ObjectiveTo establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). MethodsLower third and abdominal part of EAC patients from 2010 to 2015 were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. ResultsIn total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. The 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. ConclusionThis nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.
Objective To evaluate the predictive performance of the geometric characteristics, centerline (CL) of pulmonary nodules for prognosis in patients with surgically treatment in the National Lung Screening Trial (NLST). MethodsCT images of 178 patients who underwent surgical treatment and were diagnosed with non-small cell lung cancer (NSCLC) in the low-dose CT (LDCT) cohort from the NLST image database were selected, including 99 males and 79 females, with a median age of 64 (59, 68) years. CT images were processed using commercial software Mimics 21.0 to record the volume, surface area, CL and the area perpendicular to the centerline of pulmonary nodules. Receiver operating characteristic (ROC) curve was used to compare the predictive performance of LD, AD and CL on prognosis. Univariate Cox regression was used to explore the influencing factors for postoperative disease-free survival (DFS) and overall survival (OS), and meaningful independent variables were included in the multivariate Cox regression to construct the prediction model. ResultsThe area under the curve (AUC) of CL for postoperative recurrence and death were 0.650 and 0.719, better than LD (0.596, 0.623) and AD (0.600, 0.631). Multivariate Cox proportional risk regression analysis showed that pulmonary nodule volume (P=0.010), the maximum area perpendicular to the centerline (MApc) (P=0.028) and lymph node metastasis (P<0.001) were independent risk factors for DFS. Meanwhile, age (P=0.010), CL (P=0.043), lymph node metastasis (P<0.001), MApc (P=0.022) and the average area perpendicular to the centerline (AApc) (P=0.016) were independently associated with OS. ConclusionFor the postoperative outcomes of NSCLC patients in the LDCT cohort of the NLST, the CL of the pulmonary nodule prediction performance for prognosis is superior to the LD and AD, CL can effectively predict the risk stratification and prognosis of lung cancer, and spheroid tumors have a better prognosis.
ObjectiveTo systematically evaluate the potential value of C-reactive protein to albumin ratio (CAR) as an indicator of prognosis and survival in patients with pancreatic cancer. MethodsThe literatures were searched comprehensively in the PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang, CNKI, and CQVIP databases from the establishment of the databases to May 20, 2021. The combined hazard ratio (HR) and 95% confidence interval (95%CI) were used to evaluate the correlation between the CAR and the overall survival (OS), progression-free survival (PFS), or disease-free survival (DFS) in the patients with pancreatic cancer. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the non-randomized controlled studies, and the Stata SE 15.0 software was used for meta-analysis. ResultsA total of 2 985 patients with pancreatic cancer were included in this meta-analysis of 15 studies. The results of meta-analysis showed that the higher CAR value, the shorter OS [effect size (ES)=0.60, 95%CI (0.50, 0.69), Z=12.04, P<0.001], DFS [ES=0.63, 95%CI (0.47, 0.78), Z=3.61, P<0.001], and PFS [ES=0.41, 95%CI (0.19, 0.63), Z=7.91, P<0.001] in the patients with pancreatic cancer. The results of subgroup analysis of OS according to different countries, sample size, mean age, follow-up time, CAR cut-off value, and NOS score showed that the higher CAR value was related to the shorter OS (P<0.05). The result of linear regression analysis showed that there was no correlation between the CAR cut-off value and lnHR of OS (r2=0.947, P=0.455). Conclusion From results of this study, CAR is closely related to OS of patients, and it is expected to be used as a new reference index for monitoring and judging prognosis of patients with pancreatic cancer.
ObjectiveTo analyze the impact of neoadjuvant regimens on prognosis in patients with rectal cancer in the current version of the Database from Colorectal Cancer (DACCA) database. MethodsPatient information was extracted from the updated version of DACCA on November 24, 2022 according to the established screening criteria, and the following items were analyzed: gender, age, body mass index (BMI), marriage, economic conditions, degree of differentiation, neoadjuvant treatment regimen, and pTNM staging. According to the neoadjuvant treatment regimen, the patients were divided into three groups: chemotherapy group, chemotherapy combined radiotherapy group, and chemotherapy combined targeted therapy group, and the overall survival (OS) and disease-specific survival (DSS) of patients in the three groups were analyzed, and the influencing factors of OS and DSS were analyzed by univariate and multivariate Cox proportional hazard regression models. ResultsAccording to the screening criteria, 1 716 valid data were obtained from the DACCA database, of which 954 (55.6%) were in the chemotherapy group, 332 (19.3%) in the chemotherapy combined radiotherapy group, and 430 (25.1%) in the chemotherapy combined targeted therapy group. The differences in the Kaplan-Merier survival curves of patients with different neoadjuvant regimens for OS and DSS in the three groups were statistically significant (χ2=142.142, P＜0.001; χ2=129.528, P＜0.001). There were significant differences in OS rate and DSS rate between the three groups in 3 years and 5 years (P<0.001). Further comparison of different neoadjuvant therapy groups showed that the OS of the chemotherapy combined targeted therapy group was slightly better than that of the chemotherapy group in 3 years, however, OS and DSS in 5 years were slightly worse than those the chemotherapy group, but the difference were not statistically significant (P>0.05). The OS and DSS of the chemotherapy group and the chemotherapy combined targeted therapy group were better than those of the chemotherapy combined radiotherapy group in 3 years and 5 years, and the differences were statistically significant (P<0.01). The results of multivariate analysis showed that patients’ age, economic conditions, degree of tumor differentiation, new auxiliary scheme and pTNM staging were the influencing factors of OS and DSS. ConclusionNeoadjuvant treatment regimen will affect the long-term survival prognosis of rectal cancer patients.
At present, breast cancer is most common malignant tumor among female population. The treatment of breast cancer comprises surgery, radiotherapy, neoadjuvant and adjuvant therapy, with surgical as the main treatment approach. Common surgical methods for breast cancer include breast conservation surgery (BCS) and mastectomy. This article reviews the recent researches about the survival of breast cancer patients receiving BCS, the quality of life for patients receiving BCS, the survival of young and elderly patients receiving BCS, BCS after neoadjuvant chemotherapy, BCS for patients with breast cancer susceptibility gene mutation, and BCS for patients with ipsilateral breast tumor recurrence, so as to provide reference for the follow-up work of medical staff.
Objective To evaluate the relationship of systemic immune inflammatory index (SII) with the clinical features and prognosis of osteosarcoma patients. Methods The clinical data of patients with osteosarcoma surgically treated in Fuzhou Second Hospital between January 2012 and December 2017 were retrospectively collected. The preoperative SII value was calculated, which was defined as platelet × neutrophil/lymphocyte count. The best critical value of SII was determined by receiver operating characteristic (ROC) curve analysis, and the relationship between SII and clinical features of patients was analyzed by χ2 test. Kaplan-Meier method and Cox proportional hazard model were used to study the effect of SII on overall survival (OS). The nomogram prediction model was established according to the independent risk factors of patients’ prognosis. Results A total of 108 patients with osteosarcoma were included in this study. Preoperative high SII was significantly correlated with tumor diameter, Enneking stage, local recurrence and metastasis (P<0.05). The median follow-up time was 62 months. The 1-, 3-, 5-year survival rates of the low SII group were significantly higher than those of the high SII group (100.0%, 96.4%, 85.1% vs. 95.4%, 73.7%, 30.7%), and the survival of the two groups were statistically different (P<0.05). Univariate Cox regression analyses showed that tumor diameter, Enneking stage, local recurrence, metastasis and SII were associated with OS (P<0.05). Multiple Cox regression analysis showed that Enneking stage (P=0.031), local recurrence (P=0.035) and SII (P=0.001) were independent risk factors of OS. The nomogram constructed according to the independent risk factors screened by the Cox regression model had good discrimination and consistency (C-index=0.774), and the calibration curve showed that the nomogram had a high consistency with the actual results. In addition, the ROC curve indicated that the nomogram had a good prediction efficiency (area under the curve=0.880). Conclusions The preoperative SII level is expected to become an important prognostic parameter for patients with osteosarcoma. The higher the SII level is, the worse the prognosis of patients will be. The nomogram prediction model built on preoperative SII level, Enneking stage and local recurrence has a good prediction efficiency, and can be used to guide the diagnosis and treatment of clinical osteosarcoma.
ObjectiveTo explore the immune biomarkers for prognosis of breast cancer and to construct a risk assessment model.MethodsThe gene expression of breast cancer samples was retrieved from The Cancer Genome Map (TCGA) database and immune related genes (IRGs) were retrieved from the ImmPort database. Cox proportional hazards regression and least absolute shrinkage and selection operator (LASSO) regression were used for prognostic analysis. Gene set enrichment analysis ( GSEA) was used to explore biological signaling pathways. ESTIMATE and CIBERSORT algorithms were used to explore the relationship between risk score and tumor immune microenvironment.ResultsNine kinds of immune-related differentially expressed genes independently related to prognosis were identified: adrenoceptor beta 1 (ADRB1), interleukin 12B (IL12B), syndecan 1 (SDC1), thymic stromal lymphopoietin (TSLP), fibroblast growth factor 19 (FGF19), fatty acid binding protein 7 (FABP7), interferon epsilon (IFNE), tumor necrosis factor receptor superfamily member 18 (TNFRSF18) and interleukin 27 (IL27). The risk assessment equation constructed by these nine kinds of genes had powerful predictive ability. The “neurotrophin signaling pathway” and “adipocyte factor signaling pathway” were activated in patients of high-risk group, and “leukocyte transendothelial migration” “WNT signaling pathway” “FcεRI signaling pathway” “valine, leucine and isoleucine biosynthesis” and “protein export pathway” were activated in patients of low-risk group. A variety of tumor-killing immune cells were significantly enriched in the tumor-infiltrating immune cells of patients in the low-risk group. The immunosuppressive immune cells were significantly enriched in tumor infiltrating immune cells of patients in high-risk group.ConclusionIRGs prognostic signatures are an effective potential predictive classifier in breast cancer treatment.
Objection To analyze the relationship between blood type and prognosis of colorectal cancer patients in the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was updated on January 5, 2022. The data items analysis included age, gender, blood type, tumor location, tumor pathological nature, pathological TNM (pTNM) stage, survival status and survival time. According to the ABO blood type classification, it was divided into four blood type groups: A blood type group, B blood type group, AB blood type group, and O blood type group. The overall survival (OS) and disease specific survival (DSS) were analyzed in four blood type groups, and the OS and DSS of each blood type group were analyzed in pTNM stage stratification. Results A total of3 486 rows of data were obtained from the DACCA database according to the screening conditions. There was no significantdifference in OS and DSS among blood typy A, B, AB and O group (P>0.05); At specific time points, the 1-year OS of the blood type A group was worse than that of blood type B (95.8% vs. 99.6%), the 1-year OS of the blood type B group was better than that of blood type O group (99.6% vs. 96.9%), and the differences were statistically significant (P<0.008 7), but the differences between OS and DSS in the remaining 1, 3, 5 and 10 years of patients with different blood type groups were not statistically significant (P>0.008 7). In each pTNM staging subgroup, the differences between 1, 3, 5 and 10-year OS and DSS were not statistically significant among different blood type groups (P>0.008 7). Conclusions Overall, there was no significant difference in prognosis among the blood type A, B, AB, and O groups. Comparing specific blood types and follow-up time, patients with blood type B have slightly better 1-year OS than patients with blood type A or blood type O. Comparisons between other ABO blood groups and between ABO blood groups classified by the pTNM staging subgroup did not show a difference.
ObjectiveTo use real-world data from a large sample of papillary thyroid microcarcinoma (PTMC) in the SEER database to investigate the impact of delayed treatment on survival outcomes. MethodsA total of 40 761 patients with PTMC eligible for the study from the SEER database of the National Cancer Institute of the United States during 2000–2019 were selected as the study objects and divided into 3 groups according to the different delayed treatment time (0, 0–6 months, >6 months). Kaplan-Meir method was used to plot the survival curve and calculate 5-year cumulative disease-specific survival (DSS) rate and overall survival (OS) rate. Cox proportional hazard regression model was used to analyze the relationship between delayed treatment time, DSS and OS in PTMC patients and the influencing factors of prognosis. ResultsAmong the 40 761 patients, 7 575 (18.58%) were males and 33 186 (81.42%) were females, most of whom were females. The patients ranged in age from 3 to 97 years old [ (51.1±13.9) years old], of which 24 043 (58.99%) were <55 years old and 16 718 (41.01%) were ≥55 years old. Received treatment immediately after diagnosis in 30 823 patients (75.62%), 9 734 patients (23.88%) received treatment within 6 months after diagnosis, 204 patients (0.50%) received treatment 6 months after diagnosis. There were significant differences in age, sex, race, lymph node stage, radiotherapy, surgical method, number of lesions and invasion of thyroid capsule among the 3 groups (P< 0.001). The survival analysis results of the 3 groups showed that the delayed treatment time had no effect on DSS and OS of PTMC patients (P>0.05). The multivariate Cox proportional hazard regression model analysis results showed that the patient’s age ≥55 years old, male, married, lymph node metastasis, radiotherapy, total thyroidectomy and thyroid capsule invasion were the risk factors affecting DSS and OS in PTMC patients (P<0.05), while delayed treatment was not risk factors for DSS and OS in PTMC patients (P>0.05). ConclusionDelayed treatment is not an independent risk factor for DSS and OS in patients with PTMC, and active monitoring is a safe alternative to surgery for some PTMCS.
ObjectiveTo explore transcatheter arterial chemoembolization (TACE) influences on prognosis of patients with BCLC stage 0–A hepatocellular carcinoma (HCC).MethodsThe clinicopathologic data of BCLC stage 0–A HCC patients underwent the radical resection in the Affiliated Hospital of Southwest Medical University from January 2006 to June 2018 were retrospectively analyzed. These patients were divided into a preoperative TACE treatment group (PTT group, n=365) and a directly surgical resection group (DSR group, n=365). The Kplan-Meier method was used to compare the overall survival (OS) and disease free survival (DFS) between the two groups. The Cox proportional hazard model was used to analyze whether the preoperative TACE was an independent factor affecting the prognosis of patient with BCLC stage 0–A HCC.ResultsA total of 465 patients with BCLC stage 0–A HCC were enrolled, including 365 patients in the DSR group and 100 patients in the PTT group. The baseline data of the two groups were similar（P>0.050）. In the cohort, the 1-, 3-, 5-, 10-year OS rates and DFS rates were 95.3%, 83.5%, 74.3%, 56.8% and 88.0%, 63.8%, 51.1%, 36.4%, respectively in the DSR group, which were 92.7%, 72.9%, 52.3%, 35.3% and 78.1%, 54.2%, 40.4%, 31.2%, respectively in the PTT group. The Kplan-Meier survival analysis showed that the OS and DFS in the DSR group were significantly better than those in the PTT group (P=0.009, P=0.033). The multivariate Cox proportional hazard model analysis showed that the preoperative TACE was the independent risk factor for the poor prognosis in the patients with BCLC stage 0–A HCC [ HR=1.389, 95% CI (1.158, 2.199), P=0.021].ConclusionsFor patients with BCLC stage 0–A HCC, preoperative TACE doesn’t improve patient’s prognosis and might reduce survival rate. If there is no special reason, direct surgery should be performed.