BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear rol...BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.展开更多
BACKGROUND The number of negative lymph nodes(NLNs)and tumor size are associated with prognosis in rectal cancer patients undergoing surgical resection.However,little is known about the prognostic significance of the ...BACKGROUND The number of negative lymph nodes(NLNs)and tumor size are associated with prognosis in rectal cancer patients undergoing surgical resection.However,little is known about the prognostic significance of the NLN count after adjusting for tumor size.AIM To assess the prognostic impact of the log odds of NLN/tumor size(LONS)in rectal cancer patients.METHODS Data of patients with stage I–III rectal cancer were extracted from the Surveillance,Epidemiology,and End Results Program database.These patients were randomly divided into a training cohort and a validation cohort.Univariate and multivariate Cox regression analyses were used to determine the prognostic value of the LONS.The optimal cutoff values of LONS were calculated using the"X-tile"program.Stratified analysis of the effect of LONS on cancer-specific survival(CSS)and overall survival(OS)were performed.The Kaplan-Meier method with the log-rank test was used to plot the survival curve and compare the survival data among the different groups.RESULTS In all,41080 patients who met the inclusion criteria were randomly divided into a training cohort(n=28775,70%)and a validation cohort(n=12325,30%).Univariate and multivariate analyses identified the continuous variable LONS as an independent prognostic factor for CSS[training cohort:Hazard ratio(HR)=0.47,95%confidence interval(CI):0.44–0.51,P<0.001;validation cohort:HR=0.46,95%CI:0.41-0.52,P<0.001]and OS(training cohort:HR=0.53,95%CI:0.49-0.56,P<0.001;validation cohort:HR=0.52,95%CI:0.42-0.52,P<0.001).The Xtile program indicated that the difference in CSS was the most significant for LONS of-0.8,and the cutoff value of-0.4 can further distinguish patients with a better prognosis in the high LONS group.Stratified analysis of the effect of the categorical variable LONS on CSS and OS revealed that LONS was also an independent predictor,independent of pN stage,pT stage,tumor-node-metastasis stage,site,age,sex,the number of examined lymph nodes,race,preoperative radiotherapy and carcinoembryonic antigen level.CONCLUSION LONS is associated with improved survival of rectal cancer patients independent of other clinicopathological factors.展开更多
Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods:...Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x 2=23.20,P<0.01), while there was no significant difference between ANP group and ANN with poor prognosis group (x 2=0.19,P>0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x}2=1.56,P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u 1=0.47,u 2=1.41,P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It’s a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.展开更多
Objective:This study aimed to explore the prognostic effect of neck dissection and to identify risk factors associated with occult lymph node metastasis(OLNM)in clinically node-negative(cN0)parotid carcinoma(PC).Metho...Objective:This study aimed to explore the prognostic effect of neck dissection and to identify risk factors associated with occult lymph node metastasis(OLNM)in clinically node-negative(cN0)parotid carcinoma(PC).Methods:A retrospective analysis was conducted on cN0 PC patients who underwent primary surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,between 2012 and 2022.Kaplan–Meier(KM)survival analyses were carried out to evaluate differences in progression-free survival(PFS)and overall survival(OS)between patients undergoing neck dissection and those who did not.Clinical variables associated with OLNM in the neck dissection group were assessed using univariate and multivariate logistic regression analyses.Results:Among 472 PC patients,133 were classified as cN0 following initial surgery,of whom 75(56.4%)underwent neck dissection.Pathological lymph node metastases were confirmed in 20(26.7%)patients in the neck dissection cohort.Poor tumor differentiation was identified as an independent risk factor for OLNM(p=0.017).No significant differences in PFS or OS were observed between the no-neck dissection and neck dissection groups for patients with low-grade or well-differentiated tumors(p>0.05).However,neck dissection was associated with significantly prolonged PFS in patients with tumors of higher grade or low to moderate differentiation(p<0.05).Notably,OS did not improve with neck dissection across all subgroups(p>0.05).Conclusion:Poorly differentiated tumors in cN0 PC are independently associated with a higher risk of OLNM.While prophylactic neck dissection may enhance PFS in patients with higher grade or poorly differentiated tumors,it does not confer a survival benefit in terms of OS.These findings support the selective use of neck dissection in patients with higher risk tumor profiles.展开更多
A negative lymph node(NLN)count has been shown to have a significant impact on the prognosis of many types of cancer.However,its prognostic value for jejunoileal neuroendocrine tumors(NETs)remains unclear.In this stud...A negative lymph node(NLN)count has been shown to have a significant impact on the prognosis of many types of cancer.However,its prognostic value for jejunoileal neuroendocrine tumors(NETs)remains unclear.In this study,we investigated the prognostic value of NLN count in patients with resected jejunoileal NETs diagnosed between 1988 and 2014.The data were retrieved from the Surveillance,Epidemiology and End Results database.The X-tile program was used to determine the cutoff value of the NLN count.Univariate and multivariate Cox proportional hazards models were used to assess the prognostic value of NLN count on survival.Harrell concordance index was used to compare the prognostic validity of NLN count with 2 current prognostic systems.The optimal cutoff point of the NLN count was 8.Kaplan-Meier analysis revealed a progressively worse overall survival(OS)with an NLN count≤8 compared with an NLN count>8(P<0.001).Univariate analysis showed that the NLN count,age,tumor site,tumor size and T classification were significant prognostic factors for the OS of jejunoileal NETs,while the number of positive lymph nodes had no significant impact on OS(P=0.513).Multivariate analysis indicated that the NLN count was an independent prognostic factor for OS of jejunoileal NETs.A higher NLN count was associated with better OS(hazards ratio:0.641;95%confidence interval:0.519-0.793;P<0.001).Compared with 2 other prognostic systems,the NLN counts in this study had similar prognostic value in patients with jejunoileal NETs.Our findings suggest that the NLN count is an important independent prognostic factor for patients with jejunoileal NETs,and that it is a good adjunct for disease staging.展开更多
基金Supported by the National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-BQ-32 and No.2023-NHLHCRFYYPPLC-ZR-13National Key Research and Development Program of China,No.2024YFE0198300Beijing Municipal Natural Science Foundation,No.7222316.
文摘BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.
基金Cooperative Fund of Nanchong Government and North Sichuan Medical College,No.18SXHZ0357.
文摘BACKGROUND The number of negative lymph nodes(NLNs)and tumor size are associated with prognosis in rectal cancer patients undergoing surgical resection.However,little is known about the prognostic significance of the NLN count after adjusting for tumor size.AIM To assess the prognostic impact of the log odds of NLN/tumor size(LONS)in rectal cancer patients.METHODS Data of patients with stage I–III rectal cancer were extracted from the Surveillance,Epidemiology,and End Results Program database.These patients were randomly divided into a training cohort and a validation cohort.Univariate and multivariate Cox regression analyses were used to determine the prognostic value of the LONS.The optimal cutoff values of LONS were calculated using the"X-tile"program.Stratified analysis of the effect of LONS on cancer-specific survival(CSS)and overall survival(OS)were performed.The Kaplan-Meier method with the log-rank test was used to plot the survival curve and compare the survival data among the different groups.RESULTS In all,41080 patients who met the inclusion criteria were randomly divided into a training cohort(n=28775,70%)and a validation cohort(n=12325,30%).Univariate and multivariate analyses identified the continuous variable LONS as an independent prognostic factor for CSS[training cohort:Hazard ratio(HR)=0.47,95%confidence interval(CI):0.44–0.51,P<0.001;validation cohort:HR=0.46,95%CI:0.41-0.52,P<0.001]and OS(training cohort:HR=0.53,95%CI:0.49-0.56,P<0.001;validation cohort:HR=0.52,95%CI:0.42-0.52,P<0.001).The Xtile program indicated that the difference in CSS was the most significant for LONS of-0.8,and the cutoff value of-0.4 can further distinguish patients with a better prognosis in the high LONS group.Stratified analysis of the effect of the categorical variable LONS on CSS and OS revealed that LONS was also an independent predictor,independent of pN stage,pT stage,tumor-node-metastasis stage,site,age,sex,the number of examined lymph nodes,race,preoperative radiotherapy and carcinoembryonic antigen level.CONCLUSION LONS is associated with improved survival of rectal cancer patients independent of other clinicopathological factors.
文摘Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x 2=23.20,P<0.01), while there was no significant difference between ANP group and ANN with poor prognosis group (x 2=0.19,P>0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x}2=1.56,P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u 1=0.47,u 2=1.41,P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It’s a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.
基金funded by the Beijing Hope Run Special Fund of Cancer Foundation of China(Grant no.LC2017L04).
文摘Objective:This study aimed to explore the prognostic effect of neck dissection and to identify risk factors associated with occult lymph node metastasis(OLNM)in clinically node-negative(cN0)parotid carcinoma(PC).Methods:A retrospective analysis was conducted on cN0 PC patients who underwent primary surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,between 2012 and 2022.Kaplan–Meier(KM)survival analyses were carried out to evaluate differences in progression-free survival(PFS)and overall survival(OS)between patients undergoing neck dissection and those who did not.Clinical variables associated with OLNM in the neck dissection group were assessed using univariate and multivariate logistic regression analyses.Results:Among 472 PC patients,133 were classified as cN0 following initial surgery,of whom 75(56.4%)underwent neck dissection.Pathological lymph node metastases were confirmed in 20(26.7%)patients in the neck dissection cohort.Poor tumor differentiation was identified as an independent risk factor for OLNM(p=0.017).No significant differences in PFS or OS were observed between the no-neck dissection and neck dissection groups for patients with low-grade or well-differentiated tumors(p>0.05).However,neck dissection was associated with significantly prolonged PFS in patients with tumors of higher grade or low to moderate differentiation(p<0.05).Notably,OS did not improve with neck dissection across all subgroups(p>0.05).Conclusion:Poorly differentiated tumors in cN0 PC are independently associated with a higher risk of OLNM.While prophylactic neck dissection may enhance PFS in patients with higher grade or poorly differentiated tumors,it does not confer a survival benefit in terms of OS.These findings support the selective use of neck dissection in patients with higher risk tumor profiles.
基金supported by the National Natural Science Foundation of China(No.81573007 to YD,81572361 to WH)the Ten Thousand Plan Youth Talent Support Program of Zhejiang Province,China(to WH)+3 种基金the Zhejiang Natural Sciences Foundation of China(No.LQ18H160008 to HL)the Zhejiang Medical Science and Technology Project,China(No.2016KYB290 to XY)the Zhejiang Province Preeminence Youth Fund,China(No.LR16H160001 to WH)the Zhejiang Medical Innovative Discipline Construction Project-2016,China(to WH).
文摘A negative lymph node(NLN)count has been shown to have a significant impact on the prognosis of many types of cancer.However,its prognostic value for jejunoileal neuroendocrine tumors(NETs)remains unclear.In this study,we investigated the prognostic value of NLN count in patients with resected jejunoileal NETs diagnosed between 1988 and 2014.The data were retrieved from the Surveillance,Epidemiology and End Results database.The X-tile program was used to determine the cutoff value of the NLN count.Univariate and multivariate Cox proportional hazards models were used to assess the prognostic value of NLN count on survival.Harrell concordance index was used to compare the prognostic validity of NLN count with 2 current prognostic systems.The optimal cutoff point of the NLN count was 8.Kaplan-Meier analysis revealed a progressively worse overall survival(OS)with an NLN count≤8 compared with an NLN count>8(P<0.001).Univariate analysis showed that the NLN count,age,tumor site,tumor size and T classification were significant prognostic factors for the OS of jejunoileal NETs,while the number of positive lymph nodes had no significant impact on OS(P=0.513).Multivariate analysis indicated that the NLN count was an independent prognostic factor for OS of jejunoileal NETs.A higher NLN count was associated with better OS(hazards ratio:0.641;95%confidence interval:0.519-0.793;P<0.001).Compared with 2 other prognostic systems,the NLN counts in this study had similar prognostic value in patients with jejunoileal NETs.Our findings suggest that the NLN count is an important independent prognostic factor for patients with jejunoileal NETs,and that it is a good adjunct for disease staging.
