Risk Of Recurrence In Patients Research Articles

Real-world data on the efficacy and safety of adjuvant chemotherapy in Japanese patients with a high-risk of gastrointestinal stromal tumor recurrence.

Complete surgical resection is the only treatment for resectable gastrointestinal stromal tumors (GISTs). Three-year adjuvant chemotherapy (AC) is recommended for patients with high-risk GISTs. However, there are scarce data on this topic in Japan. We aimed to study the efficacy and safety of AC in Japanese patients with high-risk GISTs. Patients with high-risk GISTs who received complete resections during 1992-2019 in our hospitals were included in this retrospective study. We evaluated patients' treatments with or without AC, completion rates, adverse events (AEs), recurrence-free survival (RFS), and overall survival (OS). Overall, 89 patients categorized as high risk were enrolled in this study. Fifty-five patients received AC (AC group), and 34 patients did not receive AC (control group). Twenty-three (41.8%) patients experienced Common Terminology Criteria for Adverse Events Grade 2 or higher AEs. At a median follow-up of 61.6months, 41 (74.5%) patients completed the planned treatment (including six patients with ongoing treatment), whereas 14 (25.4%) patients did not complete the treatment owing to the development of AEs (nine patients), patients' request (three patients), recurrence (one patient), and mutational analysis (one patient). Comparing the data between the treatment and control groups, the RFS rate was significantly better for the AC group (P < 0.001). However, there was no significant difference in the OS rate between the two groups. Postoperative AC was well tolerated by Japanese patients at an acceptable rate, and its use may reduce the risk of recurrence in patients with high-risk GISTs.

Prognostic significance of serum CA 19-9 response and dynamics in patients with intrahepatic cholangiocarcinoma undergoing surgical resection.

479 Background: Pre and post-operative elevation of serum CA 19-9 have been associated with poor outcomes and increased risk of recurrence in patients with resected intrahepatic cholangiocarcinoma (ICC). We sought to investigate the impact of CA 19-9 response and dynamics on survival for patients with ICC undergoing surgical resection. Methods: Clinicopathologic characteristics were abstracted from a prospectively maintained database at a tertiary cancer care center for patients with ICC undergoing surgical resection from 2003 to 2020. Exclusion criteria included CA 19-9 non-producers (≤ 1 U/mL at baseline), missing baseline/pre-operative or postoperative CA 19-9 value, or total bilirubin &gt; 2 mg/dL. Overall (OS) and recurrence-free survival (RFS) was compared among patients when categorized by baseline (neoadjuvant)/pre-operative (upfront surgery) and post-operative CA 19-9 values: normal (&gt; 1 to 37 U/mL), intermediate (&gt; 37 to 200 U/mL), and elevated (&gt; 200 U/mL). Patients were then stratified by perioperative CA 19-9 response (responder [non-normal to normal CA 19-9 OR 50% reduction in CA 19-9; normal to normal CA 19-9], non-responder [non-normal to non-normal CA 19-9 OR &lt; 50% reduction in CA 19-9; normal to non-normal CA 19-9]) and CA 19-9 dynamics (normal to normal, non-normal to normal, non-normal to non-normal, normal to non-normal CA 19-9 values). Results: A total of 112 patients were identified including 67 (59.8%) who underwent upfront surgery and 45 (40.2%) who received neoadjuvant therapy. Patients with a normal CA 19-9 at diagnosis had median RFS and OS durations of 61 and 163 months, followed by intermediate CA 19-9 (20 and 98 months) and elevated CA 19-9 (18 and 46 months, p = 0.308 RFS; p = 0.295 OS). Those who had a normal CA 19-9 post-operatively had the best median RFS and OS (46 and 163 months), followed by intermediate CA 19-9 (13 and 58 months) and elevated CA 19-9 (5 and 8 months, p = 0.059 RFS; p = 0.005 OS). When stratified by perioperative CA 19-9 response, responders had a median RFS of 36 vs. 13 months in non-responders (p = 0.143), and a median OS of 98 months vs. 88 months in non-responders (p = 0.077). Patients with normal CA 19-9 post-operatively had longer RFS/OS (normal to normal, 48/98 months; non-normal to normal, 30/not estimable months) than those who had non-normal CA 19-9 both pre- and post-operatively (non-normal to non-normal, 7/34 months, p = 0.018 RFS; p = 0.007 OS). Conclusions: Patients with normal CA 19-9 levels post-operatively, who had either normal or elevated CA 19-9 pre-operatively, had the greatest RFS and OS durations. A normal (or normalized) post-operative CA 19-9 may inform patient-centered decisions on adjuvant therapy and/or surveillance intensity.

The correlation between the Oncotype DX recurrence score and Ki-67 proliferation index in ER+ve,HER2−ve, node negative breast cancer

Background: The Oncotype DX recurrence score (RS) is a 21 gene panel assay developed to predict the risk of recurrence in patients with ER+ve,HER2−ve,node negative breast cancer,the technique used to measure it is a quantitative real-time reverse transcription polymerase chain reaction assay (qRT-PCR).The panel formed of 5 reference genes and 16 cancer-related genes,they include genes associated with cell proliferation ,tumour invasion,and hormone receptors expression.The expression of 16 genes is utilized to assess the RS and the result presented as a numerical results (0-100%).The calculated scores are grouped into three risk categories:low risk,intermediate risk and high risk.RS has prognostic and predictive value for in early stage breast cancer management and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine treatment.Assessment of the Ki-67 proliferation index is based on immune-histochemical staining of the tumour cells for the Ki-67 protein,it is detected in the active course of the cell cycle(G1,S,G2,and M),and not detected during G0.The malignant cells show a significantly higher expression of Ki-67 proliferative index than in the normal tissues.The Ki-67 proliferative index is frequently incorporated in the biomarkers group used in breast cancer assessment and may provide additional information to aid decision making for adjuvant chemotherapy.Our aim is to explore the relationship between the RS and the Ki-67 in the early ER+VE,HER2-VE,node negative operable early breast cancer .

Abstract TP98: Diagnostic Utility Of Transcranial Color Flow Imaging Identifying High Risk Patent Foramen Ovale

Background and Purpose: Recent several studies demonstrated that percutaneous patent foramen ovale (PFO) closure reduced the risk of stroke recurrence for patients with cryptogenic stroke and PFO. Our aim of this retrospective study is to evaluate the usefulness of transcranial color flow imaging (TC-CFI) in the diagnosis of anatomically high risk PFO, in which percutaneous PFO closure is expected to be more effective in preventing embolism. Methods: Subjects were ischemic stroke patients who were investigated the presence of right-to-left shunt (RLS) using TC-CFI and transesophageal echocardiography (TEE). Anatomically high risk PFO evaluated by TEE were defined as satisfying one or more of the following findings: 1) large shunt (more than 20 microbubbles (MB) identified in the left ventricular system), 2) atrial septal aneurism, and 3) the presence of shunt without Valsalva maneuver (VM). TC-CFI was performed in the middle cerebral artery and/or intracranial vertebral artery once without VM and three times with VM, respectively. The number of microembolic signals from MB was determined using international Consensus Criteria (ICC). The accuracy of TC-CFI for high risk PFO diagnosed by TEE was calculated, and then the positive rate of TC-CFI in detecting high risk PFO was also analyzed by TC-CFI’s findings (A: ICC grade II or higher, B: positive without VM, and C: positive on multiple times or in multiple vessels). Results: We analyzed 176 patients (41 females, mean age 64 years) admitted to our facility from July 2019 to July 2021. Of them, 44 patients (25%) had PFO, and 29 patients (16%) were high risk. The diagnostic power of TC-CFI was sufficient, with sensitivity of 93%, specificity of 80%, and accuracy of 89%. The positive rate of each finding was significantly higher in C than in A and B (A: 23%, B: 39%, and C: 55%. P=0.04). Conclusions: To perform the TC-CFI procedure frequently in multiple vessels is useful for screening of high risk PFO.

Optimal Surgical Extent in Patients with Unilateral Multifocal Papillary Thyroid Carcinoma.

Simple SummaryAround 30% of patients with papillary thyroid cancer (PTC) have multifocality. As tumor multifocality could increase the risk of recurrence in patients with PTC, more aggressive treatments, including total thyroidectomy and higher-dose radioiodine, are commonly used to treat patients with multifocal PTC. However, it is unclear whether aggressive treatment can decrease the risk of recurrence. Our study of 718 patients demonstrated that thyroid lobectomy showed comparable recurrence-free survival to that of total thyroidectomy. Moreover, our findings indicated that thyroid lobectomy could be safely performed on multifocal PTC patients with high-risk factors, such as large tumor size or lymph node metastasis. In conclusion, thyroid lobectomy was not associated with the risk of recurrence in patients with multifocal PTCs. Multifocality in PTC may not always require aggressive surgery.Multifocality increases the risk of recurrence in patients with papillary thyroid carcinoma (PTC); however, it is unclear whether multifocality justifies more extensive or aggressive surgical treatment. Here, we evaluated the effect of the operative extent on the recurrence-free survival (RFS) of patients with multifocal PTC. Between 2010 and 2019, 718 patients with unilateral multifocal PTC were enrolled; 115 patients (16.0%) underwent ipsilateral thyroid lobectomy, and 606 patients (84.0%) underwent total thyroidectomy. With a mean follow up of 5.2 years, RFS was comparable between the total thyroidectomy and lobectomy groups (p = 0.647) after adjusting for potential confounders. Multivariable Cox regression analysis also demonstrated that the operative extent was not an independent predictor of recurrence (HR 1.686, 95% CI: 0.321–8.852). Subgroup analyses further indicated that both total thyroidectomy and thyroid lobectomy resulted in comparable RFS for multifocal PTC patients with other high-risk factors, including tumor size > 1 cm (p = 0.711), lymph node metastasis (p = 0.536), and intermediate ATA risk of recurrence (p = 0.682). In conclusion, thyroid lobectomy was not associated with the risk of recurrence in patients with multifocal PTCs. Multifocality in PTC may not always require aggressive surgery.

Identification of Effective Factors in Recurrence of Schizophrenia Spectrum Disorder Using Poisson Regression Model

Background and Objectives: Schizophrenia is one of the most severe psychiatric disorders that has a recurrent nature. Frequent relapses have destructive impacts on patient’s thoughts, behaviors and relationships. These can lead to disruption of personal and social performance of patient. The aim of this study was to identify risk factors for increasing the number of relapses. Methods: In this retrospective cohort study, data from medical records of individuals with SSD who were admitted at least once to Farabi Hospital between 2015 and 2019 years extracted. To determine factors related to recurrence of Schizophrenia, Univariate and multivariate analysis and multivariate Poisson Regression were performed respectively. Analysis was done using STATA 14.1. Results: Based on extracted data from 401 medical records, 255 (63.6%) were males and 146 (36.4%) were females. A total of 1105 relapse were observed in males with 683 cases, and females with 422 cases. 65 patient experienced relapse from 5 to 11 times. Among considered variables, Employment status (RR=0.85, P-value=0.043), age (RR=0.99, P-value=0.03), Mode of Onset (RR=0.78, P-value=0.027) and Medication Adherence (RR=1.67, P&lt;0.001) were significant on increasing readmission. Conclusion: According to the results of this study, the young age of onset of schizophrenia, the gradual onset of the disorder, unemployment and drug non-compliance had a significant effect on increasing the risk of recurrence in patients with schizophrenia. considering above risk factors, it seems necessary to perform preventive and therapeutic measures to reduce the risk of relapses. Patients with non-adherence can be under education and counseling.

Clinical Implication of Mutifocality for Risk of Recurrence in Patients With Papillary Thyroid Carcinoma

Clinical Implication of Mutifocality for Risk of Recurrence in Patients With Papillary Thyroid Carcinoma

Posterior Dynamic Stabilization with Limited Rediscectomy for Recurrent Lumbar Disc Herniation.

Objective Recurrent lumbar disc herniation (RLDH) is the most common cause of sciatica after primary discectomy. The purpose of this study was to evaluate the efficacy of transpedicular dynamic stabilization (TDS) combined with limited rediscectomy in the treatment of single-level RLDH. Methods We retrospectively evaluated a consecutive series of 24 middle-aged patients who underwent TDS (Dynesys system) combined with limited rediscectomy (i.e., removing only extruded or loose disc fragments) for single-level Carragee type II and type IV RLDH between April 2012 and September 2017. Clinical results were evaluated with visual analog scale (VAS) for leg and low back pain, Oswestry Disability Index (ODI) scores, and complications. Imaging data include lumbar segment motion and intervertebral height. Results The mean follow-up period was 38 months. The VAS and ODI scores were significantly improved at the last follow-up. The average range of motion (ROM) at the stabilized segment was 6.4° before surgery and 4.2° at the last follow-up, with a 78.6% mean preservation (P < 0.05). Intervertebral height at the stabilized segment decreased slightly after surgery (P < 0.05). However, there was no further decline at the last follow-up. There were no cases of reherniation, screw loosening, or segmental instability. Conclusions TDS combined with limited rediscectomy resulted in an effective procedure in middle-aged patients with Carragee type II and type IV RLDH. It was able to stabilize the operated segment with partial motion preservation. Moreover, it could maintain disc height and decrease the risk of recurrence in patients with a large posterior annular defect.

Does size affect the prognosis of resectable thymoma beyond the eighth edition TNM?

BackgroundThymoma is a type of rare mediastinal tumor whose clinical characteristics and indicators of prognosis are poorly understood. This single‐institution retrospective study aimed to assess the predictive value of tumor, node, metastasis (TNM) staging incorporating tumor size in predicting the risk of thymoma recurrence after resection.MethodsFour binary logistic regression models were developed. Models I and II included median tumor size and TNM stage, respectively. Model III included the above two variables. Model IV was model III containing these two variables and their interaction terms. All models were adjusted for WHO histological type, operational time, and adjuvant therapy.ResultsA total of 276 patients with a median age of 51.0, including 21 patients with thymoma recurrence, were included in this study. Models II or III showed a lower ‐2LogL and higher AUC (0.735 and 0.738 vs. 0.576) with significantly better discrimination than model I, and model III and model II shared similar discrimination. In model III, TNM stage was positively correlated with thymoma recurrence. The recurrence risk of patients with TNM stage IV was significantly higher than those with TNM stage I (OR of 11.03, p = 0.022). No significant correlation between the tumor size and recurrence risk (p = 0.779) and no interaction was found between medium tumor size and TNM stage in model IV.ConclusionsThis study suggests that the prediction contribution of the TNM stage combined with tumor size is similar to the TNM stage alone for tumor recurrence in patients with thymoma after surgical resection.

Classification of early-stage colon cancer with Immunoscore®: clinical evidence and case studies.

Immunoscore® is a digital pathology diagnostic immunoassay used to complement tumor node metastasis staging for the prediction of recurrenceriskin patients with early-stage colon cancer. In combination with standard clinicopathological features, Immunoscore informs adjuvant chemotherapy decision-making for patients with early-stage colon cancer. Immunoscore has been validated in patients with stage II/III colon cancer and demonstrated to be a stronger prognostic factor for survival than tumor node metastasis staging alone. Immunoscore improves theprognostic definition of patients with colon cancer, theidentification of those patients at high risk of tumor recurrence, and the ability to predict which patients will derive most benefit from the use of adjuvant chemotherapy. Immunoscore has robust analytical performance characteristicswhich include good interlaboratory reproducibility and overall assay precision.

Does Laparoscopic Adhesiolysis Decrease the Risk of Recurrence in Small Bowel Obstruction and Who Benefits the Most from Laparoscopic Approach? A literature review.

Adhesions are usual sequelae of almost all abdominal surgery and their incidence increases with multiple explorations. One of the most common reasons for emergency general surgery is Small bowel obstruction due to adhesions (ASBO). The patients usually have classic signs and symptoms of intestinal occlusion and many will be treated by non-operative measures and ingestion of a water-soluble contrast medium. Some patients may not respond to conservative measures and will need surgical exploration and around 46% will end up in further episodes of intestinal obstruction. Laparoscopy has been utilized in these cases recently in contrast to the earlier belief that rendered it relatively contraindicated in the past. Laparoscopy has been advantageous in causing less pain, early mobilisation, and fast return of the bowel function, along with the low incidence of further adhesion formation, thus fewer recurrence rates of small bowel obstruction. We carried out a non-systemic search of the available literature (Pub Med, Google Scholar) to determine whether laparoscopic adhesiolysis decreases the risk of recurrence in patients with small bowel obstruction or not and to see which patients are suitable for laparoscopic adhesiolysis. We concluded that each patient should be individualised as this approach allows many patients with possible benefits from minimally invasive surgery. However, randomised control trials are needed to properly delineate the benefits of laparoscopic adhesiolysis over the conventional open procedures in the form of long-term outcomes and recurrence rates.

Glasgow Prognostic Score and modified Glasgow Prognostic Score and survival in patients with hepatocellular carcinoma: a meta-analysis

ObjectiveTo evaluate the association between inflammation-related markers, modified Glasgow Prognostic Score (mGPS) and Glasgow Prognostic Score (GPS), and survival outcome and recurrence risk in patients with hepatocellular carcinoma (HCC) after...

Evaluation of the Risk of Recurrence in Patients with Local Advanced Rectal Tumours by Different Radiomic Analysis Approaches.

The word radiomics, like all domains of type omics, assumes the existence of a large amount of data. Using artificial intelligence, in particular, different machine learning techniques, is a necessary step for better data exploitation. Classically, researchers in this field of radiomics have used conventional machine learning techniques (random forest, for example). More recently, deep learning, a subdomain of machine learning, has emerged. Its applications are increasing, and the results obtained so far have demonstrated their remarkable effectiveness. Several previous studies have explored the potential applications of radiomics in colorectal cancer. These potential applications can be grouped into several categories like evaluation of the reproducibility of texture data, prediction of response to treatment, prediction of the occurrence of metastases, and prediction of survival. Few studies, however, have explored the potential of radiomics in predicting recurrence-free survival. In this study, we evaluated and compared six conventional learning models and a deep learning model, based on MRI textural analysis of patients with locally advanced rectal tumours, correlated with the risk of recidivism; in traditional learning, we compared 2D image analysis models vs. 3D image analysis models, models based on a textural analysis of the tumour versus models taking into account the peritumoural environment in addition to the tumour itself. In deep learning, we built a 16-layer convolutional neural network model, driven by a 2D MRI image database comprising both the native images and the bounding box corresponding to each image.

Evaluation of recurrence risk in patients with papillary thyroid cancer through tumor-node-metastasis staging: A single-center observational study in Taiwan

BackgroundMany patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. However, 8%–28% of patients with PTC show tumor recurrence, which may affect prognosis. Therefore, identifying factors associated with tumor recurrence in patients with PTC may be helpful to refine therapeutic strategies. MethodsTo identify factors associated with PTC recurrence, we retrospectively reviewed demographic features (sex and age), operation method, image character, serum thyroglobulin (Tg), accumulated radioactive iodine (I-131) therapeutic dose, I-131 uptake, and metastases at diagnosis in 829 patients with PTC. Patients were grouped into early (stage I and II; n = 698) and advanced (stage III and IV; n = 131) tumor-node-metastasis (TNM) stages. Recurrence rate, mortality rate, risk factors of recurrence, recurrent free survival and overall survival curve were compared between two groups. ResultsPatients in the early stage demonstrated a lower recurrence rate (7.2%) than did those in the advanced stage (28.2%, p < 0.05). The mortality rate of patients with recurrence in the advanced stage was higher than that of those in the early stage (51.4% vs. 12.0%). The major impact factors on tumor recurrence in early TNM stage were distant metastasis and lymph node metastasis, while in advanced TNM stage were distant metastasis, male gender, total thyroidectomy with limited lymph node dissection, and a high serum Tg level. ConclusionsStrategies to monitor tumor recurrence might be refined according to the TNM stages of PTC patients.

Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma.

The incidence of thyroid cancer has dramatically increased over the last few decades, and up to 60% of patients have multifocal tumors. However, the prognostic impact of multifocality in patients with papillary thyroid carcinoma (PTC) remains unestablished and controversial. We evaluate whether multifocality can predict the recurrence of PTC. A total of 1249 patients who underwent total thyroidectomy for PTC at the Ewha Medical Center between March 2012 and December 2019 were reviewed. In this study, multifocality was found in 487 patients (39.0%) and the mean follow-up period was 5.5 ± 2.7 years. Multifocality was associated with high-risk features for recurrence, including extrathyroidal extension, lymph node metastasis, and margin involvement. After adjustment of those clinicopathological features, 10-year disease-free survival was 93.3% in patients with multifocal tumors, whereas those with unifocal disease showed 97.6% (p = 0.011). Multivariate Cox regression analysis indicated that male sex (HR 2.185, 95% CI 1.047–4.559), tumor size (HR 1.806, 95% CI 1.337–2.441), N1b LN metastasis (HR 3.603, 95% CI 1.207–10.757), and multifocality (HR 1.986, 95% CI 1.015–3.888) were independent predictors of recurrence. In conclusion, multifocality increased the risk of recurrence in patients with PTC. Patients with multifocal PTCs may need judicious treatment and follow-up approaches.

Lymph node yield in the initial central neck dissection (CND) associated with the risk of recurrence in papillary thyroid cancer: A reoperative CND cohort study

BackgroundTo evaluate the relationship between lymph node yield (LNY) from the initial central neck dissection (CND) and the risk of recurrence in patients undergoing reoperative CND for papillary thyroid cancer (PTC). MethodWe reviewed clinical data from all patients with pathologically proven PTC who underwent central neck and/or lateral neck dissection reoperations at Nanfang Hospital between 2012 and 2020. Patient demographics, tumor characteristics, clinical data and follow-up information were obtained. In the initial CND, the total number of lymph nodes removed (LNY), total positive nodes removed, and the percentage of positive lymph nodes to the number of lymph nodes removed (PLN%) were determined. ResultsA total of 162 patients were included in the study, with a median follow-up of 44 months. 62 had central neck disease recurrence. The optimal LNY and PLN% cut-off values for recurrence were 11 and 65%, respectively. Group 2 (LNY ≥ 11, PLN% < 65%) showed a significantly higher RFS rate than group 1 (LNY < 11 and PLN% < 65%; P < 0.001), group 3 (LNY < 11, PLN% ≥ 65%; P < 0.001), and group 4 (LNY ≥ 11, PLN% ≥ 65%; P = 0.038). Furthermore, group 4 had a higher RFS rate than group 1 (P = 0.008) and group 3 (P = 0.001). Multivariate analysis revealed that LNY < 11 in the central neck was an independent risk factor for recurrence/persistence in the initial surgery (P < 0.001). ConclusionHigher LNY in central and neck dissections is associated with lower papillary thyroid cancer recurrence rates, which was confirmed by a reoperative CND procedure. To minimize the risk of recurrence and the need for secondary therapy, surgeons should perform compartment-oriented CNDs when indicated.

Development and assessment of machine learning models for predicting recurrence risk after endovascular treatment in patients with intracranial aneurysms.

Intracranial aneurysms (IAs) remain a major public health concern and endovascular treatment (EVT) has become a major tool for managing IAs. However, the recurrence rate of IAs after EVT is relatively high, which may lead to the risk for aneurysm re-rupture and re-bleed. Thus, we aimed to develop and assess prediction models based on machine learning (ML) algorithms to predict recurrence risk among patients with IAs after EVT in 6months. Patient population included patients with IAs after EVT between January 2016 and August 2019 in Hunan Provincial People's Hospital, and an adaptive synthetic (ADASYN) sampling approach was applied for the entire imbalanced dataset. We developed five ML models and assessed the models. In addition, we used SHapley Additive exPlanations (SHAP) and local interpretable model-agnostic explanation (LIME) algorithms to determine the importance of the selected features and interpret the ML models. A total of 425 IAs were enrolled into this study, and 66 (15.5%) of which recurred in 6months. Among the five ML models, gradient boosting decision tree (GBDT) model performed best. The area under curve (AUC) of the GBDT model on the testing set was 0.842 (sensitivity: 81.2%; specificity: 70.4%). Our study firstly demonstrated that ML-based models can serve as a reliable tool for predicting recurrence risk in patients with IAs after EVT in 6months, and the GBDT model showed the optimal prediction performance.

A novel online calculator to predict recurrence risk in patients with distal cholangiocarcinoma after radical pancreaticoduodenectomy.

Patients with distal cholangiocarcinoma (DCC) are prone to relapse even after radical pancreaticoduodenectomy. In this study, we sought to create an online nomogram calculator to accurately predict the recurrence risk of DCC. A total of 184 patients were included. Multivariate Cox regression analysis was used to identify independent prognosis factors for recurrence-free survival and overall survival. A nomogram was constructed according to the prognostic factors in the training cohort and then tested in the validation cohort. Multivariate Cox analysis showed preoperative carbohydrate antigen 19-9 (p < 0.001), maximum tumor size (p = 0.076), perineural invasion (p = 0.044), and N stage (p = 0.076) were independent prognostic factors for DCC relapse. We then constructed a nomogram with these four factors. The consistency index (C-index) of the nomogram in the training and validation cohorts were 0.703 and 0.665, respectively. Time-dependent receiver operating characteristic and decision curve analyses revealed that the nomogram provided higher diagnostic power and net benefit compared with other staging systems. In this study, we developed an online nomogram calculator that can accurately predict the recurrence risk of DCC and identify patients with a high risk of recurrence in a simple and convenient manner.

Evaluation of Clinical and Pathological Factors to Predict High Risk of Recurrence in Patients With Stage II Colon Cancer

Background: The ability to predict patients with stage II colon cancer at high risk of recurrence is currently limited to certain clinicopathologic factors. Patients and Methods: This population-based study reviewed various prognostic factors to identify those associated with worse time to recurrence (TTR) and improved disease-specific survival (DSS), and to subsequently develop a prognostic index (PI) to identify high risk cancers. Results: Multivariate analyses revealed factors significant for TTR and DSS. A PI derived from the TTR risk factors identified 3 risk groups using 5-year rate without relapse: 88% for low-risk, 81% for intermediate-risk, and 59% for high risk. Conclusion: This model was better at identifying high risk patients than using equally weighted standard risk factors.

P06.06 Clinical Implications of Tumour Spread Through Air Spaces (STAS) In Lung Adenocarcinoma Patients Treated With Surgery

Tumour spread through air spaces (STAS) in lung adenocarcinoma is a novel mechanism of invasion, which is important for pathologist to recognize. STAS has been proposed as an independent predictor of high risk of recurrence in patients with lung adenocarcinoma. The aim of this study was to assess the clinical implications of STAS and the distance from the edge of the tumor to the farthest STAS as prognostic factors in patients with lung adenocarcinoma treated with surgery.