Predictive Factors For Tumor Recurrence Research Articles

Diagnostic impact of postoperative CA19-9 dynamics on pancreatic cancer recurrence: a single-institution retrospective study.

Postoperative CA19-9 elevation after pancreatic cancer resection suggests recurrence but can also occur in benign conditions. This study aimed to investigate the interpretation of postoperative CA19-9 elevation after pancreatic cancer surgery in terms of cancer recurrence. A cohort of patients undergoing pancreatectomy for pancreatic cancer at our hospital was included. Among them, 52 patients exhibited postoperative CA19-9 elevation without radiological evidence of recurrence. These patients were evaluated with follow-up CA19-9 measurements. The CA19-9 increase rates were calculated based on the first elevation and the follow-up measurement. The association between the CA19-9 increase rate and tumor recurrence was assessed. Patients with a CA19-9 increase rate of ≥ 30% had a significantly higher frequency of recurrence within 3months compared to those without such an increase (p = 0.0002). Multivariate analysis demonstrated that a CA19-9 increase rate of ≥ 30% was an independent risk factor for recurrence (odds ratio 8.17, p = 0.0309). The CA19-9 value at the first elevation (p = 0.1794) and at the follow-up measurement (p = 0.1121) were not associated with recurrence. After the first postoperative CA19-9 elevation, the CA19-9 increase rate based on follow-up measurements can serve as a predictive factor for tumor recurrence.

Laser interstitial thermal therapy in the treatment of brain metastases: the relationship between changes in postoperative magnetic resonance imaging characteristics and tumor recurrence.

Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence. We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence. Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30days postoperatively. All the volume-related data were delineated and calculated using 3D Slicer software. Related predictors were also collected to evaluate the correlation with local tumor control. Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58min (range, 2.88-37.15min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90days and 180days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control. LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.

Nuclear Factor-Kappa B in Gliomas as a Predictive Factor for Tumor Recurrence – A Clinicopathological Study

BACKGROUND: Glioma is the most common primary malignant brain tumor. Nuclear factor κB (NF-κB) has emerged as a regulator of the malignant phenotype in glioma, and in particular glioblastoma multiforme, with clear relation to tumor size, recurrence, and invasiveness. AIM: The aim of the study was to study the analysis of NF-κB expression in gliomas of different histologic types and grades and its correlation with various clinicopathologic indicators. METHODS: One hundred and ten paraffin blocks of glioma cases classified according to WHO classification into 14 (12.7%) cases of Grade I pilocytic astrocytoma, 27 (24.5%) cases of Grade II gliomas, 26 (23.6%) cases of Grade III gliomas, and 43 (39.1%) cases of Grade IV glioblastoma. The correlations between immunostainings and clinicopathological parameters were analyzed statistically. RESULTS: Positive immunostaining for NF-κB was encountered in (64/110) 58.2% of gliomas. Statistical analysis revealed significant association between positive NF-κB expression and high histological grade (p < 0.001), recurrence of the tumors (p = 0.001), large tumor size (≥5 cm) (p < 0.001), histological subtypes (glioblastoma represented 51.6% of NF-κB positive cases, while pilocytic astrocytoma represented 1.6% of NF-κB positive cases) (p < 0.001) and age of the patient (≥40) (p = 0.039). CONCLUSIONS: A strong direct relation between NF-κB expression and the grade of glioma was observed. NF-κB expression behaves as a negative independent prognostic factor for the risk of tumor recurrence. Hence, inhibition of NF-κB may be a new therapeutic strategy to prevent recurrence of gliomas, particularly the high-grade type.

Fluoroscopic Stent Placement as a Bridge to Surgery for Malignant Colorectal Obstruction: Short- and Long-Term Outcomes.

To assess the outcomes of single-stage surgery following fluoroscopic stent placement for malignant colorectal obstruction. This retrospective study included 46 patients (28 male and 18 female; mean age, 67.2 years) who had undergone fluoroscopic stent placement followed by laparoscopic resection (n = 31) or open surgery (n = 15) for malignant colorectal obstruction. The surgical outcomes were analyzed and compared. After a mean follow-up of 38.9 months, the recurrence-free and overall survival were estimated, and prognostic factors were evaluated. The mean interval between stent placement and surgery was 10.2 days. Primary anastomosis was possible in all patients. The mean postoperative length of hospitalization was 11.0 days. Bowel perforation was detected in six patients (13.0%). During the follow-up, ten patients (21.7%) developed recurrence; these included five of the six patients with bowel perforation. Bowel perforation had a significant effect on recurrence-free survival (p = 0.010). Single-stage surgery following fluoroscopic stent placement may be effective for treating malignant colorectal obstruction. Stent-related bowel perforation is a significant predictive factor for tumor recurrence.

SAT312 - Predictive factors of tumor recurrence after liver transplantation for hepatocellular carcinoma: analysis of a multicenter prospective study including 371 patients

SAT312 - Predictive factors of tumor recurrence after liver transplantation for hepatocellular carcinoma: analysis of a multicenter prospective study including 371 patients

Dynamic Change of Albumin-Bilirubin Score Is Good Predictive Parameter for Prognosis in Chronic Hepatitis C-hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization.

Background and Aims: The Albumin-Bilirubin (ALBI) grade is a good index for liver function evaluation and is also associated with the outcomes of hepatocellular carcinoma patients receiving TACE. However, the correlation between the dynamic change to the ALBI score and clinical outcome is seldom discussed. Therefore, this study aimed to investigate the application of ALBI grade and dynamic change of ALBI grade (delta ALBI grade) after first TACE for prognosis prediction in HCC patients with chronic hepatitis C infection. Method: From January 2005 to December 2015, newly diagnosed naive chronic hepatitis C-hepatocellular carcinoma (CHC-HCC) patients who were treated with TACE as the initial treatment at the Chang Gung Memorial Hospital, Linkou Medical Center, were retrospectively recruited. The pre-treatment host factors, tumor status and noninvasive markers were collected. The Cox regression model was used to identify independent predictors of overall survival and tumor recurrence. Results: Among 613 treatment-naive CHC-HCC patients, 430 patients died after repeated TACE during a median follow-up of 26.9 months. Complete remission after repeated TACE occurred in 46.2% patients, and 208 patients (33.9%) had tumor recurrence, with a median recurrence-free interval of 8.5 months. In Cox regression analysis, ALBI grade II/III (aHR: 1.088, p = 0.035) and increased delta ALBI grade (aHR: 1.456, p = 0.029) were independent predictive factors for tumor recurrence. Furthermore, ALBI grade II/III (aHR: 1.451, p = 0.005) and increased delta ALBI grade during treatment (aHR: 1.436, p = 0.006) were predictive factors for mortality, while achieving complete response after repeated TACE (aHR: 0.373, p < 0.001) and anti-viral therapy (aHR: 0.580, p = 0.002) were protective factors for mortality. Conclusion: Both ALBI and delta ALBI grade are independent parameters to predict survival and tumor recurrence of CHC-HCC patients receiving TACE treatment.

The role of apparent diffusion coefficient as a predictive factor for tumor recurrence in patients with cerebellopontine angle epidermoid tumor.

Intracranial epidermoid tumors are slowly growing benign tumors, but due to adjacent critical neurovascular structures, surgical resection is challenging, with the risk of recurrence. The apparent diffusion coefficient (ADC) has been used to evaluate the characteristics of brain tumors, but its utility for intracranial epidermoid tumors has not been specifically explored. This study analyzed the utility of preoperative ADC values in predicting tumor recurrence for patients with intracranial epidermoid tumors. Between 2008 and 2019, 21 patients underwent surgery for cerebellopontine angle (CPA) epidermoid tumor, and their preoperative ADC data were analyzed. The patients were divided into two groups: the recurrence group, defined by regrowth of the remnant tumor or newly developed mass after gross total resection on magnetic resonance imaging (MRI); and the stable group, defined by the absence of growth or evidence of tumor on MRI. Receiver operating characteristic (ROC) analysis was used to obtain the ADC cutoff values for predicting tumor recurrence. The prognostic value of the ADC was assessed using Kaplan-Meier curves. The minimum ADC values were significantly lower in the recurrence group than in the stable tumor group (P = 0.020). ROC analysis showed that a minimum ADC value lower than 804.5 × 10-6 mm2/s could be used to predict higher recurrence risk of CPA epidermoid tumors. Non-total resection and mean and minimum ADC values lower than the respective cutoffs were negative predictors of recurrence-free survival. Minimum ADC values could be useful in predicting the recurrence of CPA epidermoid tumors.

P098 - Predictive factors of tumor recurrence and progression in high-risk non-muscle-invasive bladder cancer

P098 - Predictive factors of tumor recurrence and progression in high-risk non-muscle-invasive bladder cancer

Association of human papilloma virus (HPV) infection with oncological outcomes in urothelial bladder cancer

BackgroundBladder cancer is one of the leading causes of cancer death in adults worldwide. There are various risk factors described for the bladder cancer development including genetic background as well as environmental exposure. Currently, infectious agents such as human papilloma virus (HPV) has also been linked to bladder cancer risk. The current study aimed to evaluate the potential correlation between HPV infection and the oncological outcome in urothelial bladder cancer.MethodsTotally 106 tissue samples of histopathologically confirmed transitional cell carcinoma (TCC) of the urinary bladder were included in this study. The presence of high risk (types 16 and 18) and low risk (types 11 and 6) types of HPV was evaluated using polymerase chain reaction (PCR) followed by in situ hybridization.ResultsOut of 106 bladder cancer patients, a total of 24 cases (22.6%) were positive HPV infection. The most common type of HPV detected was type 16 followed by types 11 and 18, and 6. According to independent T-test results, there was a significant association between mean age and HPV infection (P = 0.015). Moreover, our findings showed a significant relation between infection with HPV and tumor stage, tumor grade, muscle invasion of the tumor, as well as tumor recurrence. The results of Chi-square Test indicated that there is significant statistical association between types of HPV and tumor grade (P-Value = 0.044).ConclusionOur findings indicated that a family history of cancer and HPV infection can be potential independent predictive factors for tumor recurrence in bladder cancer. Overall, the results of this study strongly indicate a significant relationship between HPV infection and an aggravated outcome of the disease and a higher risk of recurrence in patients with bladder cancer.

MP57-02 PREDICTIVE FACTORS FOR RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR CLINICAL T1 RENAL CELL CARCINOMA: A RETROSPECTIVE STUDY OF 1568 CASES FROM A SINGLE INSTITUTION

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP57)1 Apr 2020MP57-02 PREDICTIVE FACTORS FOR RECURRENCE AFTER PARTIAL NEPHRECTOMY FOR CLINICAL T1 RENAL CELL CARCINOMA: A RETROSPECTIVE STUDY OF 1568 CASES FROM A SINGLE INSTITUTION Kazuhiko Yoshida*, Toshio Takagi, Arisa Ebinuma, Tsunenori Kondo, Hironori Fukuda, Hiroki Ishihara, Hirohito Kobayashi, Junpei iizuka, Masayoshi Okuimi, Hideki Ishida, and Kazunari Tanabe Kazuhiko Yoshida*Kazuhiko Yoshida* More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Arisa EbinumaArisa Ebinuma More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Hironori FukudaHironori Fukuda More articles by this author , Hiroki IshiharaHiroki Ishihara More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Junpei iizukaJunpei iizuka More articles by this author , Masayoshi OkuimiMasayoshi Okuimi More articles by this author , Hideki IshidaHideki Ishida More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000926.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Partial nephrectomy (PN) is a standard surgical approach for T1 renal tumors. Several studies have evaluated oncological outcome after PN. Identifying the predictive factors for tumor recurrence after PN is also useful to determine patients who require careful observation after surgery. Therefore, we investigated recurrence after partial nephrectomy (PN) in patients with clinical T1 renal cell carcinoma (RCC) and analyzed predictive factors for recurrence-free survival (RFS). METHODS: Patients with clinical stage 1 RCC who underwent PN between 1990 and 2018 were included. Patients without sufficient medical records for at least 6 months or those with genetically confirmed hereditary RCCs were excluded. Finally, 1568 patients were included in the analysis. The primary outcome of this study was recurrence-free survival (RFS), which was defined as the time from surgery to the date of recurrence. Recurrence included distant metastasis and local recurrence. Local recurrence was defined as tumor recurrence at the resected bed. RESULTS: The median patient age was 59 years, and the median tumor size was 30 mm. Although 1202 (77%) and 366 (23%) patients had clinical T1a and T1b RCCs, respectively, 21 patients (1.3%) were upstaged to pathological T3a. A positive surgical margin was found in 22 (1.4%) patients. The distribution of surgical approaches was open surgery in 656 (42%) patients and minimally invasive surgery in 912 (58%) patients. With a median follow-up of 30 months, 55 (3.5%) patients, including 17 with local recurrence, 13 with recurrence in the ipsilateral kidney, and 35 with distant metastasis, developed recurrence. Five-year RFS was 95%, and the median recurrence time from PN was 31 months. Multivariate analysis identified high grade tumor, multifocal tumors, and upstaging to pT3a as significant predictors for worse RFS (table). CONCLUSIONS: Patients with high grade tumors, multifocal tumors, and tumors upstaged to pT3 had a high risk of worse RFS, which suggested that careful monitoring is required for such patients after PN, even if a good prognosis is achieved in patients with clinical T1 RCC. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e857-e858 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazuhiko Yoshida* More articles by this author Toshio Takagi More articles by this author Arisa Ebinuma More articles by this author Tsunenori Kondo More articles by this author Hironori Fukuda More articles by this author Hiroki Ishihara More articles by this author Hirohito Kobayashi More articles by this author Junpei iizuka More articles by this author Masayoshi Okuimi More articles by this author Hideki Ishida More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement PDF downloadLoading ...

Predictive factors for recurrence after partial nephrectomy for clinical T1 renal cell carcinoma: a retrospective study of 1227 cases from a single institution.

Identifying the predictive factors for tumor recurrence after partial nephrectomy (PN) is useful to determine patients who require careful observation after surgery. Therefore, we investigated recurrence after partial nephrectomy (PN) in patients with clinical T1 renal cell carcinoma (RCC) and analyzed predictive factors for recurrence-free survival (RFS). This study included 1227 patients who underwent PN for clinical T1 RCC and retrospectively investigated patients' characteristics and tumor factors that are associated with tumor recurrence. The median patient age was 59years, and the median tumor size was 30mm. Although 970 (74%) and 319 (26%) patients had clinical T1a and T1b RCCs, respectively, 20 patients (1.6%) were upstaged to pathological T3a. A positive surgical margin was found in 19 (1.5%) patients. The distribution of surgical approaches was open surgery in 428 (35%) patients and minimally invasive surgery in 799 (65%) patients. With a median follow-up of 35months (Interquartile range 19-55months), 39 (3.2%) patients, including ten with local recurrence, five with recurrence in the ipsilateral kidney, and 28 with other organs or lymph-nude, developed recurrence. The 3-year RFS was 99%, and the median recurrence time from PN was 19months (interquartile range: 11-37months). Multivariate analysis identified high grade tumor and upstaging to pT3a as significant predictors for worse RFS. Patients with high grade tumors and tumors upstaged to pT3 had a high risk of worse RFS, which suggested that careful monitoring is required for such patients after PN, even if a good prognosis is achieved in patients with clinical T1 RCC.

Non-hypervascular hepatobiliary phase hypointense nodules on gadoxetic acid-enhanced MR can help determine the treatment method for HCC.

This study was conducted in order to evaluate whether the presence of nonhypervascular hepatobiliary phase (HBP) hypointense nodules can help determine the treatment method for single nodular hepatocellular carcinoma (HCC) ≤ 3cm. This study was approved by the institutional review board. A total of 345 patients with single nodular HCC ≤ 3cm underwent pretreatment gadoxetic acid-enhanced MR followed by hepatic resection (n = 123) or radiofrequency ablation (RFA) (n = 222). We retrospectively analyzed the results of tumor recurrence according to the presence of nonhypervascular HBP hypointense nodules at each treatment method. Nonhypervascular HBP hypointense nodules were found in 18 of 123 patients treated by hepatic resection and in 63 of 222 patients who underwent RFA. The presence of nonhypervascular HBP hypointense nodules was a significant affecting factor for recurrence-free survival (RFS) after both hepatic resection (p = 0.004, hazard ratio [HR] = 2.75 [1.38-5.51]) and RFA (p = 0.004, HR = 1.78 [1.20-2.63]). In patients with nonhypervascular HBP hypointense nodules, 5-year RFS was 34.0% after hepatic resection, which was not significantly different from the 28.0% after RFA (p = 0.618). However, in patients without nonhypervascular HBP hypointense nodules, 5-year RFS was 65.0% after hepatic resection, which was significantly better than the 51.0% after RFA (p = 0.042), owing to significantly lower cumulative incidence of local tumor progression after hepatic resection (p < 0.001). While the presence of nonhypervascular HBP hypointense nodules on gadoxetic acid-enhanced MR taken prior to treatment was a significant predictive factor of tumor recurrence after both hepatic resection and RFA, in patients without nonhypervascular HBP hypointense nodules, hepatic resection can provide significantly better RFS than RFA. • The presence of nonhypervascular hepatobiliary phase (HBP) hypointense nodules was a significant risk factor for tumor recurrence after either hepatectomy or radiofrequency ablation (RFA). • Hepatectomy provided significantly better recurrence-free survival than RFA in patients without nonhypervascular HBP hypointense nodules. • In patients with nonhypervascular HBP hypointense nodules, recurrence-free survival after RFA was comparable to hepatectomy.

Predictive Factors of Tumor Recurrence and Survival in Patients with Hepatocellular Carcinoma treated with Transarterial Chemoembolization.

To evaluate the predictive factors for recurrence of the disease and overall survival (OS) after achieving complete response (CR) in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). From January 2013 to December 2017, 168 treatment-naïve patients diagnosed with HCC underwent TACE as a first-line therapy and the gathered data was retrospectively reviewed. We determined the predictive factors for complete response (CR), for recurrence after CR and for survival using the Cox proportional hazard model. Median follow-up was 27.4 months (range 4-65 months). The mean patient age was 62.2+/-7.9 years. Eighty-three patients had an α-fetoprotein (AFP) level > 20ng/mL. The median maximal diameter of the tumors was 3.5 cm. Sixty-three patients (37.5%) achieved CR after TACE, and recurrence after CR was detected in 37 patients (58.7%). In multivariate analysis, tumor size (</=4.5 cm) and a single tumor were found to be predictive factors for CR, with hazard ratios (HRs) of 2.352 (p=0.022) and 3.964 (p<0.0001), respectively. After achieving CR the median time to recurrence was 12 months (range 6-24 months). Elevated serum AFP > 25 ng/mL and multiple tumors were demonstrated to have a significant relationship with recurrence after CR, with HRs of 1.650 (p=0.05) and 3.932 (p=0.038), respectively. Increased initial serum AFP > 22 ng/mL, tumor size > 4.5 cm, outside Milan criteria, not receiving a liver transplant and presence of portal vein thrombosis (PVT) were correlated with poor survival. In patients treated with TACE as an initial therapy, tumor size (≤4.5 cm) and single tumor were predictive factors for CR. Multiple nodules and an elevated serum AFP > 25 ng/mL were predictive factors for recurrence after CR. Outside Milan criteria tumors, elevated AFP levels and the presence of PVT were significantly correlated with decreased survival.

Outcome of Unilateral Intraocular Retinoblastoma

Background: retinoblastoma is the most common primary, malignant intraocular tumor of childhood, the aim of the study is to evaluate the outcome of management of 50 consecutive cases of unilateral retinoblastoma. Aims of the Work: to evaluate the outcome of management of unilateral retinoblastoma and to assess the risk of recurrence. Patients and Methods: prospective study of 50 consecutive cases with unilateral intraocular retinoblastoma. The management of cases was performed in the National eye center (Rod El Farag). Fundus examination was done under general anesthesia with RetCam 3. Management of cases according to the staging was group A: Focal treatment, TTT or cryotherapy, group B & C: chemotherapy with focal treatment, group D: If the patient has good visual potential (according to macular affection) Chemotherapy with focal treatment, if the patient has poor visual potential Enucleation, group E Enucleation. Results: as regard cases that managed with chemotherapy, there was 23 cases, 13 out of them treated with chemotherapy and transpupillary thermotherapy and showed complete regression, 10 cases showed initial regression with further new tumor recurrence after finishing chemotherapy, 5 cases was well managed by focal therapy, and another 5 cases failed to be controlled by focal therapy and Intra vitreal melphalan and ended by enucleation. As regard cases that was managed by enucleation, there was 32 cases, 27 out of them managed by primary enucleation, and 5 cases managed by secondary enucleation after failure of chemotherapy and focal therapy, 17 cases out of the enucleated eyes revealed presence of high risk pathological features, none of the cases developed local or metastatic tumors in the follow up period. Conclusion: retinal seeding, vitreous seeding are major predictive factors for tumor recurrence

Nonfunctioning Pituitary Adenoma Recurrence and Its Relationship with Sex, Size, and Hormonal Immunohistochemical Profile

Tumor recurrence or incomplete resection in nonfunctioning pituitary adenomas (NFPAs) is relatively common. However, predictive factors of tumor recurrence in NFPAs are not well established. We evaluated possible factors related to tumor recurrence in a large cohort of NFPAs at a single pituitary neurosurgery center. A retrospective analysis was conducted of 410 medical records of patients with NFPAs treated by transsphenoidal surgery between 2000 and2014. Among the participants, 210 were female (51.0%). A total of 14.1% had giant adenomas. Null-cell pituitary adenomas (n= 239; 58.9%) were the most frequent, followed by silent gonadotroph adenomas (n= 112; 27.3%). Null-cell adenomas were more frequent in women (P= 0.008) and silent gonadotroph adenomas were more frequent in men (P= 0.004). Recurrence was not related to sex or age. Tumor recurrence occurred more often among silent corticotropic adenomas and giant adenomas (hazard ratio 2.45; P < 0.0001 and hazard ratio 2.35; P= 0.001, respectively). Silent thyrotrophic adenoma presented a comparable frequency of recurrence of silent corticotropic adenomas, despite having borderline significance (P= 0.07). NFPA tumors have a high heterogeneous hormonal profile and may have prognostic importance. Silent corticotropic adenomas and giant adenomas present a high rate of recurrence.

Clinicopathologic factors associated with recurrence and long-term survival in node-negative advanced gastric cancer patients.

despite a better prognosis in node-negative advanced gastric cancer (GC), a proportion of patients have a tumor recurrence within five years and eventually die due to cancer-related causes. The present study aimed to evaluate the predictive factors of tumor recurrence and long-term survival in node-negative advanced GC. a total of 646 node-negative advanced GC patients who underwent a curative gastrectomy in our institution were included in the study. The impact of different clinicopathologic factors on tumor recurrence and overall survival were analyzed. tumor recurrences were observed in 181 patients and the cumulative recurrence rate at two-years and five-years were 50.8% and 86.2%, respectively. Lymphovascular invasion, advanced T stage (T3-T4) and an inadequate number of retrieved lymph nodes (LNs) were independent predictive factors of tumor recurrence in node-negative advanced GC. Older age, an upper 1/3 tumor, lymphovascular invasion, infiltration growth pattern (INFγ) and the depth of tumor invasion (T4 stage) were independently associated with long-term survival. With regard to node-negative patients with ≥ 15 retrieved LNs, infiltration growth pattern (INFγ) and advanced T stage (T3-T4) were independent risk factors for both tumor recurrence and long-term survival. in addition to lymphovascular invasion, inadequate RLNs and advanced T stage, the prognostic significance of infiltration growth pattern in node-negative advanced GC was especially emphasized. These risk factors should be considered when selecting candidates for adjuvant chemotherapy and postoperative surveillance.

Prognostic value of metabolic indices and bone marrow uptake pattern on preoperative 18F–FDG PET/CT in pediatric patients with neuroblastoma

To evaluate the prognostic value of metabolic parameters and bone marrow uptake (BMU) patterns on pretherapeutic 18-F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in pediatric patients with neuroblastoma (NB). Forty-seven pediatric patients with newly diagnosed neuroblastoma who underwent 18F-FDG PET/CT were retrospectively reviewed. Clinicopathological factors and metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and bone marrow uptake patterns on PET/CT were compared to predict recurrence-free survival (RFS) and overall survival (OS) by univariate and multivariate analysis. During the follow-up period, 27 (57.4%) patients experienced recurrence. MTV (P=0.001), TLG (P=0.004) and BMU patterns (P=0.025) remained significant predictive factors for tumor recurrence, along with tumor size, histology, stage, lactate dehydrogenase (LDH) and other distant metastasis (except bone metastasis). Univariate analysis showed that histology, stage, tumor size (>37.25cm), other distant metastasis, MTV (>88.10cm3) and TLG (>1045.2g) and BMU patterns correlated with both RFS and OS (P<0.05). On multivariate analysis, TLG remained the only independent prognostic factor for RFS (P=0.016) and OS (P=0.012), and BMU patterns and MTV were statistically significant for OS (P=0.024 and P=0.038, respectively). Pretherapeutic 18F-FDG PET/CT can provide reliable prognostic information for neuroblastoma pediatric patients, and patients with high MTV, TLG and focal bone marrow (unifocal and multifocal) uptake on PET/CT may have inferior outcomes during subsequent treatment.

Predictive factors for surgical outcome in anterior clinoidal meningiomas: Analysis of 59 consecutive surgically treated cases.

Despite the advances in the microsurgical technique and anatomical understanding of the anterior and middle skull base, anterior clinoidal meningiomas are still challenging lesions to resect completely and safely due to their intimate relationship with vital neurovascular structures. We report predictive factors for tumor recurrence and postoperative complications based on surgical outcome of patients with anterior clinoidal meningiomas treated at our institution.Fifty-nine consecutive patients with anterior clinoidal meningioma who were surgically treated between March, 1993, and July, 2015, were reviewed retrospectively. For microsurgical tumor removal, orbitocranial or orbitozygomatic (78.0%), extended pterional (15.3%) and subfrontal approach (6.8%) were performed.The median follow-up duration was 54.1 months. Gross total resection (GTR, Simpson's grade I or II) was achieved in 38 patients (64.4%). The overall recurrence rate (new lesion in GTR cases and re-growth in non-GTR cases) was 18.6%. GTR (Hazard ratio [HR] 0.014, 95% confidence interval [CI] 0.001–0.256; P = .004), absence of internal feeder (HR 0.058, 95% CI 0.004–0.759; P = .030) and benign pathology (WHO grade I, HR 0.056, 95% CI 0.005–0.674; P = .023) were independent prognostic factors for recurrence-free. Fourteen patients (23.7%) developed permanent complications. The most common complication was cranial nerve injury (n = 6; 10.2%), followed by postoperative hemorrhage/infarction, hydrocephalus and infection. Larger size (≥ 40 mm) was significant as an independent predictive factor for permanent complication (HR 0.139, 95% CI 0.030–0.653; P = .012). Old age (≥60 years, P = .056) and peritumoral edema (thickness ≥ 5 mm, P = .303) did not reach statistical significance in multivariate analysis.In surgical resection of anterior clinoidal meningiomas, various clinicoradiological factors were related with resection degree, complication, and progression rate. Although our results showed acceptable resection degree and morbidity, mortality, and recurrence rate, compared to the results of past, anterior clinoidal meningioma remain as neurosurgical challenges because of their close contact to critical vascular and neural structures.

THU-093 - Predictive factors of tumor recurrence and death in patients with hepatocellular carcinoma treated by locoregional therapies: results of a retrospective cohort study

THU-093 - Predictive factors of tumor recurrence and death in patients with hepatocellular carcinoma treated by locoregional therapies: results of a retrospective cohort study

CD133 expression in well-differentiated pancreatic neuroendocrine tumors: a potential predictor of progressive clinical courses

The present study aimed to elucidate whether the stemness molecule, CD133, is expressed in well-differentiated pancreatic neuroendocrine tumors (PanNETs; World Health Organization grades 1 and 2) and establish its clinical relevance using 2 separate cohorts. In the first series (n = 178) in which tissue microarrays were available, immunohistochemistry revealed that CD133 was expressed in 14 cases (8%). CD133+ PanNETs had higher TNM stages (P < .01), more frequent lymphovascular invasion (P = .01), and higher recurrence rates (P = .01). In the second cohort (n = 56), the expression of CD133 and CK19 was examined in whole tissue sections. CD133 and CK19 were positive in 10 (18%) and 36 (64%) cases, respectively. CD133 expression correlated with higher pT scores (P < .01), the presence of microscopic venous infiltration (P = .03), and shorter disease-free periods (P < .01). When cases were divided into grade 1 and 2 neoplasms, patients with CD133+ PanNET continued to have shorter disease-free periods than did those with CD133- tumors in both groups (P < .01 and P = .02, respectively). Although CK19+ cases had shorter disease-free periods than did CK19- cases in the whole cohort (P = .02), this difference was less apparent in subanalyses of grade 1 and 2 cases. CD133 expression also appeared to be an independent predictive factor for tumor recurrence in a multivariate analysis (P = .018). The CD133 phenotype was identical between primary and metastatic foci in 17 of 18 cases from which tissues of metastatic deposits were available. In conclusion, the combination of CD133 phenotyping and World Health Organization grading may assist in stratifying patients in terms of the risk of progressive clinical courses.