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PubMed1987

Carcinoma IB of the endometrium: spread and prognostic factors.

The prognostic factors and their intercorrelation in 47 patients with IB endometrial cancer are presented. The data reveal the particular behaviour of the lymphatic involvement: five patients (10.6%) showed metastases to pelvic lymph nodes and six patients (12.8%) had paraaortic node metastases; altogether two women (4.2%) had histological evidence of involvement of pelvic and paraaortic nodes. Both histological grade and depth of myometrial invasion showed a characteristic relationship with the lymphatic spread: the percentage of lymph node metastases seems to bear relation to progression of myometrial penetration (M2-M3) and to histological differentiation (G2-G3).

Adenocarcinoma↗

PubMed1994

[Pelvic exenteration for cancer of the uterine cervix (prognostic factors)].

The prognostic factors in 104 patients subjected to pelvic exenterations for cervical cancer recurrent after radiation therapy, at The Oncology Service Hospital General de Mexico, S.S., who survived the surgical procedures with a follow-up for three years or more, are presented here. Results were with statistical significance in the next cases: Patients with 35 years old or less, had a better prognosis when compared with the others: 15/22, 68.1%, vs. 36/82, 43.9%, P = 0.03; clinical reports of tumour localized in cervix, 17/22, 77.2%, vs. infiltration of lateral wall of the pelvis: 11/39, 28.2%, P = 0.008. Pyelographic findings of hydronephrosis or renal exclusion: 2/13, 15.3% vs. normal reports: 9/13, 69.2%, P = 0.01. Infiltration of urinary bladder and or rectal wall: 15/41, 36.5% vs. absence of these: 36/63, 57.1%, P = 0.03; tumour involving myometrium with or without ovarian metastases: 2/15, 13.0% vs. absence of these reports: 49/89, 55.5%, P = 0.03 and the absence of lymph metastatic nodes: 40/68, 58.8% vs. the presence of 3 or more positive lymph nodes: 4/15, 26.6%, P = 0.01. In this series we didn't find differences with statistical significance when compared, the modalities of schemes of radiotherapy, the variety of exenterative procedures and the period of time less or more than a year, between the radiotherapy and the surgery.

Adult↗

PubMed2003

[Inducible nitric oxide synthase and basic fibroblast growth factor expression as prognostic factors in supraglottic squamous cell carcinoma].

BACKGROUND & OBJECTIVE: The prognosis of supraglottic squamous cell carcinoma (SGSCC) was poor. To authors' knowledge, the relationship between inducible nitric oxide synthase (iNOS) and basic fibroblast growth factor (bFGF) and the prognosis of SGSCC has not been addressed to date. This study was designed to evaluate the prognostic significance of these two parameters in SGSCC. METHODS: The expression of iNOS and bFGF protein in 64 patients with SGSCC using LSAB method and pathologic imagine analysis system and their association with neck lymph node metastases, recurrence, and prognosis. RESULTS: (1) The expression of iNOS and bFGF was significantly higher in cervical lymph node positive group (33.2+/-8.8 and 36.1+/-7.8) than in negative group (27.3+/-7.4 and 24.5+/-7.5) with statistical significance. The expression of iNOS and bFGF was higher in recurrence group (36.9+/-1.7 and 34.6+/-2.0) than in no-recurrence group (29.1+/-1.3 and 27.2+/-1.4) with statistical significance. (2) Patients with positive neck lymph node had poorer 5-year survival than those with negative neck lymph node (31.0% vs. 57.1%). Patients with positive iNOS expression had poorer 5-year survival than those with the negative iNOS expression (40.0% vs. 77.8%). However, there was no statistical significance between positive bFGF expression group and negative bFGF expression group. (3) Cox model multivariate regression analysis showed that lymph node status, the expression of iNOS and postoperative radiotherapy were independent prognosis factors, whereas the T staging and the expression of bFGF were not. CONCLUSION: The expression of iNOS was one of the independent prognostic factors, but it is necessary to study further for iNOS and bFGF to predict the prognosis of patients with SGSCC using immunohistochemical technique.

Adult↗

PubMedDate not supplied

Intra-aortic balloon pumping support in surgically treated valvular heart disease: prognostic factors and survival.

Prognostic factors of Low Output Syndrome (LOS) requiring operative circulatory support by intra-aortic balloon-pumping (IABP) counterpulsation, were analysed in a population of 841 patients who underwent heart valve replacement surgery between June 1977 and May 1985. The incidence of IABP circulatory support was 6.8%. Mean survival time of patients who needed IABP was 2.35 years +/- 0.425 vs 6.30 years +/- 0.103 for patients who didn't have this complication. A multivariate analysis using the logistic model was done to pinpoint factors predictive of IABP support. The prognostic factors were pre-operative functional class, presence of prior valve replacement, presence of concomitant surgery and presence of endocarditic etiology. The subgroup of 58 patients undergoing balloon counterpulsation was analysed for factors predictive of survival using a multivariate analysis of the Cox' model. Presence of aortic or mitral regurgitation was found to be the independent risk factor of mortality. Using a combination of prognostic factors, we pinpointed groups of patients at high risk of needing post-operative balloon pump counterpulsation support. The necessity of an alternative procedure for the mechanical support of the failing circulation is underlined.

Aortic Valve↗

PubMed1995

[Immunohistologic tumor cell detection in lymph nodes in node negative breast cancer: correlation with "established" and "recent" prognostic factors].

OBJECTIVES: The prognostic value of immunohistochemically detected micrometastases in lymph nodes as well as its association with newer prognostic factors is discussed controversially. PATIENTS AND METHODS: Using a monoclonal pancytoceratine antibody 1807 axillary lymph nodes of 122 pT1-2N0M0-patients were examined. Histological findings, established and newer prognostic factors were investigated additionally. The mean follow up time was 50 months. RESULTS: The detection of micrometastases in 16 of 122 (13.1%) patients were related with a prognostic disadvantage for recurrence free survival (p = .03). Tumour size, grading, vessel invasion and S-phase, but not the detection of micrometastases, were confirmed as independent prognostic factors in nodal negative patients by Cox-regression. CONCLUSION: Immunohistochemically detected micrometastases in axillary lymph nodes are of prognostic and therapeutic value but they are not independent prognostic factors.

Biomarkers, Tumor↗

PubMedDate not supplied

Comorbidity as a prognostic factor in small cell lung cancer.

AIMS AND BACKGROUND: Many factors have prognostic significance in small cell lung cancer (SCLC). The aim of this study was to define the prognostic factors influencing the response to therapy and the survival in SCLC. METHODS: A consecutive series of 90 patients with SCLC was analyzed retrospectively using 32 pretreatment and 3 treatment-related prognostic factors with respect to their influence on survival. Prognostic factors were evaluated by univariate analysis and by the Cox multivariate regression model. Patients who survived more than 2 months were included in the univariate analysis. RESULTS: The median survival of the whole population was 7 months, with a 1-year survival rate of 20%. In univariate analysis, prognosis was significantly influenced by gender, comorbidity, thoracic irradiation, receipt of more than 3 cycles of chemotherapy, response to chemotherapy, and performance status. The Cox model identified comorbidity (P = 0.03), receipt of more than 3 cycles of chemotherapy (P = 0.003) and response to chemotherapy (P = 0.002) as the only significant factors. CONCLUSIONS: The prognosis of SCLC is poor, and comorbidity information should be included in prognostic studies.

Aged↗

PubMedDate not supplied

Comparison of serum growth factors and tumor markers as prognostic factors for survival in non-small cell lung cancer.

Tumor markers have been shown to correlate with stage of disease and histologic type of non-small cell lung cancer (NSCLC). Probably their most important role is monitoring of treatment response and prediction of relapse. More recently, measurement of growth factors became possible. The purpose of this review was to compare the usefulness of serum tumor markers and growth factors as prognostic factors in NSCLC. The endpoint was the hazard ratio in multivariate analysis. Studies published between January 1995 and December 2002 were identified by a comprehensive MEDLINE search and systematically selected. Overall, 25 articles were found and analysed. We evaluated data from up to 1600 patients per marker. The exact type of assay and the cut-off values varied widely. This analysis failed to demonstrate a clear prognostic role for many commonly used markers, especially for squamous cell carcinoma antigen. Conflicting results were found for carcinoembryonic antigen, neuron-specific enolase and tissue polypeptide specific antigen. The most convincing data were those for Cyfra 21-1, where the vast majority of studies was positive. With regard to growth factors, the vascular endothelial growth factor studies uniformly came out negative, whereas basic fibroblast growth factor appears more promising. So far, growth factors do not appear superior to Cyfra 21-1. Overall, established prognostic factors such as performance status and stage continue to remain more important than biological markers. In virtually all large studies with multivariate analysis, their influence was higher than that of emerging factors.

Antigens, Neoplasm↗

PubMed2000

Vascular endothelial growth factor (VEGF) expression is a prognostic factor for radiotherapy outcome in advanced carcinoma of the cervix.

The aim of the study was to evaluate VEGF expression in tumour biopsies as a prognostic factor for radiotherapy outcome in advanced carcinoma of the cervix. A retrospective study was carried out on 100 patients. Pre-treatment tumour VEGF expression was examined immunohistochemically in formalin-fixed, paraffin-embedded biopsies using a widely available commercial antibody. A semi-quantitative analysis was made using a scoring system of 0, 1, 2, and 3, for increasing intensity of staining. High VEGF expression was associated with a poor prognosis. A univariate log rank analysis found a significant relationship with overall survival (P = 0.0008) and metastasis-free survival (P = 0.0062), but not local control (P = 0.23). There was no correlation between VEGF expression and disease stage, tumour differentiation, patient age, or tumour radiosensitivity (SF2). In a Cox multivariate analysis of survival VEGF expression was the most significant independent prognostic factor (P = 0.001). After allowing for VEGF only SF2 was a significant prognostic factor (P = 0.003). In conclusion, immunohistochemical analysis of VEGF expression is a highly significant and independent prognostic indicator of overall and metastasis-free survival for patients treated with radiotherapy for advanced carcinoma of the cervix. It is also a rapid and easy method that could be used in the clinical setting, to identify patients at high risk of failure with conventional radiotherapy who may benefit from novel approaches or chemoradiotherapy.

Adenocarcinoma↗

PubMed2002

Multivariate analysis of prognostic factors in CLL: clinical stage, IGVH gene mutational status, and loss or mutation of the p53 gene are independent prognostic factors.

This study evaluates the prognostic significance of genetic abnormalities (detected at or shortly after presentation), clinical stage, lymphocyte morphology, CD38 expression, and IGVH gene status in 205 patients with chronic lymphocytic leukemia (B-CLL). Deletion of chromosome 11q23, absence of a deletion of chromosome 13q14, atypical lymphocyte morphology, and more than 30% CD38 expression are significantly associated with the presence of unmutated IGVH genes. Advanced stage, male sex, atypical morphology, more than 30% CD38 expression, trisomy 12, deletion of chromosome 11q23, loss or mutation of the p53 gene, and unmutated IGVH genes are all poor prognostic factors in a univariate analysis. However, only 98% or more homology of IGVH genes to the germline sequence, loss or mutation of the p53 gene, and clinical stage retain prognostic significance in a multivariate analysis. The median survival of patients with mutated IGVH genes, unmutated IGVH genes, and loss or mutation of the p53 gene regardless of IGVH gene status is 310, 119, and 47 months, respectively. These data should facilitate the design of new trials for the management of patients presenting with advanced disease or poor prognosis early stage disease.

ADP-ribosyl Cyclase↗

PubMed1991

Screening as a prognostic factor in cervical cancer: analysis of survival and prognostic factors based on Icelandic population data, 1964-1988.

Survival rates were computed for 376 women diagnosed with carcinoma of the uterine cervix between 1964 and 1988. The 5-year survival rate for the entire group was 63%. The effect of age at diagnosis, clinical stage, histopathology, year of diagnosis, and screening program attendance was studied by univariate analysis and simultaneously with a multivariate analysis, the Cox proportional hazards model. All these parameters had a significant effect on survival, with clinical stage as the strongest parameter followed by histology, year of diagnosis, age at diagnosis, and attendance at screening. Women who had attended the cervical screening program fared significantly better than those who had never attended. Patients treated in the late years of the study period had a significantly better survival rate, possibly indicating improved treatment. Young women had a significantly better prognosis than older women. Women with adenocarcinoma and anaplastic tumors had a significantly worse prognosis than women with squamous and adenosquamous carcinoma. The prognostic effect of screening was mainly attributed to the more favorable distribution of early stages and younger age at diagnosis among the screened women. After all the analyzed parameters had been adjusted for the nonattenders still had poorer prognosis.

Adult↗

PubMed1992

Risk factors, epidemiology, screening, and prognostic factors in female genital cancer.

This review, which due to limitations of space cannot be exhaustive, summarizes the recent literature on risk factors and epidemiology, screening and prognostic factors in a cervical, ovarian, and endometrial cancer. There have been a large number of pertinent publications during this period and this paper summarizes and highlights recent advances in the identification of women at particularly high risk of developing gynecologic cancer, analyzes studies on early detection and screening, and reviews prognostic studies with particular reference to selection of therapy according to risk of relapse and likelihood of benefit.

Female↗

PubMed1996

[The prognostic factors in astrocytic tumors: analysis by the Kaplan-Meier method and the Weibull log-linear model].

As the prognosis of astrocytic tumors depends on various factors, identifying prognostic factors should be useful for developing strategies to cope with them. Between 1975 and 1994, more than 200 patients with astrocytic tumors were treated in Kagoshima University. Of these patients, 149 (grade I: 17, grade II: 42, grade III: 41, grade IV: 42, unproven: 7) have been followed up. Records of these patients were retrospectively reviewed for age at the time of initial symptoms, gender, histological grade (WHO), extent of tumor resection, radiation therapy, and administration of anticancer agents. We used the Kaplan-Meier method and the Weibull log-linear model to analyze the relation between survival time and these prognostic factors. Survival time was counted from onset of symptoms, and age of initial treatment was used as a covariant. The mean age of males at the initial diagnosis was 40.8 years (n = 77), and that of females was 39 years (n = 72). Using the Kaplan-Meier method, the mean survival time of the 149 patients was 101 months (males; 72.7 months, females; 134.5 months). Mean survival time of grade II was 144.3 months, that of grade III was 95.2 months, and grade IV (glioblastoma) was 15.9 months. Histological grades and mean ages of the groups showed a positive correlation. Among grades II, III and IV, the Kaplan-Meier survival curves were significantly different (p < 0.0001) according to the log-rank test. By the extent of surgical resection (subtotal or greater resection, partial resection, and less than partial resection), the mean survival time showed a significant difference (p < 0.05) on the log-rank test. However, we could not detect a significant difference in survival time between the group that received chemotherapy and the group which did not. The Weibull log-linear analysis indicated that gender, age, histological grade (WHO), extent of surgery, and dose of radiation therapy were prognostic factors. Covariants of grades II, III, and IV made survival time 0.314, 0.179, and 0.069 times as long as that of grade I. The survival time after "partial resection" became 1.415 times as long as the survival time after "less than partial resection". The covariant of "greater than subtotal resection" showed a prolonged survival time of 2.916 compared with that of "less than partial resection". As for age at treatment, the older the patient was, the shorter the survival time. The rate was 0.986 for each year of age. Irradiation of one Gy increased survival time by 1.015 times. Chemoimmunotherapy (dose of ACNU and interferon beta) could not be confirmed as an effective covariant.

Adult↗

PubMed2002

Prognostic factors in mesothelioma.

Prognostic factors in oncology may help physicians give their patients a prognosis for their disease and thus allow them to make plans for the future. These factors also assist in the selection of patients more likely to benefit from intensive treatments, especially in the context of clinical trials. Recently it has become clear that prognostic factors may have an additional benefit: they may provide insight into the biology of the cancer being studied and lead to improved understanding of the molecular pathogenesis. For malignant mesothelioma, the prognostic scoring systems of the Cancer and Leukemia Group B (CALGB) and European Organization for Research and Treatment of Cancer (EORTC) are the most useful of those currently available. These systems rate performance status, age, histological subtype, weight loss, and hematological parameters as the best prognostic factors for malignant mesothelioma. In the future, biological markers may provide additional information on mesothelioma and will help in prognostication.

Humans↗

PubMed2000

Clinical course, prognostic factors, and outcome prediction for HIV patients in the ICU. The PIP (Pulmonary complications, ICU support, and prognostic factors in hospitalized patients with HIV) study.

STUDY OBJECTIVE: To describe the clinical course and prognostic factors in patients with HIV admitted to the ICU. DESIGN: Prospective, observational. SETTING: A university-affiliated medical center. METHODS: : We included 169 consecutive ICU admissions, from April 1995 through March 1999, of 141 adults with HIV. Data collected included APACHE (acute physiology and chronic health evaluation) II score, CD4(+) lymphocyte count, serum albumin level, in-hospital mortality, and the development of organ failure, systemic inflammatory response syndrome (SIRS), and ARDS. RESULTS: The ICU admission rate of hospitalized patients with HIV infection was 12%. The most common reason for ICU admission was respiratory failure, occurring in 65 patient admissions. Mechanical ventilation was required in 91 admissions (54%), ARDS developed in 37 admissions (22%), Pneumocystis carinii pneumonia was diagnosed in 24 admissions (14%), and SIRS developed in 126 admissions (75%). One or more organ failures developed in 131 admissions (78%). The actual and predicted mortality rates were 29.6% and 45.2%, respectively, with a standardized mortality ratio of 0.65. The most frequent immediate cause of death was bacterial infection. The CD4(+) lymphocyte count (median, 27.5 cells/microL vs 59 cells/microL; p = 0.0310) and serum albumin level (median 2.2 g/dL vs 2.6 g/dL; p = 0.0355) of nonsurvivors were lower and the APACHE II score (median, 30 vs 21; p < 0.0001) was higher, compared to those of survivors. A higher APACHE II score (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05 to 1.16) and a transfer from another hospital ward (OR, 3.03; 95% CI, 1.20 to 7.68) were independently associated with increased mortality. The median number of organ failures that developed in survivors was one, compared to four in nonsurvivors (p < 0.0001). CONCLUSIONS: The outcome of HIV-infected patients admitted to the ICU has improved over the years. The CD4 count does not correlate with in-hospital mortality. Higher APACHE II scores and a transfer from another hospital ward are associated with a poor outcome.

APACHE↗

PubMed2001

[Expression of vascular endothelial growth factor and nm23 as prognostic factors in nasopharyngeal carcinoma].

OBJECTIVE: To evaluate the prognostic significance of vascular endothelial growth factor (VEGF) and nm23 expression for patients with nasopharyngeal carcinoma(NPC). METHODS: From Jan. 1991 to Dec. 1995, 75 NPC patients treated in Department of Radiotherapy & Chemotherapy, Zhongnan Hospital of Wuhan University, with follow-up of more than 4 yrs, were selected to enter this study. Specimens of 75 NPC were studied by immunohistochemical staining for VEGF and nm23. The immunohistochemical data were correlated with development of locoregional failure, distant metastasis and survival. RESULTS: Positive expression of VEGF and negative expression of nm23 were found in 54.7% and 56% of NPC specimens. Positive expression of VEGF and negative expression of nm23 correlated with the development of distant metastasis (P = 0.0181; P = 0.0091) and shorter survival (P = 0.0136; P = 0.0207). No association was observed with locoregional failure. No association was observed between the expression of VEGF and the expression of nm23.Cox proportional hazard model was used to compare the various factors and found the VEGF and nm23 expression were significant prognostic factors for patients with NPC. CONCLUSION: The results of the study show that the VEGF and nm23 expression are significant prognostic factors for patients with NPC and indicate that expression of VEGF and nm23 may be useful in identifying patients who may benefit from systemic chemotherapy or other novel treatment strategies.

Adolescent↗

PubMed2002

Soluble syndecan-1 and serum basic fibroblast growth factor are new prognostic factors in lung cancer.

Syndecan-1 is a ubiquitous and multifunctional extracellular matrix proteoglycan,which mediates basic fibroblast growth factor (bFGF) binding and activity. Shedding of syndecan-1 ectodomain from the plasma membrane is highly regulated. We evaluated the influence of soluble syndecan-1 and serum bFGF determined by ELISA on outcome in 184 lung cancer patients (non-small cell lung cancer, n = 138; small cell lung cancer, n = 46). Serum syndecan-1 and bFGF levels were determined from sera taken before treatment. The median follow-up of the patients alive (n = 21) was 8.1 years (range, 6.6-8.9 years). High serum syndecan-1 and bFGF levels tended to occur in the same patients (P = 0.044). When the serum values corresponding to the highest tertile were used as the cutoff value, the median survival time of the patients with a high serum syndecan-1 level (>59 ng/ml) was 4 months [95% confidence interval (CI), 3-6 months] as compared with 11 months (9-16 months) among those with lower serum levels (P = 0.0001), and the median survival time of the patients with a high bFGF level (>3.4 pg/ml) was 5 months (3-8 months) versus 11 months (8-14 months) in those with a lower level (P = 0.023). In general, the prognostic influence of both factors was independent of the histological subtype. Both serum syndecan-1 level (relative risk, 1.8; 95% CI, 1.1-3.1) and serum bFGF level (relative risk, 1.6; 95% CI, 1.0-2.7) had independent influence on survival in a multivariate survival analysis in non-small cell lung cancer. We conclude that high serum syndecan-1 and bFGF levels at diagnosis are associated with poor outcome in lung cancer.

Adult↗

PubMed2006

Prognostic factor analysis and proposed prognostic model for conventional treatment of high-grade primary gastric lymphoma.

OBJECTIVES: We conducted a clinical risk factors analysis to define a prognostic model for high-grade primary gastric lymphoma (HG-PGL). METHODS AND RESULTS: The median event-free survival and overall survival of 214 HG-PGL patients were 54 and 104.5 months, respectively, after a median follow-up duration of 60 months. According to the prognostic factor analysis, survival, advanced age, male gender, higher LDH levels and the presence of ascites were identified as independent prognostic factors for HG-PGL. We identified four groups at different risk: group 1, no adverse effect; group 2, one factor; group 3, two factors; group 4, three or four factors. The new prognostic model showed excellent prognostic capacity to differentiate subgroups according to their risk stratification. CONCLUSIONS: The proposed new prognostic model for HG-PGL demonstrated a balanced distribution of patients into four groups with good prognostic capacity.

Adult↗

PubMed2005

Reliability of platelet-derived endothelial cell growth factor as a prognostic factor for oral and oropharyngeal carcinomas.

OBJECTIVE: To identify a strong prognostic biological marker for patients with oral and oropharyngeal squamous cell carcinomas. DESIGN: We evaluated the protein expressions of 26 tumor-associated factors, including cytokines and cytokine receptors (granulocyte colony-stimulating factor [G-CSF], interleukin 10 [IL-10], G-CSF receptor [G-CSFR], and IL-12 receptor); angiogenic factors (platelet-derived endothelial cell growth factor [PD-ECGF] and vessel count); cell cycle-related proteins (p27, cyclin D1, and cyclin E); apoptosis-related factors (wild-type p53, Bax, Bcl-2, apoptotic index, Fas, and Fas ligand); oncogene proteins (c-fos and c-Myc); cell-surface proteins (P-glycoprotein, multidrug resistance-associated protein, nm23, and CD40); intracellular proteins (aryl hydrocarbon receptor nuclear translocator, aryl hydrocarbon receptor, and heat shock protein 27); and DNA mismatch-repair genes (protein encoded by human mutL homologue 1 and the human mutS homologue of the chromosome 2p gene) by means of immunohistochemical analysis. SETTING: Department of Otorhinolaryngology-Head and Neck Surgery, University of Fukui, Fukui, Japan. PATIENTS: Fifty-eight patients who underwent surgical resections of oral and oropharyngeal squamous cell carcinomas. RESULTS: A low-level PD-ECGF expression, a hypovascular count, or a low-level G-CSFR expression was associated with a favorable clinical outcome using the Kaplan-Meier method. Univariate analysis showed that PD-ECGF expression (odds, 4.19; P = .02), G-CSFR expression (odds, 4.10; P = .01), and vessel count (odds, 2.80; P = .04) had significant hazard rates. When multivariate analysis was performed on 6 factors, including sex, tumor size, lymph node metastasis, PD-ECGF expression, G-CSFR expression, and vessel count, patients with a positive expression of PD-ECGF had the highest relative risk value for death due to the disease (odds, 4.94; P = .01). Also, G-CSFR was an independent prognostic indicator in the model (odds, 3.29; P = .04). No correlations between other factors and prognoses were detected. CONCLUSION: Expression of PD-ECGF was the most effective marker for making prognoses for oral and oropharyngeal squamous cell carcinomas, and G-CSFR expression was the second most effective among 26 tumor-associated factors.

Aged↗