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PubMed2002

Prognostic factors of secondary ovarian carcinoma.

OBJECTIVE: Although the ovaries are common sites of metastases from a variety of primary neoplasms excluding carcinomas of the genital tract, there were few reports concerning survival and prognostic factors. The objective of this study was to assess the clinical factors affecting survival. METHODS: Fifty-three secondary ovarian carcinomas excluding metastases from genital tract carcinoma were registered by the Tokai Ovarian Tumor Study Group from 1989 to 1999. FIGO staging was set without considering the pathologic findings of the lymph nodes and the primary tumors. RESULTS: Twenty-four patients were stage I, 11 were stage II, 16 were stage III, and 2 were stage IV. There were significant differences in the survival curves between the early stages (I and II) and advanced stages (III and IV). The 5-year survival rate for patients without residual tumors was 39.9%, while all patients with residual tumors after surgery died within 33 months. The most frequent primary tumor was large intestinal carcinoma, and the second was gastric carcinoma. The 5-year survival rate for patients with large intestinal primary tumors was significantly better than that with stomach tumors. Multivariate analysis demonstrated that tumor stage and primary tumor sites were significant prognostic factors. CONCLUSION: FIGO staging without considering lymph node involvement and the primary tumor was a significant prognostic factor, and prognostic factors for primary ovarian carcinomas can be applied to secondary ovarian carcinomas. Furthermore, the primary tumor site was also an important prognostic factor for survival.

Ascites↗

PubMed2000

Comparing prostate specific antigen outcomes after different types of radiotherapy management of clinically localized prostate cancer highlights the importance of controlling for established prognostic factors.

PURPOSE: We evaluated the impact that the composition of prognostic factors in a patient cohort may have on prostate specific antigen (PSA) outcome following external beam radiation therapy for clinically localized prostate cancer. MATERIALS AND METHODS: The distribution of PSA, biopsy Gleason score and American Joint Committee on Cancer (AJCC) T stage in men with prostate cancer treated with interstitial plus external beam radiation therapy was used to select a matched cohort who underwent 3-dimensional (D) conformal external beam radiation therapy. We compared PSA outcomes after 3-D conformal external beam radiation therapy in the overall and matched cohorts of 766 and 570 patients, respectively. RESULTS: Men treated with interstitial plus external beam radiation therapy had a significantly lower rate of PSA greater than 10 to 20 (p = 0. 02) and greater than 20 ng./ml. (p <0.0001), biopsy Gleason score 7 (p = 0.02) and 8 to 10 (p <0.0001), and AJCC stage T2c disease (p <0. 0001). Likewise, these men also had a significantly higher rate of PSA greater than 4 to 10 ng./ml. (p <0.0001), biopsy Gleason score 5 to 6 (p = 0.0001) and AJCC stage T1 disease (p <0.0001) than those who underwent 3-D conformal external beam radiation therapy. The 5-year estimate of PSA failure-free survival after 3-D conformal external beam radiation therapy was 45% versus 67% (p = 0.0007) for all 766 consecutively treated patients and the matched cohort of 570, respectively. CONCLUSIONS: The composition of prognostic factors in a patient cohort may impact PSA outcome. Therefore, controlling for established prognostic factors is essential when comparing PSA outcome after different forms of radiotherapy for adenocarcinoma of the prostate.

Adenocarcinoma↗

PubMed2006

Biological diagnosis for neuroblastoma using the combination of highly sensitive analysis of prognostic factors.

BACKGROUND/PURPOSE: To select the optimal treatment according to the degree of malignancy of neuroblastoma, it is essential to accurately and rapidly identify any genetic abnormalities associated with the prognosis. This study aims to assess the correlation between the combination of prognostic factors and the biologic findings of neuroblastoma using a highly sensitive analysis of prognostic factors. METHODS: In 44 neuroblastoma primary samples, we determined the gene dosages of MYCN and Survivin (as the target of 17q gain) and the expression levels of MYCN, Survivin, and BIN1 using highly sensitive analysis (the quantitative polymerase chain reaction method); furthermore, we assessed the correlation between the combination of their prognostic factors and the biology of neuroblastoma. RESULTS: The gene dosage of MYCN or Survivin was significantly associated with all known prognostic factors. The expression level of MYCN or Survivin was not significantly associated with any prognostic factors, whereas the expression level of BIN1 was significantly associated with 5 of 6 prognostic factors. Regarding the combination of MYCN amplification and 17q gain (the gene dosage of Survivin), and the low expression of BIN1, the rates of advanced stages (stage III or IV) were 100% for the cases with 3 factors, 63% for the cases with 2 factors, 42% for the cases with 1 factor, and 0% for the cases with null factor. Furthermore, the survival rates were 20% for the cases with 3 factors, 50% for the cases with 2 factors, 100% for the cases with 1 factor, and 100% for the cases with null factor. CONCLUSION: The combination of gene dosages of MYCN and Survivin and the expression level of BIN1 using the quantitative polymerase chain reaction method was significantly correlated with the clinical stage and the patients' outcome. This combination of biologic factors may enhance the accuracy to the conventional criteria, but this would have to be shown in a much larger study that is adequately powered to detect such an advantage.

Adaptor Proteins, Signal Transducing↗

PubMed1992

Prognostic factors in node-positive operable breast cancer patients receiving adjuvant chemotherapy.

A retrospective analysis of prognostic factors in 214 consecutive node-positive (N+) operable breast cancer patients, receiving Melphalan + 5-fluorouracil adjuvant chemotherapy between 1980 and 1984 was performed. Median follow-up was 95 months. Actuarial disease-free interval (DFI) and survival (S) were determined according to age, menopausal status, histology, size of primary tumor (T), multifocality, tumor location, hormonal receptor status, number of N+, size of N+, tumor spread in axillary fat, and interval between surgery and onset of adjuvant chemotherapy. On univariate analysis two factors were prognostic for DFI and S: number of N+ and T size. A comparison between traditionally classified T1 and T2 patients revealed no significant difference, but when the cut-off point was shifted from 2 cm to 3 cm, T size represented a highly significant prognostic factor. In patients with T less than or equal to 3 cm 5-year DFI was 54% and 5-year S was 76%, while in patients with T greater than 3 cm the respective values were 23% (p less than 0.001) and 41% (p less than 0.001). These significant DFI and S differences persisted after adjustment for number of N+ by bivariate analysis. Multivariate analysis supported the importance of T greater than 3 cm as a strong adverse predictor. Four adverse variables, T greater than 3 cm, number of N+ greater than or equal to 4, multifocality, and tumor spread in axillary fat were used to divide our patients into three subsets with significantly different DFI: Group I, with none of the above factors; Group II, with only one factor present; and Group III, with more than one factor present (5 years DFI 66%, 45%, and 21%, respectively; p less than 0.001).

Breast Neoplasms↗

PubMed1993

Prognostic factors in large-cell lymphomas.

A review of the most significant prognostic factors found in large cell lymphomas is presented. Prognostic factors are divided in four categories: (a) those related to the patient: age at diagnosis; (b) those related to the tumor: stage, tumor bulk, spreading of tumor, extranodal sites, LDH and beta 2-microglobulin levels; (c) those related to the host-tumor relationship: performance status, presence of B symptoms, serum albumin level, and interleukin secretion; and (d) those related to the physicians: type of treatment, dose intensity of this treatment. Most of these parameters are related to each others and only a few of them keep statistically significant correlation with outcome in multiparametric studies. New prospective studies with new therapeutic strategies should stratify patients before treatment on these most important prognostic factors.

Age Factors↗

PubMed1998

Prognostic factors for mortality in nasopharyngeal cancer: accounting for time-dependence of relative risks.

BACKGROUND: Few studies have assessed the role of prognostic factors for mortality from nasopharyngeal cancer and even fewer used multivariable methods. Most of these studies relied on the Cox model without testing the proportional hazards assumption. METHODS: A cohort of 76 cases of nasopharyngeal cancer recorded in the Rhône, France, between 1980 and 1985, was followed until 1995. Proportional hazards assumption was tested for each putative prognostic factor. Two multivariable models were built using forward selection of prognostic factors: the Cox model and a flexible model in which variables not meeting the proportional hazards assumption were represented by a time-varying hazard ratio. RESULTS: Only Epstein Barr Virus Nuclear Antigen (EBNA) serology, a marker of infection by the Epstein-Barr virus, and tumoral extent were selected in the analysis based on the Cox model. In contrast, four prognostic factors were significant at alpha = 0.05 level in the flexible model: initial EBNA serology, tumoral histology, age and tumoral extent, the last two not verifying the proportional hazards assumption. The relative risk of age increases with duration of follow-up whereas the effect of tumoral extent changes in a non-monotonic pattern. CONCLUSION: We showed the importance of taking into account the non-proportionality of hazards which can influence results and yield new insights about the role of prognostic factors in nasopharyngeal cancer. Because of the small size of our cohort, our results have to be confirmed in an independent study.

Adult↗

PubMed1992

Recurrent malignant melanoma: the identification of prognostic factors to predict survival.

The prognostic factors for stage 1, 2 melanoma have been elucidated. Tumor thickness, ulceration of the primary melanoma, and perhaps, primary site may be used to predict the percentage of patients with regional nodal disease or systemic metastases and the prognosis of patients who have only cutaneous disease at diagnosis. Very little is known about prognosis once there is a recurrence. A retrospective, computer-aided chart review identified 4,185 patients registered at the Duke University Melanoma Database who had stage 1, 2 disease at diagnosis. During a mean follow-up period of 7 years, 35.9% experienced a recurrence. Local regional recurrences explained 62.5% to 85.5% of the recurrences. Even after elective node dissections, local regional recurrences explained most relapses (58.1%). Sixty-five percent of the recurrences occurred within the first 3 years of of follow-up. There was a pronounced difference in 5-year survival in those patients who suffered a recurrence sometime during their clinical course compared with those who never relapsed (p = 0.00001, for trunk primary melanoma). Patients with local or regional recurrence have a better prognosis than patients who relapse systemically, with 5-year survivals from the time of recurrence of 55% for a patient with a local recurrence, 51% for a patient with a regional nodal recurrence, and 20% for a patient with a systemic recurrence. A multivariate regression analysis identified thickness, ulceration of the primary melanoma, and age and location of the primary melanoma on the extremity as variables that predicted prognosis. The only factors concerning the recurrent state that added prognostic information was the disease-free interval and the presence of systemic metastases as the initial recurrence.

Adolescent↗

PubMed2005

[Prognostic factors in lung cancer].

INTRODUCTION: Knowledge of prognostic factors is important for therapeutic decision making but above all, at a population level, for the interpretation of data in the literature and as a guide to clinical research. To be useful in practice they must be both independent and reproducible. Despite an impressive number of publications few descriptions achieve this standard in lung cancer. BACKGROUND: The TNM classification plays a predominant role in the choice of treatment, in prognosis and as an index of performance. Depending on the population studied (small cell or non-small cell cancer, operable or not) other independent factors, identified in large series, improve the prediction of prognosis: sex, age, loss of weight, LDH, leukocytosis, neutrophilia, haemoglobin, serum calcium, NSE, Cyfra 21-1. VIEWPOINT: The numerous biological factors described should be the object of further investigations but may lead to the assessment of new therapeutic strategies. CONCLUSION: Large multicentre studies are essential before a role may be attributed to an independent prognostic factor and before it may be used as a guide to the management of a patient or to improve our prediction of the progress of a patient or a group of patients.

Humans↗

PubMed1991

Analysis of cytosolic phosphoethanolamine and ethanolamine and their correlation with prognostic factors in breast cancer.

Availability of accurate prognostic factors is vital in making decisions on cancer therapy. We have measured the cytosolic contents of phosphoethanolamine and ethanolamine in tumor tissues of 53 breast cancer patients in an attempt to explore the possibility that these amines could be used as prognostic indicators. The levels of phosphoethanolamine and ethanolamine were determined by high-performance liquid chromatography. The ratios of the molar quantity of these amines or amino acids to that of alanine plus tyrosine, which eluted as a single peak, were used to analyze and compare the results among different tumor samples. The results indicated that the values for phosphoethanolamine or ethanolamine varied significantly more than the values for amino acids, such as glycine plus threonine or glutamine plus serine (these amino acids were eluted as single peaks, respectively). The values for phosphoethanolamine, ethanolamine, and phosphoethanolamine plus ethanolamine were analyzed in relation to several commonly used prognostic factors of breast disease. The results indicated that groups having higher mitotic indices had significantly higher values for phosphoethanolamine or phosphoethanolamine plus ethanolamine than the group having lower mitotic indices. As the stage of the disease increased, the values for phosphoethanolamine plus ethanolamine also seemed to become higher. No correlation, however, was observed between steroid hormone receptor positive and negative groups or between positive and negative groups with regard to involved axillary lymph nodes. The content of phosphoethanolamine or phosphoethanolamine plus ethanolamine in cytosol therefore seems to be correlated with some prognostic indicators.

Amino Acids↗

PubMedDate not supplied

[Renal cell carcinoma. Significance of prognostic factors & current treatment].

The Authors carried out a literature review on prognostic factors and current management of renal cell carcinoma. A significant factor influencing survival appears to be the extension of the primary tumor (T). The finding of no nodal involvement is not always a favourable prognostic factor if the tumor is no more confined. A perfect knowledge of the prognostic factors may be useful to identify those patients who need post-operative chemotherapy. Surgery is still the treatment of choice for renal cell carcinoma. Extensive lymphadenectomy does not influence long-term survival, nevertheless since there is no additional mortality or morbidity, it is considered useful for a correct staging and a better evaluation of long-term prognosis.

Carcinoma, Renal Cell↗

PubMed1980

Acute non myeloid leukaemia in adults. Prognostic factors in 92 patients.

An analysis of prognostic factors was performed on a series of 92 adult patients with acute non-myeloid leukaemia (ANML). Four factors were shown to be correlated with a poor short-term prognosis: (1) Neuropathy involving a single cranial nerve (numbness of the chin) as a presenting feature. (2) A low percentage blast cell infiltration of bone marrow (less than 55%). (3) Cytological L2 type or L3 type of cells according to FAB classification proposals. (4) Increased age. Two factors were shown to be correlated with a poor long-term prognosis: 1) A high level of circulating blast cells; 2) A high tumour burden, as in childhood ANML. These two long-term prognostic factors were interrelated. In addition, our results suggested that myelofibrosis could be a poor long-term prognosis factor as well.

Acute Disease↗

PubMedDate not supplied

[Prognostic factors of survival in obstructive and non-obstructive excisable colorectal cancer].

OBJECTIVES: Determining the prognostic factors, clinical and pathological characteristics, surgical morbidity and mortality and actuarial survival after five (5) years of patients with obstructive and non-obstructive excisable colorectal cancer. MATERIAL AND METHODS: Descriptive, correlative, longitudinal and observational study at the Belen Hospital in Trujillo of 88 patients with excisable colorectal cancer and a histological confirmation of their disease, between 1966 and 2000. RESULTS: The mean age of the total series was 62.35 +/- 14.64 years; the primary tumor (p = 0.001) and regional ganglionic condition (p = 0.0001) were the factors associated with the five year survival in both groups of patients with obstructive and non-obstructive colorectal cancer. Furthermore, the size of the tumors and distance metastasis were also prognostic factors associated in patients with non-obstructive colorectal cancer. Actuarial survival at 60 months of patients with obstructive and non-obstructive colorectal cancer who had surgery for curative purposes was 65.5% and 20%, respectively (p = 0.0135). The actuarial survival rate of patients with obstructive excisable colorectal cancer was 9.5% and in patients with non-obstructive colorectal cancer it was 35.1% (p = 0.1480). CONCLUSIONS: The primary tumor and regional ganglionic condition were prognostic factors in both groups. Furthermore, size of the tumors, distance metastasis and clinical stage were also prognostic factors in patients with non-obstructive colorectal cancer.

Colectomy↗

PubMed2004

Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region.

Papillary (PTC) and follicular thyroid carcinoma (FTC) are known as differentiated thyroid carcinoma (DTC). Nevertheless, according to the UICC/AJCC (TNM) classification PTC and FTC are frequently analyzed as one cancer. The aim of this study is to show differences in outcome and specific prognostic factors in an iodine-replete endemic goiter region. Six hundred and three patients with DTC treated within a 35-year-period were retrospectively analyzed with respect to carcinoma-specific survival. Prognostic factors were tested for their significance using univariate and multivariate analysis. The histological type (PTC versus FTC) was found to be a highly significant factor - carcinoma-specific survival both in univariate (P<0.001) and multivariate analyses (P=0.003) was significantly different. Univariate analysis revealed patients' age, extra-thyroid tumor spread, lymph node and distant metastases, increasing tumor size, and the tall cell variant to be significant prognostic factors for PTC patients. Age > or =45 years, positive lymph nodes and increasing tumor size were confirmed as independent prognostic factors. Univariate analysis of FTC patients revealed age at presentation, gender, extrathyroidal tumor spread, lymph node and distant metastases, increasing tumor size, multifocality, widely invasive tumor growth and oxyphilic variant to be factors bearing prognostic significance. The presence of distant metastases and increasing tumor size could be identified as independent prognostic factors for FTC patients. This study shows distinctive differences in prognostic factors of PTC and FTC: independent factors predicting poor prognosis are age > or =45 years, positive lymph nodes and increasing tumor size for PTC, and distant metastases and increasing tumor size for FTC. PTC and FTC patients should be analyzed and reported separately.

Adenocarcinoma, Follicular↗

PubMed1980

Prognostic factors in meningococcal disease.

Two groups of prognostic factors in meningococcal disease can be distinguished. One group is associated with fatal outcome and the other with permanent psychoneurological sequelae. A review of the literature is given and the results discussed. The importance of selecting prognostic factors that reflect central events in the pathogenesis is stressed. The factors can then be used as a well standardized means to describe the degree of illness in a patient or a group of patients. A basis for comparison of patient groups from different times and places as well as patient groups treated in different ways is thus established.

Adolescent↗

PubMed2005

[Prognostic factors on outcome of radiofrequency ablation of 172 primary hepatic tumors].

OBJECTIVE: To investigate the prognostic factors affecting outcome in Radiofrequency (RF) ablation of primary hepatic tumors by univariate and multivariate analyses, and to assess the therapeutic efficacy of Radio-frequency ablation. METHODS: A total of 172 patients with primary hepatic tumors underwent RF treatment in our department between 1999 and 2004. Among them, 150 patients were not the surgery candidates. The follow-up period ranged from 4 to 51 months and follow-up rate was 94.8% (163 patients). Kaplan-Meier model and log-rank test were used in univariate analyses and COX regression model was used in multivariate analyses, to identify prognostic factors for survival. RESULTS: The survival rates at half a year, 1 year, 2 year and 3 year were 91.5%, 77.4%, 55.7% and 51.2% respectively. Using univariate analyses, 24 potential factors were analyzed and 8 of them were found significant for survival. These 8 factors were Child-Pugh grade, UICC stage, AFP value before first RF, Portal hypertension, first treatment or treatment for recurrence, pathological grade, treatment purpose and method, ablative safe margin. For 116 patients who underwent RF when first diagnosis, the survival rates in patients with different tumor stage (UICC standard of hepatocellular carcinoma) at half a year, 1 year, 2 year and 3 year were estimated as follows: 96.7%, 92.3%, 81.6% and 65.3% in 33 patients of stage I-II; 91.2%, 76.3%, 56.6% and 51.4% in 83 patients of stage III-IV; There was significant difference in survival rates between patients of stage I-II and patients of stage III-IV. For 56 patients suffered from recurrent hepatic tumors, the survival rates at half a year, 1 year, 2 year and 3 year were 88.5%, 70.2%, 41.4% and 24.5%, being similar to those of stage III-IV. The 8 factors mentioned above were further analyzed by multivariate model and 3 of them were identified as prognostic factors for survival. These 3 factors included Child-Pugh grade, Portal hypertension, treatment purpose and method. CONCLUSION: Based on our statistical analysis, the prognostic factors on outcome in Radio-frequency ablation of hepatic tumors were grouped into two categories. Child-Pugh grade, and Portal hypertension were the characteristics of patients and uncontrollable. While treatment purpose and method also had significant impact on survival and was controllable during RF procedure. This information might be useful to improve treatment level of Radio-frequency ablation of hepatic tumors.

Adult↗

PubMed1987

Prognostic factors in stage II endometrial carcinoma.

The rarity of Stage II endometrial carcinoma and variable treatment modalities have made the evaluation of prognostic factors difficult. Clinical, surgical, and pathologic characteristics were evaluated in 64 patients treated with whole pelvic irradiation and intracavitary radium followed by hysterectomy at The University of Texas M.D. Anderson Hospital and Tumor Institute from January 1965 to December 1983. Comparison of 5-year actuarial survival rates revealed the following statistically significant categories: age, grade, depth of myometrial invasion, disease extent at surgery including lymph node metastases, and pelvic cytology. Race, weight, and cell type were not significant prognostic factors. Evaluation of prognostic factors at surgery includes pelvic and para-aortic lymph node biopsies, omental biopsy, pelvic cytologic washings, and biopsy of any suspicious tissues. Patients with adverse prognostic factors are candidates for trials with adjuvant therapy.

Actuarial Analysis↗

PubMed1998

Survival and prognostic factors of early ovarian cancer.

Survival and prognostic factors were analysed in 150 patients with histologically confirmed epithelial ovarian cancer stage IA-IIA. The relapse-free and overall survival rates were, respectively, 81% and 88% after 3 and 74% and 84% after 5 years. The analysis of various prognostic factors indicates as the main factor the grade differentiation of the tumour.

Adult↗

PubMed1998

Prognostic factors in extraovarian primary peritoneal carcinoma.

OBJECTIVE: To determine the pathological, clinical, and therapeutic factors which had prognostic significance in women with extraovarian primary peritoneal carcinoma (EOPPC). METHODS: A retrospective, clinicopathologic study was conducted of 75 women diagnosed with EOPPC. Diagnosis and assessment of prognostic pathological factors were based on the Gynecologic Oncology Group (GOG) criteria. Univariate and multivariate analyses were used to assess the following factors for their effect on overall survival: age, parity, presenting symptoms and signs, ascites, CA 125 level, history of oophorectomy, maximum ovarian dimension, histologic type, architectural and nuclear grades, number of mitosis and psammoma bodies, depth of ovarian invasion, estrogen and progesterone receptors (positive, negative), p53 overexpression (present, absent), performance status (GOG criteria), stage (FIGO criteria for ovarian cancer), debulking surgery (optimal versus suboptimal), first-line chemotherapy (platin-based without paclitaxel versus platin/paclitaxel), secondary cytoreduction, and second-line chemotherapy (paclitaxel-based versus no paclitaxel). RESULTS: The median overall survival of all patients was 23.5 months (95% CI 18.6, 39.8 months). The 5-year survival was 26.5% (SE 6.7%). p53 overexpression and estrogen and progesterone receptor positivity were demonstrated in 42.4, 50.0, and 6.3%, respectively. In univariate analysis, performance status, primary debulking surgery, stage, and age were significant on overall survival (P < 0.001, <0. 001, 0.004, and 0.012, respectively). In multivariate analysis, only performance status (P < 0.001) and primary debulking surgery (P = 0. 03) were independent prognostic factors. Conclusions. Overall survival in women with EOPPC is affected significantly by performance status and primary debulking surgery as independent variables. To improve survival, efforts should be made to achieve optimal tumor cytoreduction at primary surgery.

Adult↗