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Shimada A, Matsuda T, Sawada R, Hasegawa H, Yamashita K, Harada H, Urakawa N, Goto H, Kanaji S, Oshikiri T, Kakeji Y. The modified Glasgow prognostic score is a reliable predictor of oncological outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. Sci Rep 2023; 13:17111. [PMID: 37816855 PMCID: PMC10564952 DOI: 10.1038/s41598-023-44431-w] [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] [Received: 06/28/2023] [Accepted: 10/08/2023] [Indexed: 10/12/2023] Open
Abstract
There has been no reliable marker for predicting oncological outcomes in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (NACRT). We retrospectively analyzed 73 patients with LARC who underwent curative surgery after NACRT. The modified Glasgow prognostic score (mGPS) was assessed after NACRT, and clinical outcomes were compared between the high (mGPS = 1 or 2; n = 23) and low (mGPS = 0; n = 50) groups. Body mass index was significantly higher in the low mGPS group. The 5-year disease-free survival (DFS) rate was significantly worse in the high mGPS group than that in the low mGPS group (36.7% vs. 76.6%, p = 0.002). Univariate and multivariate analyses of DFS revealed that mGPS was the most significant predictor (p < 0.001). mGPS appears to be a reliable predictor of oncological outcomes in patients with LARC undergoing NACRT.
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Affiliation(s)
- Atsushi Shimada
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeru Matsuda
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
- Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, 650-0017, Japan.
| | - Ryuichiro Sawada
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Hasegawa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimihiro Yamashita
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hitoshi Harada
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Urakawa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Goto
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Gremese E, Bruno D, Varriano V, Perniola S, Petricca L, Ferraccioli G. Serum Albumin Levels: A Biomarker to Be Repurposed in Different Disease Settings in Clinical Practice. J Clin Med 2023; 12:6017. [PMID: 37762957 PMCID: PMC10532125 DOI: 10.3390/jcm12186017] [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: 08/19/2023] [Revised: 09/10/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Serum albumin (ALB), one of the most important proteins in human physiology, has the main functions of maintaining plasma oncotic pressure and plasma volume, transporting hormones, vitamins, oligominerals and drugs, and exerting a powerful antioxidant-anti-inflammatory role. Its prognostic value in liver and malabsorption syndromes is well known. In this narrative review, an analysis of the most important studies evaluating the prognostic significance of low serum ALB levels in hospitalized patients was performed. Specifically, the risk in emergency medicine, cardiovascular diseases, Coronavirus Disease 19 (COVID-19) infection, nephrology, oncology, and autoimmune rheumatic diseases has been examined to fully explore its clinical value. ALB is a negative acute-phase reactant and the reduction in its serum levels represents a threatening parameter for long-term survival in several clinical settings, and a strong biomarker for a poor prognosis in most diseases. Therefore, clinicians should consider serum ALB as a valuable tool to assess the efficacy of specific therapies, both in hospitalized patients and in chronic follow-up.
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Affiliation(s)
- Elisa Gremese
- Clinical Immunology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Catholic University of the Sacred Heart, 00168 Roma, Italy
- Immunology Core Facility, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Roma, Italy
| | - Dario Bruno
- Clinical Immunology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168, Roma, Italy; (D.B.); (V.V.); (S.P.)
| | - Valentina Varriano
- Clinical Immunology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168, Roma, Italy; (D.B.); (V.V.); (S.P.)
| | - Simone Perniola
- Immunology Core Facility, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Roma, Italy
- Clinical Immunology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168, Roma, Italy; (D.B.); (V.V.); (S.P.)
| | - Luca Petricca
- Rheumatology Division, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Roma, Italy;
| | - Gianfranco Ferraccioli
- Department of Internal Medicine, Catholic University of the Sacred Heart, 00168 Rome, Italy;
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3
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Ozveren A, Erdogan AP, Ekinci F. The inflammatory prognostic index as a potential predictor of prognosis in metastatic gastric cancer. Sci Rep 2023; 13:7755. [PMID: 37173358 PMCID: PMC10182084 DOI: 10.1038/s41598-023-34778-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/08/2023] [Indexed: 05/15/2023] Open
Abstract
Clinical studies aimed at identifying effective and simple prognostic markers for gastric cancer are still being carried out. Inflammatory prognostic index (IPI) is being recognized as a promising prognostic marker in patients with Non-Small Cell Lung Cancer. To evaluate the prognostic utility of IPI in stage 4 gastric cancer. A total of 152 patients with stage 4 gastric cancer, whose laboratory parameters, progression-free survival (PFS) and overall survival (OS) data could be accessed, were evaluated. Kaplan Meier analysis was used for survival analyses. Hazard ratios were expressed with 95% CI values. All methods were performed in accordance with the relevant guidelines and regulations. Study was approved by the Manisa Celal Bayar University's Non-Invasive Clinical Research Ethics Committee (approval No. E-85252386-050.04.04-49119, date: 22.03.2021). We confirm that all methods were performed in accordance with relevant named guidelines and regulations. Median age at diagnosis was 63 years (range: 32-88). The number of patients who received first-line chemotherapy was 129 (84.9%). Median PFS with first-line treatment was 5.3 months, while it was 3.3 months with second-line treatment. Median OS was 9.4 months. Median IPI score was 22.2. We evaluated IPI score for its value in detecting survival status with ROC analysis and identified an IPI cut-off score of 14.6. Low IPI score was significantly associated with longer PFS and OS compared to high IPI (PFS in high vs. low IPI, 3.6 vs. 7 months; p < 0.001) (OS in high vs. low IPI, 6.6 vs. 14.2 months; p < 0.001). IPI score can be an independent prognostic index that is inexpensive, easy to access and evaluate for patients with metastatic gastric cancer, and may be useful in predicting survival in daily practice.
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Affiliation(s)
- Ahmet Ozveren
- Medical Oncology Department, Internal Medicine, Izmir Private Kent Hospital, Izmir, Turkey.
| | - Atike Pinar Erdogan
- Medical Oncology Department, Internal Medicine, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Ferhat Ekinci
- Medical Oncology Department, Internal Medicine, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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4
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Tanaka T, Yoshida T, Masuda K, Takeyasu Y, Shinno Y, Matsumoto Y, Okuma Y, Goto Y, Horinouchi H, Yamamoto N, Ohe Y. Prognostic role of modified Glasgow Prognostic score in elderly non-small cell lung cancer patients treated with anti-PD-1 antibodies. Respir Investig 2023; 61:74-81. [PMID: 36460585 DOI: 10.1016/j.resinv.2022.10.003] [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: 08/09/2022] [Revised: 09/26/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study aimed to investigate whether the immunosenescence-related score is a critical prognostic predictor of anti-programmed cell death protein 1 (PD-1) axis inhibitors in elderly patients with advanced non-small cell lung cancer (NSCLC). METHODS We reviewed 51 patients with advanced NSCLC aged ≥75 years, who were treated with nivolumab or pembrolizumab at the National Cancer Center Hospital between December 2015 and April 2019. Factors such as modified Glasgow prognostic score (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson comorbidity index (CCI) were used to assess immunosenescence. RESULTS The objective response rate (ORR) and disease control rate (DCR) of all patients were 25.4% (95% confidence interval [CI]: 14.3-39.6) and 52.9% (95% CI: 38.5-67.1), respectively. High mGPS (score of 2) was associated with low DCR compared to low mGPS (score of 0-1) (26.0% vs. 54.0%, p = 0.03). However, none of these scores were significantly related to the ORR. High mGPS was significantly linked to shorter median progression-free survival (mPFS) (4.2 mos. vs. 12.7 mos, p < 0.01), and median overall survival (mOS) (4.8 mos. vs. 28.1 mos, p = 0.03). However, neither CCI nor NLR was associated with prognosis. Multivariate regression analysis identified high mGPS as a significant prognostic factor for mOS (hazard ratio, HR: 0.31 [95% CI: 0.13-0.71], p < 0.01). CONCLUSIONS High mGPS scores significantly impaired DCR, mPFS, and mOS in patients with advanced NSCLC treated with anti-PD-1 antibodies.
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Affiliation(s)
- Tomohiro Tanaka
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Medical & Dental Hospital, Niigata, Japan; Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Masuda
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Takeyasu
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Shinno
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuji Matsumoto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hidehito Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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5
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Shindo T, Maehana T, Tanaka T, Hashimoto K, Kobayashi K, Takahashi A, Hotta H, Kunishima Y, Taguchi K, Tachiki H, Ito N, Matsukawa M, Kato R, Miyamoto S, Hinotsu S, Masumori N. Are there differences in the characteristics of patients who respond to gemcitabine plus cisplatin chemotherapy and those who respond to pembrolizumab therapy for metastatic urothelial carcinoma? Multicenter retrospective study. Int J Urol 2022; 29:1010-1016. [PMID: 35654444 DOI: 10.1111/iju.14941] [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: 11/23/2021] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate factors to predict overall survival of metastatic urothelial carcinoma patients treated with gemcitabine plus cisplatin chemotherapy or pembrolizumab therapy. METHODS We retrospectively evaluated two metastatic urothelial carcinoma cohorts treated with (i) gemcitabine plus cisplatin or (ii) pembrolizumab. The gemcitabine plus cisplatin cohort was treated from December 2005 through December 2014 while the pembrolizumab cohort was treated from January 2018 through December 2020. Using multivariate analyses, we evaluated the risk factors for overall survival in each cohort and compared them. None of the gemcitabine plus cisplatin cohort patients were treated with pembrolizumab. All patients in the pembrolizumab cohort were treated with prior platinum-based chemotherapy. RESULTS There were 184 patients in the gemcitabine plus cisplatin cohort and 91 in the pembrolizumab cohort. The mean follow-up periods were 714 and 284 days, respectively. In multivariate analysis, the risk factors for overall survival in the gemcitabine plus cisplatin cohort were liver metastasis, worse Eastern Cooperative Oncology Group performance status (1 or more), no primary site resection, and a high prognostic index (1 or more). In the pembrolizumab cohort, liver metastasis, bone metastasis, and worse Eastern Cooperative Oncology Group-performance status (1 or more), and high prognostic index (1 or more) were the risk factors for overall survival. In the pembrolizumab cohort, patients with a complete response or partial response during prior platinum-based chemotherapy had better overall survival with the following pembrolizumab treatment than those with stable or progressive disease (P = 0.004). CONCLUSIONS Considering the similarity of these risk factors in two sequential treatments, it may be possible to predict the response to pembrolizumab according to the response to prior chemotherapy.
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Affiliation(s)
- Tetsuya Shindo
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Maehana
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Takahashi
- Department of Urology, Hakodate Koseiin Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - Hiroshi Hotta
- Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | | | - Keisuke Taguchi
- Department of Urology, Oji General Hospital, Tomakomai, Japan
| | - Hitoshi Tachiki
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Naoki Ito
- Department of Urology, NTT East Corporation Sapporo Hospital, Sapporo, Japan
| | | | - Ryuichi Kato
- Department of Urology, Muroran City General Hospital, Muroran, Japan
| | - Shintaro Miyamoto
- Department of Urology, Japanese Red Cross Kushiro Hospital, Kushiro, Japan
| | - Shiro Hinotsu
- Department of Biostatistics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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6
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Li N, Jiang M, Wu WC, Zou LQ. The value of prognostic nutritional index in nasal-type, extranodal natural killer/T-cell lymphoma. Ann Hematol 2022; 101:1545-1556. [PMID: 35635579 DOI: 10.1007/s00277-022-04849-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/19/2022] [Indexed: 02/05/2023]
Abstract
Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive disorder with heterogeneous clinical characteristics and poor prognosis. The combined value of baseline serum albumin level and absolute peripheral lymphocyte count showed prognostic information in a variety of malignancies, but its evidence is limited in ENKTL. The purpose of this study is to evaluate the impact of prognostic nutritional index (PNI) in ENKTL, and to provide some nutritionally and immunologically relevant information for better risk stratification. We conducted a retrospective study in 533 patients newly diagnosed with ENKTL. The PNI was calculated as albumin (g/L) + 5 × lymphocyte count (109/L). The optimal cutoff values for serum albumin and lymphocyte count were 40.6 g/L and 1.18 × 109/L, respectively, and 47.3 for PNI. After a median follow-up of 70 months, the 5-year overall survival (OS) and progression-free survival (PFS) were 56.2% and 49.5%, respectively. Patients in low PNI group had more unfavorable clinical features, and tended to have worse 5-year OS and PFS compared with those in high PNI group. According PNI-associated prognostic score, patients were classified into different risk groups. Significant difference has been found in 5-year OS and PFS in different risk groups. When PNI and PNI-associated prognostic score were superimposed on the International Prognostic Index (IPI), prognostic index of natural killer lymphoma (PINK), or nomogram-revised risk index (NRI) categories, the PNI and PNI-associated prognostic score provided additional prognostic information. Therefore, PNI and PNI-associated prognostic score could be independent prognostic factors for ENKTL and may be useful for risk stratification and clinical decision-making.
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Affiliation(s)
- Na Li
- Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.,Department of Oncology, West China Fourth Hospital, West China School of Public Health, Sichuan University, Chengdu, China
| | - Ming Jiang
- Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Wan-Chun Wu
- Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China
| | - Li-Qun Zou
- Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
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7
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Taguchi A, Nakajima Y, Furusawa A, Yoshino Y, Takao M, Kashiyama T, Kino N, Yasugi T. High neutrophil-to-lymphocyte ratio is a predictor of short-term survival for patients with recurrent cervical cancer after radiation-based therapy. J Obstet Gynaecol Res 2021; 47:1862-1870. [PMID: 33611808 DOI: 10.1111/jog.14712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/20/2021] [Accepted: 02/06/2021] [Indexed: 01/04/2023]
Abstract
AIM Patients with recurrent cervical cancer after radiotherapy have poor prognoses because of the lack of effective treatment options. Biomarkers to predict survival outcomes for recurrent cervical cancer are warranted because patients with limited life expectancy sometimes benefit from less aggressive treatment in combination with early palliative care. Therefore, we aimed to explore a predictive biomarker for the outcomes of patients with recurrent cervical cancer. METHODS We retrospectively investigated 231 patients initially treated with radiation-based therapy between January 2004 and December 2015. The associations between clinicopathological features at the time of relapse and overall survival after relapse were assessed. As factors which reflect patients' conditions, we particularly focused on C-reactive protein-to-albumin ratio (CAR) and neutrophil-to-lymphocyte ratio (NLR) at the time of relapse. Additionally, we investigated biomarkers predictive of short-term survival. RESULTS Among 231 patients, 91 patients experienced relapse and 74 patients died during the follow-up period. Multivariate analysis revealed that treatment after relapse, CAR, and NLR was significantly associated with overall survival. Among them, treatment after relapse significantly affected survival outcomes, and patients who received definitive local treatment had a better 3-year survival rate than those who received other treatments. Conversely, NLR was the most influential biomarker for short-term survival, and the prognosis of patients with high NLRs was much worse than those with low NLRs. CONCLUSIONS This study thus demonstrated that, for the patients with recurrent cervical cancer who received radiation-based therapy, definitive local treatment can provide long-term survival and extremely high NLRs are predictive of short-term survival.
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Affiliation(s)
- Ayumi Taguchi
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.,Department of Obstetrics and Gynecology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan
| | - Yujiro Nakajima
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.,Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Furusawa
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yasunori Yoshino
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Maki Takao
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tomoko Kashiyama
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.,Department of Obstetrics and Gynecology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan
| | - Nao Kino
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Toshiharu Yasugi
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
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Powell AGMT, Eley C, Chin C, Coxon AH, Christian A, Lewis WG. Prognostic significance of serum inflammatory markers in esophageal cancer. Esophagus 2021; 18:267-277. [PMID: 32865623 PMCID: PMC7960607 DOI: 10.1007/s10388-020-00772-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/24/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND The aim of this study was to assess the relative prognostic value of biomarkers to measure the systemic inflammatory response (SIR) and potentially improve prognostic modeling in patients undergoing potentially curative surgery for esophageal adenocarcinoma (EC). METHODS Consecutive 330 patients undergoing surgery for EC between 2004 and 2018 within a regional UK cancer network were identified. Serum measurements of haemoglobin, C-reactive protein, albumin, modified Glasgow Prognostic Score (mGPS), and differential neutrophil to lymphocyte ratio (NLR) were obtained before surgery, and correlated with histopathological factors and outcomes. Primary outcome measures were disease-free (DFS) and overall survival (OS). RESULTS Of 330 OC patients, 294 underwent potentially curative esophagectomy. Univariable DFS analysis revealed pT, pN, pTNM stage (all p < 0.001), poor differentiation (p = 0.001), vascular invasion (p < 0.001), R1 status (p < 0.001), perioperative chemotherapy (p = 0.009), CRP (p = 0.010), mGPS (p = 0.011), and NLR (p < 0.001), were all associated with poor survival. Multivariable Cox regression analysis of DFS revealed only NLR [Hazard Ratio (HR) 3.63, 95% Confidence Interval (CI) 2.11-6.24, p < 0.001] retained significance. Multivariable Cox regression analysis of OS revealed similar findings: NLR [HR 2.66, (95% CI 1.58-4.50), p < 0.001]. CONCLUSION NLR is an important SIR prognostic biomarker associated with DFS and OS in EC.
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Affiliation(s)
- Arfon G. M. T. Powell
- Division of Cancer and Genetics, University Hospital of Wales, Cardiff University, Heath Park, Cardiff, UK
| | - Catherine Eley
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Carven Chin
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Alexandra H Coxon
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Adam Christian
- Department of Pathology, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Wyn G. Lewis
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
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9
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Knotek M, Novak R, Jaklin-Kekez A, Mrzljak A. Combined liver-kidney transplantation for rare diseases. World J Hepatol 2020; 12:722-737. [PMID: 33200012 PMCID: PMC7643210 DOI: 10.4254/wjh.v12.i10.722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/30/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
Combined liver and kidney transplantation (CLKT) is indicated in patients with failure of both organs, or for the treatment of end-stage chronic kidney disease (ESKD) caused by a genetic defect in the liver. The aim of the present review is to provide the most up-to-date overview of the rare conditions as indications for CLKT. They are major indications for CLKT in children. However, in some of them (e.g., atypical hemolytic uremic syndrome or primary hyperoxaluria), CLKT may be required in adults as well. Primary hyperoxaluria is divided into three types, of which type 1 and 2 lead to ESKD. CLKT has been proven effective in renal function replacement, at the same time preventing recurrence of the disease. Nephronophthisis is associated with liver fibrosis in 5% of cases and these patients are candidates for CLKT. In alpha 1-antitrypsin deficiency, hereditary C3 deficiency, lecithin cholesterol acyltransferase deficiency and glycogen storage diseases, glomerular or tubulointerstitial disease can lead to chronic kidney disease. Liver transplantation as a part of CLKT corrects underlying genetic and consequent metabolic abnormality. In atypical hemolytic uremic syndrome caused by mutations in the genes for factor H, successful CLKT has been reported in a small number of patients. However, for this indication, CLKT has been largely replaced by eculizumab, an anti-C5 antibody. CLKT has been well established to provide immune protection of the transplanted kidney against donor-specific antibodies against class I HLA, facilitating transplantation in a highly sensitized recipient.
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Affiliation(s)
- Mladen Knotek
- Department of Medicine, Tree Top Hospital, Hulhumale 23000, Maldives
- Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Rafaela Novak
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | | | - Anna Mrzljak
- Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia.
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10
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El Asmar A, Ghabi E, Saber T, Abou-Malhab C, Akl B, El Rassi Z. Platelet-to-lymphocyte ratio is correlated with a delay in feeding resumption following a transhiatal esophagectomy with cervical anastomosis. World J Surg Oncol 2020; 18:267. [PMID: 33054830 PMCID: PMC7559741 DOI: 10.1186/s12957-020-02035-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction The lymphocytic population, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are prognostic tools predictive of adverse outcomes for several solid tumors and oncologic surgeries, one of which is esophageal adenocarcinoma. Furthermore, delayed resumption of oral feeding postoperatively is associated with significant morbidity. Given the controversies regarding post-op nutritional support in these patients, this study investigates the prognostic role of the lymphocytic percentage, the NLR, and the PLR in predicting prolonged length of hospital stay (LOHS) and ICU stay (LOICUS) as well as delayed oral feeding following transhiatal esophagectomy (THE) for adenocarcinoma of the esophagogastric junction (AEG). Methods Forty consecutive patients who underwent transhiatal esophagectomy performed by a single surgeon for Siewert type II and type III adenocarcinoma of the esophagogastric junction at a tertiary referral center were selected. Retrospective data collection was performed from the patients’ medical records, and statistical analysis was performed using Pearson correlation and Student’s t test and Chi-square testing. Results An increased LOHS was correlated with a lower preoperative lymphocyte percentage (p = 0.043), higher NLR (p = 0.010) and PLR (p = 0.015), and an increased number of packed red blood cell (PRBC) transfusions perioperatively (p = 0.030). An increased LOICUS was correlated with a lower preoperative lymphocyte percentage (p = 0.033), higher NLR (p = 0.018) and PLR (p = 0.044), an increased number of PRBC transfusions (p = 0.001), and patients’ comorbidities (p < 0.05). A delay in feeding resumption was correlated with a lower preoperative lymphocyte percentage (p = 0.022), higher NLR (p = 0.004) and PLR (p = 0.001), an increased PRBC transfusions (p = 0.001), and diabetes mellitus (p = 0.033). Multivariate analysis with automatic linear modeling showed that only the preoperative PLR was a powerful predictor for the delay of feeding resumption (p < 0.01). Conclusion The lymphocyte percentage, PLR, and NLR are found to be associated with prolonged hospitalization and ICU stay and delayed oral feeding following THE for Siewert types II and III AEG. We hope by this series, to have set, at least one preliminary cornerstone, in the creation of a prognostic model, capable of assessing the need for an intraoperative jejunostomy placement, in patients undergoing esophagectomy for distal esophageal carcinoma.
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Affiliation(s)
- Antoine El Asmar
- Institut Jules Bordet, Boulevard de Waterloo 121, 1000, Brussels, Belgium.
| | - Elie Ghabi
- Department of Urology, Saint George Hospital University Medical Center, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon
| | - Toufic Saber
- Department of General Surgery, Saint George Hospital University Medical Center, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon
| | - Christina Abou-Malhab
- Faculty of Medicine and Medical Sciences, University of Balamand, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon
| | - Bernard Akl
- Department of Urology, Saint George Hospital University Medical Center, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon
| | - Ziad El Rassi
- Department of General Surgery, Saint George Hospital University Medical Center, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon
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11
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Tsushima T, Kasai H, Tanigawara Y. Pharmacokinetic and pharmacodynamic analysis of neutropenia following nab-paclitaxel administration in Japanese patients with metastatic solid cancer. Cancer Chemother Pharmacol 2020; 86:487-495. [PMID: 32930844 DOI: 10.1007/s00280-020-04140-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/06/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To develop a pharmacokinetic (PK) and pharmacodynamic (PD) model for neutropenia following nab-paclitaxel administration and identify factors associated with drug disposition and changes in neutrophil counts in patients with solid cancer. METHODS PK/PD analysis by nonlinear mixed effects approach was performed using the data from 27 patients who participated in phase I studies of nab-paclitaxel monotherapy conducted in Japan. The patients were treated with either weekly (80, 100, or 125 mg/m2) or every 3 weeks (200, 260, or 300 mg/m2). The observed paclitaxel concentrations in whole blood and neutrophil counts in the first cycle were used for PK/PD analysis. Covariate analysis was performed to identify factors affecting PK and the decrease in neutrophil counts. RESULTS The developed 3-compartment, non-linear PK model described relationships of body surface area with total body clearance and volume of distribution for the peripheral compartment. Covariate factors affecting neutrophil counts were age and serum albumin level. Simulation based on the developed PK/PD model showed a substantial impact of age and serum albumin level on the time course of neutrophil counts after nab-paclitaxel administration. Advanced age was related to greater decrease in neutrophil counts, and serum albumin level, inversely related to change in neutrophil counts. CONCLUSION We have developed a novel PK/PD model for nab-paclitaxel in which age and serum albumin level were considered clinically important covariate factors. This model needs to be further validated using a larger patient population.
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Affiliation(s)
- Takahiro Tsushima
- Department of Clinical Pharmacokinetics and Pharmacodynamics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Division of Gastrointestinal Oncology, Shizuoka Cancer Centre, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Hidefumi Kasai
- Department of Clinical Pharmacokinetics and Pharmacodynamics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yusuke Tanigawara
- Department of Clinical Pharmacokinetics and Pharmacodynamics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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12
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Alan O, Telli TA, Basoğlu T, Arikan R, Demircan NC, Ercelep O, Bozkurt S, Atasoy BM, Dane F, Yumuk PF. Prognostic value of modified Glasgow prognostic score in recurrent high-grade glial tumors treated with systemic treatment. Clin Neurol Neurosurg 2020; 196:105976. [PMID: 32531614 DOI: 10.1016/j.clineuro.2020.105976] [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: 03/14/2020] [Revised: 05/03/2020] [Accepted: 05/26/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor. We aimed to evaluate the prognostic value of modified Glasgow Prognostic Score (mGPS), which is combination of C-reactive protein (CRP) and albumin, in recurrent high-grade glioma patients treated with systemic treatment. PATIENTS AND METHODS Data of 85 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. Patients were grouped according to mGPS criteria: mGPS-0: CRP < 10 mg/L and albumin >3.5 g/dL; mGPS-1: CRP < 10 mg/L and albumin <3.5 g/dL or CRP > 10 mg/L and albumin >3.5 g/dL; and mGPS-2: CRP > 10 mg/L and albumin <3.5 mg/L. We investigated the prognostic role of mGPS groups, mutations and survival outcomes. RESULTS There were 42 (49.4 %), 25 (29.6 %), and 18 (21 %) patients in mGPS-0, mGPS-1, and mGPS-2 groups, respectively. Median follow-up duration was 10 months (1-70 months). Median OS was 8.1 months. According to mGPS-0, -1 and -2; median OS was 13.8 months, 7.3 months and 3.6 months respectively (p = 0.003). mGPS, ATRX and IDH-1 mutation status, and ECOG PS were found to be independent prognostic factors for OS. CONCLUSION In our study, mGPS was found to be an independent prognostic factor in patients with recurrent high-grade gliomas. If validated, mGPS can be used as an objective, easily calculated, cheap, and readily available prognostic model in routine practice.
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Affiliation(s)
- Ozkan Alan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey.
| | - Tugba Akın Telli
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Tugba Basoğlu
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Rukiye Arikan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nazim Can Demircan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ozlem Ercelep
- Department of Medical Oncology, Pendik Education and Research Hospital, Marmara University, Istanbul, Turkey
| | - Suheyla Bozkurt
- Department of Pathology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Beste Melek Atasoy
- Department of Radiation Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Faysal Dane
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Gastric Inflammatory Prognostic Index (GIPI) in Patients with Metastatic Gastro-Esophageal Junction/Gastric Cancer Treated with PD-1/PD-L1 Immune Checkpoint Inhibitors. Target Oncol 2020; 15:327-336. [DOI: 10.1007/s11523-020-00723-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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14
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Amgarth-Duff I, Hosie A, Caplan G, Agar M. A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes. BMC Psychiatry 2020; 20:182. [PMID: 32321448 PMCID: PMC7178636 DOI: 10.1186/s12888-020-02584-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 04/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Delirium is a serious and distressing neurocognitive disorder of physiological aetiology that is common in advanced cancer. Understanding of delirium pathophysiology is largely hypothetical, with some evidence for involvement of inflammatory systems, neurotransmitter alterations and glucose metabolism. To date, there has been limited empirical consideration of the distinction between delirium pathophysiology and that of the underlying disease, for example, cancer where these mechanisms are also common in advanced cancer syndromes such as pain and fatigue. This systematic review explores biomarker overlap in delirium, specific advanced cancer-related syndromes and prediction of cancer prognosis. METHODS A systematic review (PROSPERO CRD42017068662) was conducted, using MEDLINE, PubMed, Embase, CINAHL, CENTRAL and Web of Science, to identify body fluid biomarkers in delirium, cancer prognosis and advanced cancer-related syndromes of interest. Studies were excluded if they reported delirium tremens only; did not measure delirium using a validated tool; the sample had less than 75% of participants with advanced cancer; measured tissue, genetic or animal biomarkers, or were conducted post-mortem. Articles were screened for inclusion independently by two authors, and data extraction and an in-depth quality assessment conducted by one author, and checked by two others. RESULTS The 151 included studies were conducted in diverse settings in 32 countries between 1985 and 2017, involving 28130 participants with a mean age of 69.3 years. Seventy-one studies investigated delirium biomarkers, and 80 studies investigated biomarkers of an advanced cancer-related syndrome or cancer prognosis. Overall, 41 biomarkers were studied in relation to both delirium and either an advanced cancer-related syndrome or prognosis; and of these, 24 biomarkers were positively associated with either delirium or advanced cancer syndromes/prognosis in at least one study. The quality assessment showed large inconsistency in reporting. CONCLUSION There is considerable overlap in the biomarkers in delirium and advanced cancer-related syndromes. Improving the design of delirium biomarker studies and considering appropriate comparator/controls will help to better understanding the discrete pathophysiology of delirium in the context of co-existing illness.
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Affiliation(s)
- Ingrid Amgarth-Duff
- University of Technology Sydney, Faculty of Health, IMPACCT -Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Sydney, NSW, Australia.
| | - Annmarie Hosie
- grid.117476.20000 0004 1936 7611University of Technology Sydney, Faculty of Health, IMPACCT -Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Sydney, NSW Australia
| | - Gideon Caplan
- grid.1005.40000 0004 4902 0432Prince of Wales Clinical School, University of New South Wales, Sydney, NSW Australia ,grid.415193.bDepartment of Geriatric Medicine, Prince of Wales Hospital, Sydney, NSW Australia
| | - Meera Agar
- grid.117476.20000 0004 1936 7611University of Technology Sydney, Faculty of Health, IMPACCT -Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Sydney, NSW Australia ,grid.1005.40000 0004 4902 0432South West Sydney Clinical School, University of New South Wales, Liverpool, New South Wales Australia ,grid.429098.eClinical Trials, Ingham Institute of Applied Medical Research, Liverpool, New South Wales Australia
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15
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The prevalence of cancer associated systemic inflammation: Implications of prognostic studies using the Glasgow Prognostic Score. Crit Rev Oncol Hematol 2020; 150:102962. [PMID: 32344318 DOI: 10.1016/j.critrevonc.2020.102962] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 02/07/2023] Open
Abstract
The prognostic importance of SIR in patients with cancer is widely recognised. More recently it has become clear that the systemic inflammatory response is an important etiologic factor in the development of cancer cachexia. Two recent meta-analysis carried out in 2017 and 2018 were interrogated and the number of patients with specific cancer types were identified. The percentage of patients with operable cancer (n>28,000) who were systemically inflamed varied from 21% to 38%. The percentage of patients with inoperable cancer (n>12,000) who were systemically inflamed varied from 29% to 79%. Overall, the percentage of patients (n>40,000) who were systemically inflamed varied from 28% to 63% according to tumour type. The most commonly studied cancer was colorectal cancer (n∼10,000 patients) and 40% were systemically inflamed.
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Local Inflammatory Response Can Predict Clinical Outcome in Patients with Curatively Resected Stage-IIB Colon Cancer: An Advanced Methodological Study. Pathol Oncol Res 2019; 26:1805-1816. [PMID: 31748877 DOI: 10.1007/s12253-019-00758-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/02/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Although local inflammatory response (LIR) is a reliable survival marker in colon cancers (CCs), there is no consensus on its use in daily practice. We investigated the prognostic value of LIR in a highly homogeneous population with a well-designed methodology. METHODS Eighty stage-IIB CC patients operated between 2002 and 2012 were included in the study. Standardization was investigated for extra-biopsy evaluation methods (magnification, staining, and counting). Model A was used for intra-biopsy evaluation methods (block, section, and focus). So, this study makes important contributions to the standardization of pathological evaluations. RESULTS In method 1, the following analyzes showed more successful results for LIR: relationship with prognostic factors [tumour deposits (p=0.017), Crohn's-like reaction (p=0.019), advanced grade, (p=0.012), positive surgical margin (p=0.019), perineural invasion (p=0.025), mismatch repair proteins-proficiency (p=0.031)], reproducibility of the study (Kappa=0.49-0.73, Intra-class correlation=0.442-0.724), and correlation of estimates (r=0.704). The cut-off value was also quite useful (area of under ROC=0.820 [0.694-0.920]). In univariate analysis, low LIR was related to poor overall survival (OS; p<0.001) and poor relapse-free survival (RFS, p=0.001) . Multivariate analysis confirmed that low LIR is an independent poor survival marker for OS (Hazard Ratio [HR]=1.32 [1.08-1.61, p=0.005) and RFS (HR=1.50 [1.22-1.85], p<0.001). CONCLUSIONS Our results showed that low LIR had an independent prognostic significance in stage -IIB CCs. We also recommend using model A and method 1 for successful results and standardization.
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17
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Song H, Xu B, Luo C, Zhang Z, Ma B, Jin J, Zhang Q. The prognostic value of preoperative controlling nutritional status score in non-metastatic renal cell carcinoma treated with surgery: a retrospective single-institution study. Cancer Manag Res 2019; 11:7567-7575. [PMID: 31496811 PMCID: PMC6693320 DOI: 10.2147/cmar.s209418] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/25/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to investigate the significance of the controlling nutritional status (CONUT) score as a predictor for survival outcomes for non-metastatic renal cell carcinoma (RCC) patients. Methods We retrospectively reviewed 325 patients who received surgical treatment for renal cell carcinoma between 2010 and 2012 at Peking University First Hospital. Patients were divided into two groups according to the optimal cut-off value of CONUT score. Kaplan–Meier method and log-rank test were used for survival analysis according to different CONUT groups. Cox proportional hazards regression models were performed to assess the prognostic value of clinicopathological parameters for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) respectively. Results The optimal cut-off value of CONUT score was 3. High CONUT score significantly correlated to higher tumor grade (P<0.001), later pathological T stage (P<0.001) and tumor necrosis (P<0.001). Patients with higher CONUT score had worse OS (HR 5.34, 95% CI 2.29–12.46, P<0.001), CSS (HR 5.51, 95% CI 2.12–14.33, P<0.001) and DFS (HR 4.23, 95% CI 2.16–8.29, P<0.001). In multivariable analysis, high CONUT score was an independent risk factor for OS, CSS and DFS (OS: HR=3.36, 95% CI 1.73–6.56, P<0.001; CSS: HR=3.34, 95% CI 1.59–6.98, P=0.001; DFS: HR=1.85, ]95% CI 1.07–3.21, P=0.029) Conclusion Preoperative CONUT score was an independent prognostic factor for OS, CSS and DFS in non-metastatic RCC patients treated with surgery.
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Affiliation(s)
- Haifeng Song
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Ben Xu
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Cheng Luo
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Zhenan Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Binglei Ma
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Qian Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
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18
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Prognostic value of pretreatment Glasgow prognostic score in stage IIIB geriatric non-small cell lung cancer patients undergoing radical chemoradiotherapy. J Geriatr Oncol 2019; 10:567-572. [DOI: 10.1016/j.jgo.2018.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/27/2018] [Accepted: 10/18/2018] [Indexed: 12/25/2022]
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Prognostic role of tumour-infiltrating T lymphocytes in stage IIA (T3N0) colon cancer: A broad methodological study in a fairly homogeneous population. Ann Diagn Pathol 2019; 41:69-78. [PMID: 31146180 DOI: 10.1016/j.anndiagpath.2019.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/11/2019] [Indexed: 12/11/2022]
Abstract
AIM Tumour-infiltrating T lymphocytes (TIL) are considered to be a reliable prognostic marker in CC, but the use in daily practice is unclear. We investigated the survival effect of TIL methodologically in a highly homogeneous population. METHODS Seventy-two stage IIA (T3N0) CC patients who underwent surgical resection from 2000 to 2014 were included. CD3 and CD8 were separately scored for different blocks, areas and foci. To the best of our knowledge, this study has the most comprehensive methodology in the literature. RESULTS Foremost, we searched for the optimal evaluation method. We found better results with Model A (deepest invasive block&hot spot area&invasive margin focus), e.g. for CD3, the relationship with prognostic factors [Crohn's-like reaction (p = 0.015), positive surgical margin (p = 0.019), Mismatch repair proteins deficiency (p = 0.003), advanced grade (p = 0.015)], the correlation of distinct estimates (r = 0.708), the reproducibility of research (Κappa = 0.60-0.71), and the usefulness of cut-off value (area of under ROC = 0.800 [0.683-0.917]) were best. Then, survival analysis was performed with two better methods including Model A. In univariate analysis, low TIL with Model A was associated with worse OS (CD3, p < 0.001; CD8, p = 0.023) and RFS (CD3, p < 0.001; CD8, p = 0.005). Multivariate analyses confirmed low TIL with same method as an independent worse prognostic marker for OS (CD3, Hazard ratio [HR] = 1.42 [1.10-1.85], p = 0.005) and RFS (CD3, HR = 1.46 [1.17-1.83], p = 0.001; CD8, HR = 1.32 [1.05-1.64], p = 0.032). CONCLUSIONS Our results confirm that low TIL is an independent worse prognostic marker in stage IIA (T3N0) CC and that the use of CD3 with Model A can contribute to improving the prognostication of early CCs.
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20
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Engelhardt EG, Révész D, Tamminga HJ, Punt CJA, Koopman M, Onwuteaka-Philipsen BD, Steyerberg EW, de Vet HCW, Coupé VMH. Inventory of oncologists' unmet needs for tools to support decision-making about palliative treatment for metastatic colorectal cancer. BMC Med Inform Decis Mak 2018; 18:132. [PMID: 30551735 PMCID: PMC6295030 DOI: 10.1186/s12911-018-0712-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Decision-making about palliative care for metastatic colorectal cancer (mCRC) consists of many different treatment-related decisions, and there generally is no best treatment option. Decision support systems (DSS), e.g., prognostic calculators, can aid oncologists' decision-making. DSS that contain features tailored to the needs of oncologists are more likely to be implemented in clinical practice. Therefore, our aim is to inventory colorectal cancer specialists' unmet decision support needs. METHODS We asked oncologists from the Dutch colorectal cancer group (DCCG), to participate in an online inventory questionnaire on their unmet decision support needs. To get more in-depth insight in required features of the DSS they need, we also conducted semi-structured telephone interviews. RESULTS Forty-one oncologists started the inventory questionnaire, and 27 of them completed all items. Of all respondents, 18 were surgeons (44%), 22 were medical oncologists (54%), and 28 (68%) had more than 10 years of experience treating mCRC. In both the inventory questionnaire and interviews, respondents expressed a need for an overarching DSS incorporating multiple treatment options, and presenting both the treatment benefits and harms. Respondents found it relevant for other outcomes, such as cost-effectiveness of treatment or quality of life, to be incorporated in DSS. There was also a wish for DSS incorporating an up-to-date "personalized" overview of the ongoing trials for which a specific patient is eligible. CONCLUSIONS Experienced oncologists indicate that their treatment advice is currently almost solely based on the available clinical guidelines. They experience a lack of good quality DSS to help them personalize their treatment advice. New tools integrating multiple treatment options and providing a broad range of clinically relevant outcomes are urgently needed to stimulate and safeguard more personalized treatment decision-making.
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Affiliation(s)
- Ellen G Engelhardt
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUMC, F-wing Medical Faculty building, PO Box 7057 1007, MB, Amsterdam, The Netherlands.
| | - Dóra Révész
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUMC, F-wing Medical Faculty building, PO Box 7057 1007, MB, Amsterdam, The Netherlands
| | - Hans J Tamminga
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUMC, F-wing Medical Faculty building, PO Box 7057 1007, MB, Amsterdam, The Netherlands
| | - Cornelis J A Punt
- Department of Medical Oncology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht and University Utrecht, Utrecht, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, and Palliative Care Expertise Centre, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ewout W Steyerberg
- Department of Public Health, Centre for Medical Decision Making, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Henrica C W de Vet
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUMC, F-wing Medical Faculty building, PO Box 7057 1007, MB, Amsterdam, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUMC, F-wing Medical Faculty building, PO Box 7057 1007, MB, Amsterdam, The Netherlands
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Kim SH, Go SI, Seo J, Kang MH, Park SW, Kim HG, Lee GW. Prognostic impact of pretreatment albumin to globulin ratio in patients with diffuse large B-cell lymphoma treated with R-CHOP. Leuk Res 2018; 71:100-105. [PMID: 30048838 DOI: 10.1016/j.leukres.2018.07.014] [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: 04/19/2018] [Revised: 07/09/2018] [Accepted: 07/16/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We evaluated the clinical implications of the albumin to globulin ratio (AGR) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). METHODS Data of 232 patients with DLBCL treated with first-line R-CHOP from 2004 to 2017 were reviewed retrospectively. Patients with AGR values ≥1.22 and <1.22 were assigned to the high and low AGR groups, respectively. Treatment response, treatment-related toxicity, and survival were compared according to the AGR. RESULTS The complete response rate was significantly lower in the low AGR group than in the high AGR group (59.1% vs. 81.3%; p < 0.001). Treatment-related mortality was also more frequent in the low AGR group than in the high AGR group (14.0% vs. 4.3%; p = 0.009). The low AGR group (median overall survival [OS] = 26.87 months; 95% confidence interval [CI] = 4.19-49.55) showed a significant decrease in OS compared to the high AGR group (median OS = 148.83 months; 95% CI = 76.26-221.41; p < 0.001). Progression-free survival (PFS) also decreased significantly in the low AGR group (median PFS = 14.29 months; 95% CI = 2.58-26.01) compared to the high AGR group (median PFS = 148.83 months; 95% CI = 76.21-221.45; p < 0.001). In a multivariate analysis, low AGR was an independent poor prognostic factor for OS and PFS. CONCLUSIONS Pretreatment AGR was useful for predicting treatment response, treatment-related toxicity, and prognosis in patients with DLBCL treated with R-CHOP. Further large prospective studies will be necessary to validate our findings.
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Affiliation(s)
- Seok-Hyun Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Se-Il Go
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jangho Seo
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Myoung Hee Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Sung Woo Park
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hoon-Gu Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Gyeong-Won Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Prognostic value of the Glasgow Prognostic Score for glioblastoma multiforme patients treated with radiotherapy and temozolomide. J Neurooncol 2018; 139:411-419. [PMID: 29696530 DOI: 10.1007/s11060-018-2879-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/22/2018] [Indexed: 01/01/2023]
Abstract
INTRODUCTION To evaluate the prognostic value of the Glasgow Prognostic Score (GPS), the combination of C-reactive protein (CRP) and albumin, in glioblastoma multiforme (GBM) patients treated with radiotherapy (RT) and concurrent plus adjuvant temozolomide (GPS). METHODS Data of newly diagnosed GBM patients treated with partial brain RT and concurrent and adjuvant TMZ were retrospectively analyzed. The patients were grouped into three according to the GPS criteria: GPS-0: CRP < 10 mg/L and albumin > 35 g/L; GPS-1: CRP < 10 mg/L and albumin < 35 g/L or CRP > 10 mg/L and albumin > 35 g/L; and GPS-2: CRP > 10 mg/L and albumin < 35 g/L. Primary end-point was the association between the GPS groups and the overall survival (OS) outcomes. RESULTS A total of 142 patients were analyzed (median age: 58 years, 66.2% male). There were 64 (45.1%), 40 (28.2%), and 38 (26.7%) patients in GPS-0, GPS-1, and GPS-2 groups, respectively. At median 15.7 months follow-up, the respective median and 5-year OS rates for the whole cohort were 16.2 months (95% CI 12.7-19.7) and 9.5%. In multivariate analyses GPS grouping emerged independently associated with the median OS (P < 0.001) in addition to the extent of surgery (P = 0.032), Karnofsky performance status (P = 0.009), and the Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA) classification (P < 0.001). The GPS grouping and the RTOG RPA classification were found to be strongly correlated in prognostic stratification of GBM patients (correlation coefficient: 0.42; P < 0.001). CONCLUSIONS The GPS appeared to be useful in prognostic stratification of GBM patients into three groups with significantly different survival durations resembling the RTOG RPA classification.
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Wakahara T, Ueno N, Maeda T, Kanemitsu K, Yoshikawa T, Tsuchida S, Toyokawa A. Is the Glasgow Prognostic Score Applicable to Both Early- and Advanced-Stage Gastric Cancers? Gastroenterology Res 2018; 10:359-365. [PMID: 29317944 PMCID: PMC5755638 DOI: 10.14740/gr943w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/27/2017] [Indexed: 12/18/2022] Open
Abstract
Background The Glasgow prognostic score (GPS) has been reported as a sensitive prognostic marker for gastric cancer. This study aimed to investigate whether the GPS is equally applicable to patients with early-stage and advanced-stage gastric cancers. Methods Patients (n = 544) who underwent elective gastrectomy for gastric cancer between 2007 and 2015 were retrospectively studied. GPSs of 2, 1, and 0 were allocated to patients with both an elevated C-reactive protein level (> 1.0 mg/dL) and hypoalbuminemia (< 3.5 mg/dL), patients with only one of these abnormalities, and patients with neither abnormality, respectively. The prognostic factors relevant to patients with early-stage (pStage I, n = 304) and advanced-stage (pStage II, III, and IV, n = 240) gastric cancer were analyzed through univariate and multivariate analyses. Results In the early-stage group, only the serum carbohydrate antigen (CA) 19-9 level (P = 0.037) was a significant prognostic factor in the multivariate analysis; the GPS was not significant (P = 0.095). In the advanced-stage group, an American Society of Anesthesiologists physical status of 3 or 4 (P = 0.032), elevated carcinoembryonic antigen (CEA) (P = 0.043) and CA19-9 (P = 0.045) levels, a GPS 1 - 2 (P = 0.017), and type 4 tumor (P = 0.020) correlated significantly with worse overall survival. Conclusions GPS is a simple and useful prognostic score for patients with advanced-stage, but is not applicable to early-stage patients.
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Affiliation(s)
| | - Nozomi Ueno
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Tetsuo Maeda
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | | | - Takuro Yoshikawa
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Shinobu Tsuchida
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Akihiro Toyokawa
- Department of Surgery, Yodogawa Christian Hospital, Osaka, Japan
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Powell AGMT, Parkinson D, Patel N, Chan D, Christian A, Lewis WG. Prognostic Significance of Serum Inflammatory Markers in Gastric Cancer. J Gastrointest Surg 2018; 22:595-605. [PMID: 29234999 PMCID: PMC5869874 DOI: 10.1007/s11605-017-3597-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/19/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND The aim of this study was to assess the relative prognostic value of biomarkers to measure the systemic inflammatory response (SIR) and improve prognostic modeling in a cohort of patients undergoing potentially curative surgery for gastric adenocarcinoma. The hypothesis was that a single SIR biomarker would be associated with the most prognostic value. METHODS Consecutive 331 patients undergoing surgery for gastric cancer between 2004 and 2016 within a regional UK cancer network were identified. Serum measurements of hemoglobin, C-reactive protein, albumin, modified Glasgow Prognostic Score, and differential white cell counts were obtained before surgery, and correlated with histopathological factors (pTNM stage, differentiation, and vascular invasion) and survival. Primary outcome measures were disease-free (DFS) and overall survival (OS). RESULTS Consecutive 331 patients were identified and 291 underwent potentially curative gastrectomy for adenocarcinoma. On univariable DFS analysis, female gender (p = 0.027), proximal location (p = 0.018), pT stage (p < 0.001), pN stage (p < 0.001), pTNM stage (p < 0.001), vascular invasion (p < 0.001), poor differentiation (p = 0.001), lymph node ratio (p < 0.001), R1 status (p < 0.001), platelet count (p = 0.038), and mGPS (p = 0.001) were significantly associated with poor survival. The mGPS was associated with advanced pT stage (p = 0.001), pTNM stage (p = 0.013), and poor differentiation (p = 0.030). On multivariable DFS analysis, mGPS [hazard ratio (HR) 2.51, 95% confidence interval (CI) 1.35-4.65, p = 0.011] was the only inflammatory marker to retain independent significance. Multivariable OS analysis revealed similar findings; mGPS (HR 2.75, (95% CI 1.65-4.59), p < 0.001). CONCLUSION mGPS is an important and only SIR-related prognostic biomarker independently associated with both DFS and OS in gastric cancer.
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Affiliation(s)
- Arfon G. M. T. Powell
- Division of Cancer Genetics, University Hospital of Wales, Cardiff University, Heath Park, Cardiff, UK
| | - Debora Parkinson
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Neil Patel
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - David Chan
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Adam Christian
- Department of Pathology, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Wyn G. Lewis
- Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK
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Zhang X, Rao H, Xu X, Li Z, Liao B, Wu H, Li M, Tong X, Li J, Cai Q. Clinical characteristics and outcomes of Castleman disease: A multicenter study of 185 Chinese patients. Cancer Sci 2017; 109:199-206. [PMID: 29124835 PMCID: PMC5765290 DOI: 10.1111/cas.13439] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/10/2017] [Accepted: 10/31/2017] [Indexed: 12/26/2022] Open
Abstract
Castleman disease (CD) is a rare lymphoproliferative disorder. To assess the clinical features, outcomes, and prognostic factors of this disease, we retrospectively analyzed 185 HIV-negative CD patients from four medical centers in southern China. The median age was 37 years. One hundred and twenty-one patients (65.4%) were classified as unicentric CD (UCD) and 64 patients (34.6%) were classified as multicentric CD (MCD). The histology subtype was hyaline-vascular for 132 patients (71.4%), plasma cell for 50 patients (27%), and mixed type for 3 patients (1.6%). The 5-year overall survival (OS) of 185 CD cases was 80.3%. All UCD patients underwent surgical excision, whereas the treatment strategies of MCD patients were heterogeneous. The outcome for UCD patients was better than MCD patients, with 5-year OS rates of 93.6% and 51.2%, respectively. In further analysis of the MCD subgroup, a multivariate analysis using a Cox regression model revealed that age, splenomegaly and pretreatment serum albumin level were independent prognostic factors for OS. This multicenter study comprising the largest sample size to date suggested that MCD is a distinct entity from UCD with a significantly worse outcome. Older age (≥40 years), splenomegaly, and hypoalbuminemia were risk factors for poorer MCD prognosis.
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Affiliation(s)
- Xuanye Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Huilan Rao
- Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Xiaolu Xu
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Zhihua Li
- Department of Medical Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Bing Liao
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hongmei Wu
- Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mei Li
- Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Xiuzhen Tong
- Department of Hematology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Juan Li
- Department of Hematology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qingqing Cai
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
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Jakubowska K, Kisielewski W, Kańczuga-Koda L, Koda M, Famulski W. Stromal and intraepithelial tumor-infiltrating lymphocytes in colorectal carcinoma. Oncol Lett 2017; 14:6421-6432. [PMID: 29151905 PMCID: PMC5680638 DOI: 10.3892/ol.2017.7013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/15/2017] [Indexed: 12/25/2022] Open
Abstract
The local mechanisms of antitumor immune defense determine the development and organization of the tumor microenvironment, and the composition and relative proportions of the inflammatory cell population affect the quality and characteristics of the immune response. The aim of the present study was to conduct a quantitative morphological evaluation of two types of tumor-infiltrating lymphocyte (TILs) populations, including those located in the stroma and intraepithelial cancer structures, in the invasive front and the center of the tumor in patients with colorectal cancer (CRC). The study included 160 patients with CRC who had undergone surgery. The tissue material was stained with hematoxylin and eosin, as used in routine histopathological diagnosis, and the two TIL populations were observed and counted with light microscopy. The relative extent of infiltration of stromal and intraepithelial TILs into the front and center of the primary tumors was similar. The extent of infiltration by stromal TILs was negatively correlated with the morphological features of tumor progression including the cancer infiltration of blood vessels (P=0.016), the invasion of lymph vessels (P=0.007), perineural invasion (P=0.036), lymph node involvement (P=0.047) and distant metastases (P=0.032). The infiltration by intraepithelial TILs was positively correlated with a desmoplastic reaction (P=0.002). Disease-free survival time was statistically shorter in patients without intraepithelial TILs in the center of the primary tumor mass (P=0.049; hazard ratio = 1.45). These results confirm that the infiltration of TILs into the invasive front and center of the tumor in patients with CRC serves an important role in the invasion and progression of the disease, and should be considered in routine histopathological examinations.
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Affiliation(s)
- Katarzyna Jakubowska
- Department of Pathomorphology, Comprehensive Cancer Center, 15-027 Bialystok, Poland
| | - Wojciech Kisielewski
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Luiza Kańczuga-Koda
- Department of Pathomorphology, Comprehensive Cancer Center, 15-027 Bialystok, Poland
| | - Mariusz Koda
- Department of General Pathomorphology, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Waldemar Famulski
- Department of Pathomorphology, Comprehensive Cancer Center, 15-027 Bialystok, Poland
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-269 Bialystok, Poland
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Riedl JM, Posch F, Moik F, Bezan A, Szkandera J, Smolle MA, Kasparek AK, Pichler M, Stöger H, Stotz M, Gerger A. Inflammatory biomarkers in metastatic colorectal cancer: prognostic and predictive role beyond the first line setting. Oncotarget 2017; 8:96048-96061. [PMID: 29221186 PMCID: PMC5707080 DOI: 10.18632/oncotarget.21647] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/08/2017] [Indexed: 12/27/2022] Open
Abstract
Introduction Inflammatory biomarkers are useful prognostic tools in cancer patients. However, the prognostic and predictive value of inflammatory biomarkers beyond the 1st-line setting in metastatic colorectal cancer (mCRC) is unclear. Results In multivariate analysis 1 standard deviation increase in neutrophil-lymphocyte-ratio (NLR) was associated with an 8.5% absolute lower objective-response-rate (ORR) in 1st-line (p<0.0001), 3% lower ORR in 2nd-line (p< 0.0001), and 3% lower ORR in 3rd-line (p=0.24), respectively. Regarding progression free survival (PFS), an increase in the NLR was significantly associated with rising hazard-ratios (HR) over all treatment lines (HR=1.30, p= 0.021 1st-line); (HR=1.37, p<0.0001 2nd-line); (HR=1.44, p=0.042 3rd-line). The platelet-lymphocyte-ratio (PLR) was associated with 6-month PFS over all three treatment lines. Higher C-reactive-protein (CRP) predicted for worse PFS in the first two chemotherapy lines and in best supportive care (BSC). (HR=1.49 (p<0.0001 1st-line); HR=1.25 (p=0.007 2nd-line); HR=1.09 (95%CI 0.81–1.48, p=0.552 3rd-line and HR=1.43 (p= 0.002 in BSC)). Methods Two-hundred-fifty-eight patients with mCRC undergoing palliative chemo(immuno-)therapy were retrospectively included. Primary endpoints were 6-month PFS and ORR during 1st-line, 2nd-line, and 3rd-line treatment, and 6-month overall survival during BSC. Conclusion This study shows that inflammatory biomarkers are useful predictors of disease outcome and treatment response over several treatment lines in mCRC patients.
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Affiliation(s)
- Jakob Michael Riedl
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Florian Posch
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Florian Moik
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Angelika Bezan
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Joanna Szkandera
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Maria Anna Smolle
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Anne-Katrin Kasparek
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria.,Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Herbert Stöger
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Michael Stotz
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, 8036 Graz, Austria.,Center for Biomarker Research in Medicine, 8010 Graz, Austria
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Characterization of systemic neutrophil function in patients undergoing colorectal cancer resection. J Surg Res 2017; 220:410-418.e1. [PMID: 28890131 DOI: 10.1016/j.jss.2017.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/19/2017] [Accepted: 07/25/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND In patients with colorectal cancer, the generation and maintenance of a systemic inflammatory response is associated with poor outcomes. Neutrophils have been implicated in the prognosis of such patients, but little is known about their functional response to surgery. This study was conducted to characterize neutrophil function of patients undergoing colorectal cancer resection. MATERIALS AND METHODS Systemic neutrophils were isolated from patients with colorectal cancer who underwent surgical resection preoperatively (day 0) and postoperatively (day 1 and day 3). Neutrophils were stimulated to produce neutrophil extracellular traps, which were quantified by a measure of the fluorescence of the extracellular DNA. Neutrophil apoptosis and phagocytosis were measured by fluorescence-activated cell sorting. RESULTS Forty-five patients were evaluated. Statistically significant differences were identified in NET formation over the perioperative period (reduced NET production [day 0 to day 1] and restored NET production [day 1 to day 3]) in the absence of stimulation (P = 0.0016) and in response to stimulation with interleukin 8 (P = 0.0045), lipopolysaccharide (P = 0.0025), and N-formylmethionyl-leucyl-phenylalanine (P = 0.0014). No statistically significant differences were identified in apoptosis at 4-hour incubation; however, at 24-hours, significant differences were identified in alive (P < 0.0001), early apoptotic (P = 0.0008) and late apoptotic (P = 0.0018) stages (impaired apoptosis [day 0 to day 1] and restored apoptosis [day 1 to day 3]). Demonstrable, but nonsignificant, increases in neutrophil phagocytotic activity were revealed on sequential perioperative days, and a significant increase in phagocytosis was identified from day 1 to day 3 in response to E coli (P = 0.0078). CONCLUSIONS A novel neutrophil phenotype demonstrating reduced NET formation, reduced apoptosis, and increased phagocytosis has been demonstrated in patients undergoing colorectal cancer resection. As a consequence of impaired cell death, an accumulation of neutrophils in the circulation could be potentially harmful to the host following surgery and an early phenotypic switch may be desirable.
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Neutrophil Extracellular Trap Production in Patients with Colorectal Cancer In Vitro. Int J Inflam 2017; 2017:4915062. [PMID: 28828191 PMCID: PMC5554570 DOI: 10.1155/2017/4915062] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/18/2017] [Accepted: 06/27/2017] [Indexed: 12/23/2022] Open
Abstract
Purpose Neutrophil Extracellular Traps (NETs) are extracellular neutrophil derived DNA webs which have been implicated in cancer progression and in the development of metastases. NETs production in patients with colorectal cancer was investigated to elucidate their role and prognostic significance. Methods Systemic neutrophils were isolated from consecutive patients with colorectal cancer and from age-matched healthy volunteers. Neutrophils were stimulated to produce NETs which were quantified by a measure of the fluorescence of the extracellular DNA. The impact of cancer location, tumour stage, and patient outcomes (complications, length of stay, and mortality) on NET production was investigated. Results Quantification of NET formation was performed in patients with colorectal cancer (n = 45) and in well-matched healthy individuals (n = 20). Significant increases in NETs production in response to no stimulant (9,735 AFU versus 11347 AFU, p = 0.0209), IL-8 (8,644 AFU versus 11,915 AFU, p = 0.0032), and LPS (10,576 AFU versus 12,473 AFU, p = 0.0428) were identified in patients with colorectal cancer. A significant increase in NETs production in response to fMLP was detected in patients who developed significant postoperative complications (11,760 AFU versus 18,340 AFU, p = 0.0242) and who had a prolonged hospital recovery (9,008 AFU versus 12,530 AFU, p = 0.0476). An increase in NETs production was also observed in patients who died, but this did not reach statistical significance. Cancer location and tumour stage did not appear to affect preoperative NETs production. Conclusions Patients with colorectal cancer have significantly increased NETs production in vitro when compared to healthy volunteers, possibly implicating them in cancer development. Adverse patient outcomes were associated with increased preoperative NETs production, which highlights them as potential therapeutic targets.
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Hamburg-Glasgow classification: preoperative staging by combination of disseminated tumour load and systemic inflammation in oesophageal carcinoma. Br J Cancer 2017; 117:612-618. [PMID: 28704837 PMCID: PMC5572176 DOI: 10.1038/bjc.2017.219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/10/2017] [Accepted: 06/15/2017] [Indexed: 12/24/2022] Open
Abstract
Background: The aim of this study was to establish a new preoperative staging classification and evaluate its comparability to the post-operative tumour stage, lymph node invasion and metastasis (TNM) classification. To date, adequate, preoperative staging in patients with oesophageal carcinoma (EC) is still missing but urgently needed. Systemic inflammation and disseminated tumour load have a pivotal role in recurrence and oncological outcome. To improve the clinical staging, we merged the Glasgow Prognostic Score (GPS) and disseminated tumour cells (DTC) into a new sufficient preoperative staging classification, the Hamburg-Glasgow classification (HGC). Methods: In this prospective, single-centre study, 326 patients following curative oesophagectomy were included. From all patients preoperative bone marrow was aspirated from the iliac crest to detect DTCs by immunostaining with the pan-keratin antibody A45-B/B3. HGC was subdefined into four prognostic groups on the basis of C-reactive protein (CRP), albumin and DTC. The three prognostic groups of the GPS were supplemented by DTC detection status. Results were correlated with clinicopathological parameters and clinical outcome. Results: Increasing HGC significantly correlated with lymph node invasion (P=0.022), post-operative pathohistological TNM staging (P=0.001) and tumour recurrence (P=0.001). The four HGC prognostic groups displayed a gradual decrease in overall as well as disease-free survival (P<0.001, each). Hamburg-Glasgow classification was a strong, significant independent predictor of overall survival and disease-free survival (P<0.001, both) in multivariate analysis. Conclusions: Hamburg-Glasgow classification seems to be a promising preoperative additive staging classification for accurate and simple outcome stratification.
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Iino C, Shimoyama T, Igarashi T, Aihara T, Ishii K, Sakamoto J, Tono H, Fukuda S. Biliary drainage improves the predictive value of modified Glasgow Prognostic Scores in inoperable pancreatic cancer. PLoS One 2017. [PMID: 28644836 PMCID: PMC5482428 DOI: 10.1371/journal.pone.0178777] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective To assess the influence of biliary drainage to cholangitis on modified Glasgow Prognostic Score (mGPS) in patients with pancreatic cancer. Methods mGPS was calculated before and after biliary drainage in 47 consecutive patients with inoperable pancreatic cancer who were receiving chemotherapy. Biliary drainage was indicated for malignant obstructive jaundice that prevented the administration of chemotherapy. To elucidate mGPS values, serum levels of CRP and albumin were measured at the time of diagnosis (before biliary drainage). Overall survival was evaluated and risk factors, which contribute to overall survival, were examined. Results Biliary drainage was performed in 15 patients. Using values obtained before biliary drainage, there were no significant differences in median survival time between patients with a mGPS of 0 and those with a mGPS of 1 or 2 (10.7 vs. 9.4 months; p = 0.757). However, using values obtained after biliary drainage, median survival time was significantly higher in patients with a mGPS of 0 than in those with a mGPS of 1 or 2 (11.4 vs. 4.7 months; p = 0.002). Multivariate analysis revealed that a mGPS of 1 or 2 (HR: 3.38; 95% CI: 1.35–8.46, p = 0.009), a carbohydrate antigen 19–9 >1000 U/mL (2.52; 1.22–5.23, p = 0.013), a performance status of 2 (7.68; 2.72–21.28, p = 0.001), carcinoembryonic antigen level >10 ng/mL (2.29; 1.13–4.61, p = 0.021) were independently associated with overall survival. Conclusion mGPS values obtained after biliary drainage appear to be a more reliable indicator of overall survival in patients with inoperable pancreatic cancer.
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Affiliation(s)
- Chikara Iino
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- * E-mail:
| | - Tadashi Shimoyama
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takasato Igarashi
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoyuki Aihara
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Kentaro Ishii
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Juichi Sakamoto
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Hiroshi Tono
- Department of Internal medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Rossi S, Basso M, Strippoli A, Schinzari G, D'Argento E, Larocca M, Cassano A, Barone C. Are Markers of Systemic Inflammation Good Prognostic Indicators in Colorectal Cancer? Clin Colorectal Cancer 2017; 16:264-274. [PMID: 28412137 DOI: 10.1016/j.clcc.2017.03.015] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/16/2017] [Indexed: 02/07/2023]
Abstract
Systemic inflammation has been proved to play a crucial role in promoting cancer progression and metastasis in many cancer types, including colorectal cancer (CRC). The aim of the present review was to provide an overview of studies regarding the prognostic value of inflammation-based markers in patients with CRC. A literature search was performed for articles reporting the prognostic value of the Glasgow prognostic score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in relation to CRC outcomes. In resectable early-stage CRC, high GPS scores seem significantly associated with cancer-specific survival. It has also been suggested that adjuvant chemotherapy for stage II CRC could improve cancer-specific survival in patients with high GPS scores. In patients with both resectable and unresectable metastatic CRC and a higher GPS score, all studies suggested poorer overall survival. In early-stage and resectable metastatic CRC, the NLR seemed related to overall survival; however, the data for disease-free survival were discordant. In metastatic disease, a possible correlation between a greater NLR and poorer response to bevacizumab has been suggested. Data concerning the prognostic and predictive role of the PLR and LMR in CRC are to date insufficient. In patients with unresectable metastatic disease, inflammation markers can be used to predict the chemotherapeutic outcome and monitor tumor progression. However, further prospective studies might lead to better risk stratification for patients eligible for curative surgery, thus, allowing the restriction of neoadjuvant and adjuvant therapy to patients with high-risk CRC.
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Affiliation(s)
- Sabrina Rossi
- Department of Medical Oncology, Humanitas Clinical and Research Center, Milan, Italy.
| | - Michele Basso
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Antonia Strippoli
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Schinzari
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Ettore D'Argento
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Mario Larocca
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
| | - Carlo Barone
- Department of Medical Oncology, Catholic University of Sacred Heart, Rome, Italy
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Tan G, Novo C, Dayal S, Chandrakumaran K, Mohamed F, Cecil T, Moran B. The modified Glasgow prognosis score predicts for overall and disease-free survival following cytoreductive surgery and HIPEC in patients with pseudomyxoma peritonei of appendiceal origin. Eur J Surg Oncol 2017; 43:388-394. [DOI: 10.1016/j.ejso.2016.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/12/2016] [Accepted: 10/07/2016] [Indexed: 01/21/2023] Open
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Kimura J, Kunisaki C, Makino H, Oshima T, Ota M, Oba M, Takagawa R, Kosaka T, Ono HA, Akiyama H, Endo I. Evaluation of the Glasgow Prognostic Score in patients receiving chemoradiotherapy for stage III and IV esophageal cancer. Dis Esophagus 2016; 29:1071-1080. [PMID: 26471766 DOI: 10.1111/dote.12420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
High Glasgow Prognostic scores (GPSs) have been associated with poor outcomes in various tumors, but the values of GPS and modified GPS (mGPS) in patients with advanced esophageal cancer receiving chemoradiotherapy (CRT) has not yet been reported. We have evaluated these with respect to predicting responsiveness to CRT and long-term survival. Between January 2002 and December 2011, tumor responses in 142 esophageal cancer patients (131 men and 11 women) with stage III (A, B and C) and IV receiving CRT were assessed. We assessed the value of the GPS as a predictor of a response to definitive CRT and also as a prognostic indicator in patients with esophageal cancer receiving CRT. We found that independent predictors of CRT responsiveness were Eastern Cooperative Oncology Group (ECOG) performance status, GPS and cTNM stage. Independent prognostic factors were ECOG performance status and GPS for progression-free survival and ECOG performance status, GPS and cTNM stage IV for disease-specific survival. GPS may be a novel predictor of CRT responsiveness and a prognostic indicator for progression-free and disease-specific survival in patients with advanced esophageal cancer. However, a multicenter study as same regime with large number of patients will be needed to confirm these outcomes.
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Affiliation(s)
- J Kimura
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - C Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - H Makino
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - T Oshima
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - M Ota
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - M Oba
- Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
| | - R Takagawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
| | - T Kosaka
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
| | - H A Ono
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
| | - H Akiyama
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama-city University, Yokohama, Japan
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Melling N, Grüning A, Tachezy M, Nentwich M, Reeh M, Uzunoglu FG, Vashist YK, Izbicki JR, Bogoevski D. Glasgow Prognostic Score may be a prognostic index for overall and perioperative survival in gastric cancer without perioperative treatment. Surgery 2016; 159:1548-1556. [DOI: 10.1016/j.surg.2016.01.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 01/05/2016] [Accepted: 01/05/2016] [Indexed: 12/27/2022]
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Tan D, Fu Y, Su Q, Wang H. Prognostic role of platelet-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e3837. [PMID: 27310960 PMCID: PMC4998446 DOI: 10.1097/md.0000000000003837] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Many studies have been reported that platelet-lymphocyte ratio (PLR) may be associated with the prognosis of colorectal cancer (CRC), but the results are inconsistent. Current opinion on the prognostic role of the PLR in CRC is inconsistent and inconclusive. Therefore, we conduct a meta-analysis that combines these studies and to identify the prognostic value of PLR in patients with CRC. Data were retrieved from PubMed, EMBASE, Cochrane Library, and Web of Science databases that came from inception through January 2016. We extracted data from the characteristics of each study and analyzed the relationship between PLR and overall survival (OS), disease-free survival (DFS), or other prognosis in patients with CRC by using the hazard ratio (HR) and 95% confidence intervals (95% CIs). Of the 256 identified studies, 15 studies were included and a total of 3991 patients were included. In a meta-analysis, patients with an elevated PLR had a significantly lower OS (pooled HR, 1.53; 95% CI, 1.24-1.89; P ≤ 0.001), DFS (pooled HR, 1.68; 95% CI, 1.07-2.62; P = 0.023). Even after sensitivity analyses and trim and fill method, high PLR remains significantly predictive poorer OS, but not DFS. In addition, our meta-analysis indicated that increased PLR is also significantly associated with the poor tumor differentiation [odds ratio (OR) 2.12; 95% CI, 1.45-3.08, P < 0.001)], the propensity toward depth of infiltration (OR 1.69; 95% CI, 1.20-2.39, P = 0.003), and recurrence in patients with CRC (HR, 2.71; 95% CI, 1.31-5.60, P = 0.005). This meta-analysis suggested that a high peripheral blood PLR can be used as a predictor of OS connected with clinicopathological parameters in patients with CRC, not DFS. These ratios may thus contribute to inform more personalized treatment decisions and predict treatment outcomes.
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Affiliation(s)
- Dewen Tan
- Department of General Surgery, Shengjing Hospital Affiliated with China Medical University, Shenyang
| | - Yan Fu
- Department of Head and Neck Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Qi Su
- Department of General Surgery, Shengjing Hospital Affiliated with China Medical University, Shenyang
| | - Heling Wang
- Department of General Surgery, Shengjing Hospital Affiliated with China Medical University, Shenyang
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[The Glasgow inflammatory score and lung cancer: A predictor of admissions to emergency units]. Rev Mal Respir 2016; 33:759-765. [PMID: 27017064 DOI: 10.1016/j.rmr.2016.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/11/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In a first study, we found predictive factors for hospital admission in lung cancer patients consulting at the emergency department. Knowing that systemic inflammation is a prognostic factor in cancer patients, the goal of our study was to determine whether systemic inflammation measured using the modified Glasgow prognostic score can improve the predictive value of our previous model. METHODS We conducted a retrospective study including all patients with lung cancer consulting at the emergency department of an oncology hospital between January 1st 2008 and December 31st 2010. RESULTS Of the 548 emergency department visits, C-reactive protein and albumin needed for calculating the Glasgow score, were available for 291 visits. Multivariate analysis identified three predictors of hospitalization subsequent to a visit at the emergency ward: the Modified Glasgow Prognostic Score (mGPS) (OR=2.72; P<0.0001), arrival by ambulance (odds ratio [OR]=21.38; P<0.0001) and the presence of physical signs associated with the complaint (OR=2.72; P<0.05). CONCLUSION The mGPS is an independent predictor for hospitalization in patients with lung cancer consulting at the emergency department.
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Abstract
OBJECTIVES The modified Glasgow prognostic score (mGPS) is known to be useful in determining the prognosis of cancers. However, the utility of mGPS for pancreatic cancer (PC) has been examined based primarily on a surgical series of early-stage cancers. The purpose of this study was to examine the utility of mGPS for PC of all stages using a retrospective cohort design. METHODS We conducted a retrospective cohort study using data from a computerized database. A total of 807 patients with pathologically confirmed PC were analyzed (mGPS-0, n = 620; mGPS-1, n = 153; mGPS-2, n = 34). RESULTS Median overall survival (OS) was significantly worse for the mGPS-1 group than for the mGPS-0 group (5.8 vs 15.8 months, respectively) but was comparable between the mGPS-2 and mGPS-1 groups (4.8 vs 5.8 months, respectively). After adjustment, both mGPS-1 and mGPS-2 were independent predictive factors of OS (mGPS-1: hazard ratio, 1.772; 95% confidence interval, 1.417-2.215; mGPS-2: hazard ratio, 2.033; 95% confidence interval, 1.284-3.219). Subgroup analysis showed that OS was significantly worse in the mGPS-1 and mGPS-2 groups than in the mGPS-0 group for all except the following 2 subgroups: localized disease and curative resection. CONCLUSIONS The present results show that the mGPS is an independent prognostic factor in patients with PC, especially for advanced-stage disease.
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Systemic Inflammatory Response Based on Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker in Bladder Cancer. DISEASE MARKERS 2016; 2016:8345286. [PMID: 26880857 PMCID: PMC4736380 DOI: 10.1155/2016/8345286] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/04/2015] [Indexed: 12/18/2022]
Abstract
A growing body of evidence suggests that systemic inflammatory response (SIR) in the tumor microenvironment is closely related to poor oncologic outcomes in cancer patients. Over the past decade, several SIR-related hematological factors have been extensively investigated in an effort to risk-stratify cancer patients to improve treatment selection and to predict posttreatment survival outcomes in various types of cancers. In particular, one readily available marker of SIR is neutrophil-to-lymphocyte ratio (NLR), which can easily be measured on the basis of absolute neutrophils and absolute lymphocytes in a differential white blood cell count performed in the clinical setting. Many investigators have vigorously assessed NLR as a potential prognostic biomarker predicting pathological and survival outcomes in patients with urothelial carcinoma (UC) of the bladder. In this paper, we aim to present the prognostic role of NLR in patients with UC of the bladder through a thorough review of the literature.
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Shrotriya S, Walsh D, Bennani-Baiti N, Thomas S, Lorton C. C-Reactive Protein Is an Important Biomarker for Prognosis Tumor Recurrence and Treatment Response in Adult Solid Tumors: A Systematic Review. PLoS One 2015; 10:e0143080. [PMID: 26717416 PMCID: PMC4705106 DOI: 10.1371/journal.pone.0143080] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 10/30/2015] [Indexed: 12/14/2022] Open
Abstract
PURPOSE A systematic literature review was done to determine the relationship between elevated CRP and prognosis in people with solid tumors. C-reactive protein (CRP) is a serum acute phase reactant and a well-established inflammatory marker. We also examined the role of CRP to predict treatment response and tumor recurrence. METHODS MeSH (Medical Subject Heading) terms were used to search multiple electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, EBM-Cochrane). Two independent reviewers selected research papers. We also included a quality Assessment (QA) score. Reports with QA scores <50% were excluded. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology was utilized for this review (S1 PRISMA Checklist). RESULTS 271 articles were identified for final review. There were 45% prospective studies and 52% retrospective. 264 had intermediate QA score (≥50% but <80%); Seven were adequate (80% -100%); A high CRP was predictive of prognosis in 90% (245/271) of studies-80% of the 245 studies by multivariate analysis, 20% by univariate analysis. Many (52%) of the articles were about gastrointestinal malignancies (GI) or kidney malignancies. A high CRP was prognostic in 90% (127 of 141) of the reports in those groups of tumors. CRP was also prognostic in most reports in other solid tumors primary sites. CONCLUSIONS A high CRP was associated with higher mortality in 90% of reports in people with solid tumors primary sites. This was particularly notable in GI malignancies and kidney malignancies. In other solid tumors (lung, pancreas, hepatocellular cancer, and bladder) an elevated CRP also predicted prognosis. In addition there is also evidence to support the use of CRP to help decide treatment response and identify tumor recurrence. Better designed large scale studies should be conducted to examine these issues more comprehensively.
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Affiliation(s)
- Shiva Shrotriya
- Department of Solid Tumor Oncology, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
- The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
| | - Declan Walsh
- Department of Solid Tumor Oncology, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
- The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
- * E-mail:
| | - Nabila Bennani-Baiti
- Department of Solid Tumor Oncology, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
- The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
| | - Shirley Thomas
- Department of Solid Tumor Oncology, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
- The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States of America
| | - Cliona Lorton
- Our Lady’s Hospice & Care Services, Harold’s Cross, Dublin, Ireland
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Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACS-NSQIP. Nutr J 2015; 14:91. [PMID: 26345703 PMCID: PMC4561437 DOI: 10.1186/s12937-015-0081-5] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 08/31/2015] [Indexed: 01/30/2023] Open
Abstract
Background Nutritional status is an important factor in predicting the risk associated with surgery for cancer patients. This is especially true in colorectal cancer. Many nutritional assessments are used in clinical practice, but those assessments are rarely evaluated for their ability to predict postoperative outcome. Methods This is a retrospective, multi-institutional study of the ACS-NSQIP database, investigating preoperative nutrition status and its association with postoperative mortality and morbidity. Results The prevalence of malnutrition is higher in colorectal cancer, when compared with other most common cancers. Among 42,483 colorectal cancer patients postoperative mortality was significantly associated with hypoalbuminemia (hazard ratio = 3.064, p < 0.001), body weight loss (hazard ratio = 1.229, p = 0.033) and body mass index of <18.5 kg/m2 (hazard ratio = 1.797, p < 0.001). Only hypoalbuminemia significantly predicted all postoperative complications, even in further multivariate logistic regression analyses (p < 0.001). Multiple regression analysis showed that the hypoalbuminemia group had the highest coefficient in significant association with length of total hospital stay (B = 3.585, p < 0.001) and overall complication (B = 0.119, p < 0.001). Conclusions In colorectal cancer, malnutrition significantly contributes to postoperative mortality, morbidity and length of total hospital stay. Hypoalbuminemia, with levels below 3.5 g/dl, serves as an excellent assessment tool and preoperative predictor of postoperative outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12937-015-0081-5) contains supplementary material, which is available to authorized users.
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Bairey O, Shacham-Abulafia A, Shpilberg O, Gurion R. Serum albumin level at diagnosis of diffuse large B-cell lymphoma: an important simple prognostic factor. Hematol Oncol 2015; 34:184-192. [PMID: 26052918 DOI: 10.1002/hon.2233] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 12/13/2022]
Abstract
This study compared the value of several simple laboratory parameters with known prognostic models for predicting survival in patients with diffuse large B-cell lymphoma (DLBCL). The data of 157 adult patients with DLBCL diagnosed at Rabin Medical Center in 2004-2008 and treated with R-CHOP immunochemotherapy were retrospectively reviewed. Main clinical features of the cohort were as follows: mean age 63.0 years, 43% male, 63% stage III/IV disease, 28% ECOG performance status >2, 60% elevated lactate dehydrogenase level. Median duration of follow-up was 6.6 years. The NCCN-International Prognostic Index (IPI) was found to be a more powerful prognosticator than the IPI. Five-year overall survival (OS) was 69.6; 73.6% for patients with intermediate NCCN-IPI and 38.4% for patients with poor NCCN-IPI. On univariate analysis, pretreatment hemoglobin and albumin levels were significantly associated with survival. By albumin level, 5-year OS was 77.6 + 4% in patients with >3.5 g/dl and 53 + 7% in patients with <3.5 g/dl (p < 0.001); 5-year progression-free survival (PFS) was 69.9% and 50.9%, respectively (p = 0.002). By hemoglobin level, 5-year OS was 82.9 + 4.5% in patients with >12 g/dl and 58.8 + 5% in patients with <12 g/dl (p = 0.007); 5-year PFS was 75.5% and 54.1%, respectively (p = 0.008). On multivariate analysis with Cox regression, pretreatment albumin level was a significant independent predictor of OS. Furthermore, 5-year OS of patients with a high NCCN-IPI and albumin < 3.5 g/dl was 29.2% compared with 60% in patients with albumin > 3.5 g/dl (p = 0.022). In conclusion, pretreatment albumin level is a strong prognostic factor for OS in patients with DLBCL and can discriminate high-risk patients for good and poor prognosis. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Osnat Bairey
- Institute of Hematology and Davidoff Cancer Center, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Shacham-Abulafia
- Institute of Hematology and Davidoff Cancer Center, Rabin Medical Center, Petach Tikva, Israel
| | - Ofer Shpilberg
- Institute of Hematology and Davidoff Cancer Center, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Gurion
- Institute of Hematology and Davidoff Cancer Center, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Zhou J, Zheng B, Ji J, Shen F, Min H, Liu B, Wu J, Zhang S. LYTAK1, a novel TAK1 inhibitor, suppresses KRAS mutant colorectal cancer cell growth in vitro and in vivo. Tumour Biol 2014; 36:3301-8. [PMID: 25524577 DOI: 10.1007/s13277-014-2961-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 12/05/2014] [Indexed: 11/24/2022] Open
Abstract
KRAS mutation in colorectal cancer (CRC) activates transforming growth factor-β (TGF-β)-activated kinase 1 (TAK1) to promote tumor progression. In the current study, we explored the potential effect of LYTAK1, a novel TAK1 inhibitor, against KRAS mutant CRC cells in vitro and in vivo. We found that LYTAK1 dose-dependently inhibited KRAS mutant CRC cell (HT-29 and SW-620 lines) growth, and induced cell cycle G1-S arrest. Further, LYTAK1 activated apoptosis in HT-29 cells and SW-620 cells, and apoptosis inhibitors almost reversed LYTAK1-mediated growth inhibition. While in KRAS wild-type (WT) CRC cell lines (DLD-1 and HCT-116), LYTAK1 had almost no effect on cell growth, cell cycle progression, or cell apoptosis. In KRAS mutant HT-29 cells and SW-260 cells, LYTAK1 blocked TAK1 activation or phosphorylation at Thr-184/187. Activation of nuclear factor κB (NF-κB) in these cells, detected by phosphorylations of p65 and IκB kinase α (IKKα) as well as expression of NF-κB-regulated gene cyclin D1, was significantly inhibited by LYTAK1. Further, LYTAK1 treatment resulted in downregulation of β-catenin and Wnt response gene Axin 2, indicating Wnt inactivation. In vivo, oral LYTAK1 significantly inhibited HT-29 xenograft growth in nude mice. Together, these results show that LYTAK1 inhibits KRAS mutant CRC cell growth both in vitro and in vivo. LYTAK1 might be investigated as a novel agent against CRC with KRAS mutation.
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Affiliation(s)
- Jundong Zhou
- The Core Laboratory of the Suzhou Cancer Center and Department of Radiotherapy, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, China
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Otowa Y, Nakamura T, Takiguchi G, Tomono A, Yamamoto M, Kanaji S, Imanishi T, Suzuki S, Tanaka K, Itoh T, Kakeji Y. Changes in modified Glasgow prognostic score after neoadjuvant chemotherapy is a prognostic factor in clinical stage II/III esophageal cancer. Dis Esophagus 2014; 29:146-51. [PMID: 25515972 DOI: 10.1111/dote.12316] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The inflammation-based modified Glasgow prognostic score (mGPS) has been shown to be a prognostic factor for esophageal cancer, but its changes in relation to neoadjuvant chemotherapy (NAC) have never been discussed. The purpose of this study was to evaluate the potential prognostic role of mGPS with regard to NAC. mGPS was evaluated on the basis of admission blood samples taken before chemotherapy and before surgery. Patients with elevated C-reactive protein (CRP) serum levels (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a score of 2, patients with elevated CRP serum levels without hypoalbuminemia were allocated a score of 1, and patients with normal CRP serum levels with or without hypoalbuminemia were allocated a score of 0. A total of 100 patients with clinical stage II/III squamous cell esophageal cancer, who underwent NAC and esophagectomy between January 2007 and August 2012, were investigated. From the multivariate analysis, the grade of response to chemotherapy and post-NAC mGPS level was found to be independent prognostic factors. The overall survival rate was significantly higher in the conserved mGPS group than in the worse mGPS group (P = 0.030). Changes in mGPS during chemotherapy affected the prognosis of patients, and post-NAC mGPS is an independent prognostic factor in patients with clinical stage II/III thoracic esophageal squamous cell cancer.
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Affiliation(s)
- Yasunori Otowa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Gosuke Takiguchi
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ayako Tomono
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masashi Yamamoto
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Imanishi
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Suzuki
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichi Tanaka
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Feng JF, Huang Y, Chen QX. The combination of platelet count and neutrophil lymphocyte ratio is a predictive factor in patients with esophageal squamous cell carcinoma. Transl Oncol 2014; 7:632-7. [PMID: 25389458 PMCID: PMC4225691 DOI: 10.1016/j.tranon.2014.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 07/29/2014] [Accepted: 07/30/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE: The prognostic value of inflammation indexes in esophageal cancer was not established. In this study, therefore, both prognostic values of Glasgow prognostic score (GPS) and combination of platelet count and neutrophil lymphocyte ratio (COP-NLR) in patients with esophageal squamous cell carcinoma (ESCC) were investigated and compared. METHODS: This retrospective study included 375 patients who underwent esophagectomy for ESCC. The cancer-specific survival (CSS) was calculated by the Kaplan-Meier method, and the difference was assessed by the log-rank test. The GPS was calculated as follows: patients with elevated C-reactive protein (> 10 mg/l) and hypoalbuminemia (< 35 g/l) were assigned to GPS2. Patients with one or no abnormal value were assigned to GPS1 or GPS0, respectively. The COP-NLR was calculated as follows: patients with elevated platelet count (> 300 × 109/l) and neutrophil lymphocyte ratio (> 3) were assigned to COP-NLR2. Patients with one or no abnormal value were assigned to COP-NLR1 or COP-NLR0, respectively. RESULTS: The 5-year CSS in patients with GPS0, 1, and 2 was 50.0%, 27.0%, and 12.5%, respectively (P < .001). The 5-year CSS in patients with COP-NLR0, 1, and 2 was 51.8%, 27.0%, and 11.6%, respectively (P < .001). Multivariate analysis showed that both GPS (P = .003) and COP-NLR (P = .003) were significant predictors in such patients. In addition, our study demonstrated a similar hazard ratio (HR) between COP-NLR and GPS (HR = 1.394 vs HR = 1.367). CONCLUSIONS: COP-NLR is an independent predictive factor in patients with ESCC. We conclude that COP-NLR predicts survival in ESCC similar to GPS.
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Affiliation(s)
- Ji-Feng Feng
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China ; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou 310022, Zhejiang Province, China
| | - Ying Huang
- Department of Nursing, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qi-Xun Chen
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China ; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou 310022, Zhejiang Province, China
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Feng JF, Huang Y, Chen QX. A new inflammation index is useful for patients with esophageal squamous cell carcinoma. Onco Targets Ther 2014; 7:1811-5. [PMID: 25336972 PMCID: PMC4199817 DOI: 10.2147/ott.s68084] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The prognostic value of inflammation indexes in esophageal cancer has not been established. Recent studies have shown that the advanced lung cancer inflammation index (ALI) is a useful predictive factor. The purpose of the current study was to determine whether the ALI is useful for predicting long-term survival in patients with esophageal squamous cell carcinoma (ESCC). Patients and methods A total of 293 patients who had undergone esophagectomy for ESCC were included. The ALI was calculated as body mass index × serum albumin/neutrophil-to-lymphocyte ratio. Then, patients were divided into two groups: ALI ≥18 and ALI <18. The Kaplan–Meier method was used to calculate the cancer-specific survival (CSS), and the difference was assessed by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic factors. Results In our study, there were 120 patients with ALI <18 and 173 patients with ALI ≥18. ALI was significantly higher in patients with large tumors (P=0.028), poor differentiation (P=0.010), deep invasion (P=0.009), and nodal metastasis (P=0.004). The 5-year CSS was 34.5% in our study. Patients with ALI <18 had a significantly poorer 5-year CSS compared to ALI ≥18 (21.7% versus 43.4%, P<0.001). On multivariate analysis, we showed that the ALI was a significant predictive factor of CSS (P=0.024). Conclusion The ALI is still a useful predictive factor for long-term CSS in patients with ESCC. However, the prognostic value of the ALI is yet to be formally tested within randomized trials.
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Affiliation(s)
- Ji-Feng Feng
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Ying Huang
- Department of Operating Theater, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Qi Xun Chen
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
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Matsuda S, Takeuchi H, Kawakubo H, Fukuda K, Nakamura R, Takahashi T, Wada N, Saikawa Y, Omori T, Kitagawa Y. Cumulative prognostic scores based on plasma fibrinogen and serum albumin levels in esophageal cancer patients treated with transthoracic esophagectomy: comparison with the Glasgow prognostic score. Ann Surg Oncol 2014; 22:302-10. [PMID: 24952029 DOI: 10.1245/s10434-014-3857-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study was to establish a prognostic indicator based on preoperative plasma fibrinogen and serum albumin levels (FA score) in esophageal cancer patients and to compare the correlation with survival to that of the Glasgow prognostic score. METHODS Patient characteristics, clinicopathological factors, and preoperative biochemical markers (fibrinogen, albumin, and C-reactive protein) were investigated in esophageal cancer patients who underwent transthoracic esophagectomy. Pretreatment fibrinogen and albumin levels were reviewed in patients who received neoadjuvant treatment. Patients with elevated fibrinogen and decreased albumin levels were allocated a score of 2, those with only one of these abnormalities were allocated a score of 1, and those with neither of these abnormalities were allocated a score of 0. The fibrinogen cut-off value was defined as 350 mg/dL according to our previous report, and the albumin cut-off value was defined as the lower quartile. RESULTS Among 199 consecutive patients, the interquartile range of preoperative albumin was 3.8-4.3 g/dL and the cut-off value was 3.8 g/dL. Thus, 108 (54 %), 68 (34 %), and 23 (12 %) patients had an FA score of 0, 1, and 2. The patients with a high preoperative FA score showed considerably shorter disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that pretreatment stage and preoperative FA score were independently associated with postoperative DFS and OS. CONCLUSIONS Preoperative FA score was significantly associated with postoperative survival in esophageal cancer patients, and the prognostic value is currently being validated in a prospective multicenter cohort study.
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Affiliation(s)
- Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Prognostic significance of the preoperative serum C-reactive protein level in patients with stage IV colorectal cancer. Surg Today 2014; 45:315-21. [PMID: 24817059 DOI: 10.1007/s00595-014-0909-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 04/01/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE Previous studies have revealed that an elevated preoperative serum C-reactive protein (CRP) level is associated with a poor prognosis in patients with various malignant tumors. The aim of this study was to determine the clinical significance of the preoperative serum CRP level in patients with stage IV colorectal cancer. METHODS We enrolled 144 patients who underwent surgery for stage IV colorectal cancer. A total of 53 patients with a serum CRP level of ≥ 1.0 mg/dl were classified as the high CRP individuals. The association between the preoperative serum CRP level and survival was retrospectively assessed. RESULTS The cancer-specific survival of the patients with a high CRP level was significantly worse than that of the patients with a low CRP level. A multivariate analysis indicated that the curability (non-curative surgery), the number of organs with metastasis (more than one organ), the tumor diameter (≥ 5 cm), lymphatic involvement, histological differentiation (non-differentiated) and a high CRP level (≥ 1.0 mg/dl) were independent risk factors for a poor survival. CONCLUSIONS A high preoperative serum CRP level is a convenient biomarker for identifying patients with a poor prognosis for stage IV colorectal cancer.
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Nakagawa K, Tanaka K, Nojiri K, Kumamoto T, Takeda K, Ueda M, Endo I. The modified Glasgow prognostic score as a predictor of survival after hepatectomy for colorectal liver metastases. Ann Surg Oncol 2014; 21:1711-8. [PMID: 24452408 PMCID: PMC3975087 DOI: 10.1245/s10434-013-3342-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND The inflammation-based Glasgow prognostic score (GPS) has been demonstrated to be prognostic for various tumors. We investigated the value of the modified GPS (mGPS) for the prognosis of patients undergoing curative resection for colorectal liver metastases (CRLM). METHODS A total of 343 patients were enrolled onto this study. The mGPS was calculated as follows: mGPS-0, C-reactive protein (CRP) ≤10 mg/L; mGPS-1, CRP >10 mg/L and albumin ≥35 g/L; and mGPS-2, CRP >10 mg/L and albumin <35 g/L. Prognostic significance was retrospectively analyzed by univariate and multivariate analyses. RESULTS Of the 343 patients, 295 (86.0 %) were assigned to mGPS-0, 33 (9.6 %) to mGPS-1, and 15 (4.4 %) to mGPS-2. The median disease-free survival of patients with mGPS-0, -1, and -2 was 18.3, 15.5, and 5.2 months, respectively. The median cancer-specific survival (CSS) of patients with mGPS-0, -1, and -2 was 89.5, 62.2, and 25.8 months, respectively. The CSS of patients with mGPS-0 was significantly longer than that of patients with mGPS-2. Multivariate analysis revealed a significant association between cancer-related postoperative mortality and mGPS and carcinoembryonic antigen level. CONCLUSIONS The preoperative mGPS is a useful prognostic factor for postoperative survival in patients undergoing curative resection for CRLM.
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Affiliation(s)
- Kazuya Nakagawa
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan,
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Ishizuka M, Kubota K. Clinical utility of inflammation-based prognostic systems in patients with colorectal cancer. COLORECTAL CANCER 2013. [DOI: 10.2217/crc.13.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
SUMMARY This systematic review focuses on the clinical utility of three inflammation-based prognostic systems for patients with colorectal cancer (CRC): the Glasgow Prognostic Score (GPS) and its modified version – the modified GPS, neutrophil:lymphocyte ratio (NLR) and reactive thrombocytosis. The GPS/modified GPS had prognostic value in patients undergoing surgery, patients receiving chemo-/radiation therapy, patients with inoperable CRC, patients receiving nutritional evaluation and patients with perioperative complications. The NLR and reactive thrombocytosis also had prognostic value in patients undergoing surgery, patients receiving chemo-/radiation therapy and patients with inoperable CRC. The recommended cut-off value for the NLR is considered to be 5. Because thrombocytosis has been investigated in only seven studies, involving 1971 patients, and the recommended cut-off value is considered to be 300–400 × 109/l, further studies will be required to decide the ideal cut-off value for reactive thrombocytosis in patients with CRC.
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Affiliation(s)
- Mitsuru Ishizuka
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
| | - Keiichi Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan
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