Retrospective Analysis Of Prognostic Factors Research Articles

40. Development Of Neuropathic Pain After Primary TMR And RPNI In Lower Extremity Amputation: A 4-year Retrospective Analysis Of Prognostic Factors

40. Development Of Neuropathic Pain After Primary TMR And RPNI In Lower Extremity Amputation: A 4-year Retrospective Analysis Of Prognostic Factors

Retrospective analysis of prognostic factors in esophageal adenocarcinoma.

Retrospective analysis of prognostic factors in esophageal adenocarcinoma.

Development of Neuropathic Pain after Primary TMR and RPNI in Lower Extremity Amputation: A 4-Year Retrospective Analysis of Prognostic Factors

Development of Neuropathic Pain after Primary TMR and RPNI in Lower Extremity Amputation: A 4-Year Retrospective Analysis of Prognostic Factors

A retrospective analysis of prognostic factors and treatment choices in small cell lung cancer with liver metastasis.

Small cell lung cancer (SCLC) is characterized by high aggressiveness and early dissemination, with the liver being the most common site of metastasis. Although it has been established that the prognosis for SCLC with liver metastasis is exceedingly poor, comprehensive data on clinical features, prognostic factors, treatment options, and outcomes of this patient population remain limited. This retrospective study aims to examine the clinicopathological features and current treatment landscape and to identify prognostic factors associated with SCLC with liver metastasis in real-world settings. We conducted a retrospective analysis of data on SCLC patients with liver metastasis at initial diagnosis between January 1, 2013, and January 1, 2022. Kaplan-Meier analysis and log-rank tests were employed to estimate the overall survival (OS) and progression-free survival (PFS). Cox regression models were utilized to identify independent prognostic factors. A total of 349 patients were included in the study, with 97.7% of patients exhibiting pure SCLC and 42.4% of patients presenting with concomitant bone metastasis. Approximately one-fourth of the patients had metastases in ≥3 organs, and 18.9% of patients had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2. The median OS was 10.97 months (95% CI: 9.88-12.06) for those who received first-line therapy (n=286). Of these, 263 patients were treated with chemotherapy, showing a median OS of 11.37 months. Furthermore, 43.8% of patients received second-line treatment, and 81 patients proceeded to third-line treatment. ECOG PS ≥2 and mixed-SCLC were identified as independent adverse prognostic factors in SCLC with liver metastasis, whereas treatments including systemic treatment alone or in combination with local radiotherapy were associated with better prognoses. This retrospective study substantiated that ECOG PS ≥2 and mixed SCLC are independent predictors of poor prognosis for SCLC with liver metastasis. Additionally, different treatment strategies can improve the survival of this patient population, with chemotherapy currently being the main treatment option.

Retrospective Analysis of Prognostic Factors in Patients with Small Cell Lung Cancer

Retrospective Analysis of Prognostic Factors in Patients with Small Cell Lung Cancer

Melanoma Brain Metastases: A Retrospective Analysis of Prognostic Factors and Efficacy of Multimodal Therapies

Brain metastasis in cutaneous melanoma (CM) has historically been considered to be a dismal prognostic feature, although recent evidence has highlighted the intracranial activity of combined immunotherapy (IT). Herein, we completed a retrospective study to investigate the impact of clinical-pathological features and multimodal therapies on the overall survival (OS) of CM patients with brain metastases. A total of 105 patients were evaluated. Nearly half of the patients developed neurological symptoms leading to a negative prognosis (p = 0.0374). Both symptomatic and asymptomatic patients benefited from encephalic radiotherapy (eRT) (p = 0.0234 and p = 0.011). Lactate dehydrogenase (LDH) levels two times higher than the upper limit normal (ULN) at the time of brain metastasis onset was associated with poor prognosis (p = 0.0452) and identified those patients who did not benefit from eRT. Additionally, the poor prognostic role of LDH levels was confirmed in patients treated with targeted therapy (TT) (p = 0.0015) concerning those who received immunotherapy (IT) (p = 0.16). Based on these results, LDH levels higher than two times the ULN at the time of the encephalic progression identify those patients with a poor prognosis who did not benefit from eRT. The negative prognostic role of LDH levels on eRT observed in our study will require prospective evaluations.

Retrospective Analysis of Prognostic Factors and Survival in Multiple Myeloma Patients Aged 65 Years or Older at Diagnosis in a Real-Life Setting and a Proposed New Staging System

Introduction: The incidence of multiple myeloma (MM) increases with age. Novel agents provide better treatment results. However, adults >65 years of age are often underrepresented in clinical trials making it difficult to assess treatment outcomes in older patients. Appropriate strategies are necessary and treatment must be individualized in this heterogeneous population. Methods: We retrospectively reviewed the charts of 534 patients diagnosed with MM between January 2010 and January 2020 who presented to our department. One hundred twenty-three of them were aged 65 years or older at diagnosis and were included in the study. Clinical and laboratory data were collected and potential prognostic factors of overall survival (OS) were evaluated by univariate and multivariate analyses. Results: Of 123 patients analyzed 54.5% (67) were male and 45.5% (56) were female. The median age was 71 years and 32.5% of patients were equal or older than 75 years. Median follow-up time was 28 months (1-117). Median OS and progression free survival (PFS) were 46 and 17 months, respectively. Of the patients 63.4% (78) died during the study period. The patients were divided into 3 groups according to age: 65-69 (47 patients, median OS 68 months), 70-74 (36 patients, median OS 45 months) and ≥75 (40 patients, median OS 36 months) years old (p: 0.022). International Staging System (ISS) stage could be defined in 117 patients (19 had ISS I, 40 ISS II and 58 had ISS III disease). Revised ISS (R-ISS) could also be defined in 117 patients (17 R-ISS I, 82 R-ISS II and 18 R-ISS III). Both ISS and R-ISS could not identify statistically significant differences regarding OS and PFS. Chromosomal abnormalities were detected by fluorescence in situ hybridization (FISH) and conventional cytogenetics in 56 and 39 patients respectively. Eleven of 56 patients and 4 of 39 patients had unfavorable genetic features and due to the small number these patients are not included in the survival analyses. Bortezomib based doublet and triplet induction regimens were given in 86% of patients. Univariate analysis revealed that age, hemoglobin, creatinine, calcium, albumin, extramedullary disease and bone marrow plasma cell (BMPC) percentage were strongly associated with OS. Receiver operating curve (ROC) analysis determined the optimal cut-off value of BMPC 26.5%. On multivariate analysis albumin, extramedullary disease and BMPC ratio retained prognostic value. Presence of none, one, two or all three of these factors could identify 4 patient subgroups showing median OS rates of 108, 55, 25 and 12 months, respectively (p: <0.001) (Figure). Conclusions: MM primarily affects older adults. Hence, there is a need for simple and reliable staging systems for elderly MM patients. We propose a prognostic scoring method for outcome incorporating easy to use variables such as albumin, extramedullary disease and BMPC ratio. Hypoalbuminemia (≤ 3.5 g/dl), presence of extramedullary disease and BMPC ratio ≥ 26.5% predicted different OS ratios in the study population. A validation of the score in an independent series of patients is planned. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Retrospective Analysis of Prognostic Factors in Pediatric Patients with Adrenocortical Tumor from Unique Tertiary Center with Long-Term Follow-Up.

Pediatric adrenocortical tumors (PACTs) represent rare causes of malignancies. However, the south/southeast regions of Brazil are known to have a high incidence of PACTs because of the founder effect associated with a germline pathogenic variant of tumor suppressor gene TP53. We aimed to retrospectively analyze the types of variables among hormone production, radiological imaging, tumor staging, histological and genetic features that were associated with the occurrence of malignancy in 95 patients (71% females) with PACTs from a unique center. The worst prognosis was associated with those aged &gt; 3 years (p &lt; 0.05), high serum levels of 11-desoxicortisol (p &lt; 0.001), tumor weight ≥ 200 g (p &lt; 0.001), tumor size ≥ 5 cm (p &lt; 0.05), Weiss score ≥ 5 (p &lt; 0.05), Wieneke index ≥ 3 (p &lt; 0.001) and Ki67 ≥ 15% (p &lt; 0.05). Furthermore, patients with MacFarlane stage IV had an overall survival rate almost two times shorter than patients with other stages (p &lt; 0.001). Additionally, the subtractions of BUB1B-PINK1 (&lt;6.95) expression (p &lt; 0.05) and IGF-IR overexpression (p = 0.0001) were associated with malignant behavior. These results helped identify patients who are likely to have an aggressive course; further multicenter prospective studies are required to confirm our results. In conclusion, PACTs with these patterns of prognostic factors could be treated using an adjuvant approach that may improve the overall survival in such patients.

Laparoscopic liver resection for colorectal liver metastases: retrospective analysis of prognostic factors and oncological outcomes in a single-center cohort.

Laparoscopic liver resection (LLR) has gained acceptance as an effective treatment for colorectal liver metastases (CRLM) in selected patients, providing similar oncologic outcomes compared to open liver resection (OLR). The aim of this study was to determine prognostic factors for survival outcomes associated with LLR for CRLM. A single-center retrospective analysis of a prospectively maintained database was performed. The inclusion period ranged from September 2011 until mid-March 2020. Two hundred consecutive LLRs were included. The 5-year overall survival (OS) and disease-free survival (DFS) rates equalled 54.8% and 49%, respectively. A pushing (HR = 5.42, 95% CI 1.56-18.88, p = 0.008), as well as a replacement (3.87, 1.05-14.2, p = 0.04) growth pattern of the CRLM, poor differentiation of the primary colorectal cancer (CRC) (3.72, 1.72-8.07, p < 0.001) and administration of neoadjuvant chemotherapy (NAC) (2.95, 1.28-6.8, p = 0.01) were identified as independent predictors of a worse OS. Requirement of more than 6 cycles of NAC (6.17, 2.37-16.03, p < 0.001), a replacement (4.96, 1.91-12.87, p < 0.001), as well as a pushing (4.3, 1.68-11, p = 0.002) growth pattern of the CRLM and poor differentiation of the primary CRC (2.61, 1.31-5.2, p = 0.006) were identified as independent predictors of a worse DFS. LLR for CRLM offers adequate long-term oncologic outcomes. OS and DFS rates are negatively affected by the administration of NAC and by pathological features, including the differentiation grade of the primary CRC and the histological growth pattern of the CRLM.

Impact of Adjuvant Radiotherapy on Recurrence of Surgically Treated Atypical Meningiomas and Retrospective Analysis of Prognostic Factors.

The role of adjuvant radiotherapy after surgery for atypical meningiomas remains controversial. The present study was designed to investigate the recurrence rate of atypical meningiomas after surgery (with or without adjuvant radiotherapy) and determine which factors were related with recurrence. Data obtained from 83 patients who underwent surgery and histopathologically diagnosed with atypical meningioma at a single institution between January 2009 and June 2019 were retrospectively reviewed. Then, the patients were divided into two groups: the surgery-only (n = 43) and surgery + adjuvant radiotherapy (n = 40) groups. The mean age of the patients was 53.5 ± 14.6 years. Among them, 51 (61.4%) were female and 32 (38.6%) were male. The recurrence rates were 30.2% (n = 13) in the surgery-only group and 17.5% (n = 7) in the surgery + adjuvant radiotherapy group. A statistically significant decrease in the recurrence rate was observed after adjuvant radiotherapy application (p = 0.046). Moreover, adjuvant radiotherapy significantly increased progression-free survival (p = 0.042). Peritumoral edema, sinus invasion, brain invasion, subtotal tumor resection, and complications were significant predictors of tumor recurrence, and the main risk factors for the recurrence of atypical meningiomas were brain invasion (p = 0.019) and subtotal tumor resection (p = 0.006). Progression-free survival and overall survival of the study group were 45.50 ± 27.56 and 56.69 ± 28.17 months, respectively. The parameters examined in the study, except for tumor recurrence, did not show a statistically significant influence on overall survival. This study revealed that the important prognostic factors for tumor recurrence are subtotal tumor resection and brain invasion. Moreover, adjuvant radiotherapy in addition to surgical resection reduces the recurrence rate of atypical meningiomas and improves progression-free survival of the patients. However, adjuvant radiotherapy did not show a significant influence on overall survival.

Ewing family tumors of the appendicular skeleton: a retrospective analysis of prognostic factors.

Authors retrospectively analyzed possible prognostic factors in a series of patients affected by Ewing sarcoma of extremities (eEWS) and treated over a 20-year period at a single institution. Between 1997 and 2017, 88 bone eEWS were treated at our institution. Staging, age, gender, tumoral volume, local treatment, surgical margins, post-ChT necrosis were investigated for prognostic correlation with overall survival (OS) and event-free survival (EFS). Median follow-up was 74months (1-236). Staging of disease correlated with OS (81% vs 59%, p = 0.01) and not with EFS (68% vs 57%, p = 0.28) in localized vs metastatic eEWS at presentation. Age ≥ 14years (p = 0.002) and volume ≥ 100 cm3 (p = 0.04) were significant negative prognostic factors. No difference was found in local treatment: OS was 76% vs 63% (p = 0.33), while EFS was 68% vs 49% (p = 0.06) after surgery alone or surgery + radiotherapy, respectively. Regarding surgical margins, OS was 76% vs 38% (p = 0.14), and EFS was 65% vs 33% (p = 0.14) in adequate vs not adequate, respectively. OS was 86% and 68% in good and poor responders, respectively (p = 0.13). In eEWS, metastatic disease at presentation, age > 14years and tumoral volume > 100 cm3 are negative prognostic factors. Intensified adjuvant ChT can improve prognosis in poor responders and metastatic patients.

A retrospective analysis of prognostic factors for 160 patients with stage III small cell lung cancer.

In some patients with stage III small cell lung cancer (SCLC), it is found that the treatment mode of systemic chemotherapy followed by auxiliary radiotherapy is better than early radiotherapy, but there is no clear evidence-based medical explanation for this. This study was designed to retrospectively evaluate prognostic factors for patients with stage III SCLC and explore the best treatment mode for locally advanced SCLC. A total of 160 patients with stage III SCLC who underwent chemotherapy or chest radiotherapy were enrolled in this study, including 103 patients at stage IIIA and 57 patients at stage IIIB. The short-term and long-term outcomes following chemotherapy and chest radiotherapy were compared between the two groups. There was no significant difference in progression-free survival (PFS) (9.5 vs. 10.0 months, P=0.065) or overall survival (OS) (14.0 vs. 14.0 months, P=0.231) between early radiotherapy and late radiotherapy in stage IIIA SCLC. PFS in stage IIIB patients was longer in the late radiotherapy group than in early radiotherapy (11.0 vs. 9.0 months, P=0.041), but the difference in OS was not statistically significant between the two groups (14.0 vs. 17.0 months, P=0.110). There was no significant difference in short-term and long-term therapeutic effects between stages IIIA and IIIB. Patients with stage IIIB who received late radiotherapy seemed to have a survival advantage, but the difference was not statistically significant (P=0.549). Treatment mode had no impact on patients at stage IIIA. Late radiotherapy showed more effectiveness for patients at stage IIIB.

Prognostic Factors in Penile Cancer: Should We Avoid Inguinal Lymph Node Staging?

Introduction: Penile cancer (PC) is a rare neoplasm, mostly in developed countries. Herewith, we evaluate the main prognostic factors of patients with PC undergoing surgery. Methods: This is a retrospective analysis of prognostic factors of overall survival in 65 patients with PC treated at a tertiary referral center over the last 15 years (2004–2018). Results: Almost half (48%) of the patients were diagnosed at an advanced local stage pT3/4. Thirty-eight (58%) patients underwent inguinal lymphadenectomy, and 25 (66%) were negative for lymph node (LN) invasion. Overall survival was 80% at a median follow-up of 31 months. In the multivariate analysis, the main factors of poor prognosis were nodal staging (pN) (p = 0.008) and perineural invasion (p = 0.023). The presence of LN metastasis and perineural invasion in the primary tumor increased the risk of death by 29 (hazard ratio 29.0, 95% confidence interval 2.4–354.2) and 13 (hazard ratio 12.7, 95% confidence interval 1.4–112.0) times, respectively. Discussion/Conclusion: Late diagnosis of PC has a negative impact on overall survival, as nodal invasion correlates with survival. Despite the high number of negative inguinal lymphadenectomy, we continue to advocate aggressive surgical treatment of this disease due to the poor prognosis associated with LN metastasis.

Effects of Concentrated Growth Factor and Cervical Lymph Node Metastasis on the Prognosis of Mucoepidermoid Carcinoma of the Parotid Gland

Introduction: Mucoepidermoid carcinoma (MEC) is a common salivary gland malignancy. As studies reported on large cases of mucoepidermoid carcinoma of the parotid glands are few, this paper aims to research the effects of clinical and pathological factors, such as applying concentrated growth factor (CGF) on repairing and cervical lymph node metastasis, on the prognosis of mucoepidermoid carcinoma of the parotid gland.&#x0D; Methods: The retrospective analysis of prognostic factors was conducted based on 176 cases with mucoepidermoidcarcinoma of the parotid gland, who received treatment at the Affiliated Hospital of Chengde Medical College during the period of March 2000 to March 2012.&#x0D; Results: The Five-year overall survival rate was 75.57%, while the Five-year tumor-free survival rate was 64.77%. Univariate analysis showed that the influential factors for the prognosis of mucoepidermoid carcinoma of the parotid gland included surgical approach, tumor size, clinical stage, pathological grade, lymph node metastasis, and distant metastasis, etc; among which pathological grade, lymph node metastasis, and distant metastasis were indicated by multivariate analysis to be the independent risk factors.&#x0D; Conclusion: The survival rate of mucoepidermoid carcinoma of the parotid gland is relatively high. Lymph node metastasis, pathological grade, and distant metastasis are the independent risk factors that affect the prognosis of patients with mucous epidermis carcinoma of the parotid gland.

Retrospective analysis of prognostic factors impacting survival in patients with brain metastases of gynecologic origin

Objective: Brain metastases originating from a primary gynecologic malignancy are extremely rare. With the exception of choriocarcinoma, they occur in less than 2% of all gynecologic cancers. Thus, we examined patients with brain metastases from gynecologic malignancies and explored potential prognostic factors in predicting survival.

Retrospective analysis of prognostic factors affecting the recurrence and disease-free survival following surgical management of gastrointestinal stromal tumors.

The aim of this study was to evaluate the prognostic factors effecting recurrence risk and disease-free survival of the patients who were diagnosed as gastrointestinal stromal tumor after complete resection of the tumor with or without adjuvant therapy. Between the years 2005 and 2013, data of 71 patients including clinical and demographic features, tumor localizations, pathologic examinations, survival and recurrence rates were enrolled into this retrospective study. Male/female ratio was 1.71, and mean age was 60.27 ± 14.65 years. Forty-two (59.2%) patients had tumor in stomach, 16 (22.5%) in small bowel, whereas 12 (16.9%) had extra-gastrointestinal system and one patient (%1.4) had rectal localization. Modified NIH risk stratification scheme categorized 9 (12.68%) patients in very low-, 12 (16.90%) in low-, 21 (29.58%) patients in moderate-and 29 (40.85%) patients in high-risk group. Twenty-four (33.8%) patients had a metastatic disease at follow-up while 13 (18.3%) patients were metastatic at admission. R0 resection was successfully performed in 51 (71.8%) patients, while R1 resection in 9 (12.7%) and R2 resection in 11 (15.5%) were achieved. Mean follow-up time was 47.12 ± 33.52 months (range, 1-171 months). Nineteen (26.8%) patients demonstrated recurrence with a mean time of 22.16 ± 15.89 months (range, 3-57 months). During follow-up 17 (23.9%) patients were deceased. In univariate analysis, high-risk group, small bowel and extra-gastrointestinal system localization, R1-2 resection, necrosis, positive resection margin and invasion of surrounding tissues, metastatic disease and adjuvant therapy were statistically significant in terms of recurrence. Multivariate analysis presented small bowel and extra-gastrointestinal system localization, R2 resection, mitoses count, invasion and adjuvant therapy as independent prognostic risk factors affecting disease-free survival rates. The 1, 3 and 5 years of disease-free survival rates of the patients were 89.6%, 75.4%, 64.3%, respectively. As mentioned in the literature, the mainstay of curative therapy of gastrointestinal stromal tumor is surgery. In our study, not only small bowel, extra-gastrointestinal system localization and invasion of surrounding tissues by tumor, but also R2 resection that complicate the local control of the disease were represented as independent adverse prognostic factors for disease-free survival. Unfavourable clinical outcomes of adjuvant therapy over the disease-free survival was linked to higher tumor stage with metastatic disease and emphasized that prospective trials with more cases should be practiced.

Long-Term Retrospective Analysis of Prognostic Factors in Patients with Newly Diagnosed Multiple Myeloma without Hematopoietic Stem Cell Transplantation

To retrospectively analyze the cases of multiple myeloma treated with chemotherapeatic regimens based on thalidomide, and to investigate the factors affecting MM patients treated using chemotherapeutic regimens with or without bortezomib. The clinical, laboratorial and survival data of 200 patients with newly diagnosed MM from October 2007 to December 2015 were collected, and the correlation of clinical and laboratorial indicators with the clinical characteristics and prognosis of MM patients was analyzed by using χ2 test, COX regression analysis, Kaplan-Meier method and Log-rank test. Multivariable analysis showed that age (≥65 years old), ISS staging (Ⅲ), complex karyotypes and no-complete remission were the independent prognostic factors for OS in bortezomib-treated group, while the β2-MG (≥8.95 mg/L), no-complete remission were the independent prognostic factros for OS in traditional therapy group. In addition, the MPI-1 myeloma prognostic index 1, consisted of age, complex karyotypes and complete remission in bortezomib-treated group, and MPI-2 consisted of β2-MG (≥8.95 mg/L), complex karyotypes, complete remission in traditional therapy group were suitable for evaluating the pregnosis of MM patients treated with regimens contiaining bortezomib and traditional chemotherapentic regimans. The differences of prognostic factors exist in MM patients treated with different chemotherapeutic regimens, moreover, the patients with comples karyotypes and no-complete remisson have poor prognosis. The MPI as more simple and easy clinical parameter, may be come an useful and complemental method for evaluation of prognosis except ISS and R-ISS.

Leiomyosarcoma: Clinicopathological study and retrospective analysis of prognostic factors in a series of 100 patients

The Authors reported a retrospective study of 100 Leiomyosarcoma (LMS), evaluating factors that may influence Overall Survival (OS), Local Recurrence Free Survival (LRFS), Metastasis Free Survival (MFS). Tumor Size (P = 0,0009), Local Recurrence (P = 0,0487), Distant relapse (P < 0,0001), Type of Presentation (P = 0,0213) were significant risk factors affecting overall survival (OS). Tumor Size (P = 0.024), age at diagnosis (P = 0,0086), type of presentation (P < 0,0001) and Local Recurrence (P = 0.0152) affected metastasis free survival (MFS). Type of presentation (P = 0,001) was an independent prognostic factor of local recurrence-free survival (LRFS).

Retrospective analysis of prognostic factors in patients of papillary thyroid microcarcinoma.

We performed a retrospective chart review of 245 patients with papillary thyroid microcarcinoma (PTMC) to define factors linked to central lymph node metastasis and thus prognosis. Univariate and multivariate analyses showed that being male (p < 0.001), age <45 years at diagnosis (p = 0.045), maximum tumor size > 5 mm (p = 0.030), multifocal tumor (p = 0.040) and tumor envelope invasion (p < 0.001) were all independent risk factors for central compartment lymph node metastasis. Unifocal lesions at the thyroid gland’s upper pole, middle and lower pole, had lymph node metastasis rates of 22.7%, 14.0% and 35.0%, respectively (p = 0.048). The rate of central lymph node metastasis was much higher when there was bilateral thyroid involvement than with multifocal unilateral lesions (58.6% vs 37.5%; p = 0.040). These results suggest that for patients at low risk of central lymph node metastasis, unilateral thyroid lobe and isthmus resection is sufficient. However, for patients at high risk of central lymph node metastasis, central lymph node dissection increases the likelihood of complete tumor excision.

Retrospective analysis of prognostic factors influencing very late onset PTLD.

e19561Background: Post-transplant lymphoproliferative disorder (PTLD), is a very rare complication following transplant (solid organ or allogeneic) due to proliferation of lymphoid cells in immunos...