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Zami Z, Pachuau L, Bawihtlung Z, Khenglawt L, Hlupuii L, Lalthanpuii C, Hruaii V, Lalhruaitluanga H, Kumar NS. Treatment regimens and survival among patients with head and neck squamous cell carcinoma from Mizo tribal population in northeast India - a single centre, retrospective cohort study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 24:100377. [PMID: 38444884 PMCID: PMC10914477 DOI: 10.1016/j.lansea.2024.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024]
Abstract
Background Patients with early-stage head and neck squamous cell carcinoma (HNSCC) are treated using a single-modality approach that involves either surgery (S) or radiotherapy (RT). Conversely, those with advanced-stage disease are treated using a multi-modality approach incorporating a combination of chemotherapy (CT), RT and S. In addition to behavioural factors, such as alcohol and tobacco use, clinical parameters, such as leukocyte and neutrophil counts and T and N classification, have been linked to the survival of patients with head and neck cancer. This retrospective study was designed to provide insights into the types of treatment (induction chemotherapy [IC], concurrent chemoradiotherapy [CCRT], S and RT) administered to patients with HNSCC in Mizoram, analyse their 2-year outcome, and identify potential factors that may affect the response to treatment. Methods A retrospective cohort study was conducted using patients diagnosed with HNSCC between 2017 and 2020 in Mizoram, northeast India. Data on clinical and demographic factors and treatments provided were collected from medical records from the Mizoram State Cancer Institute, Mizoram. Overall survival (OS) and progression free survival (PFS) were determined for each factor using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was used to identify the factors that affected OS and PFS. Multicollinearity test was performed between the predictors using a variance inflation factor cut-off point of 2. Findings A retrospective study was performed on 210 patients with HNSCC who were followed up for a period of 2 years. The findings revealed that hypopharynx was the most affected site, followed by the nasopharynx, oral cavity, oropharynx, and larynx. Regarding treatment regimens, 85/210 (40.5%) of the patients received IC along with CCRT or RT in a sequential manner. Moreover, 86/210 (41.0%) underwent CCRT alone, 22/210 (10.5%) received RT alone and 17/210 (8.1%) underwent surgery followed by adjuvant CCRT or RT. Two-year OS and PFS estimated using the Kaplan-Meier analysis were 78.1% (95% CI = 72.4%-84.2%) and 57.4% (95% CI = 50.8%-64.8%), respectively. Log-rank test showed that leucocytosis (p = 0.015) and neutrophilia (p = 0.014) exerted effects on OS, whereas nodal involvement (p = 0.005), neutrophilia (p = 0.043) and IC (p = 0.010) exerted effects on PFS. Multivariate analysis indicated that leucocytosis (p = 0.010 [OS], 0.025 [PFS]), neutrophilia (p = 0.029, 0.033), cancer site (laryngeal) (p = 0.009, 0.028) and nodal involvement (N2) (p = 0.020, 0.001) were predictors of poor OS and PFS. Interpretation OS was better than PFS in HNSCC patients from Mizo population. Multi-modality approach offered survival advantages over single-modality approach. Leucocytosis, neutrophilia, nodal involvement, and cancer sites were associated with poor OS and PFS. More comprehensive research with a larger sample size is needed to confirm the findings from this study. Funding There is no funding for this study.
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Affiliation(s)
- Zothan Zami
- Department of Biotechnology, Mizoram University, Tanhril, 796004, Aizawl, Mizoram, India
| | - Lallianmawii Pachuau
- Department of Biotechnology, Mizoram University, Tanhril, 796004, Aizawl, Mizoram, India
| | | | | | - Lal Hlupuii
- Mizoram State Cancer Institute, Zemabawk, 796017, Aizawl, Mizoram, India
| | - Cindy Lalthanpuii
- Mizoram State Cancer Institute, Zemabawk, 796017, Aizawl, Mizoram, India
| | - Vanlal Hruaii
- Mizoram State Cancer Institute, Zemabawk, 796017, Aizawl, Mizoram, India
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Das S, Shaikh OH, Prakash S, Gopal B. Paraneoplastic leukemoid syndrome in squamous cell carcinoma of the forearm. BMJ Case Rep 2023; 16:e249970. [PMID: 36634990 PMCID: PMC9843158 DOI: 10.1136/bcr-2022-249970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The paraneoplastic leukemoid reaction is a rare haematological paraneoplastic syndrome, which is typically seen with solid tumours and squamous cell carcinomas. As an indication of bone marrow infiltration and malignancy involvement, it indicates a poor outcome and a grave prognosis. We report a woman in her 50s, who presented with an ulcer over the right forearm. Biopsy revealed squamous cell carcinoma. The patient underwent radiological investigations, which showed the presence of metastatic squamous cell carcinoma. Incidentally, the patient was found to have leucocytosis, which was attributed to a paraneoplastic leukemoid reaction, after ruling out all other causes of leukemoid reaction. Due to metastatic disease, the patient was planned for palliative radiotherapy and the best supportive care.
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Affiliation(s)
- Snehasis Das
- Surgery, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Oseen Hajilal Shaikh
- Surgery, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Sagar Prakash
- Surgery, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
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O’Callaghan S, Yau H. Treatment of malignancy-associated hypercalcemia with cinacalcet: a paradigm shift. Endocr Connect 2021; 10:R13-R24. [PMID: 33289687 PMCID: PMC7923058 DOI: 10.1530/ec-20-0487] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/03/2020] [Indexed: 01/04/2023]
Abstract
Palliation of symptoms related to malignancy-associated hypercalcemia (MAH) is essential and clinically meaningful for patients, given the continued poor prognosis, with high morbidity and mortality associated with this disease process. Historically, agents have been temporizing, having no impact on patient morbidity nor survival. We suggest that cinacalcet can be an efficacious agent to be taken orally, reducing patients' time in the hospital/clinic settings. It is well-tolerated and maintains serum calcium levels in the normal range, while targeted cancer treatments can be employed. This has a direct, major impact on morbidity. Maintaining eucalcemia can increase quality of life, while allowing targeted therapies time to improve survival. Given that our case (and others) showed calcium reduction in MAH, there is promising evidence that cinacalcet can be more widely employed in this setting. Future consideration should be given to studies addressing the efficacy of cinacalcet in calcium normalization, improvement of quality of life, and impact on survival in patients with MAH. Though the exact mechanism of action for cinacalcet's reduction in calcium in this setting is not currently known, we can still afford patients the possible benefit from it.
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Affiliation(s)
- Sondra O’Callaghan
- Endocrinology, Diabetes & Metabolism, Orlando VA Healthcare System, Orlando, Florida, USA
| | - Hanford Yau
- Endocrinology, Diabetes & Metabolism, Orlando VA Healthcare System, Orlando, Florida, USA
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Impact of lymphovascular invasion in oral squamous cell carcinoma: A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:319-328.e1. [PMID: 33309267 DOI: 10.1016/j.oooo.2020.10.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 10/21/2020] [Accepted: 10/26/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Lymphovascular invasion (LVI) has been reported as a predictor of prognosis in multiple cancers. The aim of this meta-analysis was to investigate the potential value of LVI as a prognostic predictor of oral squamous cell carcinoma (OSCC). STUDY DESIGN To identify relevant studies, PubMed, Embase, Web of Science, and Cochrane Library database were searched from inception to October 2020. All studies exploring the association of LVI with overall survival (OS), disease-specific survival (DSS), or disease-free survival (DFS) and lymph node metastasis (LNM) were identified. RESULT Pooled odds ratios for LNM and hazard ratios for survival were calculated using fixed effects or random effects models. Thirty-six studies involving 17,109 patients with OSCC were included and further analyzed. The results showed that positive LVI was significantly associated with LNM and worse survival in patients with OSCC. Moreover, positive LVI was correlated with LNM in patients with early stage OSCC. CONCLUSIONS These findings indicate that LVI may serve as a prognostic predictor for the metastasis and prognosis of OSCC and could be considered a routine pathologic examination in clinical work.
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Roh JL, Lee H, Choi SH, Nam SY, Kim SY. Tumor-related leukocytosis predictive of recurrence and survival in patients with oral cavity squamous cell carcinoma. Oral Dis 2019; 25:1511-1518. [PMID: 31165559 DOI: 10.1111/odi.13138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/23/2019] [Accepted: 05/31/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the prognostic values of tumor-related leukocytosis (TRL) as a reliable biomarker predictive of recurrence and survival after definitive surgery for oral cavity squamous cell carcinoma (OSCC). MATERIALS AND METHODS This retrospective study involved 322 patients who underwent tumor extirpation combined with neck dissection for treatment-naïve OSCC between 2006 and 2014. Multivariate binary logistic regression analyses were used to analyze the relationship between TRL and pathological variables. Cox proportional hazard regression analyses were used to find associations between factors and disease-free survival (DFS) or overall survival (OS). RESULTS TRL was significantly related to advanced disease status, tumor size, invasion depth, poor differentiation, and T and N classifications, resulting in increased post-treatment recurrence rate, particularly in the distant site. Multivariate logistic regression analyses showed that only the T classification was significantly associated with baseline TRL (p = 0.018). Multivariate analyses also showed that the tumor depth of invasion, pathological N classification, extranodal extension, and TRL remained the independent variables predictive of DFS and OS (all p < 0.05). TRL was related to a more than twofold increased risk of post-treatment recurrence and mortality. CONCLUSIONS TRL is associated with advanced tumor disease and increased recurrence and mortality in OSCC patients.
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Affiliation(s)
- Jong-Lyel Roh
- Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hojun Lee
- Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Ho Choi
- Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Yuhl Nam
- Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Yoon Kim
- Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Muhaxheri G, Vucicevic Boras V, Fucic A, Plavec D, Sekerija M, Filipovic M, Grsic K, Stubljar B, Krnic T, Vrdoljak B. Multivariate analysis of preoperative and postoperative neutrophil-to-lymphocyte ratio as an indicator of head and neck squamous cell carcinoma outcome. Int J Oral Maxillofac Surg 2018; 47:965-970. [DOI: 10.1016/j.ijom.2018.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 12/26/2017] [Accepted: 02/26/2018] [Indexed: 02/07/2023]
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Schernberg A, Blanchard P, Chargari C, Ou D, Levy A, Gorphe P, Breuskin I, Atallah S, Caula A, Escande A, Janot F, Nguyen F, Temam S, Deutsch E, Tao Y. Leukocytosis, prognosis biomarker in locally advanced head and neck cancer patients after chemoradiotherapy. Clin Transl Radiat Oncol 2018; 12:8-15. [PMID: 30073209 PMCID: PMC6068078 DOI: 10.1016/j.ctro.2018.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/14/2018] [Accepted: 07/04/2018] [Indexed: 12/30/2022] Open
Abstract
Objective To study the prognostic value of leukocyte increase in a retrospective cohort of locally advanced head and neck squamous cell carcinoma (HNSCC) patients receiving definitive concurrent cisplatin and radiation. Materials and methods Clinical records of consecutive previously untreated locally advanced HNSCC patients treated in our Institution between March 2006 and October 2012 by concurrent cisplatin (100 mg/m2, every 3 weeks) and radiation (70 Gy in 7 weeks) were collected. The prognostic value of pretreatment leukocyte increase was examined, with focus on patterns of relapse and survival. Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophils count exceeding 10 and 7.5 G/L, respectively. Results We identified 193 patients, all treated with concurrent cisplatin-based chemoradiotherapy. Respectively 24% and 20% patients displayed baseline leukocytosis or neutrophilia. Mean leukocyte count were significantly more elevated in current smokers, patients with performance status (PS) >0, T4 and less in HPV + tumor. The 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 56% and 51% respectively. In univariate analysis, both leukocytosis and neutrophilia were strongly associated with worse OS and PFS (p < 0.001). In multivariate analysis, N classification, HPV/p16, smoking status and leukocytosis were associated with worse OS and PFS. Patients with <3 cycles of cisplatin had worse survival. Conclusion In locally advanced HNSCC treated with concurrent cisplatin and radiation, baseline leukocytosis predicts OS and PFS. In addition with HPV status, this independent biomarker could help identifying patients with high risk of tumor relapse.
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Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.,French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France.,Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France
| | - Dan Ou
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Antonin Levy
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France
| | - Philippe Gorphe
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Ingrid Breuskin
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sarah Atallah
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alexandre Caula
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alexandre Escande
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - France Nguyen
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.,Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France
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Park MJ, Roh JL, Kim SB, Choi SH, Nam SY, Kim SY. Prognostic value of circulating biomarker score in advanced-stage head and neck squamous cell carcinoma. Eur J Cancer 2018; 92:69-76. [PMID: 29428866 DOI: 10.1016/j.ejca.2018.01.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/15/2017] [Accepted: 01/07/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Circulating biomarker (CB) is a convenient, emerging predictive tool for treatment response and outcomes in human cancers. Therefore, we examined the prognostic value of pre-treatment and early post-treatment CBs and their summated scores in patients with head and neck squamous cell carcinoma (HNSCC). METHODS This study prospectively included 310 consecutive patients who underwent definitive treatment for previously untreated advanced-stage HNSCC between 2010 and 2015. The CB score was determined by complete blood counts (CBCs) and blood chemistry before and 2 months after the treatment, and the number of abnormal CB was counted from 0 to 10. Univariate and multivariate analyses with Cox proportional hazards models were used to find factors associated with disease-free survival (DFS) and overall survival (OS). RESULTS Most CBC profiles were significantly changed at 2-months post-treatment compared with those at pre-treatment. Univariate analyses showed that hypoalbuminemia, leucocytosis, C-reactive protein, high CB scores (≥6), age, performance status and comorbidity and tumour site were significantly associated with DFS and OS (all P < 0.05). Both pre- and post-treatment CB scores were independent factors predictive of DFS and OS outcomes in the multivariate analyses (P < 0.05). High CB scores at pre-treatment were associated with 7-10-fold increased risk of unfavourable DFS and OS outcomes, and those at 2-months post-treatment were associated with 2 to 4-fold increased risk of poor survival outcomes (all P < 0.05). CONCLUSIONS CB scores at pre-treatment and early post-treatment are useful for predicting survival outcomes in patients with advanced-stage HNSCC.
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Affiliation(s)
- Marn Joon Park
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Sung-Bae Kim
- Department of Internal Medicine (Oncology), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lin TC, Liang KL, Lee LC, Hsu CY, Yen TT. Cancer-related hypercalcemia in oral cancer. Int J Oral Maxillofac Surg 2017; 47:685-691. [PMID: 29153824 DOI: 10.1016/j.ijom.2017.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/03/2017] [Accepted: 10/26/2017] [Indexed: 12/09/2022]
Abstract
Cancer-related hypercalcemia (CRH) is a critical paraneoplastic disorder in advanced cancer patients. In clinical practice, patients with CRH have a poor prognosis. The medical records of 3198 oral cancer patients with CRH diagnosed at Taichung Veterans General Hospital from 1 January 2003 to 31 December 2015 were reviewed. The criteria for patient enrolment were a diagnosis of hypercalcemia or the use of antihypercalcemia medication. Patients who met any of the following criteria were excluded: use of total parenteral nutrition, incomplete serum calcium data, and unknown date of death. The total incidence of CRH was 6.95‰ per year. A total of 91 patients were enrolled; their median survival time was 28 days. The patients were divided into two groups by survival time, with a cut-off point of 30 days. Reduced serum albumin, leucocytosis, and clodronate use had a statistically significant effect on survival in the univariate analysis (all P<0.05). Forty-five patients (49.5%) had recurrence of CRH, of whom nine died within 30days. These nine patients had a shorter interval to the first episode of CRH recurrence (median 13 days) than those who survived ≥30days (median 28 days) (P<0.001). It was observed that a short interval to the first episode of CRH recurrence is a poor prognostic factor.
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Affiliation(s)
- T-C Lin
- Division of Family Medicine, Dachien General Hospital, Miaoli, Taiwan
| | - K-L Liang
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - L-C Lee
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - C-Y Hsu
- Taiwan Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - T-T Yen
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Grellety T, Cousin S, Letinier L, Bosco-Lévy P, Hoppe S, Joly D, Penel N, Mathoulin-Pelissier S, Italiano A. PRognostic factor of Early Death In phase II Trials or the end of 'sufficient life expectancy' as an inclusion criterion? (PREDIT model). BMC Cancer 2016; 16:768. [PMID: 27716199 PMCID: PMC5050995 DOI: 10.1186/s12885-016-2819-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/26/2016] [Indexed: 11/23/2022] Open
Abstract
Background Optimizing patient selection is a necessary step to design better clinical trials. ‘Life expectancy’ is a frequent inclusion criterion in phase II trial protocols, a measure that is subjective and often difficult to estimate. The aim of this study was to identify factors associated with early death in patients included in phase II studies. Methods We retrospectively collected medical records of patients with advanced solid tumors included in phase II trials in two French Comprehensive Cancer Centers (Bordeaux, Center 1 set; Lille, Center 2 set). We analyzed patients’ baseline characteristics. Predictive factors associated with early death (mortality at 3 months) were identified by logistic regression. We built a model (PREDIT, PRognostic factor of Early Death In phase II Trials) based on prognostic factors isolated from the final multivariate model. Results Center 1 and 2 sets included 303 and 227 patients, respectively. Patients from Center 1 and 2 sets differed in tumor site, urological (26 % vs 15 %) and gastrointestinal (18 % vs 28 %) and in lung metastasis incidence (10 % vs 49 %). Overall survival (OS) at 3 months was 88 % (95 % CI [83.5; 91.0], Center 1 set) and 91 % (95 % CI [86.7; 94.2], Center 2 set). Presence of a ‘life expectancy’ inclusion criterion did not improve the 3-month OS (HR 0.6, 95 % CI [0.2; 1.2], p = 0.2325). Independent factors of early death were an ECOG score of 2 (OR 13.3, 95%CI [4.1; 43.4]), hyperleukocytosis (OR 5.5, 95 % CI [1.9; 16.3]) and anemia (OR 2.8, 95 % CI [1.1; 7.1]). Same predictive factors but with different association levels were found in the Center 2 set. Using the Center 1 set, ROC analysis shows a good discrimination to predict early death (AUC: 0.89 at 3 months and 0.86 at 6 months). Conclusions Risk modeling in two independent cancer populations based on simple clinical parameters showed that baseline ECOG of 2, hyperleukocytosis and anemia are strong early-death predictive factors. This model allows identifying patients who may not benefit from a phase II trial investigational drug and may, therefore, represent a helpful tool to select patients for phase II trial entry. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2819-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thomas Grellety
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, 229 cours de l'Argonne, 33076, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Sophie Cousin
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, 229 cours de l'Argonne, 33076, Bordeaux, France
| | - Louis Letinier
- University of Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Unit Institut Bergonié, Bordeaux, France
| | - Pauline Bosco-Lévy
- University of Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Unit Institut Bergonié, Bordeaux, France
| | - Stéphanie Hoppe
- Clinical and Epidemiological Research Unit Institut Bergonié, Bordeaux, France
| | | | - Nicolas Penel
- General Oncology Department, Centre Oscar Lambret, Lille, France
| | - Simone Mathoulin-Pelissier
- University of Bordeaux, Bordeaux, France.,Clinical and Epidemiological Research Unit Institut Bergonié, Bordeaux, France.,INSERM, CIC1401 Epidemiological unit, Institut Bergonié, Bordeaux, France
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, 229 cours de l'Argonne, 33076, Bordeaux, France.
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Standardized pretreatment inflammatory laboratory markers and calculated ratios in patients with oral squamous cell carcinoma. Eur Arch Otorhinolaryngol 2016; 273:3371-84. [DOI: 10.1007/s00405-016-3950-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/22/2016] [Indexed: 12/18/2022]
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12
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Su Z, Mao YP, OuYang PY, Tang J, Xie FY. Initial Hyperleukocytosis and Neutrophilia in Nasopharyngeal Carcinoma: Incidence and Prognostic Impact. PLoS One 2015; 10:e0136752. [PMID: 26336064 PMCID: PMC4559377 DOI: 10.1371/journal.pone.0136752] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/07/2015] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to evaluate initial hyperleukocytosis and neutrophilia as prognostic indicators in patients with nasopharyngeal carcinoma. Methods A retrospective analysis of 5,854 patients identified from a cohort of 6,035 patients diagnosed with nasopharyngeal carcinoma was performed with initial hyperleukocytosis and neutrophilia analyzed as prognostic factors. Multivariate Cox proportional hazards analyses were applied. Results Hyperleukocytosis was observed in 508 patients (8.7%). Multivariate analysis showed that initial hyperleukocytosis was an independent predictor of death (HR 1.40, 95%CI 1.15–1.70, p = 0.001), progression (HR 1.25, 95%CI 1.06–1.47, p = 0.007) and, marginally, distant metastasis (HR 1.21, 95%CI 0.97–1.52, p = 0.088). Neutrophilia was also an independent predictor of death (HR 1.46, 95%CI 1.18–1.81, p = 0.001), progression (HR 1.31, 95%CI 1.10–1.56, p = 0.003), and distant metastasis (HR 1.29, 95%CI 1.02–1.65, p = 0.036), after adjusting for prognostic factors and excluding hyperleukocytosis. Conclusion Initial hyperleukocytosis and neutrophilia were independent, poor prognostic factors and may be convenient and useful biological markers for survival of patients with nasopharyngeal carcinoma.
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Affiliation(s)
- Zhen Su
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Pu-Yun OuYang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Jie Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
- * E-mail:
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