OBJECTIVEObesity has been shown to be an indicator of poor prognosis for patients with primary breast cancer. The aim of this study was to clarify the effect of obesity on Chinese women with breast cancer.

METHODSThis is a retrospective analysis of 1699 breast cancer patients. We evaluated the effect of body mass index (BMI) on disease-free survival (DFS) and overall survival (OS) in these patients. BMI was obtained before surgery. Obesity was defined as a BMI ≥ 24. Kaplan-Meier analysis and Log rank test were employed to perform survival analysis. The impact of different characteristics on survival was assessed by using Cox proportional-hazards regression model.

RESULTSIn total 635 (37.4%) patients were obese, while 1 064 (62.6%) were non-obese. Comparing the tumor characteristics in the two groups, the BMI ≥ 24 group showed a higher rate of older age (P < 0.001), postmenopausal status (P < 0.001), increased risk of lymph node metastasis (P = 0.001) and less chances of accepting breast conservation surgery (P = 0.012). The median follow-up time was 16 months, and the estimated 16-months DFS was 98.1% for non-obese and 95.0% for obese patients (P = 0.007), the estimated 16-months OS was 99.4% for non-obese and 98.4% for obese patients (P = 0.004). The multivariate analysis indicated that obesity is an independent prognostic factor for OS and DFS in breast cancer patients.

CONCLUSIONSOur findings suggest that obesity is associated with a poorer outcome in Chinese female patients with breast cancer.

Body Mass Index ; Breast Neoplasms ; epidemiology ; China ; epidemiology ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Obesity ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Analysis

OBJECTIVETo investigate the clinical characteristics and prognostic factors of patients with peripheral T cell lymphoma (PTCL).

METHODSThe clinical data of 46 elderly PTCL patients admitted in Tianjin Medical University Cancer Hospital from April 2008 to August 2014 were collected, the clinical features, prognostic factors and treatments, as well as followed-up outcome were analyzed retrospectively. Survival analysis was performed by Kaplan-Meier method, and the COX proportional hazard model was used to perform multivariate analysis.

RESULTSThe median survival time was 11 months, and the expected 1-year, 2-year and 3-year overall survival rate (OS) was 50%, 36% and 33%, respectively. Univariate analysis showed that the age, ECOG score, Charlson Comorbidity Index Score, the efficacy and course of chemotherapy were all the prognostic indicators affecting the OS and progression free survival (PFS) in this cohort of elderly patients. Multivariate analysis indicated that ECOG score and course of chemotherapy were the independent prognostic indicators affecting the OS and PFS (P < 0.05).

CONCLUSIONECOG score and course of chemotherapy are of great significance for predicting the prognosis in elderly PTCL patients. The elderly patients's general condition and completion of a certain intensity of chemotherapy are an important measure to prolong survival time in elderly PTCL patients.

Aged ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Lymphoma, T-Cell, Peripheral ; diagnosis ; pathology ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate

BACKGROUND: Pilocytic astrocytoma (PA) is a low-grade glioma that occurs primarily in children and young adults. The optimal postoperative treatment modality after subtotal resection (STR) of PAs remains to be elucidated. The aim of this study was to compare the efficacies of different post-STR treatment modalities and to examine the risk factors for the progression of PAs.METHODS: We reviewed the medical records of 91 pediatric PA patients in a single institute during a 30-year period. Kaplan-Meier analysis was used to assess overall survival (OS) and progression-free survival (PFS), and Cox proportional hazard models were used to calculate hazard ratios.RESULTS: The median age of 91 patients was 8.9 years (range, 0.3-17.9). GTR was perfomed, whenever possible. Patients who underwent STR afterwards received either radiotherapy, chemotherapy, or were observed without further treatment, according to clinician preference. In total group, 10-year OS was 97.4% and 10-year PFS was 57.2%. In GTR group (N=33), 10-year OS and PFS was 100%. In STR group (N=49), 10-year OS was 97.7%, while 10-year PFS was 38.6%. STR group underwent following postoperative (PO) modalities; observation (PO-Obs, N=32), radiotherapy (PO-RT, N=10), chemotherapy (PO-CTx, N=7). The 10-year PFS rate was higher in patients who received postoperative treatment (either PO-RT or PO-CTx) than in patients who received PO-Obs (62.5% vs 27.0%, P=0.039). In multivariate analysis for STR group, PO-CTx (Hazard ratio (HR)=0.20, P=0.035) and PO-RTx (HR=0.13, P=0.008) were superior to observation, respectively.CONCLUSION: Radiation and chemotherapy are better post-STR treatment modalities than observation for pediatric PA patients.
Astrocytoma ; Child ; Disease-Free Survival ; Drug Therapy ; Glioma ; Humans ; Kaplan-Meier Estimate ; Medical Records ; Multivariate Analysis ; Proportional Hazards Models ; Radiotherapy ; Risk Factors ; Young Adult

OBJECTIVETo study the prognostic parameters in patients with breast cancer of size smaller than or equal to 2 cm which are useful for treatment and follow-up.

METHODSFour hundred and seventy-five patients with breast cancer of size smaller than or equal to 2 cm diagnosed and treated in Affiliated Union Hospital, Fujian Medical University, China during the period from January, 2002 to December, 2008 were enrolled into the study. The clinical features, pathologic findings and follow-up data were analyzed. Kaplan-Meier curve method and Cox proportional hazard regression model were used to study factors which influenced disease-free survival and overall survival of the patients.

RESULTSOnset below 40 years of age (P=0.000), presence of axillary lymph node metastasis (P=0.000) and histologic grade 3 (P=0.013) negatively correlated with 5-year disease-free survival. Onset below 40 years of age (P=0.000), presence of axillary lymph node metastasis (P=0.000), histologic grade 3 (P=0.012) and negative estrogen receptor status (P=0.035) negatively correlated with 5-year overall survival. Multivariate analysis indicated that onset below 40 years of age (HR=3.249, 95% CI: 1.514-6.974, P=0.002) and presence of axillary lymph node metastasis (HR=3.177, 95% CI: 1.695-5.953, P=0.000) were independent predictors of 5-year disease-free survival. Onset below 40 years of age (HR=5.006, 95% CI: 2.013-12.449, P=0.001), presence of axillary lymph node metastasis (HR=4.461, 95% CI: 1.948-10.218, P=0.000) and negative estrogen receptor status (HR=2.612, 95% CI: 1.092-6.246, P=0.031) were independent predictors of 5-year overall survival.

CONCLUSIONSOnset below 40 years of age, presence of axillary lymph node metastasis and negative estrogen receptor status are prognostic indicators in patients with breast cancer of size less than or equal to 2 cm. Assessment of these prognostic parameters would be helpful in treatment and follow-up of this group of breast cancer patients.

Age Factors ; Axilla ; Breast Neoplasms ; chemistry ; mortality ; pathology ; China ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Tumor Burden

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.
Combined Modality Therapy ; Decision Making ; Disease Progression ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Proportional Hazards Models ; Prostate-Specific Antigen/analysis ; Prostatectomy ; Prostatic Neoplasms/mortality/*pathology/therapy ; Retrospective Studies

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.
Combined Modality Therapy ; Decision Making ; Disease Progression ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Proportional Hazards Models ; Prostate-Specific Antigen/analysis ; Prostatectomy ; Prostatic Neoplasms/mortality/*pathology/therapy ; Retrospective Studies

OBJECTIVETo investigate the factors influencing the prognosis of penis-sparing surgery (PSS) for early-stage penile cancer.

METHODSWe retrospectively studied the clinical data about 45 cases of early-stage penile cancer treated by PSS from January 2007 to December 2014. We calculated the rate of local recurrence-free survival by the Kaplan-Meier method, and conducted univariate and multivariate COX regression analyses on the relevant factors including the patient's age, marital status, tumor location, tumor size, postoperative sexual life, histological grade, and TNM stage.

RESULTSOne-year and three-year local recurrence-free survival rates were 95.5% and 52.2%, respectively. Multivariate analysis demonstrated that the histological grade (P = 0.039) and postoperative sexual life (P = 0.049) were independent factors for the prognosis of PSS. Logistic regression showed the patients age to be significantly associated with histological grade (P = 0.014).

CONCLUSIONHistological grade and postoperative sexual life are important independent prognostic factors of PSS for early-stage penile cancer, and the patients age is associated with the prognosis of PSS through its influence on the tumor grade.

Age Factors ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasm Grading ; Organ Sparing Treatments ; Penile Neoplasms ; surgery ; Penis ; surgery ; Prognosis ; Proportional Hazards Models ; Quality of Life ; Retrospective Studies

BACKGROUNDThe optimal surgical management of nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) is still controversial. Here, we evaluated the impact of lymph node status on postoperative recurrence in patients with NF-PNET and the potential of preoperative variables for predicting lymph node metastasis (LNM).

METHODSIn this mono-institutional retrospective cohort study conducted in 100 consecutive patients who underwent NF-PNET resection between January 2004 and December 2014, we evaluated risk factors for survival using the Kaplan-Meier method and the Cox regression model. Predictors of LNM were evaluated using the logistic regression model, and the power of predictive models was evaluated using receiver operating characteristic curve analysis.

RESULTSFive-year disease-free survival of resected NF-PNET was 64.1%. LNM was independently associated with postoperative recurrence (hazard ratio = 3.995, P = 0.003). Multivariate analysis revealed tumor grade as an independent factor associated with LNM (G2 vs. G1: odds ratio [OR] =6.287, P = 0.008; G3 vs. G1: OR = 12.407, P = 0.001). When tumor grade was excluded, radiological tumor diameter >2.5 cm (OR = 5.430, P = 0.013) and presence of symptoms (OR = 3.366, P = 0.039) were significantly associated with LNM. Compared to neoplasms with radiological diameter >2.5 cm (32.1%), tumors ≤2.5 cm had an obviously lower risk of LNM (7.7%), indicating the reliability of this parameter in predicting LNM (area under the curve, 0.693). Incidentally discovered NF-PNETs ≤2.5 cm were associated with a low-risk of LNM and excellent survival.

CONCLUSIONSLNM is significantly associated with postoperative recurrence. Radiological tumor diameter is a reliable predictor of LNM in NF-PNETs. Our results indicate that lymphadenectomy in small (≤2.5 cm) NF-PNETs is not routinely necessary.

Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Lymph Node Excision ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Multivariate Analysis ; Pancreatic Neoplasms ; complications ; pathology ; surgery ; Proportional Hazards Models ; Retrospective Studies

OBJECTIVETo investigate the expression of doublecortin-like kinase 1(DCLK1)in gastric cancer and its prognostic significance.

METHODSThe expression of DCLK1 was examined by immunohistochemical staining of paraffin-embedded tumor specimens from 122 patients who underwent curative gastrectomy for gastric cancer at Peking Union Medical College Hospital between July 2002 and December 2006. Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test. Univariate and multivariate analysis was performed with the Cox proportional hazard model.

RESULTSThe expression of DCLK1 in tumor cells was significantly upregulated in 51 of 122 patients. High expression of DCLK1 in tumor cells was strongly correlated with pN stage(P=0.029)and lymphovascular invasion(P=0.029). Kaplan-Meier analysis revealed that patients with DCLK1 high expression had a significantly lower 5-year overall survival(OS)rate than that of patients with DCLK1 low expression(39. 0% vs. 65. 8%, P=0.001), as well as a significantly lower 5-year disease-free survival(DFS)rate(37. 0% vs. 64. 5%, P=0.001). Univariate and multivariate analyses showed that DCLK1 expression(both P=0.036)was an independent factor for predicting OS and DFS rate.

CONCLUSIONSHigh expression of DCLK1 in gastric cancer cells is associated with pN stage and lymphovascular invasion. It may be a predictor for poor survival in patients undergoing surgery for gastric cancer.

Disease-Free Survival ; Gastrectomy ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Kaplan-Meier Estimate ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Protein-Serine-Threonine Kinases ; metabolism ; Stomach Neoplasms ; diagnosis ; epidemiology ; metabolism

OBJECTIVETo investigate the value of serum globulin levels before treatment in predicting the prognosis of patients with nasopharyngeal carcinoma (NPC).

METHODSA total of 127 patients with non-disseminated NPC were recruited between January, 2009 and December, 2013 at Nanfang Hospital. The pretreatment serum globulin levels were analyzed with the receiver-operating characteristic (ROC) curve analysis to select the cut-off point for low and high pretreatment serum globulin levels. Kaplan-Meier and multivariable analyses were used to evaluate the predictive value of serum globulin levels.

RESULTSThe ROC curve analysis determined 30.05 g/L as the optimal cut-off value for pretreatment serum globulin level, which was significantly associated with gender (P=0.024) and N stage (P=0.016). Kaplan-Meier analysis showed that a high pretreatment serum globulin level (>30.05 g/L) significantly predicted poor progression-free survival (P=0.019), overall survival (P=0.034) and distant metastasis-free survival (P=0.049); multivariate analysis identified pretreatment serum globulin level as an independent prognostic factor for progression-free survival (HR=2.344, P=0.031).

CONCLUSIONPretreatment serum globulin level may serve as a valuable marker to predict the prognosis of patients with NPC.

Carcinoma ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; Prognosis ; ROC Curve ; Serum Globulins ; analysis