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Robert Baatenburg J De Jong - One of the best experts on this subject based on the ideXlab platform.
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impact of severe malnutrition on short term mortality and Overall Survival in head and neck cancer
Oral Oncology, 2011Co-Authors: Frank R Datema, Marciano B Ferrier, Robert Baatenburg J De JongAbstract:Summary Background Basic patient and tumor characteristics impact Overall Survival of head and neck squamous cell carcinoma patients. Severe malnutrition, defined as weight loss > 10% in 6 months preceding primary tumor diagnosis, impacts Overall Survival as well. Little attention has been paid to the interaction between severe malnutrition and other relevant prognostic covariables. This study investigates the impact of malnutrition on short-term mortality and Overall Survival, together with the covariables age, tumor site, gender, TNM-classification, comorbidity and prior tumors. Methods 383 consecutive primary HNSCC patients, diagnosed and treated between 1995 and 1999 were followed until January 2010. Impact of covariables on short-term mortality and Overall Survival was studied univariately with Kaplan-Meier curves and the log-rank test. Cox-regression and binary logistic regression were used for multivariate analyses. Results 28 (7.3%) patients were severely malnourished. All covariables, except gender and prior tumors had significant impact on Overall Survival. The relative risk of severe malnutrition was 1.8 and is comparable to the impact of a T2 tumor, a N1 neck or moderate comorbidity. A univariate relationship between severe malnutrition and short-term mortality was established. Conclusions Severe malnutrition has an independent impact on Overall Survival of primary HNSCC patients. There is a clear distinction between patients with and without severe malnutrition from moment of diagnosis until 10 years after. This emphasizes the importance of identification and optimal treatment of malnutrition before, during and after cancer treatment.
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impact of comorbidity on short term mortality and Overall Survival of head and neck cancer patients
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2009Co-Authors: Frank R Datema, Marciano B Ferrier, Marc P Van Der Schroeff, Robert Baatenburg J De JongAbstract:Background In 2001, we presented a Cox regression model that is able to predict Survival of the newly diagnosed patient with head and neck squamous cell carcinoma (HNSCC). This model is based on the TNM classification and other important clinical variables such as age at diagnosis, sex, primary tumor site, and prior malignancies. We aim to improve this model by including comorbidity as an extra prognostic variable. Accurate prediction of the prognosis of the newly diagnosed patient with head and neck cancer can assist the physician in patient counseling, clinical decision-making, and quality maintenance. Methods All patients with HNSCC of the oral cavity, pharynx, and larynx diagnosed in the Leiden University Medical Centre between 1981 and 1998 were included. From these 1371 patients, data on primary tumor site, age at diagnosis, sex, TNM classification, and prior malignancies were already available. Comorbidity data were collected retrospectively according to the ACE27 manual. The prognostic value of each variable on Overall Survival was studied univariately by Kaplan–Meier curves and the log-rank test. The Cox regression model was used to investigate the impact of these variables on Overall Survival simultaneously. Furthermore, univariate analyses were performed to investigate the impact of comorbidity severity on short-term mortality and to investigate the impact of organ-specific-comorbidity on short-term mortality. Results Comorbidity was present in 36.4% of our patients. Mild decompensation was seen in 17.4%, moderate decompensation in 13.5%, and severe decompensation in 5.5%. Most frequently observed ailments were cardiovascular, respiratory, and gastrointestinal. In univariate analyses, all prognostic variables, including comorbidity, contributed significantly to Overall Survival. Their contribution (except sex) remained significant in the multivariate Cox model. Internal validation of this model showed a concordance index of 0.73, indicating a good predictive value. Short-term mortality was seen in 5.7% of our patients. Cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes showed a significant relationship with short-term mortality. Conclusions Comorbidity impacts Overall Survival of the newly diagnosed patient with HNSCC. There is a clear distinction between the impact of the 4 ACE27 severity grades. The impact of an ACE27 grade 3 is comparable to the impact of a T4 tumor or an N2 neck. Comorbidity impacts short-term mortality as well. Especially cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes show a strong relationship. © 2009 Wiley Periodicals, Inc. Head Neck, 2010
José F Pérez-regadera Gómez - One of the best experts on this subject based on the ideXlab platform.
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Overall Survival and disease-free Survival in endometrial cancer: prognostic factors in 276 patients
OncoTargets and therapy, 2013Co-Authors: Alvaro Tejerizo-garcia, Jesús S Jiménez-lópez, Jose L Muñoz-gonzalez, Sara Bartolomé-sotillos, Laura Marqueta-marques, Gregorio Lopez-gonzalez, José F Pérez-regadera GómezAbstract:Objective The aim of the study reported here was to assess the disease-free Survival and Overall Survival of patients with endometrial cancer and to determine independent factors affecting the prognosis.
Frank R Datema - One of the best experts on this subject based on the ideXlab platform.
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impact of severe malnutrition on short term mortality and Overall Survival in head and neck cancer
Oral Oncology, 2011Co-Authors: Frank R Datema, Marciano B Ferrier, Robert Baatenburg J De JongAbstract:Summary Background Basic patient and tumor characteristics impact Overall Survival of head and neck squamous cell carcinoma patients. Severe malnutrition, defined as weight loss > 10% in 6 months preceding primary tumor diagnosis, impacts Overall Survival as well. Little attention has been paid to the interaction between severe malnutrition and other relevant prognostic covariables. This study investigates the impact of malnutrition on short-term mortality and Overall Survival, together with the covariables age, tumor site, gender, TNM-classification, comorbidity and prior tumors. Methods 383 consecutive primary HNSCC patients, diagnosed and treated between 1995 and 1999 were followed until January 2010. Impact of covariables on short-term mortality and Overall Survival was studied univariately with Kaplan-Meier curves and the log-rank test. Cox-regression and binary logistic regression were used for multivariate analyses. Results 28 (7.3%) patients were severely malnourished. All covariables, except gender and prior tumors had significant impact on Overall Survival. The relative risk of severe malnutrition was 1.8 and is comparable to the impact of a T2 tumor, a N1 neck or moderate comorbidity. A univariate relationship between severe malnutrition and short-term mortality was established. Conclusions Severe malnutrition has an independent impact on Overall Survival of primary HNSCC patients. There is a clear distinction between patients with and without severe malnutrition from moment of diagnosis until 10 years after. This emphasizes the importance of identification and optimal treatment of malnutrition before, during and after cancer treatment.
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impact of comorbidity on short term mortality and Overall Survival of head and neck cancer patients
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2009Co-Authors: Frank R Datema, Marciano B Ferrier, Marc P Van Der Schroeff, Robert Baatenburg J De JongAbstract:Background In 2001, we presented a Cox regression model that is able to predict Survival of the newly diagnosed patient with head and neck squamous cell carcinoma (HNSCC). This model is based on the TNM classification and other important clinical variables such as age at diagnosis, sex, primary tumor site, and prior malignancies. We aim to improve this model by including comorbidity as an extra prognostic variable. Accurate prediction of the prognosis of the newly diagnosed patient with head and neck cancer can assist the physician in patient counseling, clinical decision-making, and quality maintenance. Methods All patients with HNSCC of the oral cavity, pharynx, and larynx diagnosed in the Leiden University Medical Centre between 1981 and 1998 were included. From these 1371 patients, data on primary tumor site, age at diagnosis, sex, TNM classification, and prior malignancies were already available. Comorbidity data were collected retrospectively according to the ACE27 manual. The prognostic value of each variable on Overall Survival was studied univariately by Kaplan–Meier curves and the log-rank test. The Cox regression model was used to investigate the impact of these variables on Overall Survival simultaneously. Furthermore, univariate analyses were performed to investigate the impact of comorbidity severity on short-term mortality and to investigate the impact of organ-specific-comorbidity on short-term mortality. Results Comorbidity was present in 36.4% of our patients. Mild decompensation was seen in 17.4%, moderate decompensation in 13.5%, and severe decompensation in 5.5%. Most frequently observed ailments were cardiovascular, respiratory, and gastrointestinal. In univariate analyses, all prognostic variables, including comorbidity, contributed significantly to Overall Survival. Their contribution (except sex) remained significant in the multivariate Cox model. Internal validation of this model showed a concordance index of 0.73, indicating a good predictive value. Short-term mortality was seen in 5.7% of our patients. Cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes showed a significant relationship with short-term mortality. Conclusions Comorbidity impacts Overall Survival of the newly diagnosed patient with HNSCC. There is a clear distinction between the impact of the 4 ACE27 severity grades. The impact of an ACE27 grade 3 is comparable to the impact of a T4 tumor or an N2 neck. Comorbidity impacts short-term mortality as well. Especially cardiovascular comorbidity, respiratory comorbidity, gastrointestinal comorbidity, and diabetes show a strong relationship. © 2009 Wiley Periodicals, Inc. Head Neck, 2010
Leon W M M Terstappen - One of the best experts on this subject based on the ideXlab platform.
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circulating tumor cells versus imaging predicting Overall Survival in metastatic breast cancer
Clinical Cancer Research, 2006Co-Authors: Thomas G Budd, Massimo Cristofanilli, Mathew J Ellis, Allison Stopeck, Ernest C Borden, Craig M Miller, Jeri Matera, Madeline Repollet, Gerald V Doyle, Leon W M M TerstappenAbstract:Purpose: The presence of ≥5 circulating tumor cells (CTC) in 7.5 mL blood from patients with measurable metastatic breast cancer before and/or after initiation of therapy is associated with shorter progression-free and Overall Survival. In this report, we compared the use of CTCs to radiology for prediction of Overall Survival. Experimental Design: One hundred thirty-eight metastatic breast cancer patients had imaging studies done before and a median of 10 weeks after the initiation of therapy. All scans were centrally reviewed by two independent radiologists using WHO criteria to determine radiologic response. CTC counts were determined ∼4 weeks after initiation of therapy. Specimens were analyzed at one of seven laboratories and reviewed by a central laboratory. Results: Interreader variability for radiologic responses and CTC counts were 15.2% and 0.7%, respectively. The median Overall Survival of 13 (9%) patients with radiologic nonprogression and ≥5 CTCs was significantly shorter than that of the 83 (60%) patients with radiologic nonprogression and P = 0.0389). The median Overall Survival of the 20 (14%) patients with radiologic progression and P = 0.0039). Conclusions: Assessment of CTCs is an earlier, more reproducible indication of disease status than current imaging methods. CTCs may be a superior surrogate end point, as they are highly reproducible and correlate better with Overall Survival than do changes determined by traditional radiology.
Peter J Allen - One of the best experts on this subject based on the ideXlab platform.
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postoperative complications and Overall Survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma
Journal of Surgical Oncology, 2016Co-Authors: Amudhan Pugalenthi, Mladjan Protic, Mithat Gonen, Peter T Kingham, Michael I D Angelica, Ronald P Dematteo, Yuman Fong, William R Jarnagin, Peter J AllenAbstract:Introduction Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40–50%. In this study, we analyzed the impact of high grade complications after PD for PDA on Overall Survival. Methods A total of 596 patients that underwent PD for PDA between 2001 and 2009 were identified from a prospective database. Complications were defined and graded (1–5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥grade 3. Postoperative mortality (≤90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with Overall Survival. Results Median Survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n = 129). Our 90 day mortality was 3.7% (n = 22). Anastomotic fistula/leak/abscess rate was 14% (n = 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) >600 ml, length of stay (LOS) >10 days, margin positivity, and vascular procedures as predictors of decreased Overall Survival (P < 0.05). High grade complications were not associated with Overall Survival (P = 0.948). Conclusion In this study, the occurrence of high grade postoperative complications was not associated with Overall Survival. J. Surg. Oncol. 2016;113:188–193. © 2015 Wiley Periodicals, Inc.
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response to neoadjuvant chemotherapy does not predict Overall Survival for patients with synchronous colorectal hepatic metastases
Annals of Surgical Oncology, 2009Co-Authors: David J Gallagher, Yuman Fong, Junting Zheng, Marinela Capanu, Dana Haviland, Philip B Paty, R P Dematteo, Michael I Dangelica, W R Jarnagin, Peter J AllenAbstract:Objective We investigated the relation between response to neoadjuvant chemotherapy and Overall Survival (OS) in patients with colorectal liver metastases (CLM).
