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PubMed2005

Correlation of presenting symptoms and patient characteristics with endometrial cancer prognosis in Japanese women.

OBJECTIVE: To determine whether patient characteristics and presenting symptoms could be prognostic indicators for endometrial cancer in Japanese women. METHODS: Review of the medical charts, which included presenting symptoms and other patient characteristics, of 242 women who underwent surgical treatment for FIGO stage I-IV endometrial cancer. RESULTS: FIGO stage, histologic grade, and lower abdominal pain were found to be significant independent factors for progression-free and overall survival. In contrast, abnormal uterine bleeding, comorbidities, and prior malignancy were not found to be prognostic factors. CONCLUSION: Lower abdominal pain was found to be an independent prognostic factor in endometrial cancer among Japanese women.

Abdominal Pain↗
PubMed1972

Histology in breast cancer prognosis.

Histological sections of the primary tumour and of homolateral axillary lymph nodes from 500 women with operable invasive breast cancer have been examined. The tumours have been graded and the degree of round cell infiltration assessed. These features, together with clinical palpability and pathological involvement of axillary nodes, have been related to survival.It was found that prognosis was worse in patients with a high grade tumour and in those with histological evidence of axillary node spread. Round cell infiltration of the primary tumour did not confer improved survival.The clinical state of the axillary nodes was associated with prognosis in so far that palpable nodes were twice as commonly the seat of metastatic spread as were impalpable nodes.

Axilla↗
PubMedDate not supplied

Combined expression of HLA-DR antigen and proliferating cell nuclear antigen correlate with colorectal cancer prognosis.

HLA-DR antigen expression and the proliferating cell nuclear antigen labeling index (PCNA-LI) were examined immmunohistochemically in 59 surgically resected advanced colorectal cancers to clarify the clinicopathologic significance of the HLA-DR antigen. HLA-DR antigen expression was detected in 33 (56%) of the 59 lesions, which showed less frequent liver metastasis than lesions without HLA-DR antigen expression (40 vs. 68%; p < 0.05). Five-year survival rates of patients with and without HLA-DR antigen expression were 50 and 19%, respectively. Lesions combining HLA-DR antigen expression and a relatively low PCNA-LI had the best prognosis. These results indicate that HLA-DR antigen expression, particularly combined with a low PCNA-LI, is an important outcome predictor in colorectal cancer.

Aged↗
PubMed1985

Breast cancer prognosis in a mixed Caucasian-Hispanic population.

Prognostic factors were compared between 1,249 Caucasian and 360 Hispanic women with breast cancer. A significantly greater proportion of Hispanic women were less than 50 years of age at diagnosis compared to Caucasian women (P less than .0001). Significantly more Hispanic women presented with tumors larger than 3 cm in diameter and with positive axillary lymph nodes than did Caucasian women (P = .004 and P = .0001, respectively). Significantly more Hispanic women were estrogen receptor (ER) negative (P = .005). However, when examined by age groups, the relationships between ethnicity and extent of disease and ER status were observed only among women over 50 years of age. Multivariate analyses demonstrated that there was no difference in survival between Caucasian and Hispanic women once adjustments were made for the number of positive lymph nodes and ER status. Although complete data were not available, it appeared that the incidence of breast cancer is lower in this population of Hispanic women than in Caucasian women.

Age Factors↗
PubMed1998

Plasma coenzyme Q10 concentrations in breast cancer: prognosis and therapeutic consequences.

BACKGROUND: Coenzyme Q10 or ubiquinone is a redox component of the respiratory chain, which may be involved in the pathogenesis of cancer. METHODS: In order to better understand the role of this vitamin in the pathogenesis of breast cancer, a clinical trial including 200 women hospitalized for the biopsy and/or the ablation of a breast tumor was conducted. Ubiquinone plasma concentrations were determined simultaneously with vitamin E plasma concentrations (as antioxidant reference) by HPLC. RESULTS: A coenzyme Q10 deficiency was noted both in carcinomas (80 patients) and non-malignant lesions (120 patients), while vitamin E concentrations were within the normal range. A correlation was shown between the intensity of the deficiency and the bad prognosis of the breast disease based on high TNM and SBR values or the lack of estrogen receptors. However, neither cathepsin D level nor adenopathy invasion was related to ubiquinone levels. CONCLUSIONS: Since prooxidants may promote tumorigenesis, ubiquinone supplementation in breast cancer could be relevant.

Adult↗
PubMedDate not supplied

Prostate specific antigen in the female body: its role in breast cancer prognosis.

Prostate-specific antigen, a 33 kDa serine protease, is found at high concentrations in seminal plasma and prostate epithelial cells. It is currently used for the diagnosis and monitoring of prostate carcinoma. However, several investigators have demonstrated nonprostatic sources of prostate specific antigen, including amniotic fluid, breast milk, breast cyst fluid, nipple aspirate fluid, and breast tumor cytosol. Studies have revealed that a high prostate-specific antigen level in tumors of women with breast cancer is associated with good prognosis. This finding is analyzed in this manuscript.

Amniotic Fluid↗
PubMed2003

Prognostic significance of EGFR and Her-2 in oral cavity cancer in betel quid prevalent area cancer prognosis.

Although several studies have found overexpression of epidermal growth factor receptor (EGFR) proteins EGFR and Her-2 in head and neck cancers, the clinical relevance of the finding varies. We examined the expression and clinical association of these molecules with oral squamous cell carcinoma in an area where betel chewing is prevalent. EGFR and Her-2 proteins were measured in 59 paired (grossly normal and cancer) tissues by an enzyme immunoassy method. The cutoff value for gene overexpression was defined as the level of mean expression in normal tissue plus two s.d. A total of 59% of the patients consumed alcohol, 90% smoked tobacco, and 90% chewed betel quid. Of the patients assayed, 34 (58%) and 24 (41%) had EGFR and Her-2 overexpression, with average 3.5- and 1.5-fold elevations. EGFR overexpression has been shown to be statistically associated with T stage, N stage, overall TMN stage, primary tumour depth, lymph node extra-capsular spread, and poor survival. Her-2 overexpression, however, did not demonstrate a similar association with clinicopathological parameters or therapeutic outcome. On multivariant analysis, EGFR overexpression (P=0.041) and N stage (P=0.024) were the only independent factors for overall survival. These results indicate that the molecular targeting therapy to EGFR may be a treatment for oral cavity cancer in the betel quid-chewing prevalent area.

Adult↗
PubMed2006

Colorectal cancer prognosis among patients with inflammatory bowel disease.

BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is associated with an increased risk for colorectal cancer (CRC). However, the genetic, endoscopic, and histologic features of IBD-associated CRC differ from cancers that arise sporadically. The objectives of this study were to describe the clinicopathologic features of IBD-associated CRC and to compare survival rates between patients with IBD-associated CRC and patients with sporadic CRC. METHODS: There were 290 patients with IBD-associated CRC (241 with chronic ulcerative colitis [CUC] and 49 with Crohn's disease) and an equal number of age- and sex-matched sporadic CRC patients who were evaluated at the Mayo Clinic between 1976 and 1996. Medical records were reviewed retrospectively for demographic features, endoscopic and histologic characteristics, and vital status at the time of the last follow-up evaluation. The actuarial survival of each group was calculated by the Kaplan-Meier method. The influence of clinical features on survival was assessed using Cox proportional hazards regression modeling. RESULTS: The median age at diagnosis of IBD-related CRC was 48 years. Fifty-five percent of IBD-related tumors were distal to the splenic flexure compared with 78% of sporadic tumors. During a median follow-up period of 5 years, 163 IBD-associated CRC patients died (56%), compared with 164 sporadic CRC patients (57%). The 5-year survival rates were 54% in the IBD-CRC subgroup vs 53% in the sporadic CRC subgroup (P = .94, log-rank). CONCLUSIONS: CUC-related CRC is diagnosed at a relatively young age, and IBD-related tumors tend to be distributed more evenly across the colorectum than sporadic tumors. The survival rates for IBD-associated and sporadic CRC were similar.

Adolescent↗
PubMed2004

Health-related quality of life and psychosocial status in breast cancer prognosis: analysis of multiple variables.

PURPOSE: Evidence that psychosocial status and health-related quality of life (HRQOL) are associated with breast cancer (BC) outcomes is weak and inconsistent. We examined prognostic effects of these factors in a prospective cohort study. PATIENTS AND METHODS: Three hundred ninety-seven women with surgically resected T1 to T3, N0/N1, M0 BC completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (Core 30 items), Profile of Mood States, Psychosocial Adjustment to Illness Scale, Impact of Events Scale, Mental Adjustment to Cancer Scale, and the Courtauld Emotional Control Scale 2 months after diagnosis and 1 year later. Data on tumor-related factors, treatment, and outcomes were obtained prospectively from medical records, and Cox survival analyses were performed. RESULTS: Mean age was 52.0 +/- 9.9 years. Two hundred twenty-five women had T1, 136 women had T2, 16 women had T3, and 20 women had TX tumors; 127 were N1. One hundred thirteen women received adjuvant chemotherapy, 130 received hormone therapy, 45 received both, and 109 received neither. We investigated 140 prognostic associations; four were found to be statistically significant at a P value of </= .05 (three fewer than expected by chance). Two were in the hypothesized direction of effect, and two were in the opposite direction. All arose from measurements 1 year after diagnosis, which were most susceptible to confounding by treatment. There was no evidence of consistency of associations across outcomes or questionnaires. These results are in keeping with chance as the explanation for our statistically significant findings. CONCLUSION: HRQOL and psychosocial status at diagnosis and 1 year later are not associated with medical outcome in women with early-stage BC.

Adaptation, Psychological↗
PubMed1991

Obesity and body fat distribution and breast cancer prognosis.

This study addresses the effect of obesity and body fat distribution on axillary lymph node involvement, tumor size, and estrogen receptor (ER) level in breast cancer patients. Anthropometric measurements were prospectively obtained on 248 consecutively and newly diagnosed women with invasive breast cancer. The anthropometric measurements evaluated were abdomen, thigh, subscapular, and midaxillary skinfolds; weight; and height. Weight and Quetelet Index (kg/m2) were significantly (P = 0.001) associated with lymph node involvement in postmenopausal patients. The abdomen:thigh skinfold ratio was significantly higher in premenopausal patients (P = 0.004) and postmenopausal (P = 0.03) without axillary node involvement compared with women with 4+ axillary node involvement. The abdomen:thigh skinfold was higher (P = 0.05) in women with smaller breast cancers (less than 2.0 cm) and higher ER levels. Weight and Quetelet Index did not affect tumor size or ER level. This study demonstrated that obese postmenopausal women who developed breast cancer tend to have more axillary node involvement than their leaner counterparts. Generalized obesity did not affect tumor size or ER level. Premenopausal and postmenopausal women with upper body fat distribution appear to be a subset of women who have a more favorable prognosis as measured by less lymph node involvement, smaller tumors, and higher levels of ER in their tumors.

Adult↗
PubMed2000

Relationship between c-erbB-2 and other tumor characteristics in breast cancer prognosis.

The aim of this study was to evaluate c-erbB-2 overexpression by means of a quantitative biochemical technique in 488 primary breast cancer patients with long-term follow-up (median, 10 years) and its relation to other biochemical prognostic factors (uPA, p53, and epidermal growth factor receptor) and adjuvant therapy. High levels of c-erbB-2 (>500 IU/mg protein) were associated with estrogen receptor (ER) and progesterone receptor negativity, high histoprognostic SBR grade and high levels of uPA and p53. Univariate analyses showed shorter metastasis-free survival (MFS) and overall survival (OS) in patients whose tumors overexpressed c-erbB-2 in the overall population, in subgroups defined by ER and uPA status, and in patients with positive pathological nodal status, SBR grade II, progesterone receptor, and p53-negative tumors. Patients with ER-positive, c-erbB-2-positive tumors had a shorter MFS and OS than those patients with c-erbB-2-negative tumors. No difference was observed between adjuvant-treated and untreated patients (chemotherapy and/or hormone therapy) in the c-erbB-2-negative subgroup. There was a trend toward a longer short-term MFS in c-erbB-2-positive patients treated with chemotherapy, whereas an opposite effect was observed with hormone therapy. Cox multivariate analyses showed that high levels of c-erbB-2 negatively influenced MFS in the overall population as well as in node-positive patients and in tamoxifen-treated patients, along with pN and uPA. Results for OS were comparable with those obtained for MFS. These results suggest that c-erbB-2 overexpression in breast cancer may be a better predictor of the response to tamoxifen than is ER status alone.

Adult↗
PubMed1995

Fluorescence in situ hybridization: powerful molecular tool for cancer prognosis.

We review several aspects of fluorescence in situ hybridization (FISH) technology that demonstrate its breadth and power in detecting and monitoring genetic abnormalities associated with cancers. The clinical utility of FISH in disease management is demonstrated in several examples, including trisomy 8 detection with high specificity and sensitivity in patients with myeloid leukemias; trisomy 12 detection with higher efficiency than conventional cytogenetics in patients with chronic lymphocytic leukemia; assessment of engraftment success, chimerism, and relapse in opposite sex bone marrow transplantation; and correlation of trisomy 7 with survival time in patients with prostate tumors. Advances in FISH technology include multicolor analyses, which permit the simultaneous detection of several genetic abnormalities by using cohybridization of probes labeled with several fluorescent labels or label combinations, and comparative genomic hybridization, a relatively new method whereby a single hybridization can reveal aberrations across the entire genome.

Chromosome Aberrations↗
PubMed1992

Dietary factors in lung cancer prognosis.

A hypothesis-generating analysis of the role of diet on survival was conducted among a sample of 463 men and 212 women with histologically-confirmed lung cancer. Interview information was obtained from two population-based case-control studies of lung cancer conducted on the Island of Oahu, Hawaii, between 1979 and 1985. The interview consisted of a quantitative dietary history to assess the usual intake of foods 1 year prior to diagnosis, a complete tobacco history, and other demographic and lifestyle information. Records from the Hawaii Tumor Registry were reviewed for data on stage, histology, and follow-up status of these patients. A food group analysis showed a significant reduction in the risk of death with increasing consumption of all vegetables combined among women (P for trend = 0.03), but not among men. The covariate-adjusted median survival times for women from the highest to the lowest quartiles of vegetable intake were 33, 21, 15, and 18 months, respectively. The results also suggested an association of fruit intake and survival among women (P for trend = 0.02), although a similar effect was not found among men. Increased consumption of certain foods, such as tomatoes and oranges among men, and broccoli and, perhaps, tomatoes among women, appeared to improve survival. This exploratory analysis provides mixed indications that certain components of vegetables and fruits may prolong survival in lung cancer patients.

Adult↗
PubMed2005

Multiple births and breast cancer prognosis: a population based study.

Survival in relation to endocrine or reproductive factors has rarely been studied since the focus of most studies has been on the risk of breast cancer. In this study we analysed the effect of multiple birth compared to single births on breast cancer survival. A population based cohort of 30619 women born after 1935 and diagnosed with primary breast cancer, between 1958 and 1998, was generated by linking a number of Swedish registries including Swedish Cancer Registry, Cause of Death Registry, Swedish Generation Registry and the Registry of Population and Population changes. Then we quantified the association between singleton and multiple births to breast cancer specific fatality using the Cox proportional hazards model. We found the singleton and multiple births were associated with increased fatality if breast cancer was diagnosed within 5 years of childbirth, this effect dying out to nil at 5 years after childbirth. Thereafter there was a protective effect on survival with time. Although childbirth is known to decrease breast cancer risk, this study demonstrates that a survival disadvantage exists for breast cancer diagnosed within the first 5 years of singleton and multiple births. It is concluded that breast cancer diagnosed within 5 years of childbirth, particularly if this or prior pregnancies have been multiple, should be regarded as a negative prognostic factor and considered in counselling and treatment of these patients.

Adult↗
PubMedDate not supplied

P21WAF1/CIP1 protein and tongue cancer prognosis.

The expression of the cell cycle regulatory protein p21waf1/cip1 was analyzed immunohistochemically in tissue from the tumor and adjacent non-tumor epithelia of 54 patients with tongue cancer in order to determine the proportion of tongue carcinomas with altered p21waf1/cip1 expression, establish whether this alteration is an early event in tongue carcinogenesis and to investigate whether p21waf1/cip1 expression has predictive prognostic value in these tumors. The percentage of p21waf1/cip1-positive neoplastic cells was calculated. Adjacent non-tumor epithelium was classified as normal, hyperplastic or dysplastic, and the p21waf1/cip1 expression was only considered normal in suprabasal layers. P21waf1/cip1 expression was negative in 57.4% (31/54) of the tumors and was aberrant in the non-tumor adjacent tissue of all patients studied. Neither the absence nor the degree of p21waf1/cip1 expression influenced the survival of patients in the present series. P21waf1/cip1 system alteration may be an early and frequent event in tongue carcinogenesis.

Adult↗
PubMed1992

Life events and breast cancer prognosis.

OBJECTIVE: To determine whether psychosocial stress, in the form of adverse life events and social difficulties, depressive illness, or lack of confiding relationships, shortens the postoperative disease free interval in breast cancer patients. DESIGN: Prospective follow up of a cohort of newly diagnosed breast cancer patients for 42 months after primary surgical treatment, using a life events and social difficulties schedule (LEDS) and assessment of depressive symptomatology (DSM-III). SETTING: Patients recruited from breast clinics in Southampton and Portsmouth were interviewed in their homes. PATIENTS: 204 women (83% of 246 consecutive cases) treated either by mastectomy or wide excision followed by radiotherapy interviewed four, 24, and 42 months after operation. MAIN OUTCOME MEASURES: Hazard ratios for relapse of breast cancer in relation to various measures of psychosocial stress. Relapse was defined as local recurrence or distant metastasis, or both, with histological or radiological confirmation and timed from the month when clinical symptoms began. RESULTS: After adjustment for age and axillary lymph node involvement, the hazard ratio associated with severe life events or social difficulties (excluding "own health" ones), or both, during the year before breast cancer surgery was 0.43 (95% confidence interval 0.20 to 0.93); for those during the follow up period it was 0.88 (0.48 to 1.64). For prolonged major depression before surgery and during the follow up period, hazard ratios were 1.26 (0.49 to 3.26) and 0.85 (0.41 to 1.79) respectively. For absence of a full confidant the figures were 0.93 (0.42 to 2.09) and 0.86 (0.38 to 1.93). CONCLUSION: These results give no support to the theory that psychosocial stress contributes to relapse of breast cancer.

Breast Neoplasms↗
PubMed2003

The effect of sample size and MLP architecture on Bayesian learning for cancer prognosis--a case study.

In this paper we investigate the independent effects of training sample size and multilayer perceptron (MLP) architecture on Bayesian learning to build prognostic models for metastatic breast cancer. We trained two types of Bayesian neural networks on a data set of 1477 metastatic breast cancer patients followed at the Institut Curie using disjoint training sets of sizes k = 50, 100, 200, 300, and 450. The learning performance as measured by an expected loss appeared independent of the two architectures modelling the log hazard function under either proportional or non proportional hazard assumptions, thus indicating that no other sources of nonlinearity besides interactions are present. We found a performance breakdown at k = 50, and no sample size effect for k > or = 100.

Bayes Theorem↗
PubMed2002

Polymorphisms in the androgen receptor and type II 5 alpha-reductase genes and prostate cancer prognosis.

BACKGROUND: Cytosine-adenine-guanine repeat length of the androgen receptor gene and the A49T and V89L polymorphisms of the 5 alpha-reductase (SRD5A2) gene have been associated with prostate cancer. METHODS: We investigated the relationship of the three genetic polymorphisms to tumor grade among 211 men who had undergone radical prostatectomy. Subjects had prostate cancer <3 cm(3) with a percentage of cancer represented by Gleason grade 4 or 5 (% Gleason grade 4/5) of either > or = 20% or < or = 5%. We also examined the association between those genetic markers and prostate specific antigen (PSA) failure among 112 subjects with > or = 20% Gleason grade 4/5. RESULTS: In cross-sectional analysis, none of the polymorphisms was a significant predictor of % Gleason grade 4/5. In longitudinal analysis, the LL genotype at the V89L site was associated with statistically significant four- to sixfold increase in PSA failure risk after adjustment for clinicopathologic variables. CONCLUSIONS: We observed poorer prognosis among men with the LL genotype at codon 89 of the SRD5A2 gene. Lack of consistency between studies must be resolved before clinical utility of this marker is established.

Biomarkers, Tumor↗