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Hoesseini A, Sewnaik A, van den Besselaar BN, Zhang J, van Leeuwen N, Hardillo JA, Baatenburg de Jong RJ, Offerman MPJ. Prognostic model for overall survival of head and neck cancer patients in the palliative phase. BMC Palliat Care 2024; 23:54. [PMID: 38395897 PMCID: PMC10893612 DOI: 10.1186/s12904-023-01325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/08/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Patients with head and neck squamous cell carcinoma (HNSCC) enter the palliative phase when cure is no longer possible or when they refuse curative treatment. The mean survival is five months, with a range of days until years. Realistic prognostic counseling enables patients to make well-considered end-of-life choices. However, physicians tend to overestimate survival. The aim of this study was to develop a prognostic model that calculates the overall survival (OS) probability of palliative HNSCC patients. METHODS Patients diagnosed with incurable HNSCC or patients who refused curative treatment for HNSCC between January 1st 2006 and June 3rd 2019 were included (n = 659). Three patients were lost to follow-up. Patients were considered to have incurable HNSCC due to tumor factors (e.g. inoperability with no other curative treatment options, distant metastasis) or patient factors (e.g. the presence of severe comorbidity and/or poor performance status).Tumor and patients factors accounted for 574 patients. An additional 82 patients refused curative treatment and were also considered palliative. The effect of 17 candidate predictors was estimated in the univariable cox proportional hazard regression model. Using backwards selection with a cut-off P-value < 0.10 resulted in a final multivariable prediction model. The C-statistic was calculated to determine the discriminative performance of the model. The final model was internally validated using bootstrapping techniques. RESULTS A total of 647 patients (98.6%) died during follow-up. Median OS time was 15.0 weeks (95% CI: 13.5;16.6). Of the 17 candidate predictors, seven were included in the final model: the reason for entering the palliative phase, the number of previous HNSCC, cT, cN, cM, weight loss in the 6 months before diagnosis, and the WHO performance status. The internally validated C-statistic was 0.66 indicating moderate discriminative ability. The model showed some optimism, with a shrinkage factor of 0.89. CONCLUSION This study enabled the development and internal validation of a prognostic model that predicts the OS probability in HNSCC patients in the palliative phase. This model facilitates personalized prognostic counseling in the palliative phase. External validation and qualitative research are necessary before widespread use in patient counseling and end-of-life care.
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Affiliation(s)
- Arta Hoesseini
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands.
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Boyd N van den Besselaar
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Jang Zhang
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Nikki van Leeuwen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jose A Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Robert Jan Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Marinella P J Offerman
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
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2
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Shi BW, Xu L, Gong CX, Yang F, Han YD, Chen HZ, Li CG. Preoperative Neutrophil to Lymphocyte Ratio Predicts Complications After Esophageal Resection That can be Used as Inclusion Criteria for Enhanced Recovery After Surgery. Front Surg 2022; 9:897716. [PMID: 35910480 PMCID: PMC9326077 DOI: 10.3389/fsurg.2022.897716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background The neutrophil to lymphocyte ratio (NLR) has been reported as an indicator for poor prognosis in many cancers including esophageal cancer. However, the relationship between the NLR and postoperative complications after esophageal cancer resection remains unclear. At present, enhanced recovery after surgery (ERAS) lacks inclusion criteria. The aim of this study is to determine whether the preoperative NLR (preNLR) can predict complications after esophageal cancer resection, which could represent the criteria for ERAS. Methods This was a retrospective study on 171 patients who underwent esophagectomy at Hospital between November 2020 and November 2021(68 patients from Changhai Hospital, 65 patients from Shanghai General Hospital and 38 patients from Affiliated Hospital of Qingdao University). Univariate and multivariate logistic regression analyses were performed to demonstrate that the preNLR could predict complications after esophagectomy. Results A preNLR cutoff value of 2.30 was identified as having the greatest ability to predict complications with a sensitivity of 76% and specificity of 65%. Moreover, the Chi-squared test results showed that the preNLR was significantly associated with complications (x2 = 13.641, p < 0.001), and multivariate logistic regression analysis showed that body mass index (BMI), p stage and preNLR were independent variables associated with the development of postoperative complications (p < 0.05). Conclusion The preNLR can predict complications after esophagectomy, and these predicted complications can represent the criteria for recruiting patients for ERAS.
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Affiliation(s)
- Bo-Wen Shi
- Department of Thoracic Surgery, Changhai Hospital, Navy Military Medical University, Shanghai, China
| | - Li Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun-Xia Gong
- Department of Thoracic Surgery, Changhai Hospital, Navy Military Medical University, Shanghai, China
| | - Fu Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu-Dong Han
- Department of Thoracic Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - He-Zhong Chen
- Department of Thoracic Surgery, Changhai Hospital, Navy Military Medical University, Shanghai, China
| | - Chun-Guang Li
- Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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3
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Shen Y, Zhou H, Dong S, Dong W, Zhang L. Smoking patients with laryngeal cancer screened with a novel immunogenomics-based prognostic signature. Front Genet 2022; 13:961764. [PMID: 35910213 PMCID: PMC9333188 DOI: 10.3389/fgene.2022.961764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
The immune system greatly affects the prognosis of various malignancies. Studies on differentially expressed immune-related genes (IRGs) in the immune microenvironment of laryngeal squamous cell carcinoma (LSCC) have rarely been reported. In this paper, the prognostic potentials of IRGs were explored in LSCC patients with smoking use. The RNA-seq data containing IRGs and corresponding clinical information of smoking LSCC patients was obtained from The Cancer Genome Atlas (TCGA). Differentially expressed IRGs were identified and functional enrichment analysis was used to reveal the pathway of IRGs. Then, IRGs with prognostic potentials in smoking LSCC patients were screened out by univariate Cox regression analysis. Finally, multivariate Cox regression analysis was conducted to assess the prognostic signature of 5 IRGs after adjustment of clinical factors and patients were classified into two subgroups based on different IRGs expression. The prognostic capacity of the model was verified by another independent cohort from Gene Expression Omnibus (GEO) database. Nomogram including the prognostic signature was established and shown some clinical net benefit. These findings may contribute to the development of potential therapeutic targets and biomarkers for the new-immunotherapy of LSCC patients with smoking use.
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Affiliation(s)
- Yujie Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Han Zhou
- Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shikun Dong
- Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Weida Dong
- Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liqing Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Liqing Zhang,
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4
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Murad LD, Silva TDQ, Schilithz AOC, Fernandes PV, Monteiro M, Murad LB, Fialho E. Low body mass index is associated with reduced intratumoral CD4+ T-lymphocyte infiltration in laryngeal squamous cell carcinoma patients. Nutr Res 2022; 102:1-12. [DOI: 10.1016/j.nutres.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 10/19/2022]
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Boscolo‐Rizzo P, Zanelli E, Giudici F, Boscolo‐Nata F, Cristalli G, Deganello A, Tomasoni M, Piazza C, Bossi P, Spinato G, Menegaldo A, Emanuelli E, Nicolai P, Bandolin L, Ciorba A, Pelucchi S, Lupato V, Giacomarra V, Molteni G, Marchioni D, Canzi P, Mauramati S, Fortunati A, Tofanelli M, Borsetto D, Fussey J, Tirelli G. Prognostic value of H-index in patients surgically treated for squamous cell carcinoma of the larynx. Laryngoscope Investig Otolaryngol 2021; 6:729-737. [PMID: 34401497 PMCID: PMC8356864 DOI: 10.1002/lio2.603] [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] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/14/2021] [Accepted: 06/02/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Recently, a novel host-related index, the Host-index (H-index), including both inflammatory and nutritional markers, has been described and observed to stratify prognosis in patients with squamous cell carcinoma (SCC) of the oral cavity more accurately than other host-related indexes This study aimed to investigate the prognostic performance of the H-index using pretreatment blood tests in patients receiving up-front surgery for SCC of the larynx. METHODS This retrospective observational study included a multicenter series of consecutive patients with SCC of the larynx diagnosed between 1 January 2009 and 31 July 2018, whose pretreatment blood tests were available and included the parameters necessary for the calculation of neutrophil to lymphocyte ratio (NLR) and the H-index. Their association with disease-free survival (DFS) and overall survival (OS) was measured. RESULTS A total of 231 patients were eligible for the present analysis (median [range] age, 68 [37-96] years; 191 [82.7%] men). The median follow-up was 73 months. In multivariable Cox proportional hazards regression models, increasing age (adjusted hazard ratio [aHR], 1.07 per year; 95% CI, 1.04-1.09), advanced pT stage (aHR = 1.71 95% CI: 1.07-2.71), and having close or positive surgical margins (aHR = 2.01; 95% CI: 1.21-3.33) were significantly associated with poor OS. Among blood parameters, a higher neutrophil count was a strong predictor of both worse DFS (aHR for recurrence/death = 2.34; 95% CI: 1.24-4.40) and OS (aHR for death = 2.67; 95% CI: 1.51-4.71). Among inflammatory blood indexes, while NLR was not significantly associated with DFS or OS, patients with H-index ≥8.37 showed a higher aHR for both recurrence/death (2.82; 95% CI: 1.65-4.79) and death (2.22; 95% CI: 1.26-3.89). CONCLUSION In conclusion, the present study confirms the prognostic value of pretreatment H-index, an easily measurable inflammatory and nutritional index, in patients with SCC of the larynx. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Paolo Boscolo‐Rizzo
- Department of Medical, Surgical and Health Sciences, Section of OtolaryngologyUniversity of TriesteTriesteItaly
| | - Enrico Zanelli
- Department of Medical, Surgical and Health Sciences, Section of OtolaryngologyUniversity of TriesteTriesteItaly
| | - Fabiola Giudici
- Department of Medicine, Surgery and Health SciencesUniversity of TriesteTriesteItaly
| | - Francesca Boscolo‐Nata
- Unit of OtorhinolaryngologyOspedali Riuniti Padova Sud "Madre Teresa Di Calcutta"MonseliceItaly
| | - Giovanni Cristalli
- Unit of OtorhinolaryngologyOspedali Riuniti Padova Sud "Madre Teresa Di Calcutta"MonseliceItaly
| | - Alberto Deganello
- Department of Otolaryngology—Head and Neck SurgeryUniversity of BresciaBresciaItaly
| | - Michele Tomasoni
- Department of Otolaryngology—Head and Neck SurgeryUniversity of BresciaBresciaItaly
| | - Cesare Piazza
- Department of Otolaryngology—Head and Neck SurgeryUniversity of BresciaBresciaItaly
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical OncologyASST Spedali Civili di BresciaBresciaItaly
| | | | - Anna Menegaldo
- Unit of OtolaryngologyAULSS 2—Marca TrevigianaTrevisoItaly
| | - Enzo Emanuelli
- Unit of OtolaryngologyAULSS 2—Marca TrevigianaTrevisoItaly
- Department of Neurosciences, Section of OtolaryngologyUniversity of PadovaPadovaItaly
| | - Piero Nicolai
- Department of Neurosciences, Section of OtolaryngologyUniversity of PadovaPadovaItaly
| | - Luigia Bandolin
- Department of Neurosciences, Section of OtolaryngologyUniversity of PadovaPadovaItaly
| | - Andrea Ciorba
- ENT DepartmentUniversity Hospital of FerraraFerraraItaly
| | | | - Valentina Lupato
- Unit of OtolaryngologyAzienda Ospedaliera “S. Maria degli Angeli”PordenoneItaly
| | - Vittorio Giacomarra
- Unit of OtolaryngologyAzienda Ospedaliera “S. Maria degli Angeli”PordenoneItaly
| | - Gabriele Molteni
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of OtolaryngologyUniversity of VeronaVeronaItaly
| | - Daniele Marchioni
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of OtolaryngologyUniversity of VeronaVeronaItaly
| | - Pietro Canzi
- Department of OtolaryngologyUniversity of Pavia, IRCCS Policlinico "San Matteo" FoundationPaviaItaly
| | - Simone Mauramati
- Department of OtolaryngologyUniversity of Pavia, IRCCS Policlinico "San Matteo" FoundationPaviaItaly
| | - Alfonso Fortunati
- Department of Medical, Surgical and Health Sciences, Section of OtolaryngologyUniversity of TriesteTriesteItaly
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of OtolaryngologyUniversity of TriesteTriesteItaly
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Jonathan Fussey
- Department of ENT/Head and Neck SurgeryUniversity Hospital BirminghamBirminghamUK
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of OtolaryngologyUniversity of TriesteTriesteItaly
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Murad LD, Silva TDQ, Schilithz AOC, Monteiro MC, Murad LB, Fialho E. Body Mass Index Alters the Predictive Value of the Neutrophil-to-Lymphocyte Ratio and Systemic Inflammation Response Index in Laryngeal Squamous Cell Carcinoma Patients. Nutr Cancer 2021; 74:1261-1269. [PMID: 34278900 DOI: 10.1080/01635581.2021.1952447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Laryngeal squamous cell carcinoma (LSCC) is a frequent cancer subtype among head and neck cancers. Exacerbated inflammation and nutritional deficit are common features in this type of cancer and can be used as a prognostic marker. This study aimed to investigate the relationship between body mass index (BMI), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) on overall survival (OS) of LSCC patients. In this retrospective cohort study, 168 patients were followed for 5 years. Data on clinical factors, patients' life habits, height, weight, and hematological parameters were collected. BMI, NLR, and SIRI were calculated. Pretreatment NLR≥ 2.02 and SIRI≥ 1160.85 were independent prognostic factors for poor OS. Low BMI did not significantly affect the OS. However, the inflammatory parameters had their predictive capacity altered when stratified by the BMI classification. NLR≥ 2.02 + Low BMI or SIRI≥ 1160.85 + Low BMI increased in 8.6 and 3.8 times the risk of death, respectively. In contrast, stratification by normal/high BMI classification eliminated the predictive capacity of NLR and SIRI. Here, we demonstrated the possible ability of BMI to change the prognostic capacity of inflammatory markers NLR and SIRI in patients with LSCC.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1952447.
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Affiliation(s)
- Luana Dalbem Murad
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil.,Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thays de Queiroz Silva
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Arthur Orlando Corrêa Schilithz
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil
| | - Mariana Costa Monteiro
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Borges Murad
- Nutrition and Dietetics Section, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil
| | - Eliane Fialho
- Basic and Experimental Nutrition Department, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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7
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Hoesseini A, van Leeuwen N, Offerman MPJ, Zhang J, Dronkers EAC, Sewnaik A, Lingsma HF, Baatenburg de Jong RJ. Predicting survival in head and neck cancer: External validation and update of the prognostic model OncologIQ in 2189 patients. Head Neck 2021; 43:2445-2456. [PMID: 33960553 PMCID: PMC8359959 DOI: 10.1002/hed.26716] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 03/08/2021] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Disclosing prognostic information is necessary to enable patients to make well‐informed treatment decisions. OncologIQ is a prognostic model that predicts the overall survival (OS) probability in patients with head and neck squamous cell carcinoma (HNSCC). We aimed to externally validate and update the model with new prognostic factors and translate it to a clinically useful tool. Methods A consecutive retrospective sample of 2189 patients eligible for curative treatment of a primary HNSCC were selected. Discriminative performance was determined using the C‐statistic. Results External validation showed systematic underestimation of OS in the new population, and reasonable discrimination (C‐statistic 0.67). Adding smoking, pack years, BMI, weight loss, WHO performance, socioeconomic status, and p16 positivity to the recalibrated multivariable model, improved the internally validated C‐statistic to 0.71. The model showed minor optimism and was translated in an online tool (www.oncologiq.nl). Conclusions The updated model enables personalized patient counseling during treatment decision consultations.
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Affiliation(s)
- Arta Hoesseini
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Nikki van Leeuwen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marinella P J Offerman
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jang Zhang
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Emilie A C Dronkers
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hester F Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Robert Jan Baatenburg de Jong
- Department of Otorhinolaryngology - Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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8
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Development and validation of nomogram to predict risk of survival in patients with laryngeal squamous cell carcinoma. Biosci Rep 2021; 40:225966. [PMID: 32744320 PMCID: PMC7432998 DOI: 10.1042/bsr20200228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
To the best of our knowledge, this is the first study established a nomogram to predict survival probability in Asian patients with LSCC. A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application. Background: Due to a wide variation of tumor behavior, prediction of survival in laryngeal squamous cell carcinoma (LSCC) patients received curative-intent surgery is an important but formidable challenge. We attempted to establish a nomogram to precisely predict survival probability in LSCC patients. Methods: A total of 369 consecutive LSCC patients underwent curative resection between 2008 and 2012 at Hunan Province Cancer Hospital were included in the present study. Subsequently, 369 LSCC patients were assigned to a training set (N=261) and a validation set (N=108) at random. On the basis of multivariable Cox regression analysis results, we developed a nomogram. The predictive accuracy and discriminative ability of the nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with TNM stage system by C-index, receiver operating characteristic (ROC) analysis. Results: Six independent parameters to predict prognosis were age, pack years, N-stage, lymph node ratio (LNR), anemia and albumin, which were all assembled into the nomogram. The calibration curve verified excellent models’ concordance. The C-index of the nomogram was 0.73 (0.68–0.78), and the area under curve (AUC) of nomogram in predicting overall survival (OS) was 0.766, which were significantly higher than traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had a larger net benefit than the TNM stage. Conclusion: A risk prediction nomogram for patients with LSCC, incorporating easily assessable clinicopathologic factors, generates more precise estimations of the survival probability when compared TNM stage alone, but still need additional data before being used in clinical application.
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9
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Wei C, Wei H, Wu X, Nong G, Wu C, Lee J, Meng N, Yu D, Su J, Guo M, Qin J, Fan X. LncRNA-IUR Sponges miR-24 to Upregulate P53 in Laryngeal Squamous Cell Carcinoma. Cancer Manag Res 2020; 12:11639-11647. [PMID: 33235495 PMCID: PMC7678708 DOI: 10.2147/cmar.s236188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 09/16/2020] [Indexed: 12/24/2022] Open
Abstract
Objective The functions of lncRNA-IUR in laryngeal squamous cell carcinoma (LSCC) were investigated in this study. Methods RT-qPCR and paired t-test were used to measure and compare expression levels of IUR, miR-24 and p53 in LSCC and non-tumor tissues. Human LSCC cell line UM-SCC-17A was used and transfected by pcDNA3.1 vector to overexpress IUR and miR-24. The transwell assay and wound healing assay illustrated the effect of overexpression of IUR or miR-24 in the cell invasion and migration of LSCC. Subcutaneous tumor model in nude mice was carried out to demonstrate the mechanism between IUR and miR-24 in regulating tumor growth. Results We found that IUR was downregulated in LSCC. Low expression levels of IUR were correlated with the poor survival of LSCC patients. Overexpression experiments showed that overexpression of IUR led to increased, while overexpression of miR-24 led to decreased expression levels of p53 in LSCC cells. And bioinformatics analysis showed that IUR may sponge miR-24. Cell proliferation assay showed that overexpression of IUR and p53 led to decreased proliferation rate of LSCC cells, while overexpression of miR-24 led to increased proliferation rate of LSCC cells. We also illustrated that overexpression of IUR promoted cell migration and invasion while miR-24 had opposite effects. In addition, subcutaneous tumor model in nude mice showed that overexpression of miR-24 attenuated the effects of overexpression of IUR on the expression of p53 and cancer cell proliferation. Conclusion IUR sponges miR-24 to upregulate p53 in LSCC, thereby inhibiting cancer cell proliferation.
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Affiliation(s)
- Cen Wei
- ENT & HN Surgery Department, Wuming Hospital of Guangxi Medical University, Nanning 530199, People's Republic of China
| | - Huaqing Wei
- Department of Cardiology, Wuming Hospital of Guangxi Medical University, Nanning 530199, People's Republic of China
| | - Xun Wu
- Department of Maxillofacial Surgery, Guangxi Medical University College of Stomatology, Nanning 530021, People's Republic of China
| | - Guangyao Nong
- ENT & HN Surgery Department, Wuming Hospital of Guangxi Medical University, Nanning 530199, People's Republic of China
| | - Chenglin Wu
- Department of ENT, Sixth Affiliated Hospital of Guangxi Medical University, Nanning 537000, People's Republic of China
| | - Jinli Lee
- Department of Gastroenterology, 923 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Nanning 530021, People's Republic of China
| | - Ning Meng
- Department of Maxillofacial Surgery, Guangxi Medical University College of Stomatology, Nanning 530021, People's Republic of China
| | - Dahai Yu
- Department of Stomatology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People's Republic of China
| | - Jiping Su
- ENT & HN Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning 530199, People's Republic of China
| | - Mengzhu Guo
- Department of Stomatology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People's Republic of China
| | - Jiangyuan Qin
- Department of Otolaryngology, Guangxi General Hospital of Chinses People's Armed Police Force, Nanning 530000, People's Republic of China
| | - Xuemin Fan
- Department of Maxillofacial Surgery, Guangxi Medical University College of Stomatology, Nanning 530021, People's Republic of China
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10
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Identification and validation of methylation-driven genes prognostic signature for recurrence of laryngeal squamous cell carcinoma by integrated bioinformatics analysis. Cancer Cell Int 2020; 20:472. [PMID: 33005105 PMCID: PMC7526132 DOI: 10.1186/s12935-020-01567-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Background Recurrence remains a major obstacle to long-term survival of laryngeal squamous cell carcinoma (LSCC). We conducted a genome-wide integrated analysis of methylation and the transcriptome to establish methylation-driven genes prognostic signature (MDGPS) to precisely predict recurrence probability and optimize therapeutic strategies for LSCC. Methods LSCC DNA methylation datasets and RNA sequencing (RNA-seq) dataset were acquired from the Cancer Genome Atlas (TCGA). MethylMix was applied to detect DNA methylation-driven genes (MDGs). By univariate and multivariate Cox regression analyses, five genes of DNA MDGs was developed a recurrence-free survival (RFS)-related MDGPS. The predictive accuracy and clinical value of the MDGPS were evaluated by receiver operating characteristic (ROC) and decision curve analysis (DCA), and compared with TNM stage system. Additionally, prognostic value of MDGPS was validated by external Gene Expression Omnibus (GEO) database. According to 5 MDGs, the candidate small molecules for LSCC were screen out by the CMap database. To strengthen the bioinformatics analysis results, 30 pairs of clinical samples were evaluated by digoxigenin-labeled chromogenic in situ hybridization (CISH). Results A total of 88 DNA MDGs were identified, and five RFS-related MDGs (LINC01354, CCDC8, PHYHD1, MAGEB2 and ZNF732) were chosen to construct a MDGPS. The MDGPS can effectively divide patients into high-risk and low-risk group, with the area under curve (AUC) of 0.738 (5-year RFS) and AUC of 0.74 (3-year RFS). Stratification analysis affirmed that the MDGPS was still a significant statistical prognostic model in subsets of patients with different clinical variables. Multivariate Cox regression analysis indicated the efficacy of MDGPS appears independent of other clinicopathological characteristics. In terms of predictive capacity and clinical usefulness, the MDGPS was superior to traditional TNM stage. Additionally, the MDGPS was confirmed in external LSCC cohorts from GEO. CMap matched the 9 most significant small molecules as promising therapeutic drugs to reverse the LSCC gene expression. Finally, CISH analysis in 30 LSCC tissues and paired adjacent normal tissues revealed that MAGEB2 has significantly higher expression of LSCC compared to adjacent non-neoplastic tissues; LINC01354, CCDC8, PHYHD1, and ZNF732 have significantly lower expression of LSCC compared to adjacent non-neoplastic tissues, which were in line with bioinformatics analysis results. Conclusion A MDGPS, with five DNA MDGs, was identified and validated in LSCC patients by combining transcriptome and methylation datasets analysis. Compared TNM stage alone, it generates more accurate estimations of the recurrence prediction and maybe offer novel research directions and prospects for individualized treatment of patients with LSCC.
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Arends CR, Petersen JF, van der Noort V, Timmermans AJ, Leemans CR, de Bree R, van den Brekel MW, Stuiver MM. Optimizing Survival Predictions of Hypopharynx Cancer: Development of a Clinical Prediction Model. Laryngoscope 2020; 130:2166-2172. [PMID: 31693181 PMCID: PMC7496756 DOI: 10.1002/lary.28345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/26/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To develop and validate a clinical prediction model (CPM) for survival in hypopharynx cancer, thereby aiming to improve individualized estimations of survival. METHODS Retrospective cohort study of hypopharynx cancer patients. We randomly split the cohort into a derivation and validation dataset. The model was fitted on the derivation dataset and validated on the validation dataset. We used a Cox's proportional hazard model and least absolute shrinkage and selection operator (LASSO) selection. Performance (discrimination and calibration) of the CPM was tested. RESULTS The final model consisted of gender, subsite, TNM classification, Adult Comorbidity Evaluation-27 score (ACE27), body mass index (BMI), hemoglobin, albumin, and leukocyte count. Of these, TNM classification, ACE27, BMI, hemoglobin, and albumin had independent significant associations with survival. The C Statistic was 0.62 after validation. The model could significantly identify clinical risk groups. CONCLUSIONS ACE27, BMI, hemoglobin, and albumin are independent predictors of overall survival. The identification of high-risk patients can be used in the counseling process and tailoring of treatment strategy or follow-up. LEVEL OF EVIDENCE 4 Laryngoscope, 130:2166-2172, 2020.
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Affiliation(s)
- Coralie R. Arends
- Department of Head and Neck Oncology and SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Japke F. Petersen
- Department of Head and Neck Oncology and SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | | | - Adriana J. Timmermans
- Department of Head and Neck Oncology and SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Department of Head and Neck Oncology and SurgeryAmsterdam UMCAmsterdamThe Netherlands
| | - C. René Leemans
- Department of Head and Neck Oncology and SurgeryAmsterdam UMCAmsterdamThe Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical OncologyUniversity Medical Center UtrechtThe Netherlands
| | - Michiel W.M. van den Brekel
- Department of Head and Neck Oncology and SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Institute of Phonetic SciencesAmsterdam Center of Language and Communication, University of AmsterdamAmsterdamThe Netherlands
- Department of Oral and Maxillofacial SurgeryAcademic Medical CenterAmsterdamThe Netherlands
| | - Martijn M. Stuiver
- Department of Head and Neck Oncology and SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
- Department of Clinical Epidemiology, Biostatistics, and BioinformaticsAmsterdam UMCAmsterdamThe Netherlands
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12
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Zhao TC, Liang SY, Ju WT, Liu Y, Tan YR, Zhu DW, Zhang CP, Zhang ZY, Zhong LP. Normal BMI predicts the survival benefits of inductive docetaxel, cisplatin, and 5-fluorouracil in patients with locally advanced oral squamous cell carcinoma. Clin Nutr 2020; 39:2751-2758. [PMID: 31839432 DOI: 10.1016/j.clnu.2019.11.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/18/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS This study aimed to evaluate the prognostic value of the body mass index (BMI), as well as the association with docetaxel, cisplatin, and 5-fluorouracil (TPF) induction chemotherapy in patients with locally advanced oral squamous cell carcinoma (OSCC). METHODS This retrospective study enrolled 253 patients with locally advanced OSCC between 2008 and 2010 based on our previous prospective, randomized, phase 3 trial (NCT01542931). Univariate and multivariate Cox regression models, and the Kaplan-Meier method were used for survival analyses. RESULTS Among the 253 patients, the BMI at the time of clinical diagnosis ranged from 13.16 to 34.66 kg/m2. Smoking status among patients showed a marked correlation with a higher BMI status at the time of clinical diagnosis (tobacco status: P < 0.001). The distribution of clinical nodal (cN) stage was significantly different, as patients with higher BMIs generally had earlier cN stages (P < 0.021) among the different BMI groups. The Kaplan-Meier analysis showed that the BMI was significantly correlated with overall survival (OS, P = 0.004), disease-free survival (DFS, P = 0.005), locoregional recurrence-free survival (LRFS, P = 0.003) and distant metastasis-free survival (DMFS, P = 0.007). When the BMI was included in the multivariate Cox regression model adjusted for potentially confounding clinical variables, the BMI was shown to be an independent predictive factor of OS (P = 0.015), DFS (P = 0.015), LRFS (P = 0.009), and DMFS (P = 0.023). The TPF group showed better 5-year clinical survival rates than the control group when analyzing patients with a normal BMI (OS: 64.2% vs. 55.9%; DFS: 54.7% vs. 46.4%; LRFS: 56.6% vs. 49.6%; DMFS: 64.2% vs. 56.0%), but no significant difference was observed. Subgroup survival analysis indicated that patients with a normal BMI and clinical stage IVA disease who accepted TPF induction chemotherapy had a significantly improved OS (HR: 0.425, 95% CI: 0.187-0.966, P = 0.035) and DMFS (HR: 0.425, 95% CI: 0.187-0.966, P = 0.034). CONCLUSION The BMI at the time of clinical diagnosis was showed to be an independent predictive factor for patients with locally advanced OSCC. Compared with normoweight patients, underweight patients may have worse clinical outcomes, while overweight and obese patients have a better prognosis. A normal BMI in clinical stage IVA OSCC patients predicts significant OS and DMFS benefits of TPF induction chemotherapy.
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Affiliation(s)
- Tong-Chao Zhao
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Si-Yuan Liang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Wu-Tong Ju
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Ying Liu
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Yi-Ran Tan
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China.
| | - Dong-Wang Zhu
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Chen-Ping Zhang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Zhi-Yuan Zhang
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Lai-Ping Zhong
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China.
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He Y, Liang D, Li D, Shan B, Zheng R, Zhang S, Wei W, He J. Incidence and mortality of laryngeal cancer in China, 2015. Chin J Cancer Res 2020; 32:10-17. [PMID: 32194300 PMCID: PMC7072018 DOI: 10.21147/j.issn.1000-9604.2020.01.02] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective Using data from cancer registries to estimate laryngeal cancer incidence and mortality in China, 2015. Methods Data submitted from 501 cancer registries were checked and evaluated according to the criteria of data quality control and 368 registries’ data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and combined with national population data to estimate laryngeal cancer incidence and mortality in China, 2015. China population census in 2000 and Segi’s population were used for age-standardized. Results The percentage of cases morphological verified (MV%) of laryngeal cancer was 74.18%. The percentage of death certificate-only cases (DCO%) was 2.10%. And the mortality to incidence (M/I) ratio was 0.55. About 25,300 new cases of laryngeal cancer were diagnosed in 2015 and 13,700 deaths were reported. The crude rate of laryngeal cancer was 1.84 per 100,000 (males and females were 3.20 and 0.42 per 100,000, respectively). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.18 and 1.19 per 100,000, respectively. The cumulative incidence rate (0−74 years old) was 0.15%. The crude mortality rate was 1.00 per 100,000. Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 0.61 and 0.61 per 100,000, respectively, with the cumulative rate (0−74 years old) was 0.07%. Incidence and mortality of laryngeal cancer in males were higher than those in females. And the rates in urban areas were higher than those in rural areas. Conclusions The incidence and mortality of laryngeal cancer in China were low. And the rates were significantly higher in males than in females. Risk factor control and targeted prevention should be strengthened.
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Affiliation(s)
- Yutong He
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China
| | - Di Liang
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China
| | - Daojuan Li
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China
| | - Baoen Shan
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang 050011, China
| | - Rongshou Zheng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
| | - Siwei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
| | - Jie He
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021, China
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Lee JY, Ryu HS, Yoon SS, Kim EH, Yoon SW. Extracellular-to-Intracellular Fluid Volume Ratio as a Prognostic Factor for Survival in Patients With Metastatic Cancer. Integr Cancer Ther 2019; 18:1534735419847285. [PMID: 31043080 PMCID: PMC6498769 DOI: 10.1177/1534735419847285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: This study aimed to investigate whether the
extracellular-to-intracellular fluid volume (E/I) ratio can predict survival in
patients with metastatic cancer. Methods: Clinical data were
collected from April 2016 to March 2018. Patients aged ≥19 years with metastatic
solid tumor were eligible. Bioimpedance analysis was used to assess body fluid
distribution and the E/I ratio. Clinical characteristics, including laboratory
test results and nutrition status according to the E/I ratio, were analyzed. Cox
proportional hazards models and Kaplan-Meier analysis were used to identify risk
factors for mortality. Results: In total, 87 patients were included
in the study. The 87 patients were divided into 2 groups according to the median
E/I ratio: a high E/I group (E/I ratio ≥1.0, n = 43) and a low E/I group (E/I
ratio <1.0, n = 44). Poor performance status, fluid retention, malnutrition,
elevation of C-reactive protein levels, and decreases in hemoglobin, albumin,
and protein levels were significantly associated with the high E/I group. The
median overall survival time was 1.6 and 12.5 months in the high E/I and low E/I
groups, respectively (P < .001). In the multivariate
analysis, poor performance status, leukocytosis, fluid retention, and E/I ratio
were independent prognostic factors, and the E/I ratio was the strongest
prognostic factor predicting overall survival (hazard ratio = 3.49, 95%
confidence interval = 1.75-6.96, P < .001).
Conclusions: The E/I ratio can predict survival time in
patients with metastatic cancer. More rigorous research is required to confirm
this result.
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Affiliation(s)
- Jee Young Lee
- Kyung Hee University Hospital at
Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Han Sung Ryu
- Kyung Hee University Hospital at
Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Sung Soo Yoon
- Kyung Hee University Hospital at
Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Eun Hye Kim
- Kyung Hee University Hospital at
Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Kyung Hee University Hospital at
Gangdong, Gangdonggu, Seoul, Republic of Korea
- Seong Woo Yoon, Department of Internal
Medicine, Korean Medicine Cancer Center, Kyung Hee University Hospital at
Gangdong, Dongnamro 892, Gangdonggu, Seoul 134-727, Republic of Korea.
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15
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A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma. DISEASE MARKERS 2019; 2019:5980567. [PMID: 31827637 PMCID: PMC6886334 DOI: 10.1155/2019/5980567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/04/2019] [Indexed: 12/30/2022]
Abstract
Background Long noncoding RNAs (lncRNAs), which have little or no ability to encode proteins, have attracted special attention due to their potential role in cancer disease. We aimed to establish a lncRNA signature and a nomogram incorporating the genomic and clinicopathologic factors to improve the accuracy of survival prediction for laryngeal squamous cell carcinoma (LSCC). Methods A LSCC RNA-sequencing (RNA-seq) dataset and the matched clinicopathologic information were downloaded from The Cancer Genome Atlas (TCGA). Using univariable Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, we developed a thirteen-lncRNA signature related to prognosis. On the basis of multivariable Cox regression analysis results, a nomogram integrating the genomic and clinicopathologic predictors was built. The predictive accuracy and discriminative ability of the inclusive nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with the TNM staging system by C-index and receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was conducted to evaluate the clinical value of our nomogram. Results Thirteen overall survival- (OS-) related lncRNAs were identified, and the signature consisting of the selected thirteen lncRNAs could effectively divide patients into high-risk and low-risk subgroups, with area under curves (AUC) of 0.89 (3-year OS) and 0.885 (5-year OS). Independent factors derived from multivariable analysis to predict survival were margin status, tumor status, and lncRNA signature, which were all assembled into the nomogram. The calibration curve for the survival probability showed that the predictions based on the nomogram coincided well with actual observations. The C-index of the nomogram was 0.82 (0.77-0.87), and the area under curve (AUC) of the nomogram in predicting overall survival (OS) was 0.938, both of which were significantly higher than the traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage. Conclusion An inclusive nomogram for patients with LSCC, comprising genomic and clinicopathologic variables, generates more accurate estimations of the survival probability when compared with TNM stage alone, but more data are needed before the nomogram is used in clinical practice.
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Rogers SN, Horisk K, Groom P, Lowe D. Management of anaemia and blood in patients having neck dissections or free flaps for head and neck cancer. Br J Oral Maxillofac Surg 2019; 57:543-549. [PMID: 31128950 DOI: 10.1016/j.bjoms.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 05/02/2019] [Indexed: 01/19/2023]
Abstract
Our main aims were to assess haemoglobin (Hb) concentrations from preoperative assessment to discharge from hospital, and to review which patients had blood transfusions and compliance with national transfusion guidelines. We studied a consecutive series of 131 patients between October 2016 and September 2017 who had either neck dissection or resection and free microvascular tissue transfer. Half the patients had soft tissue free flaps (n = 65), 26% had composite free flaps (n = 34), and 24% neck dissection only (n = 32). Using the WHO definition of anaemia, 4% (1/28) of patients who had neck dissections and 19% (16/85) of those who had free flaps were anaemic preoperatively. The median (IQR) Hb at discharge was 131 (119-144) g/L for patients who had neck dissections, 103 (95-114) g/L for those who had soft free flaps, and 95 (90-104) g/L for those who had composite free flaps. No patients who had neck dissection were given a red blood cell (RBC) transfusion, whereas they were given to 26/99 (26%) of those who had free flaps. Hb concentrations were checked after each unit in 31/39 transfusions (79%). Concentrations for those who had free flaps fell by about 30 g/L from admission to operation, and only four patients were given tranexamic acid peroperatively. Postoperatively Hb remained at similar concentrations until discharge, with 23/98 (24%) given iron orally on discharge. In terms of compliance with blood transfusion guidelines there was a notable absence of the use of tranexamic acid and of iron intravenously. An increase in their use could potentially reduce the number of blood transfusions required and the postoperative incidence of anaemia, and have a favourable effect on outcomes such as complications, fatigue, and overall quality of life.
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Affiliation(s)
- S N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St. Helens Road, Ormskirk L39 4QP; Consultant, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 1AE, UK.
| | - K Horisk
- Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 1AE, UK.
| | - P Groom
- University Hospital Aintree, Liverpool L9 1AE, UK.
| | - D Lowe
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk L39 4QP.
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Abt NB, Tarabanis C, Miller AL, Puram SV, Varvares MA. Preoperative anemia displays a dose‐dependent effect on complications in head and neck oncologic surgery. Head Neck 2019; 41:3033-3040. [DOI: 10.1002/hed.25788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/18/2018] [Accepted: 04/16/2019] [Indexed: 01/28/2023] Open
Affiliation(s)
- Nicholas B. Abt
- Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical School Boston Massachusetts
| | | | - Ashley L. Miller
- Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical School Boston Massachusetts
| | - Sidharth V. Puram
- Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical School Boston Massachusetts
| | - Mark A. Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical School Boston Massachusetts
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Gorphe P, Bouhir S, Garcia GCTE, Alali A, Even C, Breuskin I, Tao Y, Janot F, Bidault F, Temam S. Anemia and neutrophil-to-lymphocyte ratio in laryngeal cancer treated with induction chemotherapy. Laryngoscope 2019; 130:E144-E150. [PMID: 31006874 DOI: 10.1002/lary.28021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/21/2019] [Accepted: 04/03/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES/HYPOTHESIS We studied the influence of the neutrophil-to-lymphocyte ratio (NLR) and anemia on the response to induction chemotherapy (IC) and survival outcomes in laryngeal cancer patients treated with a preservation protocol. STUDY DESIGN Retrospective single-center case series. METHODS We analyzed patients with T3 laryngeal cancer treated with IC using a preservation protocol. The NLR and hemoglobin levels were assessed before treatment and after IC. The response to chemotherapy was assessed using Response Evaluation Criteria in Solid Tumours 1.1 and World Heath Organization standards. The oncological endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS Sixty-eight patients were analyzed. The median NLR and hemoglobin levels before and after IC were 2.76 and 14.5 g/dL, and 2.01 and 11.6 g/dL, respectively. The NLR and anemia before treatment were not correlated, and they were not associated with the response to chemotherapy. However, an NLR > 5 and anemia before treatment were both associated with shorter OS and DFS. Notably, they were the only factors found to be significantly associated with survival outcomes. CONCLUSIONS In laryngeal cancer, patients treated with a preservation protocol, a high NLR ratio, and anemia before IC were associated with shorter survival, independently of the response to chemotherapy. LEVEL OF EVIDENCE 4 Laryngoscope, 130:E144-E150, 2020.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Samia Bouhir
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Gabriel C T E Garcia
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Abeer Alali
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
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Fattouh M, Chang GY, Ow TJ, Shifteh K, Rosenblatt G, Patel VM, Smith RV, Prystowsky MB, Schlecht NF. Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer. Head Neck 2019; 41:707-714. [PMID: 30582237 PMCID: PMC6709588 DOI: 10.1002/hed.25420] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/10/2018] [Accepted: 09/06/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. METHODS We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. RESULTS Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. CONCLUSION Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.
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Affiliation(s)
- Michael Fattouh
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461
| | - Gina Y. Chang
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461
| | - Thomas J. Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Keivan Shifteh
- Department of Radiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Viraj M. Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Richard V. Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Michael B. Prystowsky
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Nicolas F. Schlecht
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Medicine (Oncology), Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Epidemiology & Population Health, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263
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Beesley LJ, Hawkins PG, Amlani LM, Bellile EL, Casper KA, Chinn SB, Eisbruch A, Mierzwa ML, Spector ME, Wolf GT, Shuman AG, Taylor JMG. Individualized survival prediction for patients with oropharyngeal cancer in the human papillomavirus era. Cancer 2019; 125:68-78. [PMID: 30291798 PMCID: PMC6309492 DOI: 10.1002/cncr.31739] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Accurate, individualized prognostication in patients with oropharyngeal squamous cell carcinoma (OPSCC) is vital for patient counseling and treatment decision making. With the emergence of human papillomavirus (HPV) as an important biomarker in OPSCC, calculators incorporating this variable have been developed. However, it is critical to characterize their accuracy prior to implementation. METHODS Four OPSCC calculators were identified that integrate HPV into their estimation of 5-year overall survival. Treatment outcomes for 856 patients with OPSCC who were evaluated at a single institution from 2003 through 2016 were analyzed. Predicted survival probabilities were generated for each patient using each calculator. Calculator performance was assessed and compared using Kaplan-Meier plots, receiver operating characteristic curves, concordance statistics, and calibration plots. RESULTS Correlation between pairs of calculators varied, with coefficients ranging from 0.63 to 0.90. Only 3 of 6 pairs of calculators yielded predictions within 10% of each other for at least 50% of patients. Kaplan-Meier curves of calculator-defined risk groups demonstrated reasonable stratification. Areas under the receiver operating characteristic curve ranged from 0.74 to 0.80, and concordance statistics ranged from 0.71 to 0.78. Each calculator demonstrated superior discriminatory ability compared with clinical staging according to the seventh and eighth editions of the American Joint Committee on Cancer staging manual. Among models, the Denmark calculator was found to be best calibrated to observed outcomes. CONCLUSIONS Existing calculators exhibited reasonable estimation of survival in patients with OPSCC, but there was considerable variability in predictions for individual patients, which limits the clinical usefulness of these calculators. Given the increasing role of personalized treatment in patients with OPSCC, further work is needed to improve accuracy and precision, possibly through the identification and incorporation of additional biomarkers.
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Affiliation(s)
- Lauren J Beesley
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Peter G Hawkins
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Lahin M Amlani
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Emily L Bellile
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Keith A Casper
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Steven B Chinn
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Michelle L Mierzwa
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Matthew E Spector
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Gregory T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Andrew G Shuman
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
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