1
|
Paal K, Stranz B, Thurner EM, Langsenlehner U, Renner W, Brunner TB, Langsenlehner T. Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients. Strahlenther Onkol 2024; 200:208-218. [PMID: 37658924 PMCID: PMC10876759 DOI: 10.1007/s00066-023-02132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The purpose of the present prospective study was to evaluate the significance of geriatric conditions measured by a comprehensive geriatric assessment (GA) for the prediction of the risk of high-grade acute radiation-induced toxicity. METHODS A total of 314 prostate cancer patients (age ≥ 65 years) undergoing definitive radiotherapy at a tertiary academic center were included. Prior to treatment, patients underwent a GA. High-grade toxicity was defined as acute toxicity grade ≥ 2 according to standard RTOG/EORTC criteria. To analyze the predictive value of the GA, univariable and multivariable logistic regression models were applied. RESULTS A total of 40 patients (12.7%) developed acute toxicity grade ≥ 2; high grade genitourinary was found in 37 patients (11.8%) and rectal toxicity in 8 patients (2.5%), respectively. Multivariable analysis revealed a significant association of comorbidities with overall toxicity grade ≥ 2 (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.260-5.502; p = 0.010) as well as with high-grade genitourinary and rectal toxicity (OR 2.169, 95%CI1.017-4.625; p = 0.045 and OR 7.220, 95%CI 1.227-42.473; p = 0.029, respectively). Furthermore, the Activities of Daily Living score (OR 0.054, 95%CI 0.004-0.651; p = 0.022), social status (OR 0.159, 95%CI 0.028-0.891; p = 0.036), and polypharmacy (OR 4.618, 95%CI 1.045-20.405; p = 0.044) were identified as independent predictors of rectal toxicity grade ≥ 2. CONCLUSION Geriatric conditions seem to be predictive of the development of high-grade radiation-induced toxicity in prostate cancer patients treated with definitive radiotherapy.
Collapse
Affiliation(s)
- Katarzyna Paal
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria
| | - Bettina Stranz
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria
| | - Eva-Maria Thurner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria
| | - Uwe Langsenlehner
- Outpatient Center for Internal Medicine, PRODOCplus, 8020, Graz, Austria
| | - Wilfried Renner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036, Graz, Austria
| | - Thomas Baptist Brunner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria.
| |
Collapse
|
2
|
Renner W, Langsenlehner U, Krenn-Pilko S, Eder P, Langsenlehner T. BCL2 genotypes and prostate cancer survival. Strahlenther Onkol 2017; 193:466-471. [PMID: 28396899 PMCID: PMC5438415 DOI: 10.1007/s00066-017-1126-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/22/2017] [Indexed: 12/29/2022]
Abstract
Purpose The antiapoptotic B‑cell lymphoma 2 (BCL2) gene is a key player in cancer development and progression. A functional single-nucleotide polymorphism (c.-938C>A, rs2279115) in the inhibitory P2 BCL2 gene promoter has been associated with clinical outcomes in various types of cancer. Aim of the present study was to analyze the role of BCL2-938C>A genotypes in prostate cancer mortality. Methods The association between BCL2-938C>A (rs2279115) genotypes and prostate cancer outcome was studied within the prospective PROCAGENE study comprising 702 prostate cancer patients. Results During a median follow-up time of 92 months, 120 (17.1%) patients died. A univariate Cox regression model showed a significant association of the CC genotype with reduced cancer-specific survival (CSS; hazard ratio, HR, 2.13, 95% confidence interval, CI, 1.10–4.12; p = 0.024) and overall survival (OS; HR 2.34, 95% CI 1.58–3.47; p < 0.001). In a multivariate Cox regression model including age at diagnosis, risk group, and androgen deprivation therapy, the CC genotype remained a significant predictor of poor CSS (HR 2.05, 95% CI 1.05–3.99; p = 0.034) and OS (HR 2.25, 95% CI 1.51–3.36; p < 0.001). Conclusion This study provides evidence that the homozygous BCL2-938 CC genotype is associated with OS and C in prostate cancer patients.
Collapse
Affiliation(s)
- Wilfried Renner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036, Graz, Austria.
| | - Uwe Langsenlehner
- Division of Internal Medicine, GKK Outpatient Department, Graz, Austria
| | - Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
| | - Petra Eder
- Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
| |
Collapse
|
3
|
Krenn-Pilko S, Langsenlehner U, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. An elevated preoperative plasma fibrinogen level is associated with poor disease-specific and overall survival in breast cancer patients. Breast 2015; 24:667-72. [PMID: 26346586 DOI: 10.1016/j.breast.2015.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 07/10/2015] [Accepted: 08/16/2015] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Plasma fibrinogen plays an important role in the pathophysiology of tumor cell invasion and metastases. High plasma fibrinogen levels have been associated with poor prognosis in different types of cancer. In the present study, we evaluated the prognostic significance of the preoperative plasma fibrinogen level in a large cohort of breast cancer patients. MATERIALS AND METHODS Data from 520 consecutive breast cancer patients, treated between 1999 and 2004, were evaluated. Disease-specific survival (DSS), overall survival (OS), and distant metastasis-free survival (DMFS) were assessed using Kaplan-Meier curves. To evaluate the independent prognostic significance of fibrinogen, multivariable Cox regression models were applied. The influence of fibrinogen on the predictive accuracy was further determined by the Harrell's c-index. RESULTS Univariable analysis revealed a significant association between an elevated plasma fibrinogen level and DSS (hazard ratio (HR) 1.70, 95% CI 1.07-2.76, p = 0.026) that remained significant in multivariable analysis (HR 1.71, 95% CI 1.02-2.85; p = 0.042). An increased fibrinogen level was also significantly associated with decreased OS in univariable (HR 1.71, 95% CI 1.11-2.64, p = 0.015) and multivariable analysis (HR 1.62, 95% CI 1.01-2.61; p = 0.048). In patients with ER/PR+, HER2- tumors, plasma fibrinogen was associated with DSS in univariable (HR 2.65, 95% CI 1.15-6.14, p = 0.023) and multivariable analysis (HR 3.63, 95% CI 1.37-9.64, p = 0.010). Furthermore, in those patients, the estimated c-index of the multivariable model for DSS was 0.755 without fibrinogen and 0.785 when fibrinogen was added. CONCLUSIONS An elevated preoperative plasma fibrinogen level may represent an independent prognostic marker for survival in breast cancer patients.
Collapse
Affiliation(s)
- Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria
| | | | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Karin S Kapp
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria.
| |
Collapse
|
4
|
Krenn-Pilko S, Langsenlehner U, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients. Tumour Biol 2015. [PMID: 26219894 DOI: 10.1007/s13277-015-3805-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Existing preclinical and clinical data suggest that the presence of a systemic inflammatory response plays a critical role in the progression of several solid tumors. The derived neutrophil-to-lymphocyte ratio (dNLR) represents an easily determinable marker of systemic inflammation and has been proposed as a potential prognostic marker. The present study was performed to validate and further clarify the prognostic relevance of an elevated pre-treatment dNLR in a large cohort of European breast cancer patients. Data from 762 consecutive female breast cancer patients treated from 1999 to 2004 were evaluated. Disease-free survival (DFS) and overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the prognostic relevance, univariate and multivariate Cox regression models were performed for each endpoint. Applying receiver operating characteristics (ROC) analysis, the optimal cutoff level for the dNLR was 3. In univariate analysis, a dNLR ≥3 was associated with poor DFS (hazard ratio (HR) 1.87, 95 % confidence interval (CI) 1.28-2.73, p = 0.001) and OS (HR 1.67, 95 % CI 1.07-2.63, p = 0.025). Multivariate analysis revealed a significant association between the elevated dNLR and poor DFS (hazard ratio (HR) 1.70, 95 % CI 1.09-2.65, p = 0.018) but did not show a significant association between the dNLR and OS (HR 1.54, 95 % CI 0.91-2.59, p = 0.106). The present study shows that the pre-treatment dNLR is an independent prognostic factor that could be useful for future individual risk assessment in breast cancer patients.
Collapse
Affiliation(s)
- Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria
| | - Uwe Langsenlehner
- Division of Internal Medicine, Outpatient Department Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Internal Medicine, Comprehensive Cancer Center, Medical University of Graz, Graz, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Department of Internal Medicine, Comprehensive Cancer Center, Medical University of Graz, Graz, Austria
| | - Karin S Kapp
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria.
| |
Collapse
|
5
|
Trummer O, Langsenlehner U, Krenn-Pilko S, Pieber TR, Obermayer-Pietsch B, Gerger A, Renner W, Langsenlehner T. Vitamin D and prostate cancer prognosis: a Mendelian randomization study. World J Urol 2015. [PMID: 26209090 DOI: 10.1007/s00345-015-1646-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Decreased vitamin D levels have been associated with prostate cancer, but it is unclear whether this association is causal. A functional single-nucleotide polymorphism (SNP) in the group-specific component (GC) gene (T > G, rs2282679) has been associated with 25-hydroxy (25-OH) vitamin D and 1.25 dihydroxy (1.25-OH2) vitamin D levels. METHODS To examine the hypothesized inverse relationship between vitamin D status and prostate cancer, we studied the association between this SNP and prostate cancer outcome in the prospective PROCAGENE study comprising 702 prostate cancer patients with a median follow-up of 82 months. RESULTS GC rs2282679 genotypes were not associated with biochemical recurrence [hazard ratios (HR) 0.91, 95 % confidence interval (CI) 0.73-1.12; p = 0.36], development of metastases (HR 1.20, 95 % CI 0.88-1.63; p = 0.25) or overall survival (HR 1.10; 95 % CI 0.84-1.43; p = 0.50). CONCLUSIONS A causal role of vitamin D status, as reflected by GC rs2282679 genotype, in disease progression and mortality in prostate cancer patients is unlikely.
Collapse
Affiliation(s)
- Olivia Trummer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Uwe Langsenlehner
- Division of Internal Medicine, GKK Outpatient Department, Graz, Austria
| | - Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
| | - Thomas R Pieber
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Armin Gerger
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Wilfried Renner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036, Graz, Austria.
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria
| |
Collapse
|
6
|
Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. PO-0682: External validation of the derived neutrophil-tolymphocyte ratio as a prognostic factor in breast cancer patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Langsenlehner T, Pichler M, Thurner EM, Krenn-Pilko S, Stojakovic T, Gerger A, Langsenlehner U. Evaluation of the platelet-to-lymphocyte ratio as a prognostic indicator in a European cohort of patients with prostate cancer treated with radiotherapy. Urol Oncol 2015; 33:201.e9-16. [PMID: 25769845 DOI: 10.1016/j.urolonc.2015.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 01/12/2015] [Accepted: 02/03/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Recent evidence suggests that the presence of a systemic inflammatory response plays an important role in the progression of several solid tumors. The platelet-to-lymphocyte ratio (PLR) has been proposed as an easily assessable marker of systemic inflammation and has been shown to represent a prognostic marker in different cancer entities. To evaluate the prognostic value of the PLR in prostate cancer, we performed the present study. METHODS AND MATERIALS Data from 374 consecutive patients with prostate cancer, treated with 3D conformal radiotherapy from 1999 to 2007, were analyzed. Distant metastases-free survival (MFS), cancer-specific survival (CSS), overall survival (OS), biochemical disease-free survival, and time to salvage systemic therapy were assessed using the Kaplan-Meier method. Cox proportional hazards analysis was performed to calculate hazard ratio (HR) and 95% CI. Multivariate Cox regression analysis was performed to adjust for other covariates. RESULTS Using receiver operating characteristics analysis, the optimal cutoff level for the PLR was 190. Kaplan-Meier analyses revealed that PLR≥190 was a prognostic factor for decreased MFS (P = 0.004), CSS (P = 0.004), and OS (P = 0.024) whereas a significant association of an elevated PLR with biochemical disease-free survival (P = 0.740) and time to salvage systemic therapy (P = 0.063) was not detected. In multivariate analysis, an increased PLR remained a significant prognostic factor for poor MFS (HR = 2.24, 95% CI: 1.06-4.76, P = 0.036), CSS (HR = 3.99, 95% CI: 1.19-13.4, P = 0.025), and OS (HR = 1.87, 95% CI: 1.02-3.42, P = 0.044). CONCLUSIONS Our findings indicate that the PLR may predict prognosis in patients with prostate cancer and may contribute to future individual risk assessment in them.
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria.
| | - Martin Pichler
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, TX
| | - Eva-Maria Thurner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Armin Gerger
- Department of Medicine, Comprehensive Cancer Center, Medical University of Graz, Austria
| | | |
Collapse
|
8
|
Langsenlehner U, Hofmann G, Renner W, Gerger A, Krenn-Pilko S, Thurner EM, Krippl P, Langsenlehner T. Association of vascular endothelial growth factor--a gene polymorphisms and haplotypes with breast cancer metastases. Acta Oncol 2015; 54:368-76. [PMID: 25152223 DOI: 10.3109/0284186x.2014.948056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF-A) is a key regulator of tumor-induced angiogenesis and essential for tumor growth and distant tumor spread. The aim of the present study was to evaluate the role of VEGF-A polymorphisms and haplotypes for metastatic progression in breast cancer patients. MATERIAL AND METHODS We performed a prospective study including 801 breast cancer patients. Occurrence of metastases was examined in regular follow-up investigations. Seven VEGF-A polymorphisms were selected and determined by 5'-nuclease assays (TaqMan). The selection of VEGF-A variants was based upon their location (promoter or UTR) as well as a minor allele frequency of at least 0.10. Haplotypes and linkage disequilibrium were determined using the Haploview program. RESULTS Within a median follow-up time of 84 months, 165 (21%) patients developed distant metastases. In univariate analysis, carriers of the CCCCC haplotype formed by five polymorphisms upstream the coding region were at decreased risk of distant metastases [hazard ratio (HR)=0.743; 95% CI 0.579-0.953; p=0.019]. Univariate analysis also revealed a decreased risk of distant metastases for postmenopausal patients carrying the -634G>C polymorphism (HR 0.704; 95% CI 0.514-0.965; p=0.029) and the CCCCC haplotype (HR=0.645; 95% CI 0.464-0.898; p=0.009). After adjustment for other co-variates, the HR for distant metastases was 0.651 (95% CI 0.447-0.948) for postmenopausal carriers of the -634G>C polymorphism (p=0.025; corrected p-value=0.262), and 0.586 (95% CI 0.393-0.873) for postmenopausal patients with the CCCCC haplotype (p=0.009, corrected p-value=0.189). CONCLUSION The results from univariate and multivariate analyses suggest an influence of VEGF-A gene variants on the development of distant metastases in breast cancer patients. However, none of the observed associations reached statistical significance after correction for the effects of multiple testing. Additional prospective and sufficiently powered studies are essential before firm conclusions about the role of VEGF-A gene variants for distant progression in breast cancer can be drawn.
Collapse
Affiliation(s)
- Uwe Langsenlehner
- Division of Internal Medicine, GKK Outpatient Department , Graz , Austria
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Thurner EM, Krenn-Pilko S, Langsenlehner U, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The elevated C-reactive protein level is associated with poor prognosis in prostate cancer patients treated with radiotherapy. Eur J Cancer 2015; 51:610-9. [DOI: 10.1016/j.ejca.2015.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 12/15/2014] [Accepted: 01/05/2015] [Indexed: 10/24/2022]
|
10
|
Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. P229 An elevated preoperative plasma fibrinogen level is related with poor prognosis in breast cancer. Breast 2015. [DOI: 10.1016/s0960-9776(15)70261-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
11
|
Langsenlehner T, Thurner EM, Krenn-Pilko S, Langsenlehner U, Stojakovic T, Gerger A, Pichler M. Validation of the neutrophil-to-lymphocyte ratio as a prognostic factor in a cohort of European prostate cancer patients. World J Urol 2015; 33:1661-7. [DOI: 10.1007/s00345-015-1494-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/14/2015] [Indexed: 02/07/2023] Open
|
12
|
Thurner EM, Krenn-Pilko S, Langsenlehner U, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The association of an elevated plasma fibrinogen level with cancer-specific and overall survival in prostate cancer patients. World J Urol 2014; 33:1467-73. [PMID: 25475065 DOI: 10.1007/s00345-014-1459-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/28/2014] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Fibrinogen plays an important role in the pathophysiology of tumour cell invasion and metastases. In recent studies, an elevated plasma fibrinogen level has been associated with poor prognosis in different types of cancer. The present study was performed to analyse the prognostic impact of an elevated fibrinogen level in prostate cancer patients. METHODS We evaluated data from 268 prostate cancer patients who underwent 3D conformal radiotherapy between 1999 and 2006 at a single tertiary academic center. Cancer-specific survival (CSS), overall survival (OS), and clinical disease-free survival (DFS) were assessed using the Kaplan-Meier method. Univariable and multivariable Cox regression models were performed for each endpoint. RESULTS Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the plasma fibrinogen level was 530 mg dl(-1), respectively. Univariable (HR 3.638, 95 % CI 1.15-11.47, p = 0.027) and multivariable analyses (HR 3.964, 95 % CI 1.06-14.87, p = 0.041) revealed a significant correlation between increased plasma fibrinogen and CSS. Univariable analysis also showed a significant association between the elevated plasma fibrinogen level and decreased OS (HR 3.242, 95 % CI 1.53-6.89, p = 0.002), that remained significant in multivariable analysis (HR 3.215, 95 % CI 1.44-7.19, p = 0.004). No significant associations were found for clinical DFS. CONCLUSION Although our data show a significant association between an elevated plasma fibrinogen level and poor prostate cancer prognosis, they have to be interpreted cautiously. Limitations of the present study are caused by its retrospective design, the limited accuracy obtained using ROC curve analysis, and potential confounding factors like cardiovascular disease and inflammatory diseases that have not been accounted for.
Collapse
Affiliation(s)
- Eva-Maria Thurner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria
| | - Sabine Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria
| | - Uwe Langsenlehner
- Division of Internal Medicine, Outpatient Department Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Karin S Kapp
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria
| | - Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria.
| |
Collapse
|
13
|
Krenn-Pilko S, Langsenlehner U, Thurner EM, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. Br J Cancer 2014; 110:2524-30. [PMID: 24675383 PMCID: PMC4021515 DOI: 10.1038/bjc.2014.163] [Citation(s) in RCA: 207] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/01/2014] [Accepted: 03/04/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The elevation of the platelet-to-lymphocyte ratio (PLR), an easily applicable blood test based on platelet and lymphocyte counts has been associated with poor prognosis in patients with different types of cancer. The present study was aimed to investigate the prognostic significance of the preoperative PLR in a large cohort of breast cancer patients. METHODS Data from 793 consecutive non-metastatic breast cancer patients, treated between 1999 and 2004, were evaluated retrospectively. The optimal cutoff values for the PLR were calculated using receiver operating curve analysis. Cancer-specific survival (CSS), overall survival (OS) as well as distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of PLR, multivariable Cox regression models were applied for all three different end points. RESULTS Univariable analysis revealed a significant association between the elevated preoperative PLR and CSS (hazard ratio (HR): 2.75, 95% confidence interval (CI): 1.57-4.83, P<0.001) that remained statistically significant in multivariable analysis (HR: 2.03, 95% CI: 1.03-4.02, P=0.042). An increased PLR was also significantly associated with decreased OS in univariable (HR: 2.45, 95% CI: 1.43-4.20, P=0.001) and in multivariable analysis (HR: 1.92, 95% CI: 1.01-3.67, P=0.047). Furthermore, univariable analysis showed a significant impact of increased PLR on DMFS (HR: 2.02, 95% CI: 1.18-3.44, P=0.010). Subgroup analysis revealed significant associations of the elevated PLR on the primary end point CSS for all breast cancer subtypes. This association retained its significance in multivariable analysis in patients with luminal B tumours (HR: 2.538, 95% CI: 1.043-6.177, P=0.040). CONCLUSIONS In this study, we identified the preoperative PLR as an independent prognostic marker for survival in breast cancer patients. Independent validation of our findings is needed.
Collapse
Affiliation(s)
- S Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - U Langsenlehner
- Division of Internal Medicine, Outpatient Department Graz, Graz, Austria
| | - E-M Thurner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - M Pichler
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Gerger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - K S Kapp
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - T Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| |
Collapse
|
14
|
Langsenlehner T, Thurner EM, Renner W, Gerger A, Kapp KS, Langsenlehner U. Association of genetic variants in VEGF-A with clinical recurrence in prostate cancer patients treated with definitive radiotherapy. Strahlenther Onkol 2014; 190:364-9. [PMID: 24435801 DOI: 10.1007/s00066-013-0503-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/08/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Vascular endothelial growth factor-A (VEGF-A), a key regulator of tumor-induced angiogenesis, is critical for tumor growth and metastasization. The goal of the present study was to evaluate the prognostic value of VEGF single nucleotide polymorphisms (SNPs) and haplotypes for clinical recurrence after definitive radiotherapy for prostate cancer. PATIENTS AND METHODS The association of seven VEGF-A polymorphisms and their haplotypes with clinical recurrence (defined as the occurrence of local recurrence and/or distant metastases) in 496 prostate cancer patients treated with definitive radiotherapy were investigated. Genotypes were determined by 5'-nuclease (TaqMan) assays; haplotypes were analyzed using the Haploview program. RESULTS Within a median follow-up time of 80 months, 44 patients (9 %) developed clinical recurrences. Haplotype analysis showed two separate blocks of high-linkage disequilibrium, formed by five polymorphisms (- 2578C > A, - 2489C > T, - 1498C > T, - 634G > C, - 7C > T) upstream of the coding sequence (CCCCC, ATTGC, CCCGC, ATTGT) and two polymorphisms (936C > T, 1612G > A) downstream of the coding sequence (CA, CG, TG). Carriers of at least 1 copy of the ATTGC haplotype were at higher risk of recurrence (hazard ratio [HR] 3.83; 95 %CI 1.48-9.90, p = 0.006); for carriers of 2 copies, the HR was 4.85 (95 %CI 1.72-13.6; p = 0.003). In multivariate analysis, patients harboring at least one copy of the ATTGC haplotype remained at increased risk of recurrence (HR 3.63, 95 %CI 1.38-9.55, p = 0.009); in patients carrying 2 copies, the HR was 4.72 (95 %CI 1.64-13.6, p = 0.004). CONCLUSION Our findings indicate that the VEGF-A ATTGC haplotype may predict clinical recurrence in prostate cancer patients treated with radiotherapy.
Collapse
Affiliation(s)
- T Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria,
| | | | | | | | | | | |
Collapse
|
15
|
Thurner EM, Krenn-Pilko S, Langsenlehner U, Renner W, Gerger A, Kapp K, Langsenlehner T. Association of genetic variants in apoptosis genes FAS and FASL with radiation-induced late toxicity after prostate cancer radiotherapy. Strahlenther Onkol 2014; 190:304-9. [DOI: 10.1007/s00066-013-0485-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/16/2013] [Indexed: 10/25/2022]
|
16
|
Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. PO-0695: Elevated plasma fibrinogen level represents an independent prognostic factor in breast cancer patients. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30813-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
17
|
Thurner E, Krenn-Pilko S, Pichler M, Gerger A, Langsenlehner U, Kapp K, Langsenlehner T. PD-0303: Elevated C-reactive protein level predicts poor prognosis in prostate cancer patients treated with radiotherapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
18
|
Absenger G, Szkandera J, Stotz M, Pichler M, Winder T, Langsenlehner T, Langsenlehner U, Samonigg H, Renner W, Gerger A. A common and functional gene variant in the vascular endothelial growth factor a predicts clinical outcome in early-stage breast cancer. Mol Carcinog 2013; 52 Suppl 1:E96-102. [PMID: 23625573 DOI: 10.1002/mc.22028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 02/25/2013] [Indexed: 11/11/2022]
Abstract
Angiogenesis and cell cycle control play critical roles in breast cancer susceptibility and clinical outcome and are mainly controlled by vascular endothelial growth factor (VEGF) and cyclin-dependent kinases, respectively. Functional germline polymorphisms in these genes alter the function, thereby causing inter-individual differences in breast cancer risk and clinical outcome. In this study, we investigated the influence of the functional polymorphisms VEGF-A rs3025039 C > T and CCND1 rs9344 G > A on risk and clinical outcome in early-stage breast cancer. DNA of 539 female patients with histologically confirmed early-stage breast cancer and 804 control subjects was genotyped for these polymorphisms. Genotypes were tested for associations with breast cancer risk and clinical outcome. There was no significant association between the polymorphisms and breast cancer risk. However, the minor allele of VEGF-A rs3025039 C > T was significantly associated with decreased recurrence-free survival (HR 1.845; 95% confidence interval [CI] 1.035-3.290; P = 0.038) and remained significant in multivariate analysis (HR 1.880; 95% CI 1.020-3.465; P = 0.043). Patients carrying at least one A-allele in CCND1 rs9344 G > A showed a trend towards decreased recurrence-free survival in univariate analysis (HR 2.379; 95% CI 0.841-6.728; P = 0.068). This study provides evidence that the functional VEGF-A rs3025039 C > T polymorphism influences recurrence-free survival in early-stage breast cancer.
Collapse
Affiliation(s)
- Gudrun Absenger
- Division of Clinical Oncology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Langsenlehner T, Thurner E, Renner W, Kapp K, Langsenlehner U. PO-0904: Genetic variants in apoptosis-related genes and radiation-induced late toxicity in prostate cancer patients. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33210-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Thurner E, Krenn-Pilko S, Renner W, Gerger A, Kapp K, Langsenlehner U, Langsenlehner T. 283 Genetic Variants in the TGF-β1 Gene and the Risk of Late Toxicity After Radiotherapy in Prostate Cancer Patients. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72081-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
21
|
Krenn-Pilko S, Hofmann G, Renner W, Gerger A, Thurner E, Kapp K, Langsenlehner U, Langsenlehner T. 473 The Role of VEGF Gene Polymorphisms in the Development of Distant Metastases in Postmenopausal Breast Cancer Patients. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70538-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Langsenlehner T, Renner W, Gerger A, Hofmann G, Thurner EM, Kapp KS, Langsenlehner U. Impact of VEGF gene polymorphisms and haplotypes on radiation-induced late toxicity in prostate cancer patients. Strahlenther Onkol 2011; 187:784-91. [DOI: 10.1007/s00066-011-1106-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 06/28/2011] [Indexed: 12/23/2022]
|
23
|
Parmar S, Stingl JC, Huber-Wechselberger A, Kainz A, Renner W, Langsenlehner U, Krippl P, Brockmöller J, Haschke-Becher E. Impact of UGT2B7 His268Tyr polymorphism on the outcome of adjuvant epirubicin treatment in breast cancer. Breast Cancer Res 2011; 13:R57. [PMID: 21658222 PMCID: PMC3218946 DOI: 10.1186/bcr2894] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/15/2011] [Accepted: 06/09/2011] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Epirubicin is a common adjuvant treatment for breast cancer. It is mainly eliminated after glucuronidation through uridine diphosphate-glucuronosyltransferase 2B7 (UGT2B7). The present study aimed to describe the impact of the UGT2B7(His268Tyr) polymorphism on invasive disease-free survival in breast cancer patients after epirubicin treatment. METHODS This is a pharmacogenetic study based on samples collected from 745 breast cancer patients of the Austrian Tumor of breast tissue: Incidence, Genetics, and Environmental Risk factors (TIGER) cohort who did not present metastases at baseline. This cohort included 205 women with epirubicin-based combination chemotherapy, 113 patients having received chemotherapy without epirubicin and 427 patients having received no chemotherapy at all. Of the epirubicin-treated subgroup, 120 were subsequently treated with tamoxifen. For all women UGT2B7(His268Tyr) was genotyped. Invasive disease-free survival was assessed using Kaplan-Meier and Cox's proportional hazard regression analysis. RESULTS Among the 205 epirubicin-treated patients, carriers of two UGT2B7(268Tyr) alleles had a mean invasive disease-free survival of 8.6 (95% confidence interval (CI) 7.9 to 9.3) years as compared to 7.5 (95% CI 6.9 to 8.0) years in carriers of at least one UGT2B7(268His) allele (adjusted hazard ratio (HR) = 2.64 (95% CI 1.22 to 5.71); P = 0.014). In addition, the impact of the UGT2B7(His268Tyr) polymorphism became even more pronounced in patients subsequently treated with tamoxifen (adjusted HR = 5.22 (95% CI 1.67 to 26.04); P = 0.015) whereas no such difference in invasive disease-free survival was observed in patients not receiving epirubicin. CONCLUSIONS Breast cancer patients carrying the UGT2B7(268Tyr/Tyr) genotype may benefit most from adjuvant epirubicin-based chemotherapy. These results warrant confirmation in further studies.
Collapse
Affiliation(s)
- Sumit Parmar
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University Ulm, Helmholtzstrasse 20, Ulm, 89081, Germany
| | - Julia Carolin Stingl
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, University Ulm, Helmholtzstrasse 20, Ulm, 89081, Germany
| | - Ariana Huber-Wechselberger
- Institute of Medical and Laboratory Diagnostics, Elisabethinen Hospital Linz, Fadingerstrasse 1, Linz, 4020, Austria
| | - Alexander Kainz
- Department of Nephrology and Dialysis, Medical University Vienna, Währingergürtel 18-20, Vienna, 1090, Austria
| | - Wilfried Renner
- Clinical Institute of Medical and Laboratory Diagnostics, Medical University Graz, Auenbruggerplatz 15, Graz, 8036, Austria
| | - Uwe Langsenlehner
- Department of Internal Medicine, Hospital of Fürstenfeld, Krankenhausgasse 1, Fürstenfeld, 8280, Austria
| | - Peter Krippl
- Department of Internal Medicine, Hospital of Fürstenfeld, Krankenhausgasse 1, Fürstenfeld, 8280, Austria
| | - Jürgen Brockmöller
- Department of Clinical Pharmacology, University Göttingen, Robert-Koch-Strasse 40, Göttingen, 37075, Germany
| | - Elisabeth Haschke-Becher
- Institute of Medical and Laboratory Diagnostics, Elisabethinen Hospital Linz, Fadingerstrasse 1, Linz, 4020, Austria
- Christian Doppler Clinic, Private Paracelsus Medical University Salzburg, Ignaz Harrerstrasse 79, Salzburg, 5020, Austria
| |
Collapse
|
24
|
Langsenlehner T, Thurner E, Renner W, Hofmann G, Kapp K, Langsenlehner U. 910 poster ASSOCIATION BETWEEN SINGLE NUCLEOTIDE POLYMORPHISMS AND HAPLOTYPES IN THE VEGF GENE AND LATE TOXICITY IN PROSTATE CANCER PATIENTS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
25
|
Thurner E, Renner W, Langsenlehner U, Gerger A, Hofmann G, Kapp K, Langsenlehner T. 913 poster CORRELATION BETWEEN SINGLE NUCLEOTIDE POLYMORPHISMS IN THE XRCC1 GENE AND THE RISK OF SEVERE SIDE EFFECTS AFTER RADIOTHERAPY FOR PROSTATE CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71035-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
26
|
Hofmann G, Langsenlehner U, Langsenlehner T, Glehr M, Gerger A, Absenger G, Szkandera J, Fuerst F, Samonigg H, Krippl P, Renner W. Single nucleotide polymorphisms of integrin alpha-2 and beta-3 genes are not associated with relapse-free and overall survival in colorectal cancer patients. Anticancer Res 2011; 31:1373-1377. [PMID: 21508388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Integrins influence tumourigenesis, tumor progression and development of metastases. The impact of polymorphisms in integrin genes on relapse-free survival (RFS) and overall survival (OS) for 433 Caucasian patients with colorectal cancer was analysed in this retrospective study. PATIENTS AND METHODS A Cox regression model including integrin genotype, age, grading, tumour size, number of lymph nodes examined, number of metastatic lymph nodes, stage and application of fluorouracil-based adjuvant chemotherapy was used to estimate their effect. RESULTS After a median follow-up of 41 months for RFS and 55 months for OS, no significant correlation between the ITGA2 1648A allele (RFS p=0.618, OS p=0.604), the ITGA2 807T allele (RFS p=0.603, OS p=0.807) and the ITGB3 176C allele (RFS p=0.719, OS p=0.261) and survival was detectable. CONCLUSION The investigated integrin polymorphisms are not associated with RFS or OS in colorectal cancer patients.
Collapse
Affiliation(s)
- Günter Hofmann
- Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Langsenlehner T, Renner W, Gerger A, Hofmann G, Thurner EM, Kapp KS, Langsenlehner U. Association between single nucleotide polymorphisms in the gene for XRCC1 and radiation-induced late toxicity in prostate cancer patients. Radiother Oncol 2011; 98:387-93. [PMID: 21345510 DOI: 10.1016/j.radonc.2011.01.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 01/19/2011] [Accepted: 01/25/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Polymorphisms in genes responsible for DNA damage signaling and repair might modulate DNA repair capacity and, therefore, affect cell and tissue response to radiation and influence individual radiosensitivity. The purpose of the present prospective investigation was to evaluate the association of single nucleotide polymorphisms in XRCC1 with radiation-induced late side effects in prostate cancer patients treated with radiotherapy. MATERIAL AND METHODS To analyze the role of XRCC1 polymorphisms for late toxicity 603 participants from the Austrian PROCAGENE study treated with three-dimensional conformal radiotherapy were included in the present investigation. Three non-synonymous candidate polymorphisms in the X-ray repair cross-complementing group 1 (XRCC1) gene (Arg194Trp; Arg280His; Arg399Gln) were selected and determined by 5´-nuclease (TaqMan) assays. RESULTS Within a median follow-up time of 35 months, 91 patients (15.7%) developed high-grade late toxicities (defined as late bladder and/or rectal toxicity RTOG≥2). In a Kaplan-Meier analysis, carriers of the XRCC1 Arg280His polymorphism were at decreased risk of high-grade late toxicity (p=0.022), in multivariate analysis including clinical and dosimetric parameters as potential confounders the XRCC1 Arg280His polymorphism remained a significant predictor for high-grade late toxicity (HR=0.221, 95% CI 0.051-0.956; p=0.043). No significant associations were found for the remaining polymorphisms. CONCLUSIONS We conclude that the XRCC1 Arg280His polymorphism may be protective against the development of high-grade late toxicity after radiotherapy in prostate cancer patients.
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, Graz, Austria.
| | | | | | | | | | | | | |
Collapse
|
28
|
Stingl JC, Parmar S, Huber-Wechselberger A, Kainz A, Renner W, Seeringer A, Brockmöller J, Langsenlehner U, Krippl P, Haschke-Becher E. Impact of CYP2D6*4 genotype on progression free survival in tamoxifen breast cancer treatment. Curr Med Res Opin 2010; 26:2535-42. [PMID: 20849243 DOI: 10.1185/03007995.2010.518304] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The cytochrome P450 2D6 (CYP2D6) polymorphism was reported to have a significant impact on outcome of tamoxifen treatment in estrogen receptor positive breast cancer patients. The objective of this study was to explore the effect of the CYP2D6*4 polymorphism on tamoxifen treatment outcome in a cohort of patients from a single clinical trial which included women with a history of previous chemotherapy. RESEARCH DESIGN AND METHODS A total of 493 patients of the Austrian TIGER study receiving adjuvant tamoxifen therapy were studied for this pharmacogenetic interaction. All women with estrogen receptor positive tumors and tamoxifen therapy longer than 6 months were genotyped for CYP2D6*4 using TaqMan technology. Time to tumor progression, defined as local, regional, distant recurrence or contralateral breast cancer and progression free survival, was analyzed. RESULTS No significant difference in time to tumor progression or progression free survival between the CYP2D6*4 genotype groups in the overall study cohort was found. In a subgroup of patients treated with chemotherapy the CYP2D6*4 poor metabolizers had a tendency towards a shorter mean time to progression. In this group the mean time to tumor progression and the progression free survival were 1.0 years in the CYP2D6*4/*4 group, 6.3 years in the *1/*4 group and 4.97 years in the *1/*1 group (Wilcoxon p = 0.104). CONCLUSION While earlier data on CYP2D6 and tamoxifen excluded women with prior chemotherapy, the present analysis suggests that CYP2D6*4 genotype might be particularly crucial in this group of high-risk patients. Key limitations are restriction to the CYP2D6*4 allele and missing data of comedication.
Collapse
Affiliation(s)
- Julia Carolin Stingl
- Institute of Pharmacology of Natural Compounds and Clinical Pharmacology, University Ulm, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Langsenlehner T, Renner W, Hofmann G, Thurner E, Kapp K, Langsenlehner U. 523 The XRCC1 Arg280His polymorphism is associated with high-grade radiation-induced late toxicity in prostate cancer patients. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
30
|
Knechtel G, Szkandera J, Stotz M, Hofmann G, Langsenlehner U, Krippl P, Samonigg H, Renner W, Langner C, Dehchamani D, Gerger A. Single nucleotide polymorphisms in the hypoxia-inducible factor-1 gene and colorectal cancer risk. Mol Carcinog 2010; 49:805-9. [PMID: 20572162 DOI: 10.1002/mc.20655] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
With an incidence of about 300 000 new cases colorectal cancer (CRC) is the second leading cause of cancer-related death in Europe and the United States. Environmental and genetic factors influence CRC risk. Hypoxia-inducible factor-1 (HIF-1), a heterodimeric protein composed of two subunits, HIF-1 alpha and HIF-1 beta, plays a critical role in oxygen homeostasis and is involved in angiogenesis and cell proliferation. The gene for the HIF-1 alpha subunit (HIF1A) carries two common missense mutations-P582S (rs11549465) and A588T (rs11549467)-which both have been related to increased trans-activation capacity of HIF1A. In our case-control study we investigated the association between these polymorphisms and CRC risk. We investigated 381 patients with histologically confirmed CRC and 2156 control subjects. HIF1A genotypes were determined by exonuclease (TaqMan) assays. For determination of microvessel density (MVD) tumor sections were stained using a mouse monoclonal antibody recognizing the pan-endothelial marker CD31. In a multivariate logistic regression analysis including age and sex neither the HIF1A 582S allele (Odds ratio: 1.204; 95% confidence interval 0.911-1.592; P = 0.193) nor the 588T allele was significantly associated with CRC (Odds ratio: 0.851; 95% confidence interval 0.444-1.631; P = 0.626). However, in an exploratory analysis, the HIF1A 588T allele was associated with tumor localization (P = 0.016) and tumor size (P = 0.003). MVD was similar in tumors of patients carrying HIF1A 588T allele and patients without this rare allele. We conclude that functional polymorphisms in the HIF1A gene do not modify CRC risk but maybe associated with clinic-pathological features of the disease.
Collapse
Affiliation(s)
- Gudrun Knechtel
- Department of Internal Medicine, Medical University Graz, Austria
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Thurner E, Partl R, Tauber G, Renner W, Kapp K, Langsenlehner U, Langsenlehner T. 850 The role of DNA repair gene polymorphisms in the development of radiation-induced late toxicity in prostate cancer patients. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71644-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
32
|
Szkandera J, Knechtel G, Stotz M, Hofmann G, Langsenlehner U, Krippl P, Langsenlehner T, Dehchamani D, Samonigg H, Renner W, Gerger A. Association of hypoxia-inducible factor 1-alpha gene polymorphisms and colorectal cancer prognosis. Anticancer Res 2010; 30:2393-2397. [PMID: 20651398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Hypoxia inducible factor-1 (HIF-1) is the key regulator of cellular responses to hypoxia and plays a central role in tumour growth. Recently, two single nucleotide polymorphisms (SNPs) in the HIF-1 alpha gene, C1772T and G1790A, were shown to cause significantly higher transcriptional activity than did the wild-type. This study aimed to investigate the effect of these SNPs on the prognosis of colorectal cancer (CRC). PATIENTS AND METHODS DNA from 336 CRC patients was genotyped. Genotypes of each polymorphism were tested for association with disease-free survival (DFS) using univariate and multivariate Cox-regression analysis. RESULTS Genotype frequencies were: CC 75.6%, CT 18.8% and TT 1.8% for HIF1A1 C1772T and GG 93.2%, GA 2.7% and AA 0% for G1790A. A statistically significant association between DFS and clinicopathological features was observed. However, no association was found between HIF1A1 C1772T (p=0.44; risk ratio of recurrence, RR=1.19, 95% confidence interval, CI=0.77 to 1.83) and G1790A (p=0.89; RR=0.92, 95% CI=0.29 to 2.90) polymorphisms and DFS in univariate and multivariate Cox-regression analysis. CONCLUSION These results suggest that HIF1A1 C1772T and G1790A polymorphisms are not involved in the progression or metastasis of CRC.
Collapse
Affiliation(s)
- Joanna Szkandera
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Yazdani-Biuki B, Krippl P, Brickmann K, Fuerst F, Langsenlehner U, Paulweber B, Pilger E, Wascher TC, Brezinschek HP, Renner W. The Functional Promoter Polymorphism of the Coagulation Factor XII Gene is not Associated With Peripheral Arterial Disease. Angiology 2009; 61:211-5. [DOI: 10.1177/0003319709337305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coagulation factor XII (FXII) plays a key role in both coagulation and fibrinolysis and has been associated with cardiovascular disease in some studies. Plasma FXIIa levels are strongly determined by a common functional polymorphism in the promoter of the FXII gene (F12-4C>T). To investigate the potential association of this polymorphism with peripheral arterial disease (PAD), we performed a case-control study including 668 patients with PAD and 762 controls participants without cardiovascular disease. F12 genotype frequencies were not significantly different between patients with PAD and control participants. After adjustment for classical risk factors, the odds ratio of carriers of a F12 -4T allele for PAD was 1.06 (95% confidence interval 0.86—1.32). F12 genotypes were associated with a modest increase of the mean-activated partial thromboplastin time but not with PAD stage or severity. We conclude that the functional F124C>T polymorphism is not associated with PAD.
Collapse
Affiliation(s)
| | - Peter Krippl
- Department of Internal Medicine, Regional Hospital of Fuerstenfeld, Austria
| | | | | | - Uwe Langsenlehner
- Internal Outpatient Department, Steiermaerkische Gebietskrankenkasse, Graz, Austria
| | | | - Ernst Pilger
- Division of Angiology, Medical University Graz, Austria
| | - Thomas C. Wascher
- Division of Metabolism and Vascular Biology Unit, Department of Medicine, Medical University Graz, Austria
| | | | - Wilfried Renner
- Division of Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Austria, wilfried.renner@ medunigraz.at
| |
Collapse
|
34
|
Gerger A, Renner W, Langsenlehner T, Hofmann G, Knechtel G, Szkandera J, Samonigg H, Krippl P, Langsenlehner U. Association of interleukin-10 gene variation with breast cancer prognosis. Breast Cancer Res Treat 2009; 119:701-5. [DOI: 10.1007/s10549-009-0417-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 04/30/2009] [Indexed: 12/23/2022]
|
35
|
Hofmann G, Langsenlehner U, Langsenlehner T, Yazdani-Biuki B, Clar H, Gerger A, Fuerst F, Samonigg H, Krippl P, Renner W. A common hereditary single-nucleotide polymorphism in the gene of FAS and colorectal cancer survival. J Cell Mol Med 2009; 13:3699-702. [PMID: 19298528 PMCID: PMC4516518 DOI: 10.1111/j.1582-4934.2009.00720.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Apoptosis plays an important role in embryogenesis, autoimmunity and tumourigenesis. Cell surface death receptors such as TNFRSF6 (FAS) confer a major apoptotic effect. A single-nucleotide polymorphism in the FAS promoter gene, −670A/G, modulates apoptotic signalling and has been related to susceptibility and progression of a variety of cancers. The present study aimed to evaluate the role of this polymorphism for survival of patients with colorectal cancer. We performed a retrospective analysis including 433 patients with histologically confirmed colorectal cancer. A Cox regression model including FAS -670 genotypes, age at diagnosis, tumour grading, primary tumour size, number of lymph nodes examined, number of metastatic lymph nodes, tumour stage and application of fluorouracil-based adjuvant chemotherapy was used to estimate the effect of the FAS genotype on survival. FAS −670A/G genotype frequencies were 24.2% (AA), 46.3% (AG) and 29.5% (GG). Forty-nine patients were excluded from the Cox regression analysis because of missing values. Out of the remaining 384 patients, 69 (18%) died during a follow-up of maximum 10 years. Mean follow-up time was 58 ± 34 months (median 55 months). Carriers of the homozygous FAS -670GG genotype had a significantly lower survival rate compared with AA/AG genotype carriers (relative risk 1.76, 95% confidence interval 1.08–2.87; P= 0.023). The FAS −670A/G polymorphism may be associated with overall survival time of patients with colorectal cancer.
Collapse
Affiliation(s)
- Guenter Hofmann
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Langsenlehner T, Mayer R, Quehenberger F, Prettenhofer U, Langsenlehner U, Pummer K, Kapp KS. The role of radiation therapy after incomplete resection of penile cancer. Strahlenther Onkol 2008; 184:359-63. [PMID: 19016034 DOI: 10.1007/s00066-008-1818-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 03/26/2008] [Indexed: 11/27/2022]
Abstract
PURPOSE To retrospectively assess the outcome in patients treated with adjuvant radiotherapy for penile cancer. PATIENTS AND METHODS Between 1987 and 2006, 24 patients (median age, 62.7 years; range, 35.5-90.4 years) with squamous cell carcinoma of the penis (T1, n = 10; T2, n = 11; T3, n = 3) received megavoltage external radiotherapy (n = 22) or (192)Ir high-dose-rate brachytherapy (n = 2) following total penectomy (n = 7), partial penectomy (n = 10), or local excision (n = 7); lymphadenectomy was performed in eight patients. In 14 patients, radiotherapy was delivered after incomplete tumor resection, and in 20 patients the planning target volume included the regional lymph nodes. Median total dose of external radiotherapy was 56 Gy/1.8-2 Gy (range, 50-60 Gy). Brachytherapy was given with a total dose of 45 Gy/3 Gy. RESULTS During a median follow-up of 58.4 months, penile or perineal recurrence was found in four patients giving a 5-year local control rate of 74.8%. Regional failure occurred in two patients. 5-year metastases-free survival and progression-free survival rates were 86.7% and 64.5%, respectively. Four patients died due to tumor progression. The actuarial 5-year cause-specific and overall survival rates were 84.3 and 56.6%, respectively. CONCLUSION Radiation therapy is a successful method of treatment for penile cancer in terms of local control and organ preservation after microscopically incomplete surgery. Radiotherapy of the regional lymph nodes might also be effective in preventing regional recurrence and can be considered in case of high-risk features and following excision of extensive lymph node involvement.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Brachytherapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Combined Modality Therapy
- Disease Progression
- Disease-Free Survival
- Humans
- Lymphatic Irradiation
- Lymphatic Metastasis/pathology
- Lymphatic Metastasis/radiotherapy
- Male
- Middle Aged
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Neoplasm, Residual/mortality
- Neoplasm, Residual/pathology
- Neoplasm, Residual/radiotherapy
- Penile Neoplasms/mortality
- Penile Neoplasms/pathology
- Penile Neoplasms/radiotherapy
- Penile Neoplasms/surgery
- Radiotherapy, Adjuvant
- Radiotherapy, High-Energy
- Retrospective Studies
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria.
| | | | | | | | | | | | | |
Collapse
|
37
|
Gerger A, Wiltgen M, Langsenlehner U, Richtig E, Horn M, Weger W, Ahlgrimm-Siess V, Hofmann-Wellenhof R, Samonigg H, Smolle J. Diagnostic image analysis of malignant melanoma inin vivoconfocal laser-scanning microscopy: a preliminary study. Skin Res Technol 2008; 14:359-63. [DOI: 10.1111/j.1600-0846.2008.00303.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
38
|
Langsenlehner T, Kapp KS, Langsenlehner U. TGFB1 single-nucleotide polymorphisms are associated with adverse quality of life in prostate cancer patients treated with radiotherapy. In regard to Peters et al. (Int J Radiat Oncol Biol Phys 2008;70:752-759). Int J Radiat Oncol Biol Phys 2008; 71:960; author reply 960-1. [PMID: 18514790 DOI: 10.1016/j.ijrobp.2008.02.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 02/01/2008] [Indexed: 11/16/2022]
|
39
|
Yazdani-Biuki B, Brickmann K, Langsenlehner U, Renner W, Truschnig M, Krippl P, Furst F, Graninger WB, Brezinschek HP. The Glu228Ala polymorphism in the ligand-binding domain of death receptor 4 is not associated with rheumatoid arthritis. Ann Rheum Dis 2008; 67:1053-4. [DOI: 10.1136/ard.2007.086124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
40
|
Langsenlehner T, Langsenlehner U, Renner W, Krippl P, Mayer R, Wascher TC, Kapp KS. Single nucleotide polymorphisms and haplotypes in the gene for vascular endothelial growth factor and risk of prostate cancer. Eur J Cancer 2008; 44:1572-6. [PMID: 18514506 DOI: 10.1016/j.ejca.2008.04.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Accepted: 04/25/2008] [Indexed: 01/27/2023]
Abstract
Vascular endothelial growth factor (VEGF) plays a key role in the regulation of angiogenesis and has been related to cancer development and progression. To evaluate the role of VEGF single nucleotide polymorphisms (SNPs) and haplotypes in prostate cancer, we performed a case-control study including 702 prostate cancer patients and 702 male age-matched healthy control subjects. Seven VEGF candidate polymorphisms were determined by 5'-nuclease (TaqMan) assays. Furthermore, VEGF plasma levels and genotypes were analysed in a group of 64 healthy men. Haplotype analysis showed two separate blocks of high-linkage disequilibrium, formed by five polymorphisms upstream of the coding sequence (promoter and 5'-untranslated region) and two polymorphisms downstream of the coding sequence. None of the single polymorphisms or haplotypes was significantly associated with the presence of prostate cancer. In a multivariate regression analysis including age, VEGF genotypes and haplotypes as covariates and VEGF plasma level as dependent variable, none of the VEGF polymorphism or haplotypes was a significant predictor of VEGF plasma levels. The present data suggest that polymorphisms or haplotypes in the VEGF gene do not modify the risk of prostate cancer.
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria.
| | | | | | | | | | | | | |
Collapse
|
41
|
Gerger A, Hofmann-Wellenhof R, Langsenlehner U, Richtig E, Koller S, Weger W, Ahlgrimm-Siess V, Horn M, Samonigg H, Smolle J. In vivo confocal laser scanning microscopy of melanocytic skin tumours: diagnostic applicability using unselected tumour images. Br J Dermatol 2008; 158:329-33. [PMID: 18215250 DOI: 10.1111/j.1365-2133.2007.08389.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In vivo confocal laser scanning microscopy (CLSM) represents a novel imaging tool that allows the noninvasive examination of skin cancer morphology in real time at a 'quasi-histopathological' resolution viewing microanatomical structures and individual cells. OBJECTIVES To validate diagnostic confocal examination of melanocytic skin tumours using unselected tumour images. METHODS In the present study, we used a total of 3709 unselected CLSM tumour images obtained from 20 malignant melanomas and 50 benign naevi. The entire set of images derived from each tumour was evaluated by independent observers. Classification tree analysis based on a subsample of 857 tumour images was performed to develop a diagnostic algorithm. RESULTS Overall, sensitivity and specificity of 97.5% and 99% could be achieved by the independent observers (positive predictive value 97.5%, negative predictive value 99%). Classification tree analysis yielded a three-step algorithm based on only three morphological CLSM features, facilitating a correct classification in 92.4% of the benign naevus images and 97.6% of melanoma images. CONCLUSIONS In vivo CLSM augurs a sea change in the way we will view skin tumour processes clinically at the bedside and merits application for use as a screening tool in skin oncology.
Collapse
Affiliation(s)
- A Gerger
- Department of Internal Medicine, Division of Oncology, Medical University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Langsenlehner T, Langsenlehner U, Renner W, Kapp KS, Krippl P, Hofmann G, Clar H, Pummer K, Mayer R. The Glu228Ala polymorphism in the ligand binding domain of death receptor 4 is associated with increased risk for prostate cancer metastases. Prostate 2008; 68:264-8. [PMID: 18163425 DOI: 10.1002/pros.20682] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Death receptor 4, encoded by the TNFRSF10A gene, is an important mediator of apoptosis and its dysfunction may be related to cancer development and distant tumor spread. A single nucleotide polymorphism in TNFRSF10A (Glu228Ala, rs20576) within a conserved region of the extracellular cysteine-rich domain of death receptor 4 has been associated with an increased risk for a variety of tumor entities. Aim of the present study was to evaluate the role of the TNFRSF10A polymorphism in metastatic progression of prostate cancer after radiation therapy. METHODS We carried out a prospective study including 702 prostate cancer patients from the Austrian PROCAGENE (Prostate Cancer Genetics) study. Development of metastases was examined in regular follow-up investigations. TNFRSF10A genotypes were determined by a 5'-nuclease assay (TaqMan). RESULTS Within a median follow-up time of 10 months (range 0-60 months), 24 (3.4%) patients developed metastases. In a Cox regression model including age at diagnosis and risk group as potential confounders, carriage of an 228Ala allele was associated with a relative risk of 2.47 (95% CI 1.10-5.54; P=0.028) for metastases. TNFRSF10A genotypes were not associated with tumor stage, grade, risk group or age at diagnosis. CONCLUSION We conclude that the TNFRSF10A Glu228Ala polymorphism may be a novel independent risk factor for prostate cancer metastases after radiation therapy.
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz, Austria.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Clar H, Renner W, Krippl P, Leithner A, Gruber G, Langsenlehner T, Hofmann G, Yazdani-Biuki B, Clar V, Windhager R, Langsenlehner U. The LCT 13910 C/T polymorphism as a risk factor for osteoporosis, has no impact on metastatic bone disease in breast cancer. Breast Cancer Res Treat 2007; 112:363-5. [PMID: 18080747 DOI: 10.1007/s10549-007-9863-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Accepted: 12/07/2007] [Indexed: 10/22/2022]
|
44
|
Clar H, Langsenlehner U, Krippl P, Renner W, Leithner A, Gruber G, Hofmann G, Yazdani-Biuki B, Langsenlehner T, Windhager R. A polymorphism in the G protein β3-subunit gene is associated with bone metastasis risk in breast cancer patients. Breast Cancer Res Treat 2007; 111:449-52. [DOI: 10.1007/s10549-007-9808-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Accepted: 10/26/2007] [Indexed: 11/28/2022]
|
45
|
Langsenlehner T, Langsenlehner U, Krippl P, Mayer R, Kapp K. 537 POSTER The Glu228Ala polymorphism in the ligand binding domain of death receptor 4 is associated with prostate cancer metastases. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
46
|
Langsenlehner T, Hofmann G, Gerger A, Kapp K, Langsenlehner U. 535 POSTER The association between the MTHFR 677C>T polymorphism and breast cancer risk in premenopausal women. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
47
|
Langsenlehner U, Wolf G, Langsenlehner T, Gerger A, Hofmann G, Clar H, Wascher TC, Paulweber B, Samonigg H, Krippl P, Renner W. Genetic polymorphisms in the vascular endothelial growth factor gene and breast cancer risk. The Austrian "tumor of breast tissue: incidence, genetics, and environmental risk factors" study. Breast Cancer Res Treat 2007; 109:297-304. [PMID: 17636397 DOI: 10.1007/s10549-007-9655-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 06/07/2007] [Indexed: 01/28/2023]
Abstract
PURPOSE Vascular endothelial growth factor (VEGF) is a key regulator of tumor-induced angiogenesis and is required for growth of tumors. We tested the hypothesis that VEGF gene polymorphisms may be associated with breast cancer. EXPERIMENTAL DESIGN We performed a case-control study including 804 female incident breast cancer patients and 804 female age-matched healthy control subjects. We selected seven VEGF candidate polymorphisms and determined genotypes by 5'-nuclease (TaqMan) assays. Furthermore, VEGF plasma levels and genotypes were analyzed in a group of 81 healthy volunteers (64 men and 17 women). RESULTS Haplotype analysis showed two separate blocks of high-linkage disequilibrium, formed by five polymorphisms upstream of the coding sequence (promoter and 5' untranslated region) and two polymorphisms downstream of the coding sequence. None of the single polymorphisms or haplotypes was significantly associated with the presence of breast cancer. After Bonferroni correction for multiple testing, only one statistical signifcant association between VEGF genotypes and haplotypes and tumor characteristics was observed (-634C allele and small tumor size; p < 0.001). In a multivariate regression analysis including sex, age, VEGF genotypes, and haplotypes as covariates and VEGF plasma level as dependent variable, none of the VEGF polymorphism or haplotypes was a significant predictor of VEGF plasma levels. CONCLUSIONS Our findings do not support the hypothesis that VEGF polymorphisms are associated with breast cancer risk. The association of the VEGF -634C allele with small tumor size is in clear contrast to a previous publication and should be interpreted with caution until replicated by additional studies.
Collapse
Affiliation(s)
- Uwe Langsenlehner
- Department of Internal Medicine, Division of Oncology, Medical University Graz, Graz, Austria.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Horn M, Gerger A, Koller S, Weger W, Langsenlehner U, Krippl P, Kerl H, Samonigg H, Smolle J. The use of confocal laser-scanning microscopy in microsurgery for invasive squamous cell carcinoma. Br J Dermatol 2007; 156:81-4. [PMID: 17199571 DOI: 10.1111/j.1365-2133.2006.07574.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Ex-vivo confocal laser-scanning microscopy offers rapid imaging of excised tissue specimens without conventional histotechnical procedures. As vertical sections are prepared, morphological features can be assessed according to standard criteria used in conventional histopathology. OBJECTIVES To validate the diagnostic confocal examination of squamous cell carcinoma (SCC) in microscopy-guided surgery. METHODS Four independent observers received standardized instructions about diagnostic confocal microscopy features of SCC. Subsequently, 120 confocal images of fresh excisions from SCC or normal skin, imaged using a commercially available, near-infrared, reflectance confocal laser-scanning microscope, were evaluated by each observer. RESULTS General morphology, such as location, size and shape of the cancer area could be visualized by the imaging system. Furthermore, densely packed and irregularly organized nuclei and nuclear atypia could be delineated. Overall, a sensitivity of 95% and a specificity of 96.25% were achieved by the four observers (positive predictive value 96.25%, negative predictive value 95.23%). CONCLUSIONS This study provides a set of well-described morphological criteria with obvious diagnostic impact which should be used in further investigations. In the future, confocal laser-scanning microscopy may guide microsurgery of any skin cancer.
Collapse
Affiliation(s)
- M Horn
- Division of Analytical-Morphological Dermatology, Department of Dermatology, Medical University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Langsenlehner T, Stiegler C, Quehenberger F, Feigl GC, Jakse G, Mokry M, Langsenlehner U, Kapp KS, Mayer R. Long-Term Follow-up of Patients with Pituitary Macroadenomas after Postoperative Radiation Therapy. Strahlenther Onkol 2007; 183:241-7. [PMID: 17497095 DOI: 10.1007/s00066-007-1706-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2006] [Revised: 01/19/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE Evaluation of long-term tumor control, normalization of hormonal hypersecretion, including incidence and time course of pituitary dysfunction following postoperative radiotherapy of pituitary macroadenomas. PATIENTS AND METHODS In a retrospective study, the data of 87 patients with pituitary macroadenomas (61 non-secreting adenomas, 26 secreting adenomas) treated between 1984 and 1994 were analyzed. All patients underwent surgery and received postoperative external-beam radiotherapy with a mean dose of 50.4 Gy (range 46-54 Gy). RESULTS After a follow-up of 15 years the local tumor control rate achieved was 93.0% for non-secreting adenomas and 100% for secreting adenomas, respectively. Normalization of endocrine hypersecretion was noted in 24 of 26 patients (92%). Detailed endocrinological follow-up data were analyzed by an experienced endocrinologist in 77 patients. After a median follow-up of 10.54 years (mean 10.22; range 1.39-20.75 years), in 75 of 77 patients (97%) a hypopituitarism was observed (partial hypopituitarism, n = 28 [36%], panhypopituitarism, n = 47 [61%]), and 68 out of 77 patients (88%) showed evidence of radiotherapy-induced pituitary disorders. The somatotropic function was most commonly affected, followed by gonadal, thyroid and adrenal function. The gonadal axis showed to be the first to be disturbed. 67 patients (87%) required a hormone replacement therapy. CONCLUSION Radiotherapy after pituitary surgery is highly effective in reducing hormonal hypersecretion and preventing recurrences of pituitary adenomas. However, pituitary insufficiencies are commonly observed after radiotherapy requiring a close follow-up to ensure timely diagnosis of pituitary dysfunction and an early inception of hormone replacement therapy.
Collapse
Affiliation(s)
- Tanja Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Austria.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Langsenlehner T, Renner W, Yazdani-Biuki B, Langsenlehner U. Methylenetetrahydrofolate reductase (MTHFR) and breast cancer risk: a nested-case-control study and a pooled meta-analysis. Breast Cancer Res Treat 2007; 107:459-60. [PMID: 17453338 DOI: 10.1007/s10549-007-9564-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Accepted: 03/09/2007] [Indexed: 11/29/2022]
Abstract
Encouraged by recent studies on the MTHFR 677C>T polymorphism and breast cancer risk that suggested an association of the 677 TT genotype with increased breast cancer susceptibility in premenopausal women, we performed an analysis of the relationship between breast cancer risk and the MTHFR 677C>T polymorphism in 210 premenopausal breast cancer patients and sex- and agematched healthy control subjects. Our data show a trend for a higher MTHFR 677T allele frequency in breast cancer cases (61.9%) than in controls (51.5%, P = 0.082) supporting the results of previous studies.
Collapse
|