Worse 5-year Overall Survival Rate Research Articles

Survival Outcomes of Patients With Stage IB3 Cervical Cancer Who Undergo Abdominal Radical Hysterectomy Versus Radiochemotherapy.

ObjectiveThis study aimed to compare the survival outcomes among stage IB3 cervical cancer patients who undergo abdominal radical hysterectomy (ARH)+pelvic lymphadenectomy ± para-aortic lymph node dissection versus radiochemotherapy (R-CT).MethodsBased on the large number of diagnoses and treatments for cervical cancer in the Chinese database, propensity score matching (PSM) was used to compare the 5-year overall survival (OS) and disease-free survival (DFS) rates of the ARH group and R-CT group.ResultsThere were 590 patients with stage IB3 cervical cancer according to the FIGO 2018 staging system, with 470 patients in the ARH group and 120 patients in the R-CT group. The ARH and R-CT groups showed different 5-year OS and DFS rates in the total study population, and the 5-year OS and DFS rates in the R-CT group (n = 120) were lower than those in the ARH group (n = 470) (OS: 78.1% vs. 92.1%, p < 0.001; DFS: 71.6% vs. 90.3%, p < 0.001). R-CT was associated with a worse 5-year OS rate (hazard ratio [HR] = 3.401; 95% confidence interval [CI] = 1.875–6.167; p < 0.001) and DFS rate (HR = 3.440; 95% CI = 2.075–5.703; p < 0.001) by Cox multivariate analysis. After 1:3 PSM, the 5-year OS and DFS rates in the R-CT group (n = 108) were lower than those in the RH group (n = 280) (OS: 76.4% vs. 94.0%, p < 0.001; DFS: 69.3% vs. 92.6%, p < 0.001, respectively). R-CT was associated with a worse 5-year OS rate (HR = 4.071; 95% CI = 2.042–8.117; p < 0.001) and DFS rate (HR = 4.450; 95% CI = 2.441–8.113; p < 0.001) by Cox multivariate analysis.ConclusionOur study found that for FIGO 2018 stage IB3 cervical cancer patients, ARH resulted in better OS and DFS than R-CT.

Impact of the Platelet-to-Lymphocyte Ratio as a Biomarker for Esophageal Squamous Cell Carcinoma.

Esophageal squamous cell carcinoma (ESCC) is a deadly malignant disease. This study examined whether the platelet-to-lymphocyte ratio (PLR) can be used as a biomarker to evaluate prognosis in patients with advanced ESCC following neoadjuvant chemotherapy (NAC) and undergoing minimally invasive esophagectomy (MIE). We examined 174 patients between January 2010 and December 2015 at the Kobe University. Of these, 121 were treated with NAC. The PLR cutoff was determined through receiver-operating characteristic curve analysis. Univariate and multivariate analyses were conducted to identify prognostic factors for overall survival (OS). The PLR cutoff for OS in 121 patients was 169.6. Patients with PLR ≥169.6 had worse 5-year OS rates (31.1%) than those with a PLR <169.6 (61.1%, p=0.001). Multivariate analysis revealed that a PLR of ≥169.6 was an independent factor for poor prognosis. PLR is an independent prognostic factor for patients with ESCC after NAC and MIE.

The prognostic significance of combined geriatric nutritional risk index and psoas muscle volume in older patients with pancreatic cancer

BackgroundThe geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. Body composition is also an important consideration when predicting the prognosis of patients with cancer. This study aimed to investigate the relationship between the GNRI and psoas muscle volume (PMV) for survival outcomes in patients with pancreatic cancer.MethodsThis retrospective study evaluated the prognostic significance of the GNRI and PMV in 105 consecutive patients aged ≥65 years who underwent pancreatectomy for histologically confirmed pancreatic cancer. The patients were divided into high (GNRI > 98) and low GNRI groups (GNRI ≤98), and into high (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) and low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) groups.ResultsBoth the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly greater among patients in the high GNRI group than among patients in the low GNRI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high PMV group than among patients in the low PMV group. Patients were stratified into three groups: those with both high GNRI and high PMV; those with either high GNRI or high PMV (but not both); and those with both low GNRI and low PMV. Patients with both low GNRI and low PMV had a worse 5-year OS rate, compared with patients in other groups (P < 0.001). The C-index of the combination of the GNRI and PMV for predicting 5-year OS was greater than the C-indices of either the GNRI or PMV alone. Multivariate analysis revealed that the combination of the GNRI and PMV was an independent prognostic factor in patients aged ≥65 years with pancreatic cancer (P = 0.003).ConclusionsThe combination of the GNRI and PMV might be useful to predict prognosis in patients aged ≥65 years with pancreatic cancer.

Clinicopathological and Molecular Features of Colorectal Cancer Patients With Mucinous and Non-Mucinous Adenocarcinoma.

BackgroundThe prognosis of mucinous adenocarcinoma (MAC) and non-mucinous adenocarcinoma (NMAC) in colorectal cancer (CRC) is controversial, and the molecular differences between them are unclear.MethodsBetween 2000 and 2010, a total of 1,483 CRC patients were included. Among them, 73 patients (4.9%) were diagnosed with MAC. The clinicopathological features and genetic alterations were compared between MAC and NMAC.ResultsAfter propensity score matching to balance age and sex between MAC and NMAC patients, 292 CRC patients (73 MAC and 219 NMAC) were enrolled in the analysis at a 1:3 ratio. In right-sided colon cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, and advanced T category and tumor, node, metastasis (TNM) stage, chemotherapy, and a similar 5-year overall survival (OS) rate compared with patients with NMAC. In left-sided colon cancer and rectal cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, lymphovascular invasion, advanced T and N categories and TNM stages, chemotherapy, and a worse 5-year OS rate than patients with NMAC. Regarding genetic alterations, for NMAC, right-sided colon cancer had more BRAF mutations than left-sided colon cancer and rectal cancer. For MAC, right-sided colon cancer was associated with more microsatellite instability-high tumors and more AKT1 mutations than left-sided colon cancer and rectal cancer.ConclusionThe genetic alterations are distinct between MAC and NMAC in CRC. Tumor location may have an impact on genetic alterations and patient prognosis in MAC and NMAC.

The Clinicopathological Characteristics And Genetic Alterations of Signet-ring Cell Carcinoma in Gastric Cancer.

Signet-ring cell carcinoma (SRC) in advanced gastric cancer (GC) is often associated with more invasiveness and a worse prognosis than other cell types. The genetic alterations associated with gastric carcinogenesis in SRC are still unclear. In this study, 441 GC patients receiving curative surgery for GC between 2005 and 2013 were enrolled. The clinicopathological characteristics and genetic alterations of GC patients with and without SRC were compared. Among the 441 GC patients, 181 had SRC. For early GC, patients with SRC had more tumors located in the middle and lower stomach, more infiltrating tumors and better overall survival (OS) rates than those without SRC. For advanced GC, patients with SRC had more scirrhous type tumors, more PIK3CA amplifications, fewer microsatellite instability-high (MSI-H) tumors, more peritoneal recurrences and worse 5-year OS rates than those without SRC. For advanced GC with SRC, patients with peritoneal recurrence tended to have PD-L1 expression. For advanced GC without SRC, patients with liver metastasis tended to have PD-L1 expression, PI3K/AKT pathway mutations, TP53 mutations and MSI-H tumors. For advanced GC, PD-L1 expression was associated with peritoneal recurrence in SRC tumors, while non-SRC tumors with liver metastasis were likely to have PI3K/AKT pathway mutations, TP53 mutations and PD-L1 expression; immunotherapy and targeted therapy may be beneficial for these patients.

Expression and clinical significance of GINS complex in colorectal cancer

To investigate the expression and clinical significance of GINS complex in colorectal cancer (CRC). The expression level of GINS complex including PSF1, PSF2, PSF3 and SLD5 in CRC specimens (n=76) were detected by real-time fluorescent quantitative polymerase chain reaction. The association of GINS complex with clinicopathological parameters and prognosis of CRC patients were analyzed. The relative expression level of PSF1, PSF2, PSF3, and SLD5 mRNA in CRC tissues was 0.001 853±0.000 651, 0.007 757±0.004 260, 0.000 967±0.000 481 and 0.003 248±0.001 721, which was significantly higher than that in normal colorectal mucosa tissues (0.000 352±0.000 169, 0.002 951±0.001 216, 0.000 472±0.000 271, and 0.001 675±0.001 156) (all P<0.01). PSF1 mRNA expression was associated with tumor size (P<0.01), and PSF2 mRNA expression with age (P<0.05) and lymph node metastasis (P<0.05). No correlations between PSF3 mRNA expression and clinicopathological parameters were observed. SLD5 mRNA expression was associated with lymph node metastasis (P<0.01). Patients with high expression of PSF1, PSF2 and SLD5 had worse 5-year overall survival rate (57.1%, 54.3%, and 54.3%) than those with low expression (77.1%, 80.0%, and 80.0%) (all P<0.05). Multivariable Cox regression analysis indicated that PSF1 mRNA expression (P<0.05) was an independent factor associated with prognosis of colorectal cancer. Overexpression of GINS complex in CRC is associated with clinicopathological characteristics and prognosis of colorectal cancer. PSF1 expression is prognostic for CRC patients.