Refine Search

New Search

Results: 226

(searched for: Prognostic Analysis of Patients with Resectable T4 Colorectal Cancer)
Save to Scifeed
Page of 23
Articles per Page
by
Show export options
  Select all
Yinghao Cao, Shenghe Deng, Lizhao Yan, Junnan Gu, Fuwei Mao, Yifan Xue, Changmin Zheng, Ming Yang, Hongli Liu, Li Liu, et al.
Oxidative Medicine and Cellular Longevity, Volume 2021, pp 1-15; doi:10.1155/2021/6693707

Abstract:
Oxidative stress plays an important role in the development of colorectal cancer (CRC). This study is aimed at developing and validating a novel scoring system, based on oxidative stress indexes, for prognostic prediction in CRC patients. A retrospective analysis of 1422 CRC patients who underwent surgical resection between January 2013 and December 2017 was performed. These patients were randomly assigned to the training set ( n = 1022 ) or the validation set ( n = 400 ). Cox regression model was used to analyze the laboratory parameters. The CRC-Integrated Oxidative Stress Score (CIOSS) was developed from albumin (ALB), direct bilirubin (DBIL), and blood urea nitrogen (BUN), which were significantly associated with survival in CRC patients. Furthermore, a survival nomogram was generated by combining the CIOSS with other beneficial clinical characteristics. The CIOSS generated was as follows: 0.074 × albumin (g/L), − 0.094 × bilirubin (μmol/L), and - 0.099 × blood urea nitrogen (mmol/L), based on the multivariable Cox regression analysis. Using 50% (0.1025) and 85% (0.481) of CIOSS as cutoff values, three prognostically distinct groups were formed. Patients with high CIOSS experienced worse overall survival (OS) ( hazard ratio HR = 4.33 ; 95% confidence interval [CI], 2.80-6.68; P < 0.001 ) and worse disease-free survival (DFS) ( HR = 3.02 ; 95% CI, 1.96-4.64; P < 0.001 ) compared to those with low CIOSS. This predictive nomogram had good calibration and discrimination. ROC analyses showed that the CIOSS possessed excellent performance ( AUC = 0.818 ) in predicting DFS. The AUC of the OS nomogram based on CIOSS, TNM stage, T stage, and chemotherapy was 0.812, while that of the DFS nomogram based on CIOSS, T stage, and TNM stage was 0.855. Decision curve analysis showed that these two prediction models were clinically useful. CIOSS is a CRC-specific prognostic index based on the combination of available oxidative stress indexes. High CIOSS is a powerful indicator of poor prognosis. The CIOSS also showed better predictive performance compared to TNM stage in CRC patients.
Shintaro Hashimoto, Kiyoaki Hamada , Yorihisa Sumida, Masato Araki, Kouki Wakata, Tota Kugiyama, Ayako Shibuya, Masato Nishimuta, Shigeyuki Morino, Masayuki Baba, et al.
Published: 5 January 2021
In Vivo, Volume 35, pp 555-561; doi:10.21873/invivo.12291

The publisher has not yet granted permission to display this abstract.
Ismail Selvi , Umut Demirci , Nazan Bozdogan, Halil Basar
International Urology and Nephrology pp 1-4; doi:10.1007/s11255-020-02766-7

The publisher has not yet granted permission to display this abstract.
Chun-Ming Huang, Ching-Wen Huang, Cheng-Jen Ma, Hsiang-Lin Tsai, Wei-Chih Su, Tsung-Kun Chang, Ming-Yii Huang, Jaw Yuan Wang
World Journal of Gastrointestinal Oncology, Volume 12, pp 1428-1442; doi:10.4251/wjgo.v12.i12.1428

Abstract:
Patients with clinical T4 colorectal cancer (CRC) have a poor prognosis because of compromised surgical margins. Neoadjuvant therapy may be effective in downstaging tumors, thereby rendering possible radical resection with clear margins. To evaluate tumor downsizing and resection with clear margins in T4 CRC patients undergoing neoadjuvant concurrent chemoradiotherapy followed by surgery. This study retrospectively included 86 eligible patients with clinical T4 CRC who underwent neoadjuvant concurrent chemoradiotherapy followed by radical resection. Neoadjuvant therapy consisted of radiation therapy at a dose of 45-50.4 Gy and chemotherapy agents, either FOLFOX or capecitabine. A circumferential resection margin (CRM) of < 1 mm was considered to be a positive margin. We defined pathological complete response (pCR) as the absence of any malignant cells in a specimen, including the primary tumor and lymph nodes. A multivariate logistic regression model was used to identify independent predictive factors for pCR. For 86 patients who underwent neoadjuvant chemoradiotherapy and surgery, the rate of pCR was 14%, and the R0 resection rate was 91.9%. Of the 61 patients with rectal cancer, 7 (11.5%) achieved pCR and 5 (8.2%) had positive CRMs. Of the 25 patients with colon cancer, 5 (20%) achieved pCR and 2 (8%) had positive CRMs. We observed that the FOLFOX regimen was an independent predictor of pCR (P = 0.046). After a median follow-up of 47 mo, the estimated 5-year overall survival (OS) and disease-free survival (DFS) rates were 70.8% and 61.4%, respectively. Multivariate analysis revealed that a tumor with a negative resection margin was associated with improved DFS (P = 0.014) and OS (P = 0.001). Patients who achieved pCR exhibited longer DFS (P = 0.042) and OS (P = 0.003) than those who did not. Neoadjuvant concurrent chemoradiotherapy engenders favorable pCR and R0 resection rates among patients with T4 CRC. The R0 resection rate and pCR are independent prognostic factors for patients with T4 CRC.
Mary Garland, Abhineet Uppal, Yalda B. Naeini, Stacey Stern, Richard Erali, Anthony J. Scholer, Adam M. Khader, Juan A. Santamaria-Barria, Kathleen Cummins-Perry, Yi Zhou, et al.
Journal of Gastrointestinal Surgery pp 1-8; doi:10.1007/s11605-020-04886-y

The publisher has not yet granted permission to display this abstract.
Christopher D’Avella, Karthik Devarajan, Martin Edelman, Daniel Geynisman
Published: 9 November 2020
by BMJ
Journal for ImmunoTherapy of Cancer, Volume 8; doi:10.1136/jitc-2020-sitc2020.0180

Abstract:
BackgroundTransfusions of packed red blood cells (PRBC) have been postulated to be immunosuppressive, an effect known as transfusion-related immunomodulation (TRIM). TRIM is thought to be a result of the immunosuppressive and pro inflammatory effects of residual leukocytes, apoptotic cells, inflammatory mediators, micro particles and free hemoglobin1 Prior studies have shown a negative association between perioperative PRBC transfusions and overall mortality in multiple malignancies.2–13 To date there are no studies addressing the impact of transfusions on survival in patients undergoing treatment with checkpoint inhibitor (CPI) immunotherapy. We conducted a retrospective study to investigate the clinical outcomes associated with PRBC transfusions in patients with non-small cell lung cancer (NSCLC), urothelial carcinoma (UC) and renal cell carcinoma (RCC) who received immunotherapy for advanced/metastatic disease.MethodsFrom January 2010 - June 2019, patients at Fox Chase Cancer Center who received a PRBC transfusion within 120 days of treatment with a CPI and with advanced NSCLC, UC and RCC were included. Patient demographics including age, sex, ethnicity, race, tobacco use and ECOG performance status (PS) were abstracted. We also assessed previous chemotherapy, radiation and targeted therapy utilization among all patients. The primary endpoints were progression free survival (PFS) and overall survival (OS) in those who have and have not received PRBCs. We then evaluated PFS and OS via a cox proportional hazards model that was adjusted for cancer type, age, PS, previous therapies and tobacco use.Results304 patients including 272 NSCLC, 24 UC and 8 RCC subjects were evaluated. 54 patients underwent a minimum of one PRBC transfusion during the pre-specified time period. Both median PFS (8.2 months versus 3.9) and overall survival (26.1 months versus 13.8) were shorter in patients who underwent transfusion. After multivariable adjustment, the negative associations between transfusion and PFS (HR: 1.53, p=0.03) and overall survival (HR: 1.40, p=0.09) were preserved (figure 1–2). A sub-analysis of the NSCLC patients was conducted and shorter PFS (HR:1.58, p=0.03) and overall survival (HR:1.56, P=0.03) were again seen in the transfusion cohort (figure 3–4).Abstract 180 Figure 1Progression free survival. Y refers to transfused population. N refers to non transfused population.Abstract 180 Figure 2Overall survival. Y refers to transfused population. N refers to non transfused population.Abstract 180 Figure 3Progression free survival in non-small cell lung cancer patients. Y refers to transfused population. N refers to non transfused populationAbstract 180 Figure 4Overall survival in non-small cell lung cancer patients. Y refers to transfused population. N refers to non transfused populationConclusionsPRBC transfusions led to an inferior PFS and OS in advanced cancer patients receiving checkpoint inhibitors even after adjustments for multiple prognostic variables. These results suggest a possible attenuation of the effectiveness of immunotherapy as a result of the immunosuppressive effects of PRBC transfusions. The findings require prospective and mechanistic confirmation as inherent bias may exist in this retrospective analysis.Ethics ApprovalThis study was approved the institutional review board at Fox Chase Cancer Center, approval number 19-9006.ConsentN/AReferencesGoubran H, Sheridan D, Radosevic J, Burnouf T, and Seghatchian J, Transfusion-related immunomodulation and cancer. Transfusion and Apheresis Science 2017;56:336–340.Acheson AG, Brookes MJ, and Spahn DR. Effects of allogeneic red blood cell transfusions on clinical outcomes in patients undergoing colorectal cancer surgery. Ann Surg 2012; 256:235–244.Morgan TM, et al., The relationship between perioperative blood transfusion and overall mortality in patients undergoing radical cystectomy for bladder cancer. Urol. Oncol. Semin. Orig. Investig 2013;31:871–877.Linder, et al., The impact of perioperative blood transfusion on cancer recurrence and survival following radical cystectomy. Eur. Urol. 2013;63:839–45.Luan H, Ye F, Wu L, Zhou Y, and Jiang J. Perioperative blood transfusion adversely affects prognosis after resection of lung cancer: A systematic review and a meta-analysis. BMC Surgery 2014; 14:34.Lee J, Chin J-H, Kim J-I, Lee E-H, and Choi I-C. Association between red blood cell transfusion and long-term mortality in patients with cancer of the esophagus after esophagectomy. Dis. esophagus Off. J. Int. Soc. Dis. Esophagus 2017;31:1–8.Sun C, Wang Y, Yao HS, and Hu ZQ. Allogeneic blood transfusion and the prognosis of gastric cancer patients: systematic review and meta-analysis. Int. J. Surg 2015;13:102–110.Wang T, et al. Perioperative blood transfusion is associated with worse clinical outcomes in resected lung cancer. Ann. Thorac. Surg 2014;97:1827–1837.Abu-Ghanem Y, Zilberman DE, Dotan Z, Kaver I, and Ramon J. Perioperative blood transfusion adversely affects prognosis after nephrectomy for renal cell carcinoma. Urol. Oncol 2018;36:12–20.Pang Q-Y, An R, and Liu H-L, Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis. World J. Surg. Oncol 2019;17:1–11.Lopez-Aguiar AG, et al., Association of perioperative transfusion with survival and recurrence after resection of gallbladder cancer: a 10-institution study from the us extrahepatic biliary malignancy consortium. J. Surg. Oncol. 2018;117:1638–1647.Reeh M, et al., Allogenic blood transfusion is associated with poor perioperative and long-term outcome in esophageal cancer. World J. Surg 2017;41:208–215.Moschini M, et al. The impact of perioperative blood transfusion on survival of bladder cancer patients submitted to radical cystectomy: role of anemia status. Eur. Urol. Focus. 2016;2:86–91.
Pranav Murthy, Pragosh Saini, Kira Russell, Wenjing Pan, Daniel Weber, Miranda Byrne-Steele, Jian Han, Viginia Espina, Lance Liotta, Herbert Zeh, et al.
Published: 9 November 2020
by BMJ
Journal for ImmunoTherapy of Cancer, Volume 8; doi:10.1136/jitc-2020-sitc2020.0260

Abstract:
BackgroundPancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy, characterized by a desmoplastic stromal reaction and an immunosuppressive tumor microenvironment (TME)1. The metabolic stress within the PDAC TME promotes autophagy, a form of programmed cell survival associated with chemotherapeutic resistance and immune evasion.2, 3MethodsWe conducted a randomized phase II study of preoperative gemcitabine and nab-paclitaxel with or without autophagy inhibition with oral hydroxychloroquine (HCQ) in patients with resectable PDAC. Autophagy inhibition increased Evans Grade histopathologic response and immune infiltrate.4Utilizing multiplex immunohistochemistry and dimer avoidance multiplex PCR-NGS5 in a subset of RNA extracted FFPE tumor specimens, we evaluated the adaptive immune response and immune correlates of response.ResultsPatients receiving HCQ had a greater CD4/CD8 immune infiltration (p = 0.033). Independent of treatment, a higher tumor immune infiltration score,6 was associated with improved overall survival (p = 0.035). Bulk tumor immunosequencing revealed a clonally expanded T cell receptor (TCR) Vβ (115±84 unique CDR3s (uCDR3s) of 3.3 × 104±2.4 total CDR3s) and B cell receptor (BCR) IgH (9.8 × 104±5.2 uCDR3s of 1.4 × 105±0.76 total CDR3s) repertoire compared to a paucity of TCR Vδ clones (2±1 uCDR3s of 43±60 total CDR3s). Patients with a higher than median TCR Vβ Diversity 50 Index (D50, proportion of uCDR3s that make up 50% of the total CDR3s) had significantly higher tumor CD4 (p = 0.003) and CD8 (p = 0.031) counts. Patients with a higher than median TRC Vβ D50 also had a reduced lymph node ratio (p = 0.039) and greater overall survival (p = 0.037, figure 1). Conversely, patients with a higher than median BCR IgH D50 had worse overall survival (p = 0.0241). Given the dichotomy of the TCR and BCR repertoire diversity and association with clinical outcome, we further analyzed the individual ratio of TRC Vβ:BCR IgH CDR3s and found that patients with a higher than median TRC Vβ:BCR IgH ratio had a greater Evan’s Grade histopathologic response (p = 0.069).Abstract 260 Figure 1Following neoadjuvant therapy, patients with resectable pancreatic cancer with a higher than median intratumoral TCR Vβ Diversity 50 (n=9, 4.624 HR; 95 CI [0.971, 21.83]) have greater overall survival compared to patients with lower than median intratumoral TCR Vβ Diversity 50 (n=10, 0.2163 HR; 95 CI [0.458, 1.021]). Representative tree maps of high and low TRC Vβ D50, where each rounded rectangle represents a unique CDR3, with the size of the rectangle corresponding to the relative frequency of the CDR3 clones across the entire repertoireConclusionsPDAC TIL repertoire with high TCR Vβ diversity is associated with decreased positive lymph node ratio and greater overall survival following neoadjuvant therapy. The divergent outcomes associated with increased intratumoral TCR and BCR diversity suggest a host response that may favor opposing T and B cell lymphocytic expansion. Regulation of this relationship may be explained by tumor MHC class I expression[3] or the presence of CD141+ cross presenting dendritic cells7, 8 and tertiary lymphoid structures,9 currently under investigation. Examination of repertoire modulating therapies is warranted.Trial RegistrationThis trial (NCT01978184) was approved by the protocol review committee and IRB 13–074 at the University of Pittsburgh and performed in full accordance with the guidelines for good clinical practice and the Declaration of Helsinki. Written informed consent was obtained from all patients prior to any protocol treatment.ReferencesHo WJ, Jaffee EM, Zheng L. The tumour microenvironment in pancreatic cancer - clinical challenges and opportunities. Nat Rev Clin Oncol 2020;17(9):527–540.Boone BA, Zeh HJ, 3rd, Bahary N. Autophagy inhibition in pancreatic adenocarcinoma. Clin Colorectal Cancer 2018;17(1):25–31.Yamamoto K, Venida A, Yano J, et al. Autophagy promotes immune evasion of pancreatic cancer by degrading MHC-I. Nature 2020;581(7806):100–105.Zeh HJ, Bahary N, Boone BA, et al. A Randomized phase ii preoperative study of autophagy inhibition with high-dose hydroxychloroquine and gemcitabine/nab-paclitaxel in pancreatic cancer patients. Clin Cancer Res 2020;26(13):3126–3134.Han J, Lotze MT. The adaptome as biomarker for assessing cancer immunity and immunotherapy. Methods Mol Biol2020; 2055:369–397.Hwang WT, Adams SF, Tahirovic E, Hagemann IS, Coukos G. Prognostic significance of tumor-infiltrating T cells in ovarian cancer: a meta-analysis. Gynecol Oncol. 2012;124(2):192–198.Spranger S, Dai D, Horton B, Gajewski TF. Tumor-Residing Batf3 Dendritic Cells Are Required for Effector T Cell Trafficking and Adoptive T Cell Therapy. Cancer Cell 2017;31(5):711–723 e714.Jang JE, Hajdu CH, Liot C, Miller G, Dustin ML, Bar-Sagi D. Crosstalk between regulatory T cells and tumor-associated dendritic cells negates anti-tumor immunity in pancreatic cancer. Cell Rep 2017;20(3):558–571.Bruno TC. New predictors for immunotherapy responses sharpen our view of the tumour microenvironment. Nature 2020;577(7791):474–476.
Qing Huang, Min-Hong Zou, Ye Jiang, Zhuan-Peng Chen, Qiang Wang, Jian-Chang Wei, Wang-Lin Li, Jie Cao
Journal of Laparoendoscopic & Advanced Surgical Techniques; doi:10.1089/lap.2020.0588

The publisher has not yet granted permission to display this abstract.
Yasmeen Z. Qwaider, David L. Berger
Annals of Surgical Oncology pp 1-1; doi:10.1245/s10434-020-09321-9

The publisher has not yet granted permission to display this abstract.
U. Nitsche , Constance Weber, Benedikt Kaufmann, Guido Von Figura, Volker Assfalg, Gregor Miller, Helmut Friess, Norbert Hüser, Daniel Hartmann
Published: 1 November 2020
Journal of Surgical Research, Volume 255, pp 346-354; doi:10.1016/j.jss.2020.05.076

The publisher has not yet granted permission to display this abstract.
Page of 23
Articles per Page
by
Show export options
  Select all
Back to Top Top