Prognostic Indicator Of Survival Research Articles

WHO BREF Quality of Life Score as a Prognostic Indicator of Survival in Patients recovered from COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis

WHO BREF Quality of Life Score as a Prognostic Indicator of Survival in Patients recovered from COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis

The diameter of cutaneous melanoma serves as a prognostic indicator for survival among acral-melanoma predominant East Asian patients.

Tumor staging plays a pivotal role in melanoma management, where the depth of tumor invasion has been traditionally used as the cornerstone of staging. Paradoxically, the tumor diameter has not been integrated into the staging system. The aim of this study is to elucidate the clinical implications and prognostic value of tumor diameter in cutaneous melanoma, with a particular emphasis on the acral-melanoma predominant East Asian population, thus potentially enriching the clinical evaluation and treatment strategies for cutaneous melanoma. From January 1st, 2006 to December 31st, 2022, a total of 352 patients were diagnosed with melanoma in our center. Among them, there were 135 patients diagnosed as cutaneous melanoma who received complete surgical wide excision and regional lymph nodes assessment. The diameter of the tumor, the depth of tumor invasion, lymph node status and patient survival were all collected and analyzed. The diameter of cutaneous melanoma had a weak positive correlation with tumor thickness (r=0.26), however, it still had a significant predictive value for patients' overall survival (p=0.005) and disease free survival (p=0.023). As for lymph node metastasis prediction, the Breslow thickness had a better predictive value than tumor diameter (p=0.002 vs. p=0.565). In this study, though with only weak positive correlation to tumor thickness, the tumor diameter of melanoma showed a statistically significant correlation with the patients' overall survival and disease free survival. However, the larger tumor diameter cannot be used as an indicator of high risk of lymph node metastasis.

Prognostic indicators of outcome in nonambulatory beef cattle presented to 2 referral hospitals: A retrospective study of 63 cases.

Down cow syndrome is commonly described in dairy cattle. The diagnosis and treatment of nonambulatory cattle is challenging and prognostic indicators of this condition in beef cattle have not been determined. Evaluate records of beef cattle (≥2 years of age) presented to 2 referral hospitals for inability to stand and identify prognostic indicators for survival to discharge. Sixty-three adult beef cattle treated for inability to stand at 2 referral hospitals. Medical records of 63 beef cattle presented for inability to stand between January 2010 and December 2022 were retrospectively analyzed. Continuous and categorical variables were included in univariate and multivariate regression models to evaluate their association with outcome. Of 63 animals included in the study, 19% (12/63) were discharged, and the remaining 81% (n = 51) either died (11.1%) or were euthanized (69.8%). The odds of being discharged increased with each additional day of hospitalization (odds ratio [OR], 2.66; 95% confidence interval [CI], 1.39-6.89) and with each additional flotation therapy session (OR, 2.108; 95% CI, 1.209-4.219). Down beef cattle with a diagnosis of calving peripheral nerve paralysis and capable of walking out the tank after the first flotation session were 6.66 (95% CI, 1.58-35.51) and 30 (95% CI, 4.4-614.98) times more likely to be discharged compared with cattle that had other diagnoses and those that were unable to walk out the tank, respectively. Treatment of nonambulatory beef cattle carries a poor prognosis. Practitioners can use information from our study as a guide for treatment or euthanasia decisions of nonambulatory beef cattle.

Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes.

Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown. To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR. A retrospective cross-sectional study. Clinical data of client owned horses which underwent colic surgery at a single UK referral hospital between 2008 and 2021, where LCV was the primary finding, were retrieved from hospital records. Statistical analyses included chi-squared, t-tests and odds ratios (ORs). Horses with concurrent lesions, and those that did not survive past anaesthetic recovery, were excluded from analysis. POR was defined as ≥2 L of gastric reflux on at least one occasion. A total of 128 horses were included in the study, 23 of which had POR (18%). Overall survival to hospital discharge was 86%, 95% in the non-POR and 44% in the POR group. Horses with POR were less likely to survive to discharge than those without (OR = 26, 95% confidence interval [CI] [7.68-88.0], p < 0.001), and less likely to be alive 3 years after surgery (OR = 13.4, 95% CI [2.78-64.8], p < 0.001). Due to the retrospective study design, full data sets were not available for every case because clinical records were incomplete or, at that time, certain tests were not performed or clinical variables were not measured. POR in LCV cases is a negative prognostic indicator for survival.

Abstract 5210: The Prognostic value of serum TK1 protein determinations using AroCell TK210 ELISA in DLBCL patients treated with R CHOP

Abstract Background: Diffuse large-cell B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin’s lymphomas (NHL) that accounts for approximately 25% of the patients. Earlier studies demonstrated the prognostic value of serum thymidine kinase 1 (STK1) activity determinations in different hematological malignancies. To date, the prognostic value of STK1 protein concentration in patients with DLBCL treated with R-CHOP has not been investigated. The purpose of this retrospective study was to determine the value of high TK levels on Overall survival among DLBCL patients treated with R-CHOP as first-line treatment. Materials and Methods: The study included 146 patients diagnosed with DLBCL between 2010 and 2016 from the Uppsala-Umeå Comprehensive Cancer Consortium (U-CAN). All patients included were treated using the standard chemotherapy regimen R-CHOP. Serum samples were collected at the time of diagnosis, during the treatment, 1 year after treatment, and after relapse. Non-infected and apparently healthy persons, matched to the DLBCL patients (57 males and 88 females), served as controls. The TK1 protein levels in all serum samples were determined by using AroCell TK 210 ELISA (AroCell AB, Sweden). The TK1 protein concentration was expressed as μg/L. Results: The TK1 concentrations in sera from DLBCL patients before treatment were significantly higher compared to the concentrations in healthy individuals, median 0.44 μg/L (IQ range 0.22 to 1.06 μg/L) vs. median 0.22 μg/L (IQ range 0.18 to 0.29 μg/L, P&amp;lt;0.00001). Serum TK1 was also significantly higher in patients with more advanced stages (P&amp;lt;0.00001), higher IPI (P&amp;lt;0.00001), and in patients with B-symptoms (P&amp;lt;0.0001). Patients with STK1 protein levels below the cut-off value (0.45 μg/L) had significantly better OS and DFS (P=0.04 and P=0.0006, respectively) compared to patients with STK1 concentration above the cut-off. In multivariate analyses, dichotomized S-TK1 measurements before treatment were found to be significant for the risk of relapse in combination with either aaIPI or IPI (p&amp;lt;0.01). Conclusions: These results confirmed that STK1 concentration correlates with risk factors such as tumor burden, Ann Arbor stage, and IPI. In conclusion, patients with high TK1 concentrations at the time of diagnosis have short overall survival and STK1 concentrations are apparently a prognostic indicator for survival in patients treated with modern chemo-immunotherapy. Citation Format: Kiran Jagarlamudi, Gustaf Hedström, Per Venge, Staffan Eriksson, Daniel Molin, Gunilla Enblad. The Prognostic value of serum TK1 protein determinations using AroCell TK210 ELISA in DLBCL patients treated with R CHOP [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5210.

Quantitative peritumoral magnetic resonance imaging fingerprinting improves machine learning-based prediction of overall survival in colorectal cancer.

To investigate magnetic resonance imaging (MRI)-based peritumoral texture features as prognostic indicators of survival in patients with colorectal liver metastasis (CRLM). From 2007-2015, forty-eight patients who underwent MRI within 3 months prior to initiating treatment for CRLM were identified. Clinicobiological prognostic variables were obtained from electronic medical records. Ninety-four metastatic hepatic lesions were identified on T1-weighted post-contrast images and volumetrically segmented. A total of 112 radiomic features (shape, first-order, texture) were derived from a 10 mm region surrounding each segmented tumor. A random forest model was applied, and performance was tested by receiver operating characteristic (ROC). Kaplan-Meier analysis was utilized to generate the survival curves. Forty-eight patients (male:female = 23:25, age 55.3 years ± 18 years) were included in the study. The median lesion size was 25.73 mm (range 8.5-103.8 mm). Microsatellite instability was low in 40.4% (38/94) of tumors, with Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation detected in 68 out of 94 (72%) tumors. The mean survival was 35 months ± 21 months, and local disease progression was observed in 35.5% of patients. Univariate regression analysis identified 42 texture features [8 first order, 5 gray level dependence matrix (GLDM), 5 gray level run time length matrix (GLRLM), 5 gray level size zone matrix (GLSZM), 2 neighboring gray tone difference matrix (NGTDM), and 17 gray level co-occurrence matrix (GLCM)] independently associated with metastatic disease progression (P < 0.03). The random forest model achieved an area under the curve (AUC) of 0.88. MRI-based peritumoral heterogeneity features may serve as predictive biomarkers for metastatic disease progression and patient survival in CRLM.

Hematological and blood biochemistry parameters as prognostic indicators of survival in canine multicentric lymphoma treated with COP and L-COP protocols.

Hematological and blood chemistry parameters are crucial for evaluating and monitoring canine multicentric lymphoma during chemotherapy. Pre-treatment hematological and blood chemistry parameters can be used as prognostic survival outcomes for this disease. Therefore, this study aimed to investigate the effect of hematological and blood chemistry parameters pre-treatment and 4 weeks post-treatment on the survival outcomes of dogs treated with either a combination of cyclophosphamide, vincristine, and prednisolone (COP) or a combination of COP with L-asparaginase (L-COP) protocols. We conducted a retrospective study. Medical records and hematological and blood chemistry parameters of 41 dogs with multicentric lymphoma treated with L-COP (n = 26) and the COP protocols (n = 15) were obtained from the hospital information system. Most cases were classified as high-grade lymphoma based on the Kiel cytological classification. The effects of hematological and blood chemistry parameters on survival outcomes were investigated using the Cox proportional hazard regression model. The median survival time (MST) for each hematological and blood chemistry parameter affecting survival outcome was established and compared using the Kaplan-Meier product limit method with the log-rank test. Dogs with high-grade multicentric lymphoma that were treated with the COP protocol and had monocytosis at pre-treatment had a significantly shorter MST than dogs with normal monocyte counts (p = 0.033). In addition, dogs with azotemia, both pre-treatment and 4 weeks post-treatment, had a significantly shorter MST than dogs with normal serum creatinine levels (p = 0.012). Dogs with high-grade multicentric lymphoma treated with the L-COP protocol who had hypoalbuminemia (serum albumin concentration <2.5 mg/dL) at both pre-treatment and 4 weeks post-treatment had a significantly shorter MST than dogs with normal serum albumin levels (p < 0.001). Furthermore, dogs with leukocytosis at 4 weeks post-treatment had a significantly shorter MST than those with a normal total white blood cell count (p = 0.024). Serum albumin level can serve as a simple negative prognostic indicator of survival outcomes in dogs with high-grade multicentric lymphoma treated with the L-COP protocol. Dogs with hypoalbuminemia pre-treatment and 4 weeks post-treatment tended to have a shorter MST than those with normal serum albumin concentrations.

Prognostic value of 18F-FDG PET/CT tumor metabolic parameters and Ki-67 in pre-treatment diffuse large B-cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive lymphoma. Rituximab-based conventional chemotherapy still leads to drug resistance or relapse in 30-40% of patients. Therefore, early identification of high-risk patients and accurate assessment of prognosis are very important for clinical decision-making. The aim of this study is to investigate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of tumor metabolic, clinical and biological parameters in the prognostic risk stratification of DLBCL before treatment. We retrospectively collected clinical data on 63 patients with newly diagnosed DLBCL admitted to Shanxi Bethune Hospital during the period from November 2016 to April 2020 who underwent 18F-FDG PET/CT prior to treatment in a cohort study. Metabolic, clinical, and biological parameters were analyzed by Cox regression. Kaplan-Meier curves of patient survival were compared by the log-rank test. The median follow-up was 21 months. The 2-year progression-free survival (PFS) was 47.62%, and the overall survival (OS) was 53.97%. The subtype, double expression, Ann Abor stage, NCCN-IPI score, Ki-67, maximum standardized uptake value (SUVmax), bulk volume glycolysis (BVG), total lesion glycolysis (TLG), total metabolic tumor volume (TMTV) were the influencing factors for PFS and OS (P<0.050) in univariate analysis. BVG (PFS: HR =6.62, P<0.001; OS: HR =3.53, P=0.029), TLG (PFS: HR =8.56, P<0.001; OS: HR =5.20, P=0.004), TMTV (PFS: HR =12.02, P=0.001; OS: HR =5.05, P=0.033) and Ki-67 were found to be independent prognostic risk stratification parameters affecting PFS and OS by multivariate regression analysis. The 2-year PFS and OS rates for patients with high BVG (≥288.00 cm3), TLG (≥1,854.00 cm3), TMTV (≥103.00 cm3), and Ki-67 (≥85%) were 20% and 28.57%, 9.68% and 22.58%, 20.51%, and 30.77%, and 25% and 33.33%, respectively; and the 2-year PFS and OS rates for patients with low BVG (<288.00 cm3), TLG (<1,854.00 cm3), TMTV (<103.00 cm3), and Ki-67 (<85%) patients were 82.14% and 85.71%, 84.37% and 84.37%, 91.67% and 91.67%, and 61.54% and 66.67%, respectively. Patients with high BVG, TLG, TMTV, and Ki-67 had a worse 2-year PFS as well as OS rate (Ki-67: P=0.0018/P=0.0025; P<0.0001 for the rest of the groups). Our findings suggest that BVG, TLG, TMTV, and Ki-67 are independent prognostic indicators for survival in patients with pre-treatment DLBCL, especially BVG, which is a novel prognostic indicator that has to be validated in future research.

BIODEMOGRAPHY OF AGING, CELEBRATING JAMES W. VAUPEL, PHD

Abstract James W. Vaupel, PhD (1945 – 2022), was an international leader in demography and aging research and a pioneer in the field of biodemography. He was a highly creative researcher and very entrepreneurial in the development of new interdisciplinary research environments. This symposium highlights a few of the biodemographic research areas that Dr. Vaupel has been a catalyst for. Denmark was Dr. Vaupel’s home country during the last third of his life, and Dr. Christensen reports on findings from Danish nationwide genetic-epidemiological studies on twins and the oldest old: familial influence on aging phenotypes, cohort differences in health among the oldest old, associations of early life events with late life health, as well as tongue-in-cheek research on perceived age and teeth. Dr. Alberts discusses the ‘invariant rate of aging’ hypothesis that was developed by Vaupel and others. She presents comparative analyses from multiple nonhuman primate populations showing that, while life expectancy can continue to improve, we probably can’t slow the demographic rate of aging. Dr. Campos presents evidence from a wild baboon population in Kenya that glucocorticoid levels—biological markers of stress responses—are strong prognostic indicators of survival and may be key explanations of life span disparities. Dr. Carey presents key discoveries from large-scale studies involving the Mediterranean fruit fly. These include the slowing of mortality at older ages, context-specific sex mortality differentials, a behavioral biomarker for morbidity, dietary conditions for maximizing lifespan versus reproduction and a stationary population identity whereby life lived equals life left.

Prognostic Factors of Survival in Veno-Arterial ECMO Patients: A Multivariable Logistic Regression Analysis

Background: Several models exist to predict mortality in patients on Veno-arterial (VA) extracorporeal membrane oxygenation (ECMO). Whether expanded demographic data points have prognostic implications is less understood. This study assessed the prognostic value of demographics in patients on VA-ECMO. Methods: This retrospective cohort study investigated 410 patients who received VA-ECMO. Survival to hospital discharge, survival to intensive care unit discharge and survival to ECMO explantation were examined. A multivariable logistic regression was performed incorporating 11 demographic variables. Results: 44% (181/410) of patients survived to ECMO explant, 37% (152/410) of patients survived to ICU discharge, and 36% (146/410) of patients survived to hospital discharge. There was an increase in odds of survival to hospital discharge in patients who were less than 55 years old (Odds Ratio (OR) = 3.91 [95% Confidence Interval (CI) 2.35-6.49]). There was a decrease in odds of survival to hospital discharge in patients who had a prior cardiac arrest (OR = 0.35 [95% CI 0.20-0.63]). Patients who survived to hospital discharge less frequently had a history of smoking (51% vs 65%, respectively; p=0.008), and were younger compared to those who did not survive (51.4+/- 14.03 vs 57.3+/- 16.54). Conclusion: Age less than 55 years old was a prognostic indicator of survival to hospital discharge following VA-ECMO, while history of smoking, history of dialysis, and history of cardiac arrest were associated with mortality. Sex, BMI, atrial fibrillation, hypertension, DM, and COPD were not significant indicators. These data may help guide optimal patient selection for VA-ECMO support.

Circulating tumour DNA and MRI circumferential resection margin are key prognostic indicators for survival in rectal cancer

Circulating tumour DNA and MRI circumferential resection margin are key prognostic indicators for survival in rectal cancer

P077 - Baseline health-related quality of life as a prognostic indicator for survival in men with intermediate risk prostate cancer following radical prostatectomy

P077 - Baseline health-related quality of life as a prognostic indicator for survival in men with intermediate risk prostate cancer following radical prostatectomy

What is a useful marker for predicting survival in patients with high-grade soft tissue sarcoma who have non-inflammatory conditions?

BackgroundThe modified Glasgow prognostic score (mGPS) is a reliable system for identifying patients at high risk of death among patients with soft tissue sarcoma (STS). The scoring systems use a combination of C-reactive protein (CRP) and albumin levels. Although patients with high-grade STS are at risk of metastasis and death, even if their mGPS is 0, the prognostic indicators in these patients are unknown. Therefore, we investigated useful prognostic indicators for survival and the development of metastasis in patients with high-grade STS and an mGPS of 0. MethodsOne hundred and four patients with CRP and albumin levels of <1.0 mg/dl and >3.5 g/dl, respectively, indicating an mGPS of 0, were included. The mean follow-up period was 79 months. ResultsThe 5-year disease-specific survival (DSS) rate was 79.2%. Cox proportional analysis showed that tumor size and absolute neutrophil count (ANC) were prognostic variables in multivariate analyses. Patients with higher ANC (ANC>3370/μl) had a worse DSS than those with lower ANC. The 5-year DSS was 74.7% vs. 91.7%, respectively (p = 0.0207). The 5-year metastasis-free survival was 67.2%. Tumor size and ANC remained significant variables for predicting the development of metastasis in the multivariate analysis. Patients with higher ANC had a worse metastasis-free survival than those with lower ANC. The 5-year metastasis-free survival was 59.5% vs. 87.3%, respectively (p = 0.00269). ConclusionsWhen patients with high-grade STS have an mGPS of 0, the ANC and tumor size should be carefully evaluated. A higher neutrophil count and larger tumor size may increase the risk of metastasis development.

Analysis of Expression of Programmed Cell Death Ligand 1 (PD-L1) and BRAFV600E Mutation in Thyroid Cancer.

In thyroid cancer, it has been suggested that PD-L1 overexpression is associated with some clinicopathological factors and prognosis. The aim of this study is to characterize the expression of PD-L1, the presence of the BRAFV600E mutation, as well as cellular and humoral immunity in thyroid cancer, and to investigate the factors that predict the effectiveness of anti-PD-L1 antibody therapy. Blood samples were collected from 33 patients who were newly diagnosed with thyroid cancer after surgery or biopsy. PD-L1 expression, BRAFV600E mutation, and CD8+ expression were examined by immunohistological staining using clinical thyroid cancer specimens. With a PD-L1 staining cut-off value of 1%, 13 (39.4%) patients were classified as PD-L1 positive. Stimulation Index (SI) is an indicator of T cell activation. PD-L1 expression was significantly correlated with low SI level (p = 0.046). Moreover, BRAFV600E mutation was detected in 24 of the 33 (72.7%) patients, and was significantly associated with PD-L1 expression (p = 0.047). In addition, enhanced CD8+ expression was significantly associated with PD-L1 expression (p = 0.003). Multivariate analyses confirmed that high CRP levels (p = 0.039) were independently and significantly associated with poor progression-free survival. These findings suggest that elevated PD-L1 status can be a prognostic indicator for survival in patients with thyroid cancer when comprehensively assessed using the expression of CD8+, the presence of BRAFV600E mutation and the patient's immune status.

Epidemiology and Prognostic Factors of Malignant Melanoma Among 200 Asian Patients from a Single Medical Center

With the prevalence of malignant melanoma increasing gradually and the progressive westernization of the Asian lifestyle, it is important to analyze and follow up on the characteristics of malignant melanoma at regular intervals. We identified the characteristics of malignant melanoma by analyzing consecutive patients from a single medical center. We also examined the trend of malignant melanoma and prognostic factors in Asian patients. We investigated 200 consecutive patients with malignant melanoma in a single medical center between 2000 and 2022. Each patient’s sex and age, tumor stage, site of the primary lesion, histological subtype, Breslow thickness, Clark level, and period of survival were collected from the historical medical records of the patients and analyzed. Survival analyses were performed using the Kaplan–Meier method to investigate the prognostic factors. The ratio of man-to-woman was 1:1.53; the most common site of the primary tumor was the lower extremity (60%), and acral lentiginous melanoma was the most common histological subtype (61%). Malignant melanoma commonly occurs in the lower extremities, primarily in the form of the lentiginous subtype. In situ melanomas are most prevalent regarding Breslow thickness, while Clark Level 4 is the most common type of malignant melanoma. Sex and Breslow thickness were significantly associated with the survival rate. However, others were not significant prognostic indicators for survival in this cohort. This study confirmed that the epidemiology of malignant melanoma in Asian patients was maintained without significant change. We also confirmed several significant prognostic indicators for survival.

Clinical Parameters as Prognostic Indicators of Survival in Hospitalized Neonatal Foals in a Neonatal Center in the Savannah of Bogota

Los potros recién nacidos son muy susceptibles a enfermedades potencialmente mortales. Por consiguiente, es de gran importancia identificar variables que permitan predecir la supervivencia de estos pacientes, e iniciar rápidamente el tratamiento adecuado para cada caso. Se realizó un estudio retrospectivo en el Centro de Perinatología Equina Foal Care, ubicado en el municipio de Cajicá, Cundinamarca. Se revisaron las historias clínicas de 106 potros que ingresaron a hospitalización entre septiembre de 2019 y diciembre de 2020, y se recolectaron y analizaron los datos necesarios para evaluar cuáles de los parámetros del examen clínico funcionan como marcadores tempranos de supervivencia, y de qué manera orientan al médico veterinario hacia un diagnóstico y pronostico más acertado. Se utilizaron diferentes pruebas estadísticas como la prueba de Kolmogorov Smirnov, la prueba de Mann-Whitney, la regresión logística binaria, las pruebas de chi cuadrado, las curvas ROC y la odds ratio (OR). Las variables más significativamente relacionadas con la supervivencia fueron la frecuencia cardiaca (p = 0,019), la temperatura rectal (p = 0,002), las orejas y extremidades tibias (p = 0,013) y el pulso fuerte lleno concordante (p = 0,002). Los factores de riesgo asociados con la no supervivencia de los potros fueron la temperatura &lt; 37,55 °C, la frecuencia cardiaca &lt; 122 lpm, la orejas y extremidades frías, y el pulso débil.

Association between marital status and all-cause mortality of patients with metastatic breast cancer: a population-based study

This study aimed to investigate the association between marital status and the prognosis of patients with metastatic breast cancer (MBC). Data of patients with MBC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were classified into married and unmarried groups. Kaplan–Meier analysis with the log-rank test was conducted to compare breast cancer-specific survival (BCSS) and overall survival (OS) between the groups. Univariable and multivariable Cox proportional models were used to determine whether marital status was independently associated with OS, and the Fine–Gray subdistribution hazard method was performed to determine whether marital status was independently associated with BCSS. In total, 16,513 patients with MBC were identified, including 8949 married (54.19%) and 7564 unmarried (45.81%) patients. The married patients were significantly younger [median age (interquartile range), 59.0 (50.0–68.0) vs. 63.0 (53.0–75.0); p < 0.001] and received more aggressive treatments, such as chemotherapy (p < 0.001) and surgery (p < 0.001), than the unmarried patients. Moreover, married patients had higher 5-year BCSS (42.64% vs. 33.17%, p < 0.0001) and OS (32.22% vs. 21.44%, p < 0.0001) rates. Multivariable analysis revealed that marital status was an independent prognostic factor, and married status was associated with a significant reduction in the risk of breast cancer-specific (sub-hazard ratio, 0.845; 95% confidence interval, 0.804–0.888; p < 0.001) and all-cause (hazard ratio, 0.810; 95% confidence interval, 0.777–0.844; p < 0.001) mortality. Unmarried patients had a 15.5% increased risk of breast cancer-specific mortality and a 19.0% increased risk of overall mortality compared with married patients with MBC. BCSS and OS were superior in married populations compared with unmarried populations in most subgroups. Marital status was an independent prognostic indicator for survival in patients with MBC and was associated with significant survival benefits.

Prognostic biomarkers for survival in mucosal melanoma.

e21576 Background: Mucosal Melanoma is a rare subtype of melanoma with a more aggressive clinical course when compared to cutaneous melanoma. In cutaneous melanoma, the absence of pigmentation and presence of NRAS/KRAS mutations are known as biomarkers indicating an aggressive clinical course with significantly shorter overall survival times. Similar data for mucosal melanoma are currently missing. Here, we present real world outcome data in a large cohort of genotyped mucosal melanoma patients and assessed the prognostic relevance of pigmentation- and NRAS/KRAS mutation status. Methods: We correlated pathological reports and clinical data with overall survival of patients with mucosal melanoma. Furthermore, we performed clinically integrated molecular genotyping and analyzed real world treatment regimens for covariates associated with clinical outcome. For institutional data analysis, we ran a source query and only included patients with the diagnosis of mucosal melanoma, available genotyping data and comprehensive clinical information. As a population-based reference and to directly compare overall survival differences we first queried the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database. Pigmentation status was assessed by pathological review. Treatment regimens were identified by chart review. Results: We identified a cohort of 39 patients with mucosal melanoma where clinical and molecular data was available. Patients with amelanotic mucosal melanoma had a significantly shorter overall survival ( p = 0.003). In addition, the presence of a NRAS or KRAS mutation was significantly associated with poor overall survival (NRAS or KRAS p = 0.024). Therapeutic regimens were heterogeneous with a mean of 5 treatment lines per patient. Patients with low stage tumors who received immunotherapy had a significantly shorter overall survival (p &lt; 0.001), although numbers were small. Conclusions: The absence of pigmentation and the presence of NRAS or KRAS mutations are poor prognostic indicators for survival in CM. Both biomarkers are have been described in MM. Currently, it is unknown if the same prognostic relevance for the lack of pigmentation and RAS mutations exists in MM. Here we analyzed a cohort of MM for outcome measures and determined that two known prognostic biomarkers for CM are in fact novel prognosticators for MM.

Cytoreductive Surgery and Hyperthermic Peritoneal Chemotherapy in Appendiceal and Colorectal Cancer: Outcomes and Survival.

We reviewed outcomes following cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with appendiceal or colorectal neoplasms and evaluated key prognostic indicators for treatment. All patients who underwent cytoreductive surgery/HIPEC for appendiceal and colorectal neoplasms were identified from an IRB-approved database. Patient demographics, operative reports, and postoperative outcomes were reviewed. 110 patients [median age 54.5 (18-79) years, 55% male] were included. Primary tumor location was colorectal (58; 52.7%) and appendiceal (52; 47.3%). 28.2%, .9%, and 12.7% had right, left, and sigmoid tumors, respectively; 11.8% had rectal tumors. 12/13 rectal cancer patients underwent preoperative radiotherapy. Mean Peritoneal Cancer Index was 9.6 ± 7.7; complete cytoreduction was achieved in 90.9%. 53.6% developed postoperative complications. Reoperation, perioperative mortality, and 30-day readmission rates were 1.8%, .09%, and 13.6%, respectively. Recurrence at a median of 11.1 months was 48.2%; overall survival at 1 and 2years was 84% and 56.8%, respectively; disease-free survival was 60.8% and 33.7%, respectively, at a median follow-up of 16.8 (0-86.8) months. Univariate analysis of preoperative chemotherapy, primary malignancy location, primary tumor perforated or obstructive, postoperative bleeding complication, and pathology of adenocarcinoma, mucinous adenocarcinoma and negative lymph nodes were identified as possible predictive factors of survival. Multivariate logistic regression analysis showed that preoperative chemotherapy (P < .001), perforated tumor (P = .003), and postoperative intra-abdominal bleeding (P < .001) were independent prognostic indicators for survival. Cytoreductive surgery/HIPEC for colorectal and appendiceal neoplasms has low mortality and high completeness of cytoreduction score. Preoperative chemotherapy, primary tumor perforation, and postoperative bleeding are adverse risk factors for survival.

Phase Angle as a Prognostic Indicator of Survival in Institutionalized Psychogeriatric Patients.

Phase angle (PhA) has been evidenced to be a useful survival indicator and predictor of morbi-mortality in different pathologies, but not in psychogeriatric patients. The aim of this study was to evaluate the clinical utility of PhA as a prognostic indicator of survival in a group of institutionalized psychogeriatric patients. A survival study was conducted on 157 patients (46.5% dementia, 43.9% schizophrenia). Functional impairment stage, frailty, dependence, malnutrition (MNA), comorbidity, polypharmacy, BMI, and waist circumference were registered. Body composition was analyzed using a 50-kHz whole-body BIA; PhA was recorded. The association between mortality and standardized-PhA was evaluated through univariate and multivariate Cox regression models and ROC-curve. The risk of death decreased when Z-PhA, BMI, and MNA were higher. Mortality increases with age, frailty, and dependence. The risk of death was statistically significantly lower (56.5%) in patients with schizophrenia vs. dementia (89%). The Z-PhA cut-off point was -0.81 (Sensitivity:0.75; Specificity:0.60). Mortality risk was multiplied by 1.09 in subjects with a Z-PhA < -0.81, regardless of age, presence of dementia, and BMI. PhA presented a remarkable clinical utility as an independent indicator of survival in psychogeriatric patients. Moreover, it could be useful to detect disease-related malnutrition and to identify subjects eligible for an early clinical approach.