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At least 55 records · Page 3Linked to original sources
PubMed2004

The quotient of number of nodes and tumour size (N/T) from primary breast cancer predicts the clinical course after diagnosis of distant relapse.

INTRODUCTION: Breast cancer is a disease with a very variable progression. Primary tumour size and metastatic lymph node involvement are the best indicators of the likelihood of relapse. However, their value in predicting progression following relapse is not clear. AIM: The aim of this study was to asses whether the relationship between tumour size and the number of lymph nodes involved had any value as predictive factors of post-relapse progression. METHOD: We established an index defined as the quotient between the number of diseased lymph nodes and the tumour size (in cm). RESULTS: Applying this index in 230 consecutive patients with metastatic breast cancer, we observed that there was a significant inverse relation between the index and post-relapse progression. CONCLUSION: We conclude that, at the time of initial diagnosis, the quotient of tumour size and the number of diseased lymph nodes could be a good predictor of time-to-progression following the diagnosis of the metastatic disease.

Adult↗
PubMed1995

Survival of patients after resection for lung cancer. Predictive value of staging by CT vs thoracotomy.

PURPOSE: The predictive value of staging of primary lung cancer by CT and thoracotomy with respect to survival was assessed in a series of 151 consecutive patients. MATERIAL AND METHODS: The new international staging system for lung cancer was used, with an additional indeterminate stage employed for cases in which a definite classification was impossible by CT. RESULTS: The survival rate curves for the stage groups assessed at CT and thoracotomy showed moderate to good parallelism. The patients with tumor stage I at thoracotomy but indeterminate or IIIa at CT had a significantly lower survival rate than those scored stage I at both. It was concluded that a sign of tumor spread obtained at any of the investigations should lead to an active approach, increasing the radicality of surgery or omitting noncurative operations.

Adult↗
PubMed2006

Maximum standardized uptake values on positron emission tomography of esophageal cancer predicts stage, tumor biology, and survival.

BACKGROUND: The stage of esophageal cancer is currently determined by the anatomic TNM classification system as opposed to information about tumor biology. METHODS: A retrospective review was made of a prospective electronic database. Patients had esophageal cancer, dedicated positron emission tomography (PET) using F-18-fluorodeoxyglucose (FDG-PET) and maximum standardized uptake value (maxSUV) measured. Biopsies were obtained from suspicious nodal and systemic locations, and when indicated, resection with complete lymphadenectomy was performed. RESULTS: There were 89 patients (53 men). The median maxSUV for patients with high grade dysplasia, stage I, IIa, IIb, III, and IVa esophageal cancer was 1.7, 2.9, 8.9, 7.7, 9.5, and 12, respectively. Multivariate analysis showed patients with a high maxSUV were more likely to have poorly differentiated tumors (risk ratio 1.89, p = 0.032) and advanced stage (risk ratio 2.6, p < 0.001). The maxSUV correlated better (r(2) = 0.85) than the current TNM staging system for survival (r(2) = 0.68). Receiving operator characteristics curve demonstrated a maxSUV of 6.6 to be the optimal cut-off point. The 4-year survival of patients with a maxSUV of 6.6 or less was 89%, whereas it was only 31% for those patients with values greater than 6.6 (p < 0.001). CONCLUSIONS: The maxSUV of an esophageal cancer on dedicated FDG-PET scan is an independent predictor of stage, tumor characteristics, and survival. It predicts survival better than the current TNM staging system. This information may help guide treatment strategies.

Adult↗
PubMed2001

A longitudinal study of physical activity and breast cancer prediction.

Physical activity was analyzed as a predictor of breast cancer in the Aerobic Center Longitudinal Study. The study sample included 4,520 healthy women, with 150 incident cases of breast cancer. The study sample was limited to women who did not have a diagnosis of breast cancer at initial entry to the Aerobic Center Longitudinal Study. Women in the study were predominantly from an upper-middle class, college-educated, Caucasian American group being evaluated at a world-famous fitness center. Women with and without breast cancer had similar reports for diet history, alcohol and tobacco use, body composition, and breast health history. Women with breast cancer were older and had an earlier menarche and later menopause. Logistic regression analysis of physical activity for women with and without breast cancer was performed controlling for age. Intensity and duration of physical activity were not predictors of breast cancer. Less frequency of jogging was a significant predictor of breast cancer among women in the sample, O.R.=1.14, P =.04. Women who reported jogging as a type of activity were less likely to develop breast cancer than those who did not report jogging, O.R.=2.32, P=0.05.

Adult↗
PubMed1996

Do beliefs, knowledge, and perceived norms about diet and cancer predict dietary change?

OBJECTIVES: We hypothesized that belief in an association between diet and cancer, knowledge of dietary recommendations and food composition, and perceived norms would predict healthful dietary changes. METHODS: Data are from a population-based sample of Washington State residents (n = 607). Psychosocial constructs measured at baseline (1989/90) were used to predict changes in dietary practices, fat intake, fiber intake, and weight over 3 years. RESULTS: Adults who strongly believed in a diet-cancer connection decreased the percentage of energy consumed from fat by 1.20 percentage points and increased fiber intake by 0.69 g, compared with decreases of 0.21 percentage points and 0.57 g among those with no belief (P < .05). Adults with knowledge of the National Cancer Institute fat and fiber goals decreased their percentage of energy from fat by 1.70 points compared with an increase of 0.27 points among those with little knowledge (P < .05). Food composition knowledge and perceived pressure to eat a healthful diet were not significant predictors of changes in fat intake, fiber intake, or weight. CONCLUSIONS: Interventions that increase the public's beliefs in diet and health associations and communicate diet recommendations can encourage healthful dietary change.

Adult↗
PubMed2001

Three-dimensional power Doppler ultrasound improves the diagnostic accuracy for ovarian cancer prediction.

OBJECTIVE: The goal of this study was to determine if three-dimensional power Doppler ultrasound improves the specificity for ovarian cancer detection as compared with two-dimensional ultrasound. METHODS: Seventy-one women with a known complex pelvic mass were referred for a preoperative ultrasound evaluation with both two-dimensional and three-dimensional gray-scale ultrasonography. The 3D studies were performed with the Kretz Voluson 530D using a mechanized transvaginal probe. Surface rendering and power Doppler imaging were performed by the same gynecologic sonologist, and reassigned to one of four echo patterns: cystic, multicystic, complex, or solid. Sonographic criteria used for diagnosing ovarian cancer were based on a system that included morphological characteristics, histological prediction, and power Doppler imaging. RESULTS: Seventy-one women underwent surgical exploration: 14 (19.7%) had ovarian cancer (2 FIGO stage I, 2 stage II, 7 stage III, and 3 metastatic colon) and 2 had uterine cancer. Two-dimensional gray-scale ultrasound identified 40 masses as suspicious for cancer, including all 14 malignancies, yielding a sensitivity, specificity, and positive predictive value of 100, 54, and 35%, respectively. However, evaluation with 3D power Doppler identified only 28 cases as suspicious (including all 14 cancers), resulting in a sensitivity, specificity, and positive predictive value of 100, 75, and 50%, respectively. CONCLUSIONS: Three-dimensional power Doppler imaging better defines the morphological and vascular characteristics of ovarian lesions. All malignancies were correctly identified by both 2D and 3D imaging; however, the specificity significantly improved with the addition of 3D power Doppler. This improved diagnostic accuracy may promote improved patient care by separating complex benign masses from ovarian cancer, therefore facilitating appropriate physician referral.

Adult↗
PubMed2004

Neoadjuvant chemotherapy of locally advanced breast cancer: predicting response with in vivo (1)H MR spectroscopy--a pilot study at 4 T.

PURPOSE: To determine if changes in the concentration of choline-containing compounds (tCho) from before primary systemic therapy (PST) to within 24 hours after the first treatment enable prediction of clinical response in patients with locally advanced breast cancer. MATERIALS AND METHODS: Sixteen women with biopsy-confirmed locally advanced breast cancer scheduled to undergo doxorubicin-based PST were recruited. Magnetic resonance (MR) imaging and spectroscopy were performed at 4 T prior to treatment, within 24 hours after the first dose, and after the fourth dose. Lesion size was assessed by using gadolinium-enhanced MR imaging. Lesion tCho concentration was quantified by using single-voxel hydrogen 1 MR spectroscopy. Statistical analysis was performed by using the Pearson correlation coefficient and the Wilcoxon rank sum test. RESULTS: Fourteen of 16 patients completed the protocol. In one patient, the level of tCho was not measurable because of unfavorable lesion morphology for MR spectroscopy voxel placement. Of the remaining 13 patients, four had inflammatory breast cancer, six had invasive ductal carcinoma, two had invasive lobular carcinoma, and one had mixed invasive ductal and lobular carcinoma. On the basis of the Response Evaluation Criteria in Solid Tumors, eight of 13 patients had an objective response and five had no response. The change in concentration of tCho from baseline to within 24 hours after the first dose of PST showed significant positive correlation with the change in lesion size (R = 0.79, P = .001). Change in tCho concentration within 24 hours after first dose was significantly different between patients with objective response and those with no response (P = .007). CONCLUSION: These results suggest that the change in tCho concentration between baseline and 24 hours after the first dose of PST can serve as an indicator for predicting clinical response to doxorubicin-based chemotherapy in locally advanced breast cancer.

Adolescent↗
PubMed2006

Does worry about breast cancer predict screening behaviors? A meta-analysis of the prospective evidence.

OBJECTIVE: Many women worry about the possibility of developing breast cancer, but there is conflicting evidence concerning whether cancer worry acts as a facilitator or inhibitor of breast cancer screening. METHOD: We conducted a meta-analysis of 12 prospective studies that measured worry about breast cancer at baseline and subsequent breast self-examination (BSE) or mammography utilization among 3342 high-risk and general population women. RESULTS: The data consistently show that breast cancer worry has a small but reliable (r = 0.12) association with breast cancer screening behavior, such that greater worry predicts a greater likelihood of screening. We also found that the means for breast cancer worry were consistently in the lower third of the scales, despite differences in measurement approaches, sample utilization, or the date that the study was conducted. CONCLUSION: The meta-analysis supports the contention that breast cancer worry may motivate screening behavior, and that high levels of breast cancer worry are uncommon.

Anxiety↗
PubMed2006

Radiation rescue for biochemical failure after surgery for prostate cancer: predictive parameters and an assessment of contemporary predictive models.

OBJECTIVES: To determine pretreatment prognostic variables that predict outcome of radiotherapy for biochemical failure after prostate cancer surgery and evaluate contemporary clinical decision tools for patient selection. METHODS: Fifty patients were identified with failure after rescue radiation was defined as a confirmed rise in PSA, distant metastases, prostate cancer death, or initiation of hormonal therapy. Univariate analysis and multivariate Cox models were constructed. Outcome was compared with decision tree and recursive partitioning predictive models. RESULTS: The median preradiation PSA (pre-RT PSA) was 1.2 ng/mL and the median dose of radiation was 66.6 Gy; median follow-up was 39.6 months. Overall, the estimated 3-year failure free survival was 54%, 95%CI [43,74]. Seminal vesicle involvement (SVI) (P = 0.003) and preradiation PSA Doubling Time (PSADT) <10 months (P = 0.01) were both significant predictors for treatment failure whereas pre-RT PSA was of borderline significance (P = 0.07). On multivariate analysis a pre-RT PSA of >1 and SVI were associated with hazard ratios of 6.2 and 7.3 (P = 0.01 and P = 0.004), respectively. An additional Cox model constructed for 31 patients for whom pre-RT PSADT could be calculated showed PSADT and SVI to be independent prognostic parameters. Two predictive models, a decision tree analysis, and a recursive partitioning model were moderately accurate in predicting outcome in this series, however, high-risk patients experienced less treatment failures than predicted. CONCLUSIONS: Pre-RT PSA <1 ng/mL, longer PSADT (>10 months) and no SVI are associated with improved outcome after rescue radiation. Contemporary clinical prediction tools are imperfect predictors of outcome for rescue radiation therapy.

Decision Trees↗
PubMed1999

Does the FDG Uptake of Primary Non-Small Cell Lung Cancer Predict Prognosis?. A Work in Progress.

OBJECTIVE: To determine if the intensity of fluorine-18-fluorodeoxyglucose (FDG) uptake in primary non-small cell lung cancer (NSCLC) could independently predict patient prognosis.METHODS: Thirty-eight patients with untreated NSCLC were studied with FDG-PET. Primary tumor FDG uptake was calculated by the standardized uptake value based on lean body mass (SUV-lean). Cumulative survival rate and the SUV-lean were compared.RESULTS: There were no significant differences between the tumor stages and the SUV-lean. Although the survival rates significantly decreased as the stage progressed (p =.0049), there was no significant difference in the survival rate between the group with lower primary tumor FDG uptake (SUV-lean </= 8.72) and the group with higher tumor FDG uptake (SUV-lean > 8.72) (p =.2256). However, in the subset of patients without metastasis, survival tended to be longer with a lower tumor SUV-lean.CONCLUSION: In this population of patients with NSCLC, the tumor FDG uptake does not independently predict the prognosis.

Journal Article↗
PubMed2000

Endocrine therapies for patients with recurrent breast cancer: predictive factors for responses to first- and second-line endocrine therapies.

Breast cancer patients have been treated with four different hormonal agents, antiestrogen, progestin, luteinizing hormone-releasing hormone agonist and aromatase inhibitor, during the past 7 years in Japan. To investigate the efficacy of these agents for the treatment of recurrent breast cancer patients, we conducted a retrospective multi-institute survey in Japan. The clinico-pathological data of 131 patients, who received endocrine therapy as first-line treatment between 1993 and 1998, were collected from seven institutes. The median age of the patients was 55 (range 27-92) years, 75% of their primary tumors were estrogen receptor (ER)-positive or unknown, and 95% of the dominant metastatic sites were bone, soft tissue or lungs. The objective response rate to first-line endocrine therapy was 42.7%, and that to second-line therapy 42.5% (17 of 40 patients). Multiple regression analyses of predictive factors for a response to first- and second-line endocrine therapies indicated two independent factors, ER status of the primary tumors and dominant site of metastasis, for the former, and one independent factor, a response to first-line endocrine therapy, for the latter. Analysis of relationships between sequences of use of hormonal agents and objective response rates revealed that the choice of first-line hormonal agent did not influence the overall efficacy of first- and second-line endocrine therapies. Overall survival after first recurrence in patients with tumors exhibiting an objective response or stable disease to first-line endocrine therapy was significantly better than that in patients with tumors exhibiting progressive disease (p < 0.01). These findings suggest that an adequate selection of recurrent breast cancer patients referring the ER status, dominant site of metastasis and a prior response to endocrine therapy may contribute to better clinical outcomes of the patients.

Antineoplastic Agents, Hormonal↗
PubMed2001

Occult tumor cells in bone marrow of patients with locoregionally restricted ovarian cancer predict early distant metastatic relapse.

PURPOSE: Based on conventional tumor staging, primary ovarian cancer is viewed as an intraperitoneal disease that rarely spreads to extraperitoneal organs. However, autopsy studies reveal a much higher rate of occult metastasis, indicating that extraperitoneal spread occurs with much greater frequency than previously appreciated. Consequently, we investigated the incidence of early hematogenous dissemination and its association with distant disease-free and overall survival. PATIENTS AND METHODS: Bone marrow aspirates from 108 patients newly diagnosed with International Federation of Gynecology and Obstetrics stage I to III ovarian cancer were prospectively analyzed with the novel anti-cytokeratin (CK) antibody A45-B/B3. We investigated the frequency of CK-positive tumor cells in bone marrow and their effect on prognosis in relation to established risk factors for tumor progression. RESULTS: Tumor cells in bone marrow were detected in 32 (30%) of 108 patients. A CK-positive finding was unrelated to established risk parameters, except for poor nuclear grading of the primary tumor. At a median follow-up of 45 months (range, 12 to 77 months), the presence of occult metastatic cells in bone marrow was associated with the occurrence of clinically overt, extraperitoneal (predominantly extraskeletal) distant metastasis (relative risk [RR], 16.5; 95% confidence interval [CI], 6.2 to 56.9; P < .0001) and death from cancer-related causes (RR, 2.3; 95% CI, 1.2 to 4.3; P = .01). Multivariate analysis identified a positive bone marrow finding as an independent prognostic factor of reduced distant disease-free survival for all patients (RR, 13.8; 95% CI, 5.4 to 52.9; P < .0001) and for the 64 stage R0-1 patients (RR, 7.3; 95% CI, 1.5 to 56.8; P = .0021). CONCLUSION: Our data signal that hematogenous dissemination of tumor cells occurs early and throughout all stages of ovarian cancer. The clinical significance of our findings is supported by the unfavorable prognosis in association with the presence of occult metastatic cells, especially in those patients who received an effective locoregional therapy.

Adult↗
PubMed2005

Postoperative prognosis of node-negative breast cancers predicted by gene-expression profiling on a cDNA microarray of 25,344 genes.

BACKGROUND: In Japan, postoperative relapse occurs within five years in 9.2 to 16% of patients whose breast cancers have not metastasized to lymph nodes at the time of initial surgery(node-negative, n0). Attempts to find molecular markers able to classify n0 breast cancers in terms of postoperative prognosis have not been successful. METHODS: To identify molecular indicators of prognosis for this type of cancer, we used a cDNA microarray consisting of 25,344 human genes to investigate expression profiles of 12 primary breast cancers from patients whose tumors recurred within five years after surgery(5Y-R) and 12 from patients who survived disease-free for more than five years (5Y-F). RESULTS: Sets of genes characterizing each group in terms of expression patterns in the tumors were selected by Mann-Whitney and random-permutation tests: these panels included 21 genes expressed highly in 5Y-R tumors than in 5Y-F tumors, and 37 with higher expression in the 5Y-F group than in the 5Y-R group. CONCLUSIONS: We established a scoring system to prediction of postoperative prognosis which was 100% accurate as to the actual clinical outcomes of the 24 cases and therefore might be useful for predicting prognosis of n0 breast cancers in a clinical setting. The prognostic score system clearly separated the two groups without any overlap, and accurately predicted prognosis in 6 additional cases. Moreover, the extensive list of tumor-related genes identified in these experiments provides valuable information about progression of breast cancer and suggests potential target molecules for therapy of n0 breast cancers.

Adult↗
PubMed1997

[Surgically treated esophageal cancers: predictive model of survival].

OBJECTIVES: The aim of this study was to identify prognostic factors in patients with esophageal cancer after curative resection, and to establish a predictive model of their long-term prognosis. PATIENTS--METHODS: Eighty-nine patients operated on for neoplasia of the esophagus, who underwent a curative resection, an who did not die within one month or during the hospital stay, were included in this study. Twenty-one variables were studied by univariate analysis. The variables linked with survival were include in a Cox model. Regression coefficient of independent prognostic factors allowed to compute a score. RESULTS: Life table analysis of the entire population, showed 2 and 5 year survival rates of 48% and 28%, respectively. In univariate analysis, 5 out of 21 factors were statistically linked with survival. In multivariate analysis (Cox model), 4 independent factors were linked with survival: age (P = 0.02), the American Society of Anesthesiologist classification (P = 0.01), parietal invasion (P = 0.03), and lymph node invasion (P = 0.009). The score established with these 4 factors allowed to distinguish 3 sub-groups, discriminated by their long term prognosis. Life table analysis of the 3 sub-groups were at 2 and 5 years 83%, 55%, 20% and 60%, 32%, 0%, respectively. CONCLUSION: This model may be useful for the assessment of prognosis in patients with esophageal cancer after curative surgical treatment.

Adenocarcinoma↗
PubMed1994

Pediatric cancer: predicting sibling adjustment.

Within the context of a coping model, the present study attempted to determine variables associated with good and poor adjustment for siblings (N = 129) of pediatric cancer patients. Family cohesion and adaptability were found to mediate the impact of pediatric cancer on the healthy sibling. Specifically, high levels of family cohesion and adaptability were associated with better adaptation for siblings. Some support also was found for Folkman, Schaefer, and Lazarus' (1979) coping model, as the following variables, proposed by the model, predicted sibling adjustment to pediatric cancer: health/energy/morale, social support, and utilitarian resources. Results from this study stress the need to examine the child in a variety of ecological contexts (e.g., parental and familial functioning; neighborhood/community support).

Adaptation, Psychological↗
PubMed2005

Elevated metallothionein (MT) expression in invasive ductal breast cancers predicts tamoxifen resistance.

Elevated expression of the low molecular weight metallothionein (MT) proteins can be found typically in breast cancer cases with less favourable prognosis. The MT gene has been described to be potentially down-regulated by estrogen receptor alpha. The present study is aimed at examining the predictive value of MT expression for results of tamoxifen treatment in breast cancer in relation to steroid receptor status. Sixty patients with primary invasive ductal breast cancers with post-operative tamoxifen treatment were enrolled in the study. In paraffin sections of the studied tumours immmunohistochemical reactions were performed using antibodies directed against MT, estrogen receptors (ER) and progesterone receptors (PgR). Results of the immunohistochemical reactions and of clinical observations were analysed using multivariate progression analysis based on the Cox proportional hazard model. Elevated MT expression was demonstrated to be typical for cases with documented relapse of the disease (P<0.001) or terminated by death (P=0.03). Decreased ER expression was found to be typical for cases of a higher grade (P=0.02) and cases terminated by death (P=0.006). The multivariate analysis showed that elevated MT expression was characteristic for cases with shorter overall survival time (P=0.04). The data showed that MT carried an independent, and also independent from ER status, unfavourable predictive value as far as results of tamoxifen treatment were concerned.

Age Factors↗
PubMed2006

High expressions of CD105 and VEGF in early oral cancer predict potential cervical metastasis.

BACKGROUND AND OBJECTIVES: Although elective neck dissection has become a popular treatment modality for early oral cancer among most head and neck surgeons, a large portion of patients revealed pathological N0 postoperatively. Our study is aimed to evaluate the expressions of the angiogenic factors, vascular endothelial growth factor (VEGF), and CD105 (endoglin) on the prediction of neck metastasis for clinical N0 patients in early oral cancer. PATIENTS AND METHODS: Between July 1996 and July 2005, the preoperative biopsy specimens among 176 patients who underwent surgical treatment for early oral cancer were retrieved for the immunohistochemical study for VEGF and CD105. RESULTS: High expressions of CD105 and VEGF significantly correlated with positive nodal metastasis, respectively (P<0.001). The expression of CD105 also significantly correlated with that of VEGF (P<0.001). Furthermore, the sensitivity and specificity for prediction of cervical metastasis by high expressions of CD105 versus VEGF were 81.8% and 97.7% versus 93.2% and 72%, respectively. Low expression of CD105 and VEGF also significantly correlated with higher survival rate, respectively (P<0.001). CONCLUSIONS: Besides the image studies, the expressions of both CD105 and VEGF could be useful to guide the elective treatment for clinical N0 neck in early oral cancer.

Analysis of Variance↗