%, positive predictive value 82.1%, negative predictive value 85.8%, diagnostic accuracy 83.7%, and area under the curve 0.835. Breast MRI sensitivity for MFMC detection in triple-negative BC was 84.6% (P = .88), specificity 70.8% (P = .63), positive predictive value 61.1% (P = .02), negative predictive value 89.5% (P = .20), diagnostic accuracy 75.7% (P = .65), and area under the curve 0.777 (P = .87).Conclusion
Performance of breast MRI for the detection of MFMC are not influenced by the BC histotypes, in accordance with published literature. Conversely, the triple-negative immunophenotypes demonstrated lower performance, statistically significant only for positive predictive value (P = .02), for the detection of MFMC. 相似文献16.
Eman Z. Kandeel Ghada El Sayed Nahla Elsharkawy Dalia Negm Eldin Hanan R. Nassar Dalia Ibrahiem Randa Amin Marwa Hanafi Mohamed Khalil Azza Kamel 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(8):541-547
Background
The significance of FMS-like tyrosine kinase 3 (FLT3)-ITD mutation in acute myeloid leukemia (AML) prognosis has been well established. The aims of this study were to investigate the prognostic impact of the FLT3 protein (CD135) expression and its association with FLT3-ITD mutation, and to identify its role in minimal residual disease.Patients and Methods
CD135 was measured by flow cytometry on leukemic blasts of 257 adults with de novo AML. High expression of CD135 ≥ 20% was correlated with clinical, laboratory, and other prognostic factors that influenced treatment outcome. FLT3-ITD mutation was tested by PCR.Results
The frequency of CD135 expression was 138 (53.7%) of 257. FLT3-ITD was detected in (21.4%). Positive CD135 expression was associated with high total leukocyte count (P = .006), platelet count (P = .003), monocytic leukemia (P < .001), and CD34 (P = .008) and CD117 (P = .006) expression. CD135 expression ≥ 25% was a predictor of FLT3-ITD mutation (P = .03). CD135 overexpression was a negative predictor of complete remission and of postinduction minimal residual disease at days 14 and 28 (P < .001). CD135 had an adverse impact on overall and disease-free survival (68.5% vs. 15%, P = .002). Multivariate analysis indicated CD135 was the sole independent prognostic factor for overall survival (hazard ratio = 2.49; 95% confidence interval, 1.855-3.345; P < .001).Conclusion
CD135 is emerging as a prognostic factor, a new marker for minimal residual disease, and a potential novel therapeutic target of AML. 相似文献17.
Aleš Obr Vít Procházka Andrea Jirkuvová Helena Urbánková Eva Kriegova Petra Schneiderová Michaela Vatolíková Tomáš Papajík 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(11):762-768
Background
TP53 mutation (TP53mut) and a complex karyotype (CK) were shown to be predictors of poor outcome in mantle-cell lymphoma (MCL). In this study we examined the combined effect of both of these risk factors.Patients and Methods
Patients diagnosed with MCL between January 2000 and December 2014 (n = 74) were evaluated. Forty-eight of them had available material for TP53 and cytogenetic examination. We analyzed the prognostic effect of combined TP53mut and CK in the cohort of patients treated with rituximab-containing therapy.Results
Three-year (3-y) overall survival (OS) and 3-y progression-free survival (PFS) in CK patients were shorter compared with non-CK (P = .001 for OS; P = .02 for PFS). TP53mut was a predictor of shorter survival compared with TP53 wild type (OS and PFS; P < .001). The incidence of TP53mut was not significantly associated with CK (P = .240). CK and TP53mut were predictors of inferior PFS and OS independent of age and Mantle-Cell Lymphoma International Prognostic Index, with hazard ratios of 2.35 (P = .024), 4.50 (P < .001) for PFS and 4.31 (P < .001), 5.46 (P < .001) for OS analysis in the CK and TP53mut groups, respectively. The combination of TP53mut and CK status stratified the patients into 3 prognostic groups (P < .001) with the worst outcome in patients with CK and TP53mut.Conclusion
TP53 mutation and CK occurred independently and patients harboring both had a dismal prognosis. The study suggests the importance of molecular cytogenetics and examination of the TP53mut status to be performed simultaneously before treatment. 相似文献18.
Nikola S. Mutschler Christoph Scholz Thomas W.P. Friedl Thomas Zwingers Peter A. Fasching Matthias W. Beckmann Tanja Fehm Svjetlana Mohrmann Jessica Salmen Carola Ziegler Bernadette Jäger Peter Widschwendter Nikolaus de Gregorio Fabienne Schochter Sven Mahner Nadia Harbeck Tobias Weissenbacher Julia Jückstock Brigitte Rack 《Clinical breast cancer》2018,18(2):175-183
Background
In addition to established prognostic factors, individual lifestyle-associated factors, such as obesity, physical activity, and diet, seem to modulate the course of breast cancer. The aim of this analysis was to evaluate the influence of weight changes during adjuvant chemotherapy on outcome in a large multicenter prospectively randomized trial.Patients and Methods
The ADEBAR trial compares a sequential chemotherapy consisting of epirubicin/cyclophosphamide followed by docetaxel to an epirubicin/5-fluorouracil/cyclophosphamide regimen in patients with lymph node–positive early breast cancer. Body weight was measured before each cycle of chemotherapy. According to the relative weight change (≥ 5%) between the first and the last cycle, patients were categorized into the weight gain, weight loss, or stable weight group. Overall survival (OS) and disease-free survival were assessed by univariate Kaplan-Meier and multivariate Cox regression analyses.Results
Concise data from 1080 of 1493 participants who completed all cycles of chemotherapy were available for analysis. Of 307 patients (24.8%) whose weight changed by ≥ 5%, 120 patients (11.1%) lost and 187 (17.3%) gained weight. Multivariate analysis showed a significant independent effect of weight change on OS (P = .039), but not on disease-free survival (P = .111). Both weight change groups had a worse OS compared to patients with stable weight (weight gain: hazard ratio, 1.55; 95% confidence interval, 1.01-2.40; P = .047; weight loss: hazard ratio, 1.55; 95% CI, 0.97-2.47; P = .067).Conclusion
Weight change of > 5% during adjuvant chemotherapy in patients with high-risk early breast cancer is associated with poor OS. 相似文献19.
Nobuaki Matsubara Yoko Yamada Ken-ichi Tabata Takefumi Satoh Naoto Kamiya Hiroyoshi Suzuki Takashi Kawahara Hiroji Uemura Akihiro Yano Satoru Kawakami Masafumi Otsuka Satoshi Fukasawa 《Clinical genitourinary cancer》2018,16(2):142-148
Background
Abiraterone (AA) and enzalutamide (ENZA) are increasingly being used in chemotherapy-naive patients with metastatic castration-resistant prostate cancer owing to efficacy and favorable toxicity. However, the order in which they should be administered has not been determined.Patients and Methods
We retrospectively reviewed the records of chemotherapy-naive patients with metastatic castration-resistant prostate cancer who had received sequential treatment with either AA followed by ENZA (AA-ENZA) or the converse (ENZA-AA). Prostate-specific antigen (PSA) response rates (defined as ≥ 50% PSA decline from baseline), first-line progression-free survival (PFS), second-line PFS, combined PFS (defined as first-line PFS plus second-line PFS), and overall survival are compared between the 2 sequence groups.Results
A total of 97 patients received sequential treatment with AA and ENZA; 50 patients were in the AA-ENZA group, and 47 patients were in the ENZA-AA group. The PSA response rate to first-line treatment was not significantly different between AA (48%) and ENZA (51%) (P = .840). However, a significant difference was observed in the PSA response rate to second-line treatment (AA, 6.4% vs. ENZA, 30%; P = .004). The median combined PFS was not significantly different between sequence groups (hazard ratio, 0.71; 95% confidence interval, 0.46-1.08; log-rank P = .105). The order of addition also had no significant effect on median overall survival (hazard ratio, 0.98; 95% confidence interval, 0.64-1.52; log-rank P = .834).Conclusion
With the exception of the second-line PSA response, there was no significant difference in clinical outcomes between the AA-ENZA and ENZA-AA groups. Our results might be useful reference in daily practice, especially for patients who do not have a suitable general condition for chemotherapy. 相似文献20.
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