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Yong Chen - One of the best experts on this subject based on the ideXlab platform.
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High C-reactive protein/albumin ratio predicts unfavorable distant Metastasis-Free Survival in nasopharyngeal carcinoma: a propensity score-matched analysis.
Cancer management and research, 2018Co-Authors: Yan Wang, Lin Yang, Liangping Xia, Yong ChenAbstract:Background Recent studies have indicated that the C-reactive protein/albumin (CRP/ALB) ratio (CAR) may represent a simple inflammation-based index for assessing the host inflammatory response. In this study, the prognostic value of the CAR for distant Metastasis-Free Survival (DMFS) in nasopharyngeal carcinoma (NPC) was assessed. Methods A total of 1,168 non-metastatic NPC patients from Sun Yat-sen University Cancer Center were retrospectively included. The optimal cutoff value for CAR was defined by the Cutoff Finder online tool. Propensity case-matched analysis was performed to adjust for potential differences in baseline characteristics. Subsequently, the prognostic value of the CAR for DMFS was validated in a 756 validation cohort with NPC. Results The optimal CAR cutoff value was 0.081. Patients with high CAR values had significantly poorer DMFS than those with low CAR in univariate and multivariate analyses before propensity score matching. The CAR could also significantly stratify patients into different risks of developing distant Metastasis in subgroup analysis. Propensity score analyses showed that CAR remained a prognostic factor for DMFS, thus excluding other interpretations and selection bias. Moreover, the prognostic value of the CAR was robustly confirmed in the external validation cohort. Conclusion CAR is an inexpensive and easy-to-measure inflammatory index that may aid clinicians in the development of individualized treatment and follow-up strategies for patients with non-metastatic NPC.
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high c reactive protein albumin ratio predicts unfavorable distant Metastasis Free Survival in nasopharyngeal carcinoma a propensity score matched analysis
Cancer management and research, 2018Co-Authors: Yan Wang, Lin Yang, Liangping Xia, Yong ChenAbstract:Background Recent studies have indicated that the C-reactive protein/albumin (CRP/ALB) ratio (CAR) may represent a simple inflammation-based index for assessing the host inflammatory response. In this study, the prognostic value of the CAR for distant Metastasis-Free Survival (DMFS) in nasopharyngeal carcinoma (NPC) was assessed. Methods A total of 1,168 non-metastatic NPC patients from Sun Yat-sen University Cancer Center were retrospectively included. The optimal cutoff value for CAR was defined by the Cutoff Finder online tool. Propensity case-matched analysis was performed to adjust for potential differences in baseline characteristics. Subsequently, the prognostic value of the CAR for DMFS was validated in a 756 validation cohort with NPC. Results The optimal CAR cutoff value was 0.081. Patients with high CAR values had significantly poorer DMFS than those with low CAR in univariate and multivariate analyses before propensity score matching. The CAR could also significantly stratify patients into different risks of developing distant Metastasis in subgroup analysis. Propensity score analyses showed that CAR remained a prognostic factor for DMFS, thus excluding other interpretations and selection bias. Moreover, the prognostic value of the CAR was robustly confirmed in the external validation cohort. Conclusion CAR is an inexpensive and easy-to-measure inflammatory index that may aid clinicians in the development of individualized treatment and follow-up strategies for patients with non-metastatic NPC.
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Development and external validation of nomograms to predict the risk of skeletal Metastasis at the time of diagnosis and skeletal Metastasis-Free Survival in nasopharyngeal carcinoma.
BMC cancer, 2017Co-Authors: Lin Yang, Liangping Xia, Yan Wang, Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong ChenAbstract:The skeletal system is the most common site of distant Metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal Metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal Metastasis at initial diagnosis (SMAD) and skeletal Metastasis-Free Survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F–deoxyglucose positron emission tomography/computed tomography (18F–FDG PET/CT) and 2496 patients without skeletal Metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P
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development and external validation of nomograms to predict the risk of skeletal Metastasis at the time of diagnosis and skeletal Metastasis Free Survival in nasopharyngeal carcinoma
BMC Cancer, 2017Co-Authors: Lin Yang, Liangping Xia, Yan Wang, Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong ChenAbstract:The skeletal system is the most common site of distant Metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal Metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal Metastasis at initial diagnosis (SMAD) and skeletal Metastasis-Free Survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F–deoxyglucose positron emission tomography/computed tomography (18F–FDG PET/CT) and 2496 patients without skeletal Metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P < 0.001). The SMFS nomogram had significantly higher c-index values in the training and validation sets than the TNM staging system (P < 0.001 and P = 0.005, respectively). Three proposed risk stratification groups were created using the nomograms, and enabled significant discrimination of SMFS for each risk group. The prognostic nomograms established in this study enable accurate stratification of distinct risk groups for skeletal Metastasis, which may improve counseling and facilitate individualized management of patients with NPC.
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Low Prognostic Nutritional Index (PNI) Predicts Unfavorable Distant Metastasis-Free Survival in Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis.
PloS one, 2016Co-Authors: Lin Yang, Liangping Xia, Yan Wang, Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong ChenAbstract:BACKGROUND Poor nutritional status is associated with progression and advanced disease in patients with cancer. The prognostic nutritional index (PNI) may represent a simple method of assessing host immunonutritional status. This study was designed to investigate the prognostic value of the PNI for distant Metastasis-Free Survival (DMFS) in patients with nasopharyngeal carcinoma (NPC). METHODS A training cohort of 1,168 patients with non-metastatic NPC from two institutions was retrospectively analyzed. The optimal PNI cutoff value for DMFS was identified using the online tool "Cutoff Finder". DMFS was analyzed using stratified and adjusted analysis. Propensity score-matched analysis was performed to balance baseline characteristics between the high and low PNI groups. Subsequently, the prognostic value of the PNI for DMFS was validated in an external validation cohort of 756 patients with NPC. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of different prognostic scores. RESULTS The optimal PNI cutoff value was determined to be 51. Low PNI was significantly associated with poorer DMFS than high PNI in univariate analysis (P
H.w.m. Van Laarhoven - One of the best experts on this subject based on the ideXlab platform.
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improved Metastasis Free Survival in nonadjuvantly treated postmenopausal breast cancer patients with chemokine receptor 5 del32 frameshift mutations
International Journal of Cancer, 2015Co-Authors: Paul N. Span, Georgios Pollakis, William A. Paxton, Fred C.g.j. Sweep, John A. Foekens, John W.m. Martens, Anieta M. Sieuwerts, H.w.m. Van LaarhovenAbstract:The CC-chemokine receptor CCR5 has been associated with cancer progression and Metastasis. CCR5 blockers such as Maraviroc are tested in metastatic cancer patients. A mutant allele of CCR5, CCR5-delta32 (CCR5del32), which encodes for a protein with a trans-dominant negative effect on the wildtype protein, is frequently found in populations of northern European origin. We set out to determine if the CCR5del32 genotype is associated with progression of breast cancer. Here, we genotyped 414 breast cancer patients and investigated whether the CCR5 genotype had an association with the likelihood to metastasize within specific subgroups of this cohort. The findings were subsequently confirmed in an independent cohort of 1,017 breast cancer patients. Specifically within the postmenopausal subgroup of the initial cohort (n = 325) individuals carrying the CCR5del32 genotype exhibited a significantly longer Metastasis-Free Survival (MFS, p = 0.038). In an independent cohort, CCR5del32 genotype was confirmed to be associated with prolonged MFS only in postmenopausal patients (n = 579, hazard ratio [HR] = 0.61, 95% confidence interval [95% CI] = 0.38-0.99, p = 0.044), and not in premenopausal patients (n = 438, HR = 1.01, 95% CI = 0.70-1.48, p = 0.94). Our results indicate that CCR5del32 genotype is associated with good prognosis in postmenopausal breast cancer patients. Considering this result, postmenopausal breast cancer patients who are wildtype for CCR5 genotype might benefit from CCR5 blockers, such as Maraviroc.
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Improved Metastasis‐Free Survival in nonadjuvantly treated postmenopausal breast cancer patients with chemokine receptor 5 del32 frameshift mutations
International journal of cancer, 2014Co-Authors: Paul N. Span, Georgios Pollakis, William A. Paxton, Fred C.g.j. Sweep, John A. Foekens, John W.m. Martens, Anieta M. Sieuwerts, H.w.m. Van LaarhovenAbstract:The CC-chemokine receptor CCR5 has been associated with cancer progression and Metastasis. CCR5 blockers such as Maraviroc are tested in metastatic cancer patients. A mutant allele of CCR5, CCR5-delta32 (CCR5del32), which encodes for a protein with a trans-dominant negative effect on the wildtype protein, is frequently found in populations of northern European origin. We set out to determine if the CCR5del32 genotype is associated with progression of breast cancer. Here, we genotyped 414 breast cancer patients and investigated whether the CCR5 genotype had an association with the likelihood to metastasize within specific subgroups of this cohort. The findings were subsequently confirmed in an independent cohort of 1,017 breast cancer patients. Specifically within the postmenopausal subgroup of the initial cohort (n = 325) individuals carrying the CCR5del32 genotype exhibited a significantly longer Metastasis-Free Survival (MFS, p = 0.038). In an independent cohort, CCR5del32 genotype was confirmed to be associated with prolonged MFS only in postmenopausal patients (n = 579, hazard ratio [HR] = 0.61, 95% confidence interval [95% CI] = 0.38-0.99, p = 0.044), and not in premenopausal patients (n = 438, HR = 1.01, 95% CI = 0.70-1.48, p = 0.94). Our results indicate that CCR5del32 genotype is associated with good prognosis in postmenopausal breast cancer patients. Considering this result, postmenopausal breast cancer patients who are wildtype for CCR5 genotype might benefit from CCR5 blockers, such as Maraviroc.
James D. Cox - One of the best experts on this subject based on the ideXlab platform.
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TGFβ1 Polymorphisms Predict Distant Metastasis-Free Survival in Patients with Inoperable Non-Small-Cell Lung Cancer after Definitive Radiotherapy.
PloS one, 2013Co-Authors: Xianglin Yuan, Qingyi Wei, Ritsuko Komaki, Zhensheng Liu, Ju Yang, Susan L. Tucker, John V. Heymach, James D. CoxAbstract:Purpose Transforming growth factor (TGF) -β1 signaling is involved in cancer-cell Metastasis. We investigated whether single nucleotide polymorphisms (SNPs) at TGFβ1 were associated with overall Survival (OS) and distant Metastasis-Free Survival (DMFS) in patients with non-small cell lung cancer (NSCLC) treated with definitive radiotherapy, with or without chemotherapy.
Anieta M. Sieuwerts - One of the best experts on this subject based on the ideXlab platform.
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improved Metastasis Free Survival in nonadjuvantly treated postmenopausal breast cancer patients with chemokine receptor 5 del32 frameshift mutations
International Journal of Cancer, 2015Co-Authors: Paul N. Span, Georgios Pollakis, William A. Paxton, Fred C.g.j. Sweep, John A. Foekens, John W.m. Martens, Anieta M. Sieuwerts, H.w.m. Van LaarhovenAbstract:The CC-chemokine receptor CCR5 has been associated with cancer progression and Metastasis. CCR5 blockers such as Maraviroc are tested in metastatic cancer patients. A mutant allele of CCR5, CCR5-delta32 (CCR5del32), which encodes for a protein with a trans-dominant negative effect on the wildtype protein, is frequently found in populations of northern European origin. We set out to determine if the CCR5del32 genotype is associated with progression of breast cancer. Here, we genotyped 414 breast cancer patients and investigated whether the CCR5 genotype had an association with the likelihood to metastasize within specific subgroups of this cohort. The findings were subsequently confirmed in an independent cohort of 1,017 breast cancer patients. Specifically within the postmenopausal subgroup of the initial cohort (n = 325) individuals carrying the CCR5del32 genotype exhibited a significantly longer Metastasis-Free Survival (MFS, p = 0.038). In an independent cohort, CCR5del32 genotype was confirmed to be associated with prolonged MFS only in postmenopausal patients (n = 579, hazard ratio [HR] = 0.61, 95% confidence interval [95% CI] = 0.38-0.99, p = 0.044), and not in premenopausal patients (n = 438, HR = 1.01, 95% CI = 0.70-1.48, p = 0.94). Our results indicate that CCR5del32 genotype is associated with good prognosis in postmenopausal breast cancer patients. Considering this result, postmenopausal breast cancer patients who are wildtype for CCR5 genotype might benefit from CCR5 blockers, such as Maraviroc.
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Improved Metastasis‐Free Survival in nonadjuvantly treated postmenopausal breast cancer patients with chemokine receptor 5 del32 frameshift mutations
International journal of cancer, 2014Co-Authors: Paul N. Span, Georgios Pollakis, William A. Paxton, Fred C.g.j. Sweep, John A. Foekens, John W.m. Martens, Anieta M. Sieuwerts, H.w.m. Van LaarhovenAbstract:The CC-chemokine receptor CCR5 has been associated with cancer progression and Metastasis. CCR5 blockers such as Maraviroc are tested in metastatic cancer patients. A mutant allele of CCR5, CCR5-delta32 (CCR5del32), which encodes for a protein with a trans-dominant negative effect on the wildtype protein, is frequently found in populations of northern European origin. We set out to determine if the CCR5del32 genotype is associated with progression of breast cancer. Here, we genotyped 414 breast cancer patients and investigated whether the CCR5 genotype had an association with the likelihood to metastasize within specific subgroups of this cohort. The findings were subsequently confirmed in an independent cohort of 1,017 breast cancer patients. Specifically within the postmenopausal subgroup of the initial cohort (n = 325) individuals carrying the CCR5del32 genotype exhibited a significantly longer Metastasis-Free Survival (MFS, p = 0.038). In an independent cohort, CCR5del32 genotype was confirmed to be associated with prolonged MFS only in postmenopausal patients (n = 579, hazard ratio [HR] = 0.61, 95% confidence interval [95% CI] = 0.38-0.99, p = 0.044), and not in premenopausal patients (n = 438, HR = 1.01, 95% CI = 0.70-1.48, p = 0.94). Our results indicate that CCR5del32 genotype is associated with good prognosis in postmenopausal breast cancer patients. Considering this result, postmenopausal breast cancer patients who are wildtype for CCR5 genotype might benefit from CCR5 blockers, such as Maraviroc.
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Correlation of breast cancer susceptibility loci with patient characteristics, Metastasis-Free Survival, and mRNA expression of the nearest genes.
Breast cancer research and treatment, 2011Co-Authors: Muhammad Riaz, Anieta M. Sieuwerts, Els M.j.j. Berns, Kirsten Ruigrok-ritstier, Vanja De Weerd, Arwin Groenewoud, André G. Uitterlinden, Maxime P. Look, Jan G. M. Klijn, Stefan SleijferAbstract:To understand the biology of low-risk breast cancer alleles, and to investigate whether these loci also contribute to disease progression that was once established, we examined the association of SNPs tagging the low-risk breast cancer loci in or near FGFR2, LSP1, MAP3K1,H19, TOX3, POU5F1P1, MYC, and 2q35, with clinical, pathological characteristics, prognosis, and mRNA expression of the nearest genes. Tumor DNA samples of 2,480 breast cancer patients were available. Out of this cohort, 1,290 patients with lymph-node negative disease who did not receive adjuvant systemic therapy, the SNP status was associated with Metastasis-Free Survival (MFS). In 1,401 patients, the mRNA expression levels of FGFR2, LSP1, MAP3K1,H19, TOX3, POU5F1P1, and MYC were determined and correlated with SNP genotypes. The SNP rs2981582 in FGFR2 was significantly associated with positive ER and PgR status (P < 0.001 and P = 0.003, respectively). No other significant associations with patient or tumor characteristics were observed. Only rs2107425 near H19 was significantly associated with shorter MFS in uni- and multi-variate analysis (HR: 1.53, CI: 1.12–2.08, P = 0.006 and HR: 1.59, CI: 1.16–2.20, P = 0.004, respectively), with the more aggressive minor allele displaying a recessive trait. The minor allele of SNP rs3803662 located near the TOX3 gene was associated with lower mRNA expression of this gene. In conclusion, except for the association of rs13283662 with TOX3 gene expression indicating a tumor suppressor role of TOX3, our findings suggest that breast cancer low-risk loci generally do not affect expression of the nearest gene in breast tumor tissue. Also the prognosis of patients is largely not affected by low-risk breast cancer loci except for the SNP near H19. How, this SNP affects prognosis warrants further study as it does not operate through altering H19 mRNA expression.
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Abstract P4-07-01: Correlation of Breast Cancer Susceptibility Loci with Patient Characteristics, Metastasis-Free Survival and Expression of the Nearest Genes
Poster Session Abstracts, 2010Co-Authors: Muhammad Riaz, Anieta M. Sieuwerts, Kirsten Ruigrok-ritstier, Vanja De Weerd, André G. Uitterlinden, Maxime P. Look, Jan G. M. Klijn, Stefan Sleijfer, Emjj Berns, John A. FoekensAbstract:Background: Genome-wide association studies has identified single nucleotide polymorphisms (SNPs) in several loci being associated with breast cancer risk: fibroblast growth factor receptor 2 (FGFR2), trinucleotide repeat containing 9 (TNRC9 or TOX3), mitogen-activated protein kinase kinase kinase 1 (MAP3K1), lymphocyte-specific protein 1 (LSP1) and the imprinted maternally expressed H19, and loci in gene deserts at 8q24 and 2q35. However, the mechanism by which these loci confer breast cancer risk in patients is still largely unknown. Here, we addressed this question by associating these SNPs with the mRNA expression of the genes located at or nearest to the SNP in the same linkage disequilibrium region. In addition, we associated the SNPs with clinical, pathological and patient characteristics and prognosis. Material and Methods : SNPs tagging breast cancer loci were genotyped in genomic tumor DNA samples of 2,480 breast cancer patients. All samples were collected between 1978-2004. The mean age was 55.6 years and median follow-up up was 106 months. The SNPs were correlated with patients and tumor characteristics. Of the 1,262 patients with lymph-node negative disease and who did not receive any adjuvant systemic therapy, SNP status was associated with distant Metastasis-Free Survival (MFS) using Cox regression analysis. Finally, in a subset of 1,400 of the 2,480 patients, the mRNA expression of FGFR2, TNRC9, MAP3K1, LSP1 and H19 genes was determined by quantitative RT-PCR and correlated with SNP genotypes. Results: The SNP rs2981582 in FGFR2 was significantly associated with ER and PgR status of the tumors (both p=0.001). Besides weak associations with tumor grade (FGFR2, p=0.01), ER (MAP3K1, p=0.03; LSP1, p=0.03), and PgR (LSP1, p=0.05), no other association with any clinical or pathological variable for any of the SNPs was observed. Of the SNPs analyzed, only rs2107425 near H19 was significantly linked in uni-and multivariable analysis with MFS (Hazard ratio [HR]=1.44, 95% Confidence interval [CI]: 1.04-1.98; p=0.026; HR=1.53; 95% CI: 1.09-2.14; p=0.013, respectively) with the more aggressive minor allele displaying a recessive trade. Interestingly, the minor allele of SNP rs3803662 was significantly associated with lower mRNA expression of the 8 kb downstream TNRC9 gene (p=0.0019). However, none of the other risk alleles, including the one in FGFR2, had an association with mRNA expression of the nearest located gene. Conclusions: In agreement with previous studies, a clear correlation of the SNPs in FGFR2 with ER and PR status of tumors was observed. The lower level of TNRC9 mRNA in tumors having the minor allele genotype suggests that TNRC9 may act as a tumor suppressor gene and its expression might have a protective effect. A significant association of the SNP near H19 with poor outcome without apparent effect on H19 mRNA expression suggests that this prognostic SNP in a well-known imprinted region is not linked to prognosis through altering H19 gene expression. This study indicates that most of the studied SNPs that confer breast cancer risk are not linked to prognosis nor do they effect, in primary tumors mRNA expression of the nearest gene. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-07-01.
Yan Wang - One of the best experts on this subject based on the ideXlab platform.
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Development and validation of a novel nomogram for predicting distant Metastasis-Free Survival among breast cancer patients.
Annals of translational medicine, 2019Co-Authors: Yan Wang, Yaping Yang, Zhengbo Chen, Teng Zhu, Heran DengAbstract:Background: Distant Metastasis (DM) from breast cancer has a poor prognosis. Our objective was to develop and validate a nomogram to predict individual distant Metastasis-Free Survival (DMFS) and risk stratification in non-metastatic breast cancer patients. Methods: A nomogram was based on an analysis of 1,201 breast cancer patients treated at Sun Yat-sen Memorial Hospital from 2001 to 2014. Using univariate and multivariate analyses to identify the predictors, this model was externally validated in an independent cohort of 538 patients from the Guangdong General Hospital between 2004 and 2012. The predictive discrimination and calibration ability of this nomogram were assessed using concordance index (C-index), risk group stratification, and calibration curve. Results: The 5-year DMFS in the training and validation cohorts were 95.74% and 91.02%, respectively. On multivariable analysis of training cohort, the prognostic factors in the nomogram comprised age, tumor size, lymph node status, molecular subtype, and lymphovascular invasion (LVI). The C-index of our model was 0.75 [95% confidence interval (CI): 0.67–0.83] for the training cohort and 0.71 (95% CI: 0.64–0.78) for the validation cohort. The calibration curves for 5-year DMFS showed good agreement between the model prediction and actual observation. Based on the risk stratification, Kaplan-Meier curves indicated that the low-risk group had significantly better prognosis than the high-risk group (P Conclusions: Our nomogram can provide an individual prediction of 5-year DMFS in non-metastatic breast cancer patients. This prognostic tool may help clinicians to make appropriate treatment regimens and optimal surveillance plans.
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High C-reactive protein/albumin ratio predicts unfavorable distant Metastasis-Free Survival in nasopharyngeal carcinoma: a propensity score-matched analysis.
Cancer management and research, 2018Co-Authors: Yan Wang, Lin Yang, Liangping Xia, Yong ChenAbstract:Background Recent studies have indicated that the C-reactive protein/albumin (CRP/ALB) ratio (CAR) may represent a simple inflammation-based index for assessing the host inflammatory response. In this study, the prognostic value of the CAR for distant Metastasis-Free Survival (DMFS) in nasopharyngeal carcinoma (NPC) was assessed. Methods A total of 1,168 non-metastatic NPC patients from Sun Yat-sen University Cancer Center were retrospectively included. The optimal cutoff value for CAR was defined by the Cutoff Finder online tool. Propensity case-matched analysis was performed to adjust for potential differences in baseline characteristics. Subsequently, the prognostic value of the CAR for DMFS was validated in a 756 validation cohort with NPC. Results The optimal CAR cutoff value was 0.081. Patients with high CAR values had significantly poorer DMFS than those with low CAR in univariate and multivariate analyses before propensity score matching. The CAR could also significantly stratify patients into different risks of developing distant Metastasis in subgroup analysis. Propensity score analyses showed that CAR remained a prognostic factor for DMFS, thus excluding other interpretations and selection bias. Moreover, the prognostic value of the CAR was robustly confirmed in the external validation cohort. Conclusion CAR is an inexpensive and easy-to-measure inflammatory index that may aid clinicians in the development of individualized treatment and follow-up strategies for patients with non-metastatic NPC.
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high c reactive protein albumin ratio predicts unfavorable distant Metastasis Free Survival in nasopharyngeal carcinoma a propensity score matched analysis
Cancer management and research, 2018Co-Authors: Yan Wang, Lin Yang, Liangping Xia, Yong ChenAbstract:Background Recent studies have indicated that the C-reactive protein/albumin (CRP/ALB) ratio (CAR) may represent a simple inflammation-based index for assessing the host inflammatory response. In this study, the prognostic value of the CAR for distant Metastasis-Free Survival (DMFS) in nasopharyngeal carcinoma (NPC) was assessed. Methods A total of 1,168 non-metastatic NPC patients from Sun Yat-sen University Cancer Center were retrospectively included. The optimal cutoff value for CAR was defined by the Cutoff Finder online tool. Propensity case-matched analysis was performed to adjust for potential differences in baseline characteristics. Subsequently, the prognostic value of the CAR for DMFS was validated in a 756 validation cohort with NPC. Results The optimal CAR cutoff value was 0.081. Patients with high CAR values had significantly poorer DMFS than those with low CAR in univariate and multivariate analyses before propensity score matching. The CAR could also significantly stratify patients into different risks of developing distant Metastasis in subgroup analysis. Propensity score analyses showed that CAR remained a prognostic factor for DMFS, thus excluding other interpretations and selection bias. Moreover, the prognostic value of the CAR was robustly confirmed in the external validation cohort. Conclusion CAR is an inexpensive and easy-to-measure inflammatory index that may aid clinicians in the development of individualized treatment and follow-up strategies for patients with non-metastatic NPC.
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Development and external validation of nomograms to predict the risk of skeletal Metastasis at the time of diagnosis and skeletal Metastasis-Free Survival in nasopharyngeal carcinoma.
BMC cancer, 2017Co-Authors: Lin Yang, Liangping Xia, Yan Wang, Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong ChenAbstract:The skeletal system is the most common site of distant Metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal Metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal Metastasis at initial diagnosis (SMAD) and skeletal Metastasis-Free Survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F–deoxyglucose positron emission tomography/computed tomography (18F–FDG PET/CT) and 2496 patients without skeletal Metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P
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development and external validation of nomograms to predict the risk of skeletal Metastasis at the time of diagnosis and skeletal Metastasis Free Survival in nasopharyngeal carcinoma
BMC Cancer, 2017Co-Authors: Lin Yang, Liangping Xia, Yan Wang, Shaodong Hong, Haiyang Chen, Shaobo Liang, Peijian Peng, Yong ChenAbstract:The skeletal system is the most common site of distant Metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal Metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal Metastasis at initial diagnosis (SMAD) and skeletal Metastasis-Free Survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F–deoxyglucose positron emission tomography/computed tomography (18F–FDG PET/CT) and 2496 patients without skeletal Metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P < 0.001). The SMFS nomogram had significantly higher c-index values in the training and validation sets than the TNM staging system (P < 0.001 and P = 0.005, respectively). Three proposed risk stratification groups were created using the nomograms, and enabled significant discrimination of SMFS for each risk group. The prognostic nomograms established in this study enable accurate stratification of distinct risk groups for skeletal Metastasis, which may improve counseling and facilitate individualized management of patients with NPC.