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PubMed2000

[Prognostic factors in non-Hodgkin's lymphoma of Waldeyer's ring and the lymph nodes of the neck].

Prognostic factors and treatment outcome of 74 patients with non-Hodgkin's lymphoma of Waldeyer's ring (male 34, female 16, median age 63 years) and cervical lymph nodes (male 17, female 7, median age 62 years) were analyzed retrospectively. The prognostic factors analyzed were: age, B-symptoms, serum LDH levels, and Ann Arbor stage. We also analysed the TNM classification (1987) of Waldeyer's ring lymphoma (previously referred as nasopharyngeal and oropharyngeal cancer) as a new prognostic factor. The 5-year-survival rate of the patients with Waldeyer's ring non-Hodgkin's lymphoma was 67%, compared with 34% for cervical lymph node lymphoma. In univariate analyses, unfavorable outcome was associated with age (age > 60 years), B-symptoms, elevated serum LDH level, and stage. Multivariate analysis showed that age and elevated serum LDH level were significant independent risk factors for death. The 5-year-survival rate according to TNM classification of Waldeyer's ring lymphoma was: T1 (4 cases) 75%, T2 (23 cases) 83%, T3 (10 cases) 56%, T4 (4 cases) 0%; according to N stage, N0 (15 cases) 91%, N1 (7 cases) 73%, N2 (11 cases) 55%, N3 (5 cases), M1 (3 cases) 0%, and according to TNM stage, stage I (one case) stage II (9 cases) 100%, stage III (12 cases) 80%, stage IV (19 cases) 34%. These results suggest that the N classification of Waldeyer's ring non-Hodgkin's lymphoma may be a new prognostic factor.

Age Factors↗

PubMed2006

Prognostic factors in sudden sensorineural hearing loss: our experience and a review of the literature.

OBJECTIVES: We investigated prognostic factors in sudden sensorineural hearing loss (SSNHL). METHODS: Our study group consisted of 133 patients with SSNHL who were treated at our department between 1980 and 2000. Eighty-one of them (group B) were treated between 1980 and 1996; they received vasodilators and small doses of steroids. The others (52 patients; group A) were treated between 1997 and 2000; they received vasodilators, steroids at high doses, and hyperbaric oxygen. A multivariate stepwise linear regression was used to identify the prognostic factors that were related to hearing improvement as measured by objective change of gain in the overall average (0.5, 1, 2, 4, 6, 8 kHz), the pure tone average (0.5, 1, 2 kHz), the high tone average (4, 6, 8 kHz), and the pure middle tone average (0.5, 1, 2, 4 kHz). The following factors were included in the analysis: group (method of treatment), age, gender, seasonal occurrence of disease, presence of tinnitus and vestibular symptoms, time delay before first visit, type of initial audiogram, and type of caloric reaction. In group A, an additional analysis was conducted to include the results of certain laboratory tests: blood morphology parameters, erythrocyte sedimentation rate, glucose level, coagulogram, lipidogram, thyroid-stimulating hormone, autoantibodies (antimitochondrial antibodies, smooth muscle antibodies, and anti-brush border antibodies), and immunoglobulins G, A, and M. Values for p of less than .05 were considered significant. RESULTS: Our analysis suggests the presence of the following prognostic factors for SSNHL: method of SSNHL treatment (better results in group A); time delay before the start of treatment (better results when treatment started within 10 days of the first symptoms of SSNHL); and type of caloric reactions (worse results in patients with canal paresis). In group A, the factors for poor prognosis for absolute hearing improvement were as follows: delayed treatment, labyrinth responsiveness disorders, and decreased level of thyroid-stimulating hormone. In group A, better hearing improvement was observed in those patients in whom SSNHL was diagnosed in the spring. CONCLUSIONS: A short time delay before starting treatment (within 10 days), treatment with high doses of steroids and hyperbaric oxygen, preserving complete caloric function of the labyrinths, normal function of the thyroid, and seasonal occurrence of the disease in the spring were positive prognostic factors for hearing recovery in SSNHL.

Acute Disease↗

PubMedDate not supplied

Risk and prognostic factors for differentiated thyroid cancer.

Papillary and follicular carcinomas, commonly referred to as follicular cell-derived differentiated thyroid carcinomas (DTC), account for 90% of all thyroid carcinomas. The prognosis of DTC is generally good, depending on the biologic behavior of the tumor and on the appropriate initial treatment which includes total thyroidectomy and ablation by radioiodine-131. However, a considerable number of patients, approximately 30%, as shown after 30 years of follow-up, have recurrent disease. It is thus of utmost importance to evaluate the prognostic factors, as derived from retrospective studies, and identify high risk patients. Age of more than 45 years or less than 25 years is a particularly strong independent prognostic factor; on the contrary gender is a poor prognostic factor. Histological type of the cancer especially tall cancer cells and columnar cancer cells, as well as increased vascular invasion of the tumor, lymph-node and distant metastases, are all considered as risk factors that can lead to poor prognosis. Combined prognostic factors have been used to form scoring systems (SS) such as AGES, MACIS, AMES, EORTC and TNM for a more precise description of high or low risk patients. However, prognostic significance of the SS is limited, since they do not take into consideration the clinical status or the treatment procedure during the course of the disease. Molecular factors such as rearrangements of genes RET/PTC, RAS mutations and fusion of, paired box and 8/peroxisome proliferator-activated receptor gamma (PAX8/PPARgamma) are also involved in thyroid cancer prognosis, while some others: human Pituitary- Tumor Transforming Gene (e.g. MIB-1, hPTTG) have been reported as additional prognostic factors. In this review we describe the risk and the prognostic factors of DTC as related to management and the outcome of DTC.

Age Distribution↗

PubMed1992

Prognostic factors of thyroid cancers in Ramathibodi Hospital.

The need to create different prognostic models for different populations is obvious after the findings that significant prognostic factors can change from one population to another. The purpose of this study is to fit a linear logistic model to a data set of Thai patients with thyroid cancers to find important prognostic factors and their effects on short-term mortality. Among the 89 cases selected, 20 died within 4 years after initial diagnosis and 69 survived more than 4 years. Age at diagnosis, sex, histological type and differentiation, microscopic vascular invasion, and extent of tumor spreading were included as independent variables. These variables were selected into the model by step-down selection procedure. Age at diagnosis was found to be the most significant prognostic factor followed by differentiation, vascular invasion and extent of spreading, respectively. However, vascular invasion appeared to exert the strongest impact on the prognosis with the risk of death increasing 62 fold for those showing microscopic evidence of this parameter. The odds ratios for the extent of spreading, age at diagnosis and differentiation were 7.5, 1.1 and 0.02, respectively.

Adult↗

PubMedDate not supplied

Prognostic factors of advanced gastric carcinoma without serosal invasion (pT2 gastric carcinoma).

BACKGROUND/AIMS: The purpose of this study was to investigate the prognostic factors of advanced gastric carcinoma without serosal invasion (pT2 gastric carcinoma), for the planning of therapeutic strategy. METHODOLOGY: Prognostic factors were evaluated by univariate and multivariate analysis in a total of 304 curatively resected pT2 gastric carcinoma patients in whom the tumor invaded the muscularis propria or the subserosa. RESULTS: Macroscopic type, depth of invasion, lymph node metastasis and venous invasion were significantly related to outcome, using univariate analysis. Lesions resembling early gastric carcinoma had better prognosis than lesions belonging to one of the Borrmann types. Multivariate analysis (Cox's proportional hazards model) demonstrated that macroscopic type, lymph node metastasis and venous invasion, but not depth of invasion, were significant prognostic factors. CONCLUSIONS: Macroscopic appearance, lymph node metastasis and venous invasion were the important prognostic factors of pT2 gastric carcinoma. Extensive lymph node dissection and aggressive post-operative chemotherapy should be performed, especially in Borrmann type lesions with lymph node metastasis.

Female↗

PubMed2004

Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis.

BACKGROUND: The aim of this study was to clarify prognostic factors and recurrence patterns in patients with node-negative intrahepatic cholangiocarcinoma (IHCC). METHODS: A retrospective study was performed to review prognostic factors and recurrence patterns (1) in 22 patients with node-negative IHCC after curative hepatic resection and (2) in 49 patients who underwent resection and lymph node dissection for IHCC. In addition to determining the clinicopathologic factors, the investigators also performed immunohistochemical examination of microvessel counts using antihuman CD-31 and antibody. RESULTS: The significant poor prognostic factors in node-negative IHCC were the presence of intrahepatic metastasis, portal vein invasion of cancer cells, and high microvessel counts. After multivariate analysis was conducted, the independent poor prognostic factors were the presence of intrahepatic metastases and high microvessel counts. Of 9 patients who had postoperative recurrence of their disease, intrahepatic recurrence was observed in 7 (78 %). CONCLUSIONS: The factors linked to poor prognosis in IHCC were tumor angiogenesis and the presence of intrahepatic metastasis. Because intrahepatic recurrence was common, regional and adjuvant chemotherapy to the liver may improve the outcome of patients with these risk factors and node-negative IHCC.

Bile Duct Neoplasms↗

PubMed1994

Muscle-invasive bladder cancer treated with external beam radiotherapy: prognostic factors.

PURPOSE: To determine the relationship of several potential prognostic factors to the outcome measures of pelvic control, freedom from metastases, and overall survival for bladder cancer patients treated with definitive external beam radiotherapy. METHODS AND MATERIALS: The records of 135 patients treated with high-dose, planned continuous-course, external beam radiotherapy for muscle-invasive transitional cell bladder cancer were reviewed. These patients were treated to an average total dose of 6588 +/- 475 cGy with an average fractional dose of 207 +/- 18 cGy using megavoltage. Median potential follow-up for all patients, including those who died, was 249 months. RESULTS: The actuarial results at 5 year were 31% pelvic control, 58% freedom from metastases, and 26% overall survival. In the univariate analyses, several factors were correlated with disease outcome including clinical stage, tumor morphology, gross total transurethral resection (TURBT), findings at bimanual exam after TURBT, clinical perivesical extension, age, and clinical complete response at first follow-up cystoscopy (Clinical-CR). A Cox proportional hazards model revealed that only Clinical-CR was independently predictive of pelvic control. In terms of freedom from metastases, only Clinical-CR and clinical stage were significantly associated with outcome in the multivariate analysis. When the multivariate analysis was restricted to T2 and T3 tumors only, then clinical perivesical extension replaced stage as being associated with freedom from metastases. The only factors significantly related to overall survival in the Cox proportional hazards model were Clinical-CR, age, and complete TURBT; stage was of borderline significance when only pretreatment factors were considered. CONCLUSIONS: Clearly, the most important prognostic factor was Clinical-CR. The pretreatment factors of stage, clinical perivesical extension, and gross total TURBT also correlated with outcome, but, to a lesser degree. For patients medically unfit for radical cystectomy radiotherapy is a viable option, particularly for selected patients. Patients with T4 tumors are poor candidates for definitive radiotherapy and should be treated palliatively if they cannot tolerate systemic therapy.

Aged↗

PubMed1988

Multivariate analysis for histologic prognostic factors in soft tissue sarcomas.

To investigate histologic prognostic factors in soft tissue sarcomas (STS), multivariate analysis was performed on 236 patients with complete clinical information. These included 141 males and 95 females with an age range from 1 to 85 years (median, 47.6 years). Histologically, malignant fibrous histiocytoma (33.5%) was the most common type followed by synovial sarcoma (11%), liposarcoma (10%), rhabdomyosarcoma (7%), and leiomyosarcoma (7%). Monofactorial analysis revealed that sex, depth, location, histologic grade, cellularity, frequency of mitosis, and necrosis were significant prognostic factors. By multivariate analysis, only frequency of mitosis and depth of tumors were proved to be of prognostic significance. The prognostic importance of the frequency of mitosis as shown in previous and the present studies indicates that further investigation of the cell proliferation in patients with STS is required.

Age Factors↗

PubMed1999

Evaluation of the proliferative index as a prognostic factor in diffuse large cell lymphoma: correlation with the International Index.

The reasons for differences in outcome between groups of patients with diffuse large cell lymphoma (DLCL) defined by clinical prognostic factors are largely unknown. Measures of cell proliferation may offer a biological explanation for these differences. This study tested the hypothesis that these survival differences between the groups defined by established prognostic factors were due to the proliferative index. The bromodeoxyuridine labeling index (LI), a measure of the S-phase fraction, was prospectively determined on fresh tumor specimens obtained at initial diagnosis in 80 patients with DLCL seen between 1986-1993 at a single institution. Patients were grouped using prognostic factors that were significant in a univariate analysis as well as the International Index (IPI). The LI in each of these groups was compared to determine whether the differences in outcome between the groups could be explained by differences in the LI. The median LI for all patients was 5.1% (range: 0.1-25%). When the predictive effect of the LI on response and survival was analyzed, the LI did not correlate with complete response or disease-free survival (DFS). There was a trend, however, for patients with a lower LI to have a poorer overall survival (p=0.06). When the patients were analyzed using the International Index (IPI), the mean LI for patients in the low-risk, low-intermediate, high-intermediate and high risk groups was 7.1%, 10.0%, 6.4% and 6.6% respectively (p=0.41). When analyzed separately, there was no significant difference in the LI for any of the patient groups defined by significant prognostic factors. The only difference in the LI was that the median LI in patients with T-cell DLCL was significantly lower than the LI in patients with B-cell DLCL (p=0.001) and these patients had an inferior complete response rate (p=0.001), disease-free survival (p=0.003) and overall survival (p=0.015). In this study, the LI, a measure of lymphoma cell proliferation, was not a significant prognostic factor for response, disease-free survival or overall survival. Furthermore, the LI did not explain the differences in outcome between patient groups defined by the IPI. However, a lower LI seen in patients with T-cell DLCL may account for their poorer response to therapy and inferior survival when compared to patients with B-cell DLCL.

Adolescent↗

PubMed2000

Prognostic factors in patients with submucosal carcinoma of the oesophagus.

To clarify the prognostic factors in patients with submucosal carcinoma of the oesophagus, we examined the results of surgical treatment for 78 cases over the last decade. The clinicopathological factors including age, sex, location of the tumour, length of the tumour, histological differentiation, subclassification of depth, lymphatic or blood vessel invasion, intramural metastasis and lymph node metastasis were all analysed. Then the correlation between these factors and prognosis was investigated. As a result, significant differences were observed in the survival rates between the groups regarding lymphatic vessel invasion (P = 0.0003), intramural metastasis (P = 0.0051) and lymph node metastasis (P = 0.0026). According to a multivariate analysis, intramural metastasis (P = 0.0038, relative risk 9.17), vessel invasion (P = 0.0033, relative risk 6.25) and lymph node metastasis (P = 0.0187, relative risk 3.62) were found to be independent prognostic factors. The prognosis of the patients with at least one of these factors was significantly poorer than that without. The five-year survival rate of the patients without these factors was as good as that with mucosal carcinoma of the oesophagus. Based on our findings, vessel invasion, intramural metastasis and lymph node metastasis are thus considered to be significant prognostic factors in patients with submucosal carcinoma of the oesophagus.

Age Factors↗

PubMed1991

[Recognition of predictive prognostic factors in recurrent colonic cancer. Apropos of a retrospective series of 178 cases].

Prognostic factors influencing the outcome of colon cancer were studied retrospectively in 178 patients who underwent curative resection between 1975 and 1985. Monovariate and multivariate analysis have been performed. Median follow-up was 8.7 years. Three factors increased the risk of recurrences: age when equal or greater than 70, poorly differentiated tumor and advanced Duke's stage. Two factors increased the risk of intra-abdominal recurrence: age when equal or greater than 70 and advanced Duke's stage. Two factors increased the risk of metastasis (including the liver): poorly differentiated tumor and advanced Duke's stage. Multivariate analysis showed that the risk of recurrences was correlated to Duke's stage, age and histological differentiation. Patterns of failure and prognostic factors reported in the literature are reviewed and implications of these prognostic factors on adjuvant treatment indications are discussed.

Adult↗

PubMed1997

Evaluation of prognostic factors for dogs with primary lung tumors: 67 cases (1985-1992).

OBJECTIVE: To determine associations between clinical and histologic factors in dogs with primary lung tumors and outcome and to develop a histologic grading method for primary lung tumors. DESIGN: Retrospective study. ANIMALS: 67 dogs undergoing thoracotomy and lobectomy for primary lung tumors. PROCEDURE: Medical records and histologic sections were reviewed to evaluate factors of prognostic importance. Association of these factors with disease-free interval (DFI) and survival time was evaluated, using the Cox proportional hazards model. Median DFI and survival time were determined, using the Kaplan-Meier product-limit method. RESULTS: Clinical and histologic factors significantly associated with prognosis were histologic score, detection of clinical signs, and metastasis to regional lymph nodes. On the basis of histologic score, a histologic grading method was developed. Dogs with well-differentiated tumors had significantly longer survival time and DFI (median DFI, 493 days) than dogs with moderately (median DFI, 191 days) or poorly (median DFI, 0 days) differentiated tumors. Dogs with clinical signs or metastasis to regional lymph nodes had shorter survival times and DFI than dogs in which lung masses were discovered as an incidental finding. CLINICAL IMPLICATIONS: Dogs with well-differentiated, nonmetastasized, primary lung tumors that do not have clinical signs associated with the tumor have a favorable prognosis. Dogs with more advanced disease or aggressive tumors histologically may require treatment, such as chemotherapy in combination with surgery. The grading method proposed here for primary lung tumors may be useful in other dogs with primary lung tumors.

Animals↗

PubMed2002

Localised Ewing sarcoma/PNET of bone--prognostic factors and international data comparison.

BACKGROUND: To determine if the distribution of prognostic factors accounted for the differences when the outcome for localised Ewing Sarcoma/PNET bone in Saudi Arabia was compared with results from countries with well developed health care systems. PROCEDURE: Retrospective analysis was undertaken of 163 consecutive patients of all ages, treated with radical intent at KFSHRC from 1975 to 1998. Standard chemotherapy was commenced in all patients. The local treatment modality was resection +/- radiation in 30% and radiation treatment alone in 67%. Size data were available for 51 patients treated from 1994 to 1998, inclusive. One third of these patients had tumors with volume >500 ml. RESULTS: Three year survival significantly increased with the year of diagnosis, 1975-1988 45%; 1989-1993 55%; and 1993-1998 63% (P = 0.006). Favorable prognostic factors were age < or =14 (P = 0.07); site, distal extremity, and skull (P = 0.08); and volume < or = 200 ml (P = 0.06). Secondary prognostic factors were response to induction chemotherapy, both histological, 100% necrosis, (P = 0.04) and clinical CR+PR, (P = 0.02). From 1994 to 1998, 3 year survival for tumors in the distal extremity and skull was 80% and for small tumors, < 200 ml, at any site was 82%. In comparison, the 3 year survival for patients with tumors at any other sites was 60%, and for tumors >200 ml, 55%. CONCLUSIONS: Overall survival progressively improved. From 1994 to 1998 the survival of patients with small tumors and/or favorable sites was similar to the best reported results. It was not possible to compare results by tumor size for large tumors, > 500 ml, due to the absence of data from elsewhere. A better staging system is required for the international comparison of results.

Adolescent↗

PubMed2004

Extracapsular spread of nodal metastasis as a prognostic factor in rectal cancer.

PURPOSE: To evaluate the prognostic value of lymph node metastasis with extracapsular extension (ECE) for local control and metastasis-free survival in rectal cancer. METHODS AND MATERIALS: A total of 145 rectal cancer patients were treated with surgery and postoperative radiochemotherapy. Patients were grouped according to nodal status (node negative, n = 49; node positive without ECE, n = 64; node positive with ECE, n = 32). In addition, well-known prognostic factors such as International Union Against Cancer (UICC) stage, T and N stage, presence of lymphangiosis, and grade were assessed. The end points were analyzed by the Kaplan-Meier method, and prognostic factors were compared in a Cox regression model. RESULTS: Of the entire group, the actuarial 5-year local control and distant metastasis-free survival rate was 85% and 66%, respectively, after a median follow-up of 47 months (range, 14-104). Patients with ECE of lymph node metastasis had an impaired 5-year local control rate (58%) compared with node-negative (83%) and node-positive without extracapsular involvement patients (87%, p = 0.041). Metastasis-free survival also differed for the three groups, with a rate of 40% for those with extracapsular involvement, 54% for those without ECE, and 78% for node-negative patients (p <0.0001). The impact of ECE on local control was confirmed in the regression model (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.01-2.7, p = 0.044). T stage was only of borderline significance (RR 2.4, 95% CI 1.0-5.7, p = 0.052). However, only UICC stage (RR 5.1, 95% CI 2.0-13.1, p <0.001) and the presence of lymphangiosis (RR 2.8, 95% CI 1.4-5.3, p = 0.002) were of independent prognostic value for distant metastasis. CONCLUSION: ECE of node metastasis is connected with a substantial decline in local control. The frequency of distant metastasis is increased in this patient group as well, but stage and lymphangiosis are the independent factors for assessment of a patient's risk of systemic spread.

Actuarial Analysis↗

PubMed1999

Significance of commonly used prognostic factors differs for children with T cell acute lymphocytic leukemia (ALL), as compared to those with B-precursor ALL. A Pediatric Oncology Group (POG) study.

T cell acute lymphocytic leukemia (T-ALL) and B-precursor ALL differ significantly in the clinical characteristics of the patients at presentation and in laboratory-defined characteristics of the leukemic cells. We assessed for pediatric patients with T-ALL the relative importance of prognostic factors previously demonstrated to predict outcome in B-precursor ALL. Presenting clinical and laboratory features were correlated with outcome for 441 children 12 months to 21 years of age with previously untreated T-ALL, registered on the Pediatric Oncology Group (POG) T3 protocol between 1986 and 1992. These T-ALL prognostic factor analyses were then compared to similar analyses for 1993 patients with B-precursor ALL enrolled during the same time period on the POG ALinC 14 protocol. Quantitative interaction between phenotype and each prognostic factor was studied to determine the relative importance of the prognostic factor for each of the two major immunophenotypes. We also analyzed the importance of maturational stage as a T-ALL prognostic factor, using a modified Ludwig definition of maturational stage. We conclude that several of the clinical and laboratory prognostic factors, which are used reliably for B-precursor ALL, are much less predictive in T-ALL (ie age, WBC, consensus risk group, hyperdiploidy, presence of trans- locations and CALLA expression). There was no significant difference between the phenotypes in the prognostic importance of race or gender. Our data demonstrate a significant difference in outcome among the three maturational stages of T-cell ALL, with the intermediate group faring best. Using traditional risk group criteria to stratify patients with T-ALL for therapy may not be appropriate.

Adolescent↗

PubMed1988

Steroid receptors and other prognostic factors in primary breast cancer.

A review and update of published studies on prognostic factors support the following conclusions: The number of axillary lymph nodes involved with tumor remains the most important prognostic factor for women with primary breast cancer. In stage I disease, the lack of estrogen receptor (ER) seems to be the most important factor for predicting earlier recurrence and poorer survival. In stage II breast cancer, progesterone receptor (PgR) content appears to be better than ER content in predicting disease-free and overall survival. Measurement of proliferative activity (S-phase DNA) by thymidine labeling or flow cytometry (FCM) and of aneuploidy by FCM also provides prognostic information. Patients with aneuploid tumors, or with high S-phase diploid tumors, are at increased risk for relapse. Amplification of oncogenes, particularly HER-2/neu, may provide additional prognostic information in combination with other established prognostic factors.

Breast Neoplasms↗

PubMed1998

[Primary gastrointestinal lymphomas: response to eradicative therapy and prognostic factors in 52 patients].

BACKGROUND: To analyze the response to eradicative therapy and prognostic factors in 52 patients with primary gastrointestinal lymphoma (PGIL) diagnosed at a single institution in a 13 year period. PATIENTS AND METHODS: The main clinical, biological and evolutive data were recorded. Pathologic diagnosis of PGIL was made according to the Working Formulation. Clinical stage was determined by the Ann Arbor system modified by Mushoff. The results of therapy as well as the influence of such characteristics on complete remission (CR), disease-free survival (DFS) and overall survival (OS) were studied. RESULTS: Mean age of the series was 53 years (SD 15). Thirty patients were males. HIV infection preceded PGIL diagnosis in 10 cases. Seventeen had bad performance status (ECOG 2-4) and 30 B symptoms. The PGIL localization was gastric in 31 cases and 29 had a low grade malignant lymphoma. B phenotype was demonstrated in 98% and 22 patients presented advanced stages (IIE2-IV). Treatment was radical surgery followed by intensive chemotherapy in 32 cases, intensive chemotherapy alone in 17, and surgical resection in 3. CR was obtained in 34 patients and 6 of them relapsed. The projected DFS from CR at 9 years was 72% and OS was 26%. CR and survival were not influenced by PGIL localization and treatment type. The main unfavourable prognostic factors were advanced stage (CR and OS), B symptoms (DFS and OS) and advanced ECOG score (CR, DFS and OS). Previous HIV infection had an independent prognostic influence on both CR and OS. CONCLUSIONS: In patients with PGIL, the achievement of CR, DFS and survival have been independent of the type of eradicative treatment used. Performance status, B symptoms and clinical stage have been the main prognostic factors. HIV infection carried an independent prognostic significance.

Adult↗

PubMed1995

Prognostic factors in erythrodermic mycosis fungoides and the Sézary syndrome.

BACKGROUND AND DESIGN: There are no large studies evaluating patients with erythrodermic mycosis fungoides and Sézary syndrome to determine the important prognostic factors that may influence survival. This is important since new treatment modalities have been proposed as superior to existing primary therapies. We performed a retrospective cohort study of 106 patients with erythrodermic mycosis fungoides and Sézary syndrome, followed up in the Stanford (Calif) Mycosis Fungoides Clinic, to define the important prognostic factors in this group. RESULTS: Patients younger than 65 years have a more favorable survival profile than those 65 years or older (P < .005). Longer duration of symptoms before diagnosis ( > or = 10 years) tends to be associated with more favorable prognosis (p = .055). Lymph node stage is significantly correlated with survival; patients with overall stage III disease have more favorable prognosis than those with stage IV disease (P < .001). Patients with circulating Sézary cells in their blood have a significantly worse prognosis than those without (P < .005). Patient sex or race had no significant effect on overall survival outcome. Three distinct prognostic groups were identified, "favorable," "intermediate," and "unfavorable," according to the number of unfavorable prognostic factors (P < .005). The median survival in each group is 10.2, 3.7, and 1.5 years, respectively. CONCLUSIONS: In patients with erythrodermic mycosis fungoides and Sézary syndrome, the important prognostic factors are patient age at presentation, the overall stage, and peripheral blood involvement. Survival varies widely, depending on these variables. These prognostic factors should be evaluated when analyzing survival and/or treatment efficacy data of these patients.

Adult↗