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Results for “prognostic factor”

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PubMed2002

[Histopathologic prognostic factors, serum markers and selected molecular biologic factors in ovarian carcinoma].

OBJECTIVE: A review of histopathological prognostic factors, serum markers and selected molecular biological factors in ovarian cancer. DESIGN: Review. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty Hradec Králové, Charles University, Prague; Department of Biological and Medical sciences, Pharmaceutical Faculty, Hradec Králové, Charles University, Prague; Department of Clinical Oncology, Medical Faculty Hradec Králové, Charles University, Prague; Bristol-Myers Squibb, Department of Oncology, Prague. METHOD: Discussion about current evidence from literature. CONCLUSION: Except clinical prognostic factors the wide spectrum behaviour of epithelial ovarian cancers is reflected by some histopathological prognostic factors, serum markers and some molecular biological factors. The most important are grade and tumor ploidy, the level of CA 125 and its changes during the treatment, mutations of p53, BRCA 1 and 2.

Biomarkers, Tumor↗

PubMed2004

Histopathological prognostic factors in patients with cervical cancer treated with radical hysterectomy and postoperative radiotherapy.

BACKGROUND: Many studies have been performed, on the clinical outcome and prognostic factors in patients with cervical cancer treated with radical hysterectomy and postoperative radiotherapy, but no useful method for predicting the risk of recurrence has been established. The purpose of this study was to analyze histopathological prognostic factors. In addition, we proposed a new risk classification and evaluated its usefulness. METHODS: One hundred and thirty patients with stage I-II uterine cervical cancer were treated with radical hysterectomy and postoperative radiotherapy at Ehime University Hospital between 1978 and 1997. All surgical specimens were reviewed, and the relationship between histopathological factors and the clinical outcome was analyzed. RESULTS: Of the histopathological prognostic factors of the surgical specimens analyzed, six factors (parametrial invasion, venous infiltration, pelvic lymph node metastases, thickness of the residual muscular layer, tumor depth, and tumor growth pattern) were significant prognostic factors. In particular, venous infiltration and pelvic lymph node metastases were strongly correlated with recurrence. Using the above five factors (excluding the thickness of the residual muscle layer), all patients were scored based on the total number of poor prognostic factors, and were classified into three groups. Patients with a score of 0-1 were classified as the low-risk group, those with a score of 2 as the intermediate group, and those with a score of 3-5 as the high-risk group. The 5-year disease-free survival rates were 93% in the low-risk group, 82% in the intermediate group, and 56% in the high-risk group (P < 0.05). CONCLUSION: Six prognostic factors were found. Our risk classification seems to be clinically useful to predict which patients are at risk of recurrence.

Adult↗

PubMed1999

[The prognostic factors in T1 superficial bladder carcinoma. Our experience].

OBJECTIVE: To identify the prognostic factors for recurrence and disease progression in T1 superficial carcinoma of the bladder for prophylactic therapeutic planning. METHODS: Of 309 patients with superficial carcinoma of the bladder that had only undergone TUR, we selected 196 patients that met the following requirements: T1 tumor, one year minimum follow-up (except for recurrence), TUR complete on gross examination. The changes observed with recurrence (presence of a tumor regardless of grade or stage) and disease progression (higher tumor stage and therefore infiltrating) in the following parameters were analyzed: tumor grade, node involvement, volume resected, number of tumors, primary or recurrent and age. RESULTS: 141 (72%) showed recurrence and 23 disease progression (11.7%) at two-years' mean follow-up. The resected tumor volume was found to be a prognostic factor for recurrence by univariate (0.010) and multivariate analysis (0.039). Tumor grade (0.0005) and node involvement (0.040) were prognostic factors for disease progression by univariate analysis and tumor grade (0.006) by multivariate analysis. CONCLUSIONS: Resected tumor volume, node involvement and tumor grade were found to be prognostic factors. The incidence of disease progression in this series falls within the lower ranges reported in the literature.

Aged↗

PubMedDate not supplied

Tumour markers CEA and CA 15-3 as Prognostic factors in breast cancer--univariate and multivariate analysis.

Tumour markers are putative prognostic indicators for patients with breast cancer, but have not been elevated independently by multivariate analysis in a large patient number. In 550 patients with breast cancer without known metastases the levels of the serum tumour markers CEA und CA 15-3 were determined preoperatively and during follow-up. The prognostic relevance of these markers for recurrence (n = 128/487) and death of disease (n = 55/550) was evaluated in relation to established prognostic factors. In univariate analysis tumour size, lymph nodes, histological grading, age, hormone receptors, preoperative value of CEA (cut-off 2 ng/mL) and CA 15-3 (cut-off 25 U/mL) and their decrease of more than 33% within seven months after operation were significant for relapse. The results for death of disease were similar except for age. In multivariate analysis tumour size, lymph nodes and decrease of CEA > 33% (p < 0.001) were independent prognostic factors for recurrence. For overall survival tumour size, lymph nodes, histological grading and preoperative levels of CEA > or = 2 ng/mL (p = 0.038) and of CA 15-3 > or = 25 U/mL (p = 0.007) were independent prognostic factors. Pre- and postoperative values of the tumour markers CEA und CA 15-3 are strong independent prognostic factors for relapse and survival in breast cancer patients.

Analysis of Variance↗

PubMed1999

Effectiveness of accelerated radiotherapy for patients with inoperable non-small cell lung cancer (NSCLC) and borderline prognostic factors without distant metastasis: a retrospective review.

PURPOSE: The standard treatment for patients with unresectable or medically inoperable non-small cell lung cancer (NSCLC) and good prognostic factors (e.g., weight loss [WL] < or = 5% and Karnofsky performance status [KPS] > or = 70) is induction chemotherapy followed by definitive radiotherapy to the primary site at 1.8-2.0 Gy per fraction with a total dose of 60-63 Gy to the target volume. Patients with poor prognostic factors usually receive radiotherapy alone, but the fractionation schedule and total dose have not been standardized. To attempt to optimize irradiation doses and schedule, we compared the effectiveness of accelerated radiotherapy (ACRT) alone to 45 Gy at 3 Gy per fraction with standard radiation therapy (STRT) of 60-66 Gy at 2 Gy per fraction in regard to tumor response, local control, distant metastasis, toxicity, and survival. METHODS AND MATERIALS: Fifty-five patients treated with radiation for NSCLC at The University of Texas M. D. Anderson Cancer Center between 1990 and 1994 were identified. All 55 patients had node-positive, and no distant metastasis (N+, M0) of NSCLC. Two cohorts were identified. One cohort (26 patients) had borderline poor prognostic factors (KPS less than 70 but higher than 50, and/or WL of more than 5%) and was treated with radiotherapy alone to 45 Gy over 3 weeks at 3 Gy/fraction (ACRT). The second cohort (29 patients) had significantly better prognostic factors (KPS > or = 70 and WL < or = 5%) and was treated to 60-66 Gy over 6 to 6 1/2 weeks at 2 Gy per fraction (STRT) during the same period. RESULTS: In the first cohort treated by ACRT, the distribution of patients by AJCC stage was IIB 8%, IIIA 19%, and IIIB 73%. Sixty-two percent had KPS <70, and 76% had a WL of >5%. The maximum response rate as determined by chest X-ray was 60% among 45 of 55 patients who were evaluable for response: combined complete responses (20%) and partial responses (40%). Overall survival in these patients was 13% at 2 and 5 years, with a locoregional control rate of 42% and a freedom from distant metastasis rate of 54%. The ACRT cohort treated with 3 Gy per fraction had significantly lower KPS scores (p = 0.003) and greater WL (p = 0.063) than the cohort STRT treated with 2 Gy per fraction. However, treatment results and toxicity were not significantly different between the two cohorts in spite of significantly better prognostic factors in the STRT cohort. CONCLUSIONS: Despite having worse prognostic factors, the cohort treated with radiotherapy alone to 45 Gy at 3 Gy per fraction over 3 weeks (ACRT) had response rates, locoregional control, and overall survival comparable to those in the cohort treated by a total dose of 60-66 Gy at 2 Gy per fraction over 6 to 6 1/2 weeks (STRT). Given that accelerated treatment schedules decrease treatment time and cost less, these may, in the current health care environment, be important factors for health care providers to consider in treating patients who have locally advanced NSCLC and borderline poor prognostic factors.

Carcinoma, Non-Small-Cell Lung↗

PubMed2003

[Analysis of prognostic factors in patients with refractory acute myeloid leukemia].

OBJECTIVE: To analyze the prognostic factors in patients with refractory acute myeloid leukemia, so as to provide theoretical basis for choosing an appropriate chemotherapy. METHODS: This study included 48 patients with refractory acute myeloid leukemia who received two standard DA regimens followed by chemotherapy with median dose of Ara-C and mitoxantrone. The factors such as age, gender, responses to the standard chemotherapy, cytogenetic abnormalities, blast cell counts in the bone marrow, peripheral blood cell counts, extramedullary infiltration exhibition and LDH were examined in light of their respective impact on the patients' survival. Cox regression model was used to analyze the prognostic factors. RESULTS: The results revealed that the factors such as achievement of the first complete remission after standard induction chemotherapy, the remission duration longer than 6 months, favorable cytogenetic abnormalities, blast cell counts less than 50% in bone marrow, absence of severe anemia, absence of liver or pancreatic enlargement or central nerves system (CNS) leukemia, and LDH less than 360 U/L, all indicated favorable prognosis of the patients. Age, gender, white cell counts in periphery blood or lymphadenopathy were not related to the survival of the patients. CONCLUSION: The patients with favorable prognostic factors should receive intensive chemotherapy for prolonged survival; allogeneic bone marrow transplantation should be performed as soon as possible in patients with unfavorable prognostic factors.

Adolescent↗

PubMed2004

Positive status of alpha-fetoprotein and des-gamma-carboxy prothrombin: important prognostic factor for recurrent hepatocellular carcinoma.

The aim of this study was to evaluate prognostic factors after the recurrence of hepatocellular carcinoma (HCC) in patients who had undergone hepatic resection. We used univariate and multivariate retrospective analyses of 29 clinicopathologic factors in 143 patients with recurrent HCC. Patients were classified into four groups according to the positivity of tumor markers at the time of recurrence. Survival rates and prognostic factors were then compared among the four groups. Multivariate analysis revealed four independent prognostic factors at recurrence: albumin level < 3.5 g/dl ( p = 0.0003), period until recurrence </= 1 year ( p = 0.0004), positive status of alpha-fetoprotein and des-gamma-carboxy prothrombin (AFP+/DCP+) ( p < 0.0001), and portal vein invasion ( p < 0.0001). Among groups with varying status of AFP/DCP, the survival rate in patients with AFP+/DCP+ at recurrence was significantly lower than those in the other three groups (+/+ 15.9% vs. +/- 47.2%, -/+ 44.8%, or -/- 61.1% at 3 years: p < 0.05). The AFP+/DCP+ group also had significantly higher rates of the recurrence appearing </= 1 year after operation (+/+ 68.3% vs. +/- 45.2%, -/+ 41.9%, or -/- 32.5%: p = 0.0108), extrahepatic recurrence (29.3% vs. 6.5%, 9.7%, or 5.0%: p = 0.0026), and no treatment at recurrence (29.3% vs. 9.7%, 9.7%, or 5.0%: p = 0.0115). These results indicate that the tumor markers AFP and DCP are significant prognostic factors for recurrent HCC, and their monitoring is essential for improving the prognosis after recurrence.

Biomarkers↗

PubMed2004

[Study of prognostic factors in patients with stage I non-small cell lung cancer].

OBJECTIVE: To analyze the prognostic factors in patients with stage I non-small cell lung cancer (NSCLC). METHODS: Fifty-eight patients with stage I NSCLC treated from 1991 to 1995 were retrospectively reviewed. The clinical features, histopathology and prognostic factors were analyzed by SPSS10.0 statistic software. The expression of c-myc, MDM2, c-erbB-2, EGFR, p53, p14(ARF), p16(INK4), p21(WAF1) and nm23 was detected by immunohistochemical assay. The overall survival rate, local-regional control rate and distant metastasis rate were observed. RESULTS: The overall survival rate, local-regional recurrent rate and distant metastasis rate were 71.1%, 11.1% and 33.5%, respectively. In univariate analysis, tumor cell differentiation was an independent prognostic factor (P = 0.028); overexpression of c-myc or c-erbB-2 had significantly poor overall survival and high distant metastasis rate (P < 0.05). The total oncogene immunoreactive score (IRS) and comprehensive IRS were associated with poor overall survival. In multivariate analysis, tumor cell differentiation and comprehensive IRS were independent prognostic factors for overall survival. Among the high-risk group of patients, those who had received chemotherapy seemed to have a higher overall survival rate and a lower distant metastasis rate in this study, but the difference was not statistically significant. CONCLUSION: For stage I NSCLC patients, tumor cell differentiation and comprehensive IRS are independent prognostic factors for overall survival. Adjuvant chemotherapy might somehow improve the survival for the patients with high-risk factors.

Adult↗

PubMed2000

Prognostic factors in advanced non-small cell lung cancer: elevated serum levels of neuron specific enolase indicate poor prognosis.

BACKGROUND: Non-small cell lung cancer (NSCLC) is resistant to chemotherapy and prognosis of advanced NSCLC patients is considered to be dependent on various prognostic factors. METHODS: We analyzed prognostic factors in patients with advanced NSCLC who had been enrolled in clinical trials conducted by the Okayama Lung Cancer Study Group between 1978 and 1992 using two kinds of multivariate analysis, Cox's multivariate analysis and recursive partitioning and amalgamation (RPA) analysis. RESULTS: The first analysis was performed on 261 patients using 28 variables. Performance status (PS), clinical stage, liver metastasis or serum albumin level was an independent prognostic factor by Cox's analysis. In the second analysis performed on 128 patients having data on neuron specific enolase (NSE), NSE was the most important prognostic factor. Using the RPA method, three subgroups with significantly different survival potentials were defined. Among them, patients with normal serum NSE levels and good PS were found to obtain a markedly favorable prognosis [median survival time (MST) 22.1 months, 3-year survival rate 42.9%], whereas the survival of patients with elevated serum NSE levels and bone metastasis was extremely short (MST 4.7 months, 3-year survival rate 0%). CONCLUSIONS: These results indicate that analysis of prognostic factors including serum levels of NSE is useful for predicting the survival of patients with advanced NSCLC.

Adult↗

PubMed1995

Prognostic factors in allogeneic bone marrow transplantation for multiple myeloma.

PURPOSE: To analyze prognostic factors for allogeneic bone marrow transplantation (BMT) in multiple myeloma. PATIENTS AND METHODS: One hundred sixty-two reports of allogeneic matched sibling-donor transplants in multiple myeloma received by the European Group for Blood and Marrow Transplantation (EBMT) registry between 1983 and early 1993 were analyzed for prognostic factors. End points were complete remission, survival, and duration of complete remission. RESULTS: Following BMT, 44% of all patients and 60% of assessable patients entered complete remission. The overall actuarial survival rate was 32% at 4 years and 28% at 7 years. The overall relapse-free survival rate of 72 patients who were in complete remission after BMT was 34% at 6 years. Favorable pretransplant prognostic factors for survival were female sex (41% at 4 years), stage I disease at diagnosis (52% at 4 years), one line of previous treatment (42% at 4 years), and being in complete remission before conditioning (64% at 3 years). The subtype immunoglobulin A (IgA) myeloma and a low beta 2-microglobulin level (< 4 g/L) also tended to have a favorable prognostic impact. The most important post-transplant prognostic factor was to enter a complete remission. Grade III to IV graft-versus-host disease (GVHD) was associated with poor survival. CONCLUSION: Patients with a low tumor burden who respond to treatment before BMT and are transplanted after first-line therapy have the best prognosis following BMT.

Adult↗

PubMedDate not supplied

Prognostic factors in breast cancer: a brief review.

Prognostic factors, e.g. metastatic disease, lymph node status, tumour size, histologic grade, estrogen and progesterone receptors, and markers of proliferation are used to predict the clinical course of breast cancer at the time of primary treatment. Patients with a poor prognosis are offered adjuvant therapy. For the choice of adjuvant therapy (endocrine or cytotoxic) treatment predictive factors, e.g. estrogen and progesterone receptor; are useful. Putative new prognostic factors (e.g. oncogenes, tumour suppressor genes, and invasive factors) should be evaluated together with the clinical established factors in multivariate analyses.

Biomarkers, Tumor↗

PubMed1997

[Analysis of prognostic factors in superficial bladder tumors].

OBJECTIVE: When the traditional prognostic factors (tumor grade, stage, size, number and cytological findings) are used as guidelines for intravesical therapy of superficial bladder tumors and the reported results are compared, it is not uncommon to find unexplainable differences. This study was conducted to determine the prognostic factors for tumor recurrence and progression before instituting any type of adjuvant therapy for superficial bladder tumors. METHODS: 81 consecutive patients with primary superficial bladder cancer (stage Ta-T1, grade 1-3) were entered into a surveillance protocol and controlled for a mean period of 14 months (range 3-44). Patient individual features (sex and age) and tumor characteristics (grade, stage, size, number, cytological findings) were analyzed to determine the risk of tumor recurrence and/or progression. RESULTS: Logistic regression analysis identified age as the only independent prognostic factor for recurrence, which was 6.37 fold (2-42) more frequent for subjects aged 65 years or older. Given the low progression rate (3 cases; 4.8%), a formal risk analysis could not be performed. CONCLUSION: The factors used to predict recurrence (tumor grade, stage, size, number and cytological findings) were not found to be independent in the present series. Certain predictors of tumor aggressiveness-such as age-, which could modify tumor biology, were found to predispose to tumor recurrence.

Adult↗

PubMed2004

Implications of prognostic factors and risk groups in the management of differentiated thyroid cancer.

OBJECTIVES/HYPOTHESIS: The outcome in differentiated thyroid cancer generally depends on the stage of the disease at the time of presentation; prognostic factors such as age, grade, size, extension, or distant metastasis; and risk groups (eg, low or high risk). The author has reviewed a large number of patients with differentiated thyroid cancer to analyze their hypothesis and to confirm that various risk groups have a major implication in relation to extent of the treatment and outcome. Differentiated thyroid cancers make up 90% of all thyroid tumors. The prognostic factors are well defined, such as age, size of the tumor, extrathyroidal extension, presence of distant metastasis, histological appearance, and grade of the tumor. The author has previously divided the risk groups into low-, intermediate-, and high-risk categories based on prognostic factors. The study describes the author's treatment approach related to the extent of thyroidectomy and adjuvant therapy based on various risk groups and the long-term survival. STUDY DESIGN: Retrospective. METHODS: In a retrospective review of 1038 patients with differentiated thyroid carcinoma, various prognostic factors were studied by univariate and multivariate analysis. The significant prognostic factors were studied in detail and, based on these prognostic factors, the patients were divided into low-, intermediate- and high-risk groups. The survival curves were plotted by Kaplan-Meier method. RESULTS: The long-term survivals in low-, intermediate- and high-risk groups were 99%, 87%, and 57% respectively. Based on these risk groups, a decision tree was made regarding extent of thyroidectomy and adjuvant treatment. In the high-risk group and selected patients in the intermediate-risk group, aggressive surgery including removal of all gross disease and extrathyroidal extension with postoperative radioactive iodine ablation is recommended. In the low-risk group and selected patients in the intermediate-risk group, lobectomy appears to be satisfactory with excellent long-term outcome. The surgical treatment offers the best long-term results in low-risk patients, and the role of adjuvant treatment in this group is questionable. CONCLUSION: The decisions in the management of well-differentiated thyroid cancer should be based on various prognostic factors and risk groups. The long-term survival in the low-risk group is excellent, and consideration should be given to conservative surgical resection depending on the extent of the disease. In the high-risk group and selected patients in the intermediate-risk group, total thyroidectomy with radioactive ablation is warranted. A consideration may be given to external-beam radiation therapy in selected high-risk patients. It is apparent, based on the author's clinical experience and critical retrospective analysis, that the author's hypothesis that risk groups are extremely important in the long-term outcome of patients with differentiated thyroid cancer is correct. Based on various risk groups, the author currently is able to guide the treatment policies for thyroid cancer.

Adult↗

PubMed1991

[Prognostic factors in a pediatric intensive care unit].

OBJECTIVES: To identify the mortality prognostic factors from a pediatric intensive care unit. STUDY DESIGN: Retrolective cohort study with an analysis of cases and controls (ambidirectional design). PLACE OF STUDY: The intensive care unit at a Pediatric Third Level Hospital. STUDY UNITS: All of the patients admitted into the I.C.U. for a year (August 1989 to August 1990). MAIN MEASUREMENTS: The patients were identified when admitted into I.C.U., while evaluating their clinical course through their charts. Afterwards, they were placed into two groups, those who died while in I.C.U. (n = 49) and those in the control group which constituted the initial cohort survivors (n = 115). The prognostic factors evaluated were age, sex, diagnosis when admitted, organic failure, changes in diagnosis and treatment. MAIN RESULTS: 164 patients were studied, with a slight predominance of the male sex (53%). The patient's age fluctuated between 1 day and 17 years of age, with a mean age of 10 months. The diagnosis established when admitted were predominantly dealing with infectious problems (n = 54, 32%). The most important prognostic factors seen during the bivaried analysis were the peritoneal dialysis (RM = 12.71, IC 95% = 2.41-98.29, P less than 0.01); a Glasgow index less than or equal to 10 points (RM = 7.33, IC 95% = 1.25-47.26, P less than 0.01), respiratory organic failure (RM = 6.32, IC 95% = 2.46-16.8, P less than 0.01) and assisted mechanical ventilation (RM = 5.61, IC 95% = 2.52-12.68, P less than 0.01). CONCLUSIONS: The mortality rate in I.C.U. was 30%. The most important prognostic factors associated to mortality after adjusting for severity were having a cardiovascular ailment, the need to administer blood products, a Glasgow index less than or equal to 10 points, heart and hematologic organic failure and when respiratory mechanical assistance was provided.

Age Factors↗

PubMed1986

Age as a prognostic factor in recurrent breast cancer.

The effect of age as a prognostic factor in recurrent breast cancer was studied in 1,168 patients treated on Eastern Cooperative Oncology Group (ECOG) protocols. Survival was significantly shorter in patients less than 35 years of age (P = .03). This was true even when other good prognostic factors were present. Eighteen prognostic factors were analyzed, and the effect on survival in each of six age groups was studied. Patients with better performance status, less than three sites of metastases, and without visceral or nodal metastases had a better survival time. A Cox proportional hazards model of survival showed that younger age groups, irrespective of menopausal status, had shorter survival times. The predicted median survival times after the first recurrence were 491 days for patients less than 35 years of age, 590 days for patients 36 to 45 years of age, and 700 days for those greater than 45 years of age.

Adult↗

PubMed2002

Determining prognostic factors for gastric cancer using the regression tree method.

BACKGROUND: The regression tree method is a useful statistical technique that has been little used in the analysis of prognosis. METHODS: The prognostic factors of gastric cancer were investigated, using the regression tree method, in 555 patients who had undergone curative resection for serosa-negative gastric cancer and who were enrolled in a randomized controlled trial of postoperative adjuvant chemotherapy (JCOG [Japan Clinical Oncology Group] 8801 study). RESULTS: By the regression tree method, the first divided prognostic factor (the most important factor) was lymph node metastasis; in particular, extent of lymphatic spread had the greatest impact on prognosis. In addition, age, tumor size, depth of invasion, and individual dose intensity were found to be significant prognostic factors, whereas sex, tumor location, macroscopic tumor type, and extent of lymph node dissection were not. The resulting tree structure consisted of nine terminal nodes with different prognostic factors, and four clusters were obtained by the merging of terminal nodes that showed a similar prognosis. The cluster which showed the best survival rate (5-year survival rate, 0.986) consisted of two terminal nodes: node 12, which contained N0T1 patients who were younger than 62 years and had a tumor size of less than 7.5 cm, and node 14, which contained N1 patients who were younger than 46 years. CONCLUSION: In serosa-negative gastric cancer, lymph node metastasis was the most important prognostic factor. Utilization of the regression tree method enabled visual interpretation of the results of statistical analyses through the graphic representation of prognostic factors. It allowed the identification of the optimal combination of these prognostic factors that defined several groups of patients with distinct prognoses and may serve as a useful reference for the individualization of treatment strategy.

Adult↗

PubMed2001

Bone marrow micrometastases detected by RT-PCR for mammaglobin can be an alternative prognostic factor of breast cancer.

PURPOSE: To evaluate a new prognostic factor of breast cancer, bone marrow micrometastases which was detected by RT-PCR for mammaglobin, a sensitive molecular marker of breast cancer, was examined. MATERIALS AND METHODS: One hundred and eleven samples from stage I-III breast cancer patients were examined. Bone marrow micrometastases and clinicopathological parameters, which were age, tumor size, lymph node metastasis and status of the estrogen receptor, were evaluated for the prognostic factor by statistical analysis. RESULTS: Median follow-up time was 21.1 months. Thirty-three (29.7%) out of 111 samples were RT-PCR positive. Eight cases (24.2%) in this group showed recurrent lesions in the distant organs. Whereas six (7.7%) out of 78 RT-PCR negative patients had distant recurrences. In the premenoposal patients, and in the patients with axillary lymph node metastases, RT-PCR positive cases showed significantly higher distant recurrent rate. Bone marrow micrometastases, axillary nodal status, and estrogen receptor were independent prognostic factors for breast cancer by both univariate and multivariate analysis. CONCLUSIONS: Bone marrow micrometastases detected by RT-PCR for mammaglobin can be a useful predictive marker for early distant recurrence of breast cancer.

Adult↗

PubMed1989

Prognosis and prognostic factors in chronic pancreatitis.

To evaluate the prognosis and prognostic factors of chronic pancreatitis, 84 patients with alcoholic chronic pancreatitis and 51 with nonalcoholic chronic pancreatitis have been followed for 1-21 years (average of 7.1 years). The follow-up period was defined as the period from diagnosis to death in those who died and to the present in those still alive. The following conclusions were obtained. (1) Patients with alcoholic chronic pancreatitis showed a significantly higher mortality rate (26.2%) and cancer death rate (8.3%) than the age- and sex-matched population. In patients with nonalcoholic chronic pancreatitis, however, the difference did not reach the level of statistical significance, although both rates tended to be higher. (2) Patients with alcoholic chronic pancreatitis showed a significantly poorer prognosis than those with nonalcoholic chronic pancreatitis. (3) Frequent causes of death in chronic pancreatitis were cancer (11 cases) and diabetes-associated conditions (renal failure in three cases, intractable pneumonia in one, hypoglycemic shock in two, and myocardial infarction in two). Death directly from pancreatitis was observed in four. (4) Unfavorable prognostic factors in alcoholic chronic pancreatitis included heavy drinking, continuance of drinking after diagnosis, smoking, insulin-dependent diabetes, and an advanced age. In nonalcoholic chronic pancreatitis, however, patients' age was the only significant prognostic factor; smoking did not reach the level of statistical significance, although it tended to lead to a poorer prognosis.

Adult↗