Significant Difference In Overall Survival Research Articles

TP53 Alterations Are an Independent Adverse Prognostic Indicator in Pseudomyxoma Peritonei of Appendiceal Origin Following Cytoreductive Surgery and Intraperitoneal Chemotherapy.

Histologic grade is a key predictor for pseudomyxoma peritonei (PMP) of appendiceal origin that is used to guide clinical management. However, some tumors demonstrate disease behavior that deviates from their histologic grade. A recent study suggested that TP53, GNAS, and RAS mutation analysis could stratify tumors into distinct molecular groups with different prognosis. We investigated molecular alterations in 114 patients with PMP of appendiceal origin who were uniformly treated with cytoreductive surgery with intraperitoneal chemotherapy (CRS+IPCT). Tumors were separated into 4 groups based on their predominant genomic alteration: RAS-mut, GNAS-mut, TP53-mut, and triple-negative (RAS/GNAS/TP53-wildtype). The results were correlated with World Health Organization (WHO) grade, peritoneal carcinomatosis index (PCI), completeness of cytoreduction (CC) score, and overall survival (OS) from the time of CRS+IPCT using multivariate Cox proportional hazard analysis. Fifty percent of TP53-mut were WHO grade 3 compared with 38% triple-negative, 10% RAS-mut, and 7% GNAS-mut tumors (P<0.001). The TP53-mut group exhibited a significantly reduced OS compared with other groups (P<0.001). No significant OS difference was identified between RAS-mut, GNAS-mut, and triple-negative groups (P>0.05). In grade 3 PMP, TP53-mut was significantly associated with reduced OS (P=0.002). In the multivariate analysis for OS after CRS+IPCT, TP53-mut [hazard ratio (HR) 3.23, P=0.004] and WHO grade (grade 2 HR 2.73, P=0.03 and grade 3 HR 5.67, P<0.001) were the only independent predictors of survival. Our results suggest that, in addition to tumor grade, TP53 status may help to provide a more patient-centered approach in guiding therapy in PMP.

Salvage Autologous Transplant in Relapsed Multiple Myeloma: Long-Term Follow-Up of the Phase 3 GMMG ReLApsE Trial.

The multicenter, phase III GMMG ReLApsE trial (EudraCT-No:2009-013856-61) randomized relapsed and/or refractory multiple myeloma (RRMM) patients equally to lenalidomide/dexamethasone (LEN/DEX, 25mg days 1-21/40mg weekly, 4-week cycles) re-induction, salvage high dose chemotherapy (sHDCT, melphalan 200mg/m2), autologous stem cell transplantation (ASCT) and LEN maintenance (10mg/day; transplant arm, n=139) versus continuous LEN/DEX (control arm, n=138). Ninety-four percent of patients had received frontline HDCT/ASCT. We report an updated analysis of survival endpoints with a median follow-up of 99 months. Median progression-free survival (PFS) was 20.5 and 19.3 months in the transplant and control arm, respectively (HR 0.98; 95% CI 0.76-1.27; p=0.9). Median overall survival (OS) was 67.1 and 62.7 months (HR 0.89; 95% CI 0.66-1.20; p=0.44). Landmark analyses from sHDCT and the contemporaneous LEN/DEX cycle 5 were performed due to dropout of 29% of patients before sHDCT/ASCT in the transplant arm but did not reveal significant differences in PFS (23.0 vs. 20.3 months; HR 0.91; 95% CI 0.68-1.22; p=0.52) or OS (76.3 vs. 66.0 months; HR 0.8; 95% CI 0.56-1.13; p=0.2). Time to progression after frontline HDCT/ASCT (TTP1) was a prognostic factor but did not predict benefit from sHDCT/ASCT. The GMMG ReLApsE trial does not support use of sHDCT/ASCT in RRMM after frontline HDCT/ASCT. EudraCT-No: 2009-013856-61.

Analysis of the effect of inflatable mediastinoscopy esophagectomy and minimally invasive Mckeown esophagectomy combined with thoracoscopy and laparoscopy in the treatment of early esophageal cancer

Objective: To explore the operioperative and long-term outcomes of inflatable mediastinoscopic resection of esophageal carcinoma (IVMTE) and minimally invasive Mckeown resection of esophageal carcinoma (MIME) in early esophageal cancer. Methods: This is a retrospective cohort study. A retrospectively analysis was conducted on 176 patients with cT1N0M0 esophageal cancer who underwent IVMTE or MIME at the Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University from April 2017 to April 2019. There were 128 males and 48 females, aged (66.4±7.7) years (range: 45 to 87 years). General data, perioperative outcomes, pathological data of the tumors, and complications were recorded. Independent sample t-test, χ² test, and Wilcoxon rank-sum test was used to compare the data between the two groups. Propensity score matching was performed with gender, age, tumor location, differentiation degree, pT stage, pN stage, American Society of Anesthesiologists (ASA) classification, smoking history, and alcohol history were considered as covariates. The IVMTE group and MIME group were matched in a 1∶2 ratio using nearest neighbor match method with a caliper value of 0.02. Kaplan-Meier method was used to plot survival curves, with Log-rank test for univariate survival analysis. The Cox proportional hazards model was applied to analyze prognostic factors for overall survival, and subgroup stratification analysis was performed for pT stage. Results: After matching, the MIME group consisted of 54 cases, and the IVMTE group consisted of 27 cases. There were no statistically significant differences between the two groups in terms of gender, age, smoking history, alcohol history, ASA classification, tumor location, and other factors. The IVMTE group had shorter surgery time (M(IQR), 220 (45) minutes vs. 245 (56) minutes, Z=2.950, P=0.003) and less intraoperative blood loss (100 (50) ml vs. 125 (100) ml, Z=2.193, P=0.028) compared to the MIME group. There were no differences between the two groups in the number and quantity of lymph node stations dissected, and the IVMTE group was not at a disadvantage in terms of the number of lymph nodes dissected around the recurrent laryngeal nerve (all P>0.05). The 1-, 3-, and 5-year overall survival (OS) rates and recurrence-free survival (RFS) rates were not significantly different between the two groups (all P>0.05). Subgroup analysis showed no significant difference in OS and RFS rates between the pT1 and pT2 subgroups (all P>0.05). Multivariate Cox regression analysis suggested that ASA classification (HR=2.516, 95%CI: 1.126 to 5.624, P=0.025), pN stage (HR=2.485, 95%CI: 0.984 to 6.274, P=0.046), and whether adjuvant therapy was given postoperatively (HR=2.915, 95%CI: 1.304 to 6.515, P=0.009) were independent risk factors affecting 5-year OS rate. For 5-year RFS, pT stage (HR=0.403, 95%CI: 0.194 to 0.838, P=0.011), pN stage (HR=5.219, 95%CI: 2.401 to 11.346, P<0.01), and whether adjuvant therapy was given postoperatively (HR=5.644, 95%CI: 2.691 to 11.838, P<0.01) were independent risk factors, while the surgical approach was not an independent risk factor affecting patient prognosis. Conclusion: The short-term and long-term effect of IVMTE in the treatment of early esophageal cancer is good, and it can achieve effects comparable to MIME.

Diffuse Large B-Cell Lymphoma/High Grade B-Cell Lymphoma with MYC and BCL6 Rearrangements: a study of 60 Cases.

Classification of cases of diffuse large B-cell lymphoma (DLBCL)/high-grade B-cell lymphoma (HGBL) with MYC and BCL6 rearrangements, also known as BCL6 double hit lymphoma (DHL), is controversial. We assessed 60 cases of BCL6-DHL and compared this cohort to 224 cases of DHL with MYC and BCL2 rearrangements (BCL2-DHL) and 217 cases of DLBCL not otherwise specified. Compared with the DLBCL cohort, BCL6-DHL patients had more aggressive clinical features such as frequent extranodal involvement, high-stage disease, high IPI score and elevated serum lactate dehydrogenase level (p <0.01 for all). Compared with the BCL2-DHL cohort, BCL6-DHL patients had similarly aggressive clinical features but a lower frequency of germinal center B-cell (GCB) immunophenotype and MYC and BCL2 double expression. Patients with BCL6-DHL showed an overall survival (OS) intermediate between patients with DLBCL and BCL2-DHL. Following induction with R-CHOP chemotherapy, BCL6-DHL patients demonstrated a poor OS similar to BCL2-DHL patients and worse than that of DLBCL patients (p = 0.024). However, among patients who received R-EPOCH, there was no significant difference in OS among the three groups (p = 0.146). Gene expression profiling showed that 60% of BCL6-DHL cases had a double hit (DH)-like signature compared with 10% of DLBCL-GCB and 93% of BCL2-DHL. The DH-like signature in BCL6-DHL cases was associated with a GCB immunophenotype. Based on these data, we suggest that BCL6-DHL cases are clinically more aggressive than DLBCL and patients may benefit from a more aggressive therapy than R-CHOP. The data also suggest that BCL6-DHL as currently defined, is heterogeneous and that neoplasms with a GCB immunophenotype are more likely to have DH-like signature and behave more aggressively. Lastly, we suggest that BCL6-DHL cases deserve to be recognized separately in a lymphoma classification to facilitate further understanding of these neoplasms and for optimal patient management.

Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiation Versus Adjuvant Chemotherapy Following Concurrent Chemoradiation for Locally Advanced Cervical Cancer: A Network Meta-Analysis

Background/Objectives: Neoadjuvant chemotherapy followed by concurrent chemoradiation therapy (NACT + CCRT) and adjuvant chemotherapy following CCRT (CCRT + ACT) have inconsistent effects on the survival of women with locally advanced cervical cancer (LACC) compared to CCRT. Moreover, the effects of NACT + CCRT and CCRT + ACT have not been clearly compared. This study compared the effects of NACT + CCRT and CCRT + ACT on survival using a network meta-analysis to select the optimal treatment in women with LACC. Methods: The PubMed, Medline, and Embase databases were searched, and six randomized controlled trials assessing the progression-free survival (PFS) and overall survival (OS) in women with newly diagnosed LACC treated with NACT + CCRT, CCRT + ACT, or CCRT alone (controls) were identified. A network meta-analysis was conducted. Results: Indirect comparisons showed no significant differences in PFS and OS between NACT + CCRT and CCRT + ACT. Direct comparisons also showed similar PFS and OS between NACT + CCRT and CCRT and between CCRT + ACT and CCRT. CCRT + ACT exhibited the highest surface under the cumulative ranking curve (SUCRA) value as a better treatment option for the PFS and OS (CCRT + ACT vs. NACT + CCRT vs. CCRT: 72% vs. 26.8% vs. 51.2% in PFS and 64.3% vs. 45.1% vs. 40.7% in OS). Conclusions: In women with LACC, NACT + CCRT had no different effects on the PFS and OS compared to CCRT + ACT, despite the relatively higher SUCRA value observed for CCRT + ACT. Further studies are warranted to clarify the effects of these strategies.

Safety and efficacy of endoscopic resection for gastric gastrointestinal stromal tumors: a retrospective cohort study

Background The aim of this study was to verify the safety and efficacy of endoscopic resection (ER) for gastric gastrointestinal stromal tumors (GISTs). Methods Among a consecutive series of resections for gastric GISTs performed in a single center, the outcomes of patients who had ER were compared to standard surgical resection (SR). Results In the cohort, 329 consecutive primary localized gastric GISTs patients (n, ER/SR = 251/78) were enrolled. Patients receiving ER were revealed to have preferable post-treatment outcomes, prolonged overall survival (OS) and disease-free survival (DFS). Tumor diameter, the only independent risk factor for a complicated post-operative course, was utilized for propensity score matching (PSM). In the PSM cohort, patients receiving ER and SR with similar tumor size (4.0 [2.7–4.5] cm) shared similar aggressiveness in terms of stomach layers of tumor origination and invasion, and modified National Institutes of Health (mNIH) risk criteria. Shorter operative time, fewer economic costs, and shorter post-operative stay were still observed in the ER group (ER vs. SR: 80 [49–120] vs. 120 [98–160] minutes, p < 0.001; 44 [38–51] vs. 60 [49–84] thousand Renminbi [kRMB], p < 0.001; 7.0 [6.0–8.0] vs. 8.5 [6.0–12] days, p = 0.018, respectively). No significant difference in OS and DFS was demonstrated in the PSM cohort. Conclusions ER is safe and effective, thus a feasible treatment option for indicated gastric GISTs patients with the advantage of faster recovery and lower economic costs.

Overall survival and progression-free survival in pediatric meningiomas: a systematic review and individual patient-level meta-analysis.

Pediatric meningiomas (PMs) are rare central nervous system tumors, accounting for 1-5% of all meningiomas, and differ from adult meningiomas in clinical, histopathological, and molecular features. Current guidelines primarily focus on adults, leaving a gap in evidence-based management for PMs. This study presents the largest meta-analysis of longitudinal individual patient data (IPD) to date, addressing progression-free survival (PFS) and overall survival (OS) in pediatric patients. Data from 20 studies (2011-2023), including 1010 pediatric meningioma cases, were analyzed to assess PFS and OS stratified by WHO grade, NF1/NF2 status, extent of resection (EOR), and adjuvant radiotherapy. Longitudinal survival data were reconstructed from Kaplan-Meier curves using IPD extraction methods. PMs affect males and females nearly equally (52.1% vs. 47.9%). WHO grade 3 tumors had significantly shorter PFS (72.1months) compared to grades 1 (209.8months) and 2 (137.5months) (p < 0.001). No significant OS difference between WHO grades 1 and 2 PMs were observed. NF1- and NF2-associated tumors showed shorter PFS (59.7 and 138.4months) than sporadic cases (180.6months) (p = 0.02). GTR significantly improved PFS (113.8 vs. 40.1months, p < 0.001) and OS (602.9 vs. 173.8months, p < 0.001). Radiotherapy enhanced PFS (72.5 vs. 23.8months, p = 0.009) and OS (140.7 vs. 63.0months, p = 0.002) in grade 3 tumors but not in WHO grade 2 PMs (p = 0.43). This largest meta-analysis highlights the critical roles of GTR and adjuvant radiotherapy in improving outcomes for high-grade PMs and underscores the urgent need for pediatric-specific management guidelines based on robust longitudinal data.

Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia.

Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA. We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival. Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed. Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016). The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.

Clinical treatment strategy for pT3N0 laryngeal squamous cell carcinoma

Objective:To investigate optimal treatment strategy for pT3N0 laryngeal squamous cell carcinoma（SCC）. Methods:A retrospective study of 150 patients with pT3N0 laryngeal SCC treated in the First Affiliated Hospital of Chongqing Medical University was performed. The efficacies of partial laryngectomy and total laryngectomy, as well as surgery alone and postoperative radiotherapy were evaluated. The overall survival（OS）, disease specific survival（DSS） and disease-free survival（DFS） were analyzed with statistical package from SPSS. Results:Among the 108 patients with glottic laryngeal SCC, there were no significant differences in OS, DSS and DFS between the partial laryngectomy group and the total laryngectomy group（Log-rank=0.184, 0.010 and 0.051, P>0.05）. Similarly, there were no significant differences in OS, DSS and DFS between the surgery-alone group and postoperative radiotherapy group（Log-rank=0.214, 0.251 and 0.003, P>0.05）. Among the 38 patients with supraglottic laryngeal SCC, the OS in the total laryngectomy group was significantly higher than that in the partial laryngectomy group（Log-rank=7.338, P=0.007）. The DSS and DFS in the total laryngectomy group were higher than in the partial laryngectomy group, but the differences were not statistically significant（Log-rank=0.895 and 1.792; P>0.05）. The DFS in the postoperative radiotherapy group was significantly higher than in the surgery-alone group（Log-rank=7.172, P=0.007）, but there were no significant differences in OS and DSS between these two groups（Log-rank=0.010 and 0.876, P>0.05）. Conclusion:For pT3N0 glottic laryngeal cancer patients, the efficacy of partial laryngectomy is comparable to total laryngectomy, same as surgery alone and postoperative radiotherapy. For pT3N0 supraglottic laryngeal cancer patients, total laryngectomy could improve the overall survival, and postoperative radiotherapy could reduce the recurrence. Prospectively randomized study with large samples is still needed.

Impact of Obesity on GVHD in Patients Undergoing Allogeneic Hematopoietic Cell Transplant for Hematologic Malignancies.

The relationship between obesity and graft-versus-host disease (GVHD) has been studied in both pre-clinical and clinical studies with varying results. We aimed to investigate the impact of obesity, as measured by body mass index (BMI), on the incidence, severity, and response to therapy of GVHD in a contemporary cohort. We conducted a retrospective study of patients undergoing allogeneic hematopoietic cell transplant (HCT) for acute myelogenous leukemia and myelodysplastic syndrome between January 2010 and December 2021 at the Cleveland Clinic. Incidence, grade, organ involvement, and response to therapy of acute and chronic GVHD were compared between patients with obesity (BMI ≥30) and without obesity. Secondary outcomes included relapse, non-relapse mortality (NRM), and overall survival (OS). 531 patients were identified, with a median follow-up of 19 months (range, 7-49). Mean (SD) BMI at time of HCT was 29.1 (6.3) kg/m2. There was no significant difference in demographic and HCT characteristics between patients with obesity (N=199) and without obesity (N=332). Development of any acute (42% vs. 43%) or chronic (29% vs. 30%) GVHD was similar in patients with and without obesity. Patients with obesity were less likely to have gastrointestinal involvement from chronic GVHD (28% vs. 48%, p=0.01). Skin (64% vs 56%), mouth (45% vs 35%) and eye (35% vs 27%) involvements were higher in patients with obesity, although statistically not significant. There were no significant differences in OS, NRM, or relapse. There were no significant differences in incidence of GVHD among patients with and without obesity. Additional studies are needed to further understand potential differences in organ involvement.

Does Weekend Discharge Affect Readmission and Survival in Liver Transplant Patients? Insights From a Cohort Study.

Weekend hospital discharges are often associated with reduced staffing, potentially impacting the quality of patient care. We studied the effects of weekend discharge after liver transplantation (LT) on early readmission rates, overall survival (OS), and graft survival (GS). We analyzed data from the Ohio State University Wexner Medical Center database (January 2016 to December 2023). The study included initial LT recipients (LTRs) including donation after brain death (DBD) and donation after cardiac death (DCD). Primary outcomes encompassed early readmission rates, and secondary outcomes included OS and GS. The cohort comprised 915 LTRs (645 DBD, 270 DCD), with 156 (17.0%) weekend and 759 (83.0%) weekday discharges. Regarding discharge disposition, 681 (74.4%) patients were discharged home, 210 (22.9%) were discharged to healthcare facilities. No significant differences were identified in the length of hospital stay (8 days vs. 9 days, weekend vs. weekday, respectively, p=0.22) or 30-day readmission (29.5%vs. 32.5%, weekend vs. weekday, respectively, p=0.75). There were no significant differences in OS (90.9%vs. 92.7% at 1-year, 84.4%vs. 88.0% at 3-year, weekend vs. weekday, p=0.27) and GS (90.9%vs. 91.5% at 1-year, 84.0%vs. 86.6% at 3-year, weekend vs. weekday, p=0.50). Multivariate logistic analysis showed no significant impact of weekend discharge (OR: 0.84 [0.57-1.22], p=0.35) or discharge disposition (OR: 1.00 [0.75-1.33], p=1.00) on 30-day readmission. Multivariate Cox regression analysis found no significant impact of weekend discharge or discharge disposition on OS and GS (all p>0.05). Weekend discharge does not impact early readmission, OS, or GS in LTRs. These findings are a testament to our multidisciplinary team efforts and suggest that with appropriate discharge planning and follow-up care, the timing of discharge may be less critical than previously assumed.

Gender Matters. Sex-related Differences in Immunotherapy Outcome in Patients with Non-small Cell Lung Cancer

Emerging evidence identified sex as a variable regulating immune system functions and modulating response to immunotherapy in cancer patients. This retrospective study analysed sex-related differences in immunotherapy outcomes in a real-world population of non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). e retrospectively investigated clinical data of 99 patients with advanced NSCLC and treated with single-agent nivolumab and pembrolizumab at Medical Oncology Unit, Careggi University Hospital, Florence (Italy), between April 2014 to August 2019. Main clinical characteristics and clinical outcomes were analysed. Our study showed that the efficacy of ICI treatment differed according to gender. A trend for better median progression-free survival (mPFS) was reported in males (mPFS 5.0 months, 95% Confidence Interval [CI] 4.0-11.0) than females (mPFS 4.5 months, 95% CI 2.0-9.0) (p=0.133), while no significant difference for overall survival (OS) between the two sex groups was observed (p=0.622). In the nivolumab cohort, we showed a statistically significant difference for a longer PFS in men compared to women (log-rank p=0.054), HR for PFS in females versus males was 1.81 (95% CI 0.97- 3.37, p=0.062). Disease control rate (DCR) was achieved in 55.7% and 45.7% of men and women, respectively, while disease progression was registered in 44.3% of males and 54.3% of females (p=0.386). Gender is a variable that should be taken into account in the choice of immunotherapy. Future prospective randomized trials testing tailored sex-based immunotherapy strategies are required to validate our findings before integrating into clinical practice.

Prognostic significance of immune reconstitution following CD19 CAR T-cell therapy for relapsed/refractory B-cell lymphoma.

Immune deficits after CD19 chimeric antigen receptor (CAR) T-cell therapy can be long-lasting, predisposing patients to infections and non-relapse mortality. In B-cell non-Hodgkin lymphoma (B-NHL), the prognostic impact of immune reconstitution (IR) remains ill-defined, and detailed cross-product comparisons have not been performed to date. In this retrospective observational study, we longitudinally characterized lymphocyte subsets and immunoglobulin levels in 105 B-NHL patients to assess patterns of immune recovery arising after CD19 CAR-T. Three key IR criteria were defined as CD4+ T helper (TH) cells > 200/µL, any detectable B cells, and serum immunoglobulin G (IgG) levels >4 g/L. After a median follow-up of 24.6 months, 38% of patients displayed TH cells, 11% showed any B cells, and 41% had IgG recovery. Notable product-specific differences emerged, including deeper TH cell aplasia with CD28z- versus longer B-cell aplasia with 41BBz-based products. Patients with any IR recovery experienced extended progression-free survival (PFS) (median 20.8 vs. 1.7 months, p < 0.0001) and overall survival (OS) (34.9 vs. 4.0 months, p < 0.0001). While landmark analysis at 90 days confirmed improved PFS in patients with any recovery (34.9 vs. 8.6 months, p = 0.005), no significant OS difference was noted. Notably, 72% of patients with refractory disease never displayed recovery of any IR criteria. Early progressors showed diminished IR at the time of progression/relapse compared to patients with late progression/recurrence (after Day 90). Our results highlight the profound immune deficits observed after CD19 CAR-T and shed light on the intersection of IR and efficacy in B-NHL. Importantly, IR was impaired considerably postprogression, carrying significant implications for subsequent T-cell-engaging therapies and treatment sequencing.

Development of a Prognostic Nomogram Incorporating the Naples Prognostic Score for Postoperative Oral Squamous Cell Carcinoma Patients.

The Naples prognostic score (NPS) and its relation to the prognosis of oral squamous cell carcinoma (OSCC) have been inconclusive. This study aimed to investigate the correlation between NPS and the prognosis of postoperative OSCC patients. Additionally, the study sought to develop a new nomogram for predicting disease-free survival (DFS) and overall survival (OS). The study included 576 OSCC patients who underwent surgical treatment at two hospitals between August 2008 and June 2018. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors. Subsequently, two nomograms were developed to predict DFS and OS based on these factors and underwent rigorous validation. The median DFS and OS were 31.5 months and 36.5 months, respectively. Significant differences in DFS and OS were observed among patients with different NPS scores. Adjuvant radiotherapy, age-adjusted Charlson comorbidity index (ACCI), extranodal extension (ENE), NPS, American Joint Committee on Cancer (AJCC) stage, surgical safety margin, eastern cooperative oncology group performance status (ECOG PS), and systemic inflammation score (SIS) were identified as independent predictors of DFS and OS. In the training cohort, the nomogram's concordance index (C-index) for predicting DFS and OS was 0.701 and 0.693, respectively. In the validation group, the corresponding values were 0.642 and 0.635, respectively. Calibration plots confirmed a high level of agreement between the model's predictions and actual outcomes. Decision curve analysis (DCA) demonstrated the nomogram's good clinical utility. Additionally, patients in the low-risk group did not benefit from adjuvant radiotherapy, while those in the medium-risk and high-risk group could benefit from adjuvant radiotherapy. NPS significantly influences the prognosis of OSCC patients following surgery. The nomogram developed in this study holds significant clinical application potential. The low-risk subgroup of patients was not required to undergo postoperative radiotherapy.

Chemoradiation for human papillomavirus positive oropharyngeal cancer in smokers: A single-institutional experience.

To determine how smoking intensity impacts the prognosis of patients with human papillomavirus (HPV)-positive oropharyngeal cancer treated by chemoradiation. The medical records of 32 patients with histologically proven squamous cell carcinoma of the oropharynx and a prior smoking history were retrospectively reviewed. All patients were treated with intensity-modulated radiotherapy to a median dose of 70Gy (range 63 to 72Gy) with concurrent cisplatin. Seventeen patients (53%) had stage II disease; and 15 patients (47%) had stage III disease. Distribution of T-classification was: T1 8 (25%); T2 4 (13%); T3 10 (31%); and T4 10 (31%). Smoking history was categorized as follows: ≤10 pack-years (10 patients); 10-20 pack-years (6 patients); 20-30 pack-years (7 patients); >30 pack-years (9 patients). With a median follow-up of 40months (range, 6 to 121months), the 3-year overall survival for the entire population was 79%. Significant differences in 3-year overall survival (83% vs 54%, p=0.01), local-regional control (86% vs 62%, p<0.001), and progression-free survival (75% vs 52%, p=0.02) were observed when comparing patients with ≤30 pack-year versus those with >30 pack-year smoking histories. The deleterious effect of smoking seemed to be most impactful in those with heavy consumption (i.e., >30 pack-year history).

Impact of Routine Follow-Ups After Curative Gastrectomy in Elderly Patients with Early Gastric Cancer.

Elderly patients with early gastric cancer exhibit a relatively shorter life expectancy and lower recurrence risk, prompting consideration of whether the regular follow-up strategy should apply to this demographic. This study was designed to determine the effect of routine postoperative follow-up on the elderly patients, specifically those pathologically diagnosed with stage I gastric cancer. This retrospective analysis was conducted at a single tertiary center and enrolled patients aged ≥ 75 years who underwent curative gastrectomy for stage I gastric cancer between January of 2007 and December of 2016. The patients were divided into routine and nonroutine follow-up groups, depending on whether the recommended follow-up examinations (endoscopy, CT, and blood tests) were complete. Propensity score matching was performed to compare the overall survival (OS) and disease-specific survival (DSS) between the two study groups. Among 385 patients enrolled, 301 (78.2%) were routine and 84 (21.8%) were nonroutine follow-up patients. After propensity score matching, each study group consisted of 83 patients. There was no significant difference in OS (85.5% vs. 83.1%, p = 0.47) and DSS (98.6% vs. 98.3%, p = 0.57) between the two study groups. There were six (1.5%) recurrences in the entire cohort: four in the routine and two in the nonroutine follow-up group. Regular follow-up of elderly patients with stage I gastric cancer did not significantly impact the OS and DSS rates.

Clinicopathological significance of androgen receptor expression and tumor infiltrating lymphocytes in triple-negative breast cancer: a retrospective cohort study.

Triple-negative breast cancer (TNBC) is a serious disease with limited treatment options. We explored the significance of androgen receptor (AR) expression and tumor-infiltrating lymphocytes (TILs) in predicting neoadjuvant chemotherapy (NAC) resistance in TNBC, hypothesizing that AR/TIL classification using pretreatment biopsies can identify NAC-resistant subgroups and improve the understanding of apocrine differentiation. This retrospective study included 156 consecutive patients with TNBC treated with NAC. AR immunostaining was defined positive if ≥ 1% of the tumor cell nuclei were stained. Stromal TIL levels were assessed, with high levels defined as ≥ 50%. Apocrine differentiation was detected using an anti-15-PGDH antibody. The pathological response to NAC was evaluated. Overall, 36% (n = 56) of the patients achieved a pathological complete response (pCR). AR+/TILlow tumors had a high non-pCR rate (76%, 42/55) and were resistant to NAC. Kaplan-Meier plots showed significant differences in overall survival (OS) and distant metastasis-free survival (DMFS) among the four AR/TIL subgroups (OS: p = 0.013; DMFS: p = 0.0016). All 11 cases with some degree of apocrine differentiation were AR+/TILlow, 15-PGDH-positive, and NAC-resistant. AR+/TILlow status was significantly associated with a high likelihood of non-pCR (OR = 0.26, p = 0.009). Multivariate analysis confirmed pCR as an independent predictor of better prognosis (OS, HR = 0.13, p = 0.006; DMFS, HR = 0.15, p = 0.002), whereas AR+/TILlow status was not significantly associated with OS or DMFS. AR/TIL classification using pretreatment biopsies identified TNBC subgroups with distinct NAC responses and prognoses. AR+/TILlow TNBC, including apocrine differentiation cases, were NAC-resistant, highlighting the need for alternative therapies.

Rapid and Deep Prostate-Specific Antigen Decline is a Prognostic Marker in Metastatic Hormone-Sensitive Prostate Cancer: A Real-World Multi-Intuitional Analysis.

Prostate-specific antigen (PSA) kinetics has been investigated as a prognostic marker in post hoc analyses of clinical trials. This study validated the prognostic value of rapid and deep PSA decline in metastatic hormone-sensitive prostate cancer (mHSPC) using real-world data. In total, 1296 patients with mHSPC were retrospectively reviewed. We assessed the prognostic value of a PSA decline to ≤ 0.2 ng/mL after 12 weeks of treatment and investigated several potential risk factors for a poor PSA response. Of 1296 patients, 714 (cohort 1: 55.1%) were treated with conventional hormonal therapy, while 582 (cohort 2: 44.9%) received androgen signaling inhibitors. There were significant differences in progression-free survival and overall survival between patients with PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment and others (p < 0.001 for each). In addition, patients with an initial PSA ≥ 200 ng/mL, Clinical T4 and Grade Group 5 were less likely to achieve PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment, with odds ratios of 0.31 (p < 0.001), 0.67 (p = 0.039) and 0.70 (p = 0.043), respectively. Our findings suggested that PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment may be a useful prognostic biomarker for mHSPC in the real-world setting. The prognostic value of this should be further investigated in a prospective cohort, and identification of an optimal cutoff value is necessary for its application in clinical trial design or clinical practice.

GLUT1 expression in patients with non-small cell lung cancer and its impact on survival

GLUT1 is an essential glucose transporter, the expression of which increases in tumor cells, especially under conditions of hypoxia, and correlates with their active proliferation. This study aimed to investigate the relationship between GLUT1 expression and biological parameters and to evaluate the potential impact on survival in patients with radically treated non-small cell lung cancer (NSCLC). Forty-two patients who received radical treatment for NSCLC were involved in the study. Gender, age, smoking history, disease stage, and tumor histological type were considered when analyzing the data. GLUT1 antibodies were used to assess the degree of hypoxia. A semi-quantitative immunohistochemical score ranging from 0 to 12 was used for calculation. The chi2 and Student's t-test were used to compare categorical and parametric variables. The Cox proportional hazards model, the Kaplan-Meier method, and the Log-rank test were used to evaluate the effect of GLUT1 expression on survival. The results were considered statistically significant at p&lt;0.05. A moderate correlation was found between GLUT1 expression and histological type of NSCLC (r=0.432, p&lt;0.0001), sex (r=0.336, p&lt;0.0009), and smoking (r=0.325, p&lt;0.0009). GLUT1 overexpression was observed more in squamous cell carcinomas than in adenocarcinomas (p=0.0001). In patients with adenocarcinomas, the level of GLUT1 expression depended on age and T category. In patients with squamous cell carcinomas, GLUT1 expression was not associated with the studied clinicopathological characteristics. Patients with T1b-2a categories, without regional lymph node metastases, younger than 60, and non-smokers have better survival. Kaplan-Meier curves demonstrated no statistically significant differences in recurrence-free survival and overall survival between the patients with high and low GLUT1 (Log-rank p=0.3284 and Log-rank p=0.7161, respectively). In conclusion, GLUT1 overexpression is associated with squamous cell lung carcinomas. GLUT1 expression has no prognostic value and does not correlate with recurrence-free and overall survival in radically treated patients with NSCLC.

Clinical characteristics and survival outcomes in patients with pulmonary sarcomatoid carcinoma: a multicenter retrospective study

Abstract Purpose The clinicopathologic features, mutational status, immunohistochemical markers, and prognosis of Pulmonary sarcomatoid carcinoma (PSC) remain uncertain. Methods This study included 81 PSC and 337 lung adenocarcinomas (LUAD). Progression-free survival (PFS), overall survival (OS), and other clinical data were examined. Results 46% PSC patients harbored KRAS mutation and 23% harbored EGFR mutation. Univariable analysis identified type and cTNM stage as significant predictor of PFS (type: HR 0.216; 95% CI 0.133–0.349; P &lt; 0.001, cTNM stage: HR 0.483; 95% CI 0.269–0.846; P = 0.014) and OS (type: HR 0.269; 95% CI 0.156–0.465; P &lt; 0.001, cTNM stage: HR 0.435; 95% CI 0.219–0.865; P = 0.018). Multivariable analysis confirmed sex, type and cTNM stage as independent predictors of PFS (sex: HR 2.026; 95%CI 1.027–3.996; P = 0.042; type: HR0.140; 95% CI 0.083–0.238; P &lt; 0.001, cTNM stage: HR0.305; 95% CI 0.165–0.564; P &lt; 0.001) and OS (type: HR0.231; 95% CI 0.132–0.404; P &lt; 0.001, cTNM stage: HR 0.394; 95% CI 0.194–0.797; P = 0.010). Significant differences in PFS (P &lt; 0.0001) and OS (P = 0.022) were observed between PSC and LUAD, and for PC compared with SCC (PFS: P = 0.00036, OS: P = 0.0053). Additionally, PSC patients treated with immunotherapy showed significantly better OS (P = 0.0019) compared with those treated without immunotherapy. Conclusions PSC exhibits high KRAS and EGFR mutation rates, and spindle cell carcinoma has a worse prognosis. Immunotherapy shows potential as a treatment for advanced PSC.