Purpose
After surgery for lung adenocarcinoma, a patient may experience various states of recurrence, with multiple factors potentially influencing the transitions between these states. Our purpose was to investigate the effects of clinical and pathological factors on tumor recurrence, death, and prognosis across various metastasizing pathways.
Materials and Methods
Our study group included 335 patients with all demographic and pathologic data available who underwent surgical resection for lung adenocarcinoma for more than 10 years. The following states of disease were defined: initial state, operation (OP); three intermediate states of local recurrence (LR), metastasis (Meta), and concurrent LR with metastasis (LR+Meta); and a terminal state, death. We identified 8 transitions representing various pathways of tumor progression. We employed a multi-state model (MSM) to separate the impacts of multiple prognostic factors on the transitions following surgery.
Results
After surgery, approximately half of patients experienced recurrence. Specifically, 142 (42.4%), 54 (16.1%), and 7 (2.1%) patients developed Meta, LR+Meta, and LR, respectively. Clinical and pathological factors associated with the transitions were different. Impact of pathological lymph node remained a risk factor for both OP to Meta (λ02, p-value=0.001) and OP to LR+Meta (λ03, p-value = 0.001).
Conclusion
Lung adenocarcinoma displays a broad spectrum of clinical scenarios even after curative surgery. Incidence, risk factors, and prognosis varied across different pathways of recurrence in lung adenocarcinoma patients. The greatest implication of this MSM is its ability to predict the timing and type of clinical intervention that will have the greatest impact on survival.
Purpose
We investigated the impact of four types of antihypertensive medications, angiotensin receptor blockers (ARBs), beta blockers (BBs; both selective and non-selective), calcium channel blockers (CCBs), and thiazide diuretics (TDs) on survival outcomes in epithelial ovarian cancer (EOC).
Materials and Methods
A single-institutional retrospective chart review of 878 patients with EOC was performed. Survival was compared according to use of the four antihypertensive medications during primary treatment. Propensity score matching (ratio 1:3) was performed to control possible associated covariates, such as age, International Federation of Gynecology and Obstetrics stage, residual status after primary debulking surgery, and co-morbidity.
Results
Among 878 patients, 56 patients (6.4%) were ARB users, 62 (7.1%) were BB users, 107 (12.2%) were CCBs users and 32 (3.6%) used TDs. Median progression-free survival (PFS) for ARB, BB, and CCB users was 37.8, 27.2, and 23.6 months compared with 33.6 months for non-users. ARB was associated with 35% decreased risk of disease progression (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.42 to 0.99; p=0.046) in multivariate analysis. After propensity score matching, median PFS for ARB users was 37.8 months and ARB use remained to be associated with lower recurrence rate in univariate (p=0.035) and multivariate analysis (HR, 0.60; 95% CI, 0.39 to 0.93; p=0.022).
Conclusion
In this study, ARBs use during primary treatment is associated with lower recurrence in EOC patients. However, CCBs, BBs, and TDs did not show beneficial impact.
Citations
Citations to this article as recorded by
Evaluation of antihypertensive medications use and survival in patients with ovarian cancer: a population-based retrospective cohort study Rūta Everatt, Irena Kuzmickienė, Birutė Brasiūnienė, Ieva Vincerževskienė, Birutė Intaitė, Saulius Cicėnas, Ingrida Lisauskienė BMC Women's Health.2024;[Epub] CrossRef
Advanced progress of the relationship between renin–angiotensin–aldosterone system inhibitors and cancers Ruixing Zhang, Hongtao Yin, Mengdi Yang, Jinjin Liu, Donghu Zhen, Zheng Zhang Journal of Hypertension.2024; 42(11): 1862. CrossRef
Impact of ACEI/ARB use on the survival of hypertensive patients with cancer: A meta‑analysis Yao Xiao, Xinlong Chen, Wancheng Li, Xin Li, Wence Zhou Oncology Letters.2024;[Epub] CrossRef
Renin-Angiotensin-Aldosterone System Inhibitors and Development of Gynecologic Cancers: A 23 Million Individual Population-Based Study Nhi Thi Hong Nguyen, Phung-Anh Nguyen, Chih-Wei Huang, Ching-Huan Wang, Ming-Chin Lin, Min-Huei Hsu, Hoang Bui Bao, Shuo-Chen Chien, Hsuan-Chia Yang International Journal of Molecular Sciences.2023; 24(4): 3814. CrossRef
Association of Hypertension and Breast Cancer: Antihypertensive Drugs as an Effective Adjunctive in Breast Cancer Therapy Yuanyuan Fan, Nazeer Hussain Khan, Muhammad Farhan Ali Khan, MD Faysal Ahammad, Tayyaba Zulfiqar, Razia Virk, Enshe Jiang Cancer Management and Research.2022; Volume 14: 1323. CrossRef
The effect of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors on progression of gastric cancer: systematic review and meta-analysis Seyed Ali Mehrdad, Farshad Mirzavi, Seyed Mohammad Reza Seyedi, Ahmad Asoodeh Anti-Cancer Drugs.2022; 33(10): 983. CrossRef
Repurposing approved drugs for cancer therapy Catherine H Schein British Medical Bulletin.2021; 137(1): 13. CrossRef
Norepinephrine inhibits migration and invasion of human glioblastoma cell cultures possibly via MMP-11 inhibition Jing Zhong, Weiran Shan, Zhiyi Zuo Brain Research.2021; 1756: 147280. CrossRef
Antihypertensive Drug Use and the Risk of Ovarian Cancer Death among Finnish Ovarian Cancer Patients—A Nationwide Cohort Study Eerik E. E. Santala, Miia Artama, Eero Pukkala, Kala Visvanathan, Synnöve Staff, Teemu J. Murtola Cancers.2021; 13(9): 2087. CrossRef
The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer José A. Carlos-Escalante, Marcela de Jesús-Sánchez, Alejandro Rivas-Castro, Pavel S. Pichardo-Rojas, Claudia Arce, Talia Wegman-Ostrosky Frontiers in Oncology.2021;[Epub] CrossRef
Post-Diagnostic Beta Blocker Use and Prognosis of Ovarian Cancer: A Systematic Review and Meta-Analysis of 11 Cohort Studies With 20,274 Patients Zhao-Yan Wen, Song Gao, Ting-Ting Gong, Yu-Ting Jiang, Jia-Yu Zhang, Yu-Hong Zhao, Qi-Jun Wu Frontiers in Oncology.2021;[Epub] CrossRef
Stress Hormones: Emerging Targets in Gynecological Cancers Guoqiang Chen, Lei Qiu, Jinghai Gao, Jing Wang, Jianhong Dang, Lingling Li, Zhijun Jin, Xiaojun Liu Frontiers in Cell and Developmental Biology.2021;[Epub] CrossRef
The Effect of Local Renin Angiotensin System in the Common Types of Cancer Moudhi Almutlaq, Abir Abdullah Alamro, Hassan S. Alamri, Amani Ahmed Alghamdi, Tlili Barhoumi Frontiers in Endocrinology.2021;[Epub] CrossRef
Does sympathetic nervous system modulate tumor progression? A narrative review of the literature Ioannis Stavropoulos, Angelos Sarantopoulos, Anastasios Liverezas Journal of Drug Assessment.2020; 9(1): 106. CrossRef
E Sun Paik, Insuk Sohn, Sun-Young Baek, Minhee Shim, Hyun Jin Choi, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Yoo-Young Lee, Duk-Soo Bae
Cancer Res Treat. 2017;49(3):635-642. Published online September 27, 2016
Purpose
This study was conducted to evaluate the prognostic significance of pre-treatment complete blood cell count (CBC), including white blood cell (WBC) differential, in epithelial ovarian cancer (EOC) patients with primary debulking surgery (PDS) and to develop nomograms for platinum sensitivity, progression-free survival (PFS), and overall survival (OS).
Materials and Methods
We retrospectively reviewed the records of 757 patients with EOC whose primary treatment consisted of surgical debulking and chemotherapy at Samsung Medical Center from 2002 to 2012. We subsequently created nomograms for platinum sensitivity, 3-year PFS, and 5-year OS as prediction models for prognostic variables including age, stage, grade, cancer antigen 125 level, residual disease after PDS, and pre-treatment WBC differential counts. The models were then validated by 10-fold cross-validation (CV).
Results
In addition to stage and residual disease after PDS, which are known predictors, lymphocyte and monocyte count were found to be significant prognostic factors for platinum-sensitivity, platelet count for PFS, and neutrophil count for OS on multivariate analysis. The area under the curves of platinum sensitivity, 3-year PFS, and 5-year OS calculated by the 10-fold CV procedure were 0.7405, 0.8159, and 0.815, respectively.
Conclusion
Prognostic factors including pre-treatment CBC were used to develop nomograms for platinum sensitivity, 3-year PFS, and 5-year OS of patients with EOC. These nomograms can be used to better estimate individual outcomes.
Citations
Citations to this article as recorded by
The Gustave Roussy immune score as a novel scoring system for predicting platinum resistance in advanced high-grade serous ovarian cancer Xianglin Nie, Ting Xu, Lin Zhang, Wenjun Cheng European Journal of Obstetrics & Gynecology and Reproductive Biology.2024; 294: 97. CrossRef
Predictive Value of Machine Learning for Platinum Chemotherapy Responses in Ovarian Cancer: Systematic Review and Meta-Analysis Qingyi Wang, Zhuo Chang, Xiaofang Liu, Yunrui Wang, Chuwen Feng, Yunlu Ping, Xiaoling Feng Journal of Medical Internet Research.2024; 26: e48527. CrossRef
Candidate prognostic biomarkers and prediction models for high-grade serous ovarian cancer from urinary proteomics Maowei Ni, Danying Wan, Junzhou Wu, Wangang Gong, Junjian Wang, Zhiguo Zheng Journal of Proteomics.2024; 304: 105234. CrossRef
Preoperative Immune Cell Dysregulation Accompanies Ovarian Cancer Patients into the Postoperative Period Jonas Ulevicius, Aldona Jasukaitiene, Arenida Bartkeviciene, Zilvinas Dambrauskas, Antanas Gulbinas, Daiva Urboniene, Saulius Paskauskas International Journal of Molecular Sciences.2024; 25(13): 7087. CrossRef
A nomogram with Ki-67 in the prediction of postoperative recurrence and death for glioma Fengfeng Li, Dongyuan Wang, Nana Wang, Linlin Wu, Bo Yu Scientific Reports.2024;[Epub] CrossRef
Machine learning for epithelial ovarian cancer platinum resistance recurrence identification using routine clinical data Li-Rong Yang, Mei Yang, Liu-Lin Chen, Yong-Lin Shen, Yuan He, Zong-Ting Meng, Wan-Qi Wang, Feng Li, Zhi-Jin Liu, Lin-Hui Li, Yu-Feng Wang, Xin-Lei Luo Frontiers in Oncology.2024;[Epub] CrossRef
Comparison of older and younger patients with ovarian cancer: A post hoc study (JGOG3016‐A3) of the treatment strength and prognostic outcomes of conventional or dose‐dense chemotherapy Yoshio Itani, Hitomi Sakai, Tetsutaro Hamano, Mikiko Asai‐Sato, Masayuki Futagami, Masaki Fujimura, Yoichi Aoki, Nao Suzuki, Yoshio Yoshida, Takayuki Enomoto Journal of Obstetrics and Gynaecology Research.2023; 49(5): 1400. CrossRef
Toward More Comprehensive Homologous Recombination Deficiency Assays in Ovarian Cancer Part 2: Medical Perspectives Stanislas Quesada, Michel Fabbro, Jérôme Solassol Cancers.2022; 14(4): 1098. CrossRef
Development of Machine Learning Models to Predict Platinum Sensitivity of High-Grade Serous Ovarian Carcinoma Suhyun Hwangbo, Se Ik Kim, Ju-Hyun Kim, Kyung Jin Eoh, Chanhee Lee, Young Tae Kim, Dae-Shik Suh, Taesung Park, Yong Sang Song Cancers.2021; 13(8): 1875. CrossRef
Beyond BRCA Status: Clinical Biomarkers May Predict Therapeutic Effects of Olaparib in Platinum-Sensitive Ovarian Cancer Recurrence Kazuho Nakanishi, Takashi Yamada, Gen Ishikawa, Shunji Suzuki Frontiers in Oncology.2021;[Epub] CrossRef
Inflammatory indexes as predictive factors for platinum sensitivity and as prognostic factors in recurrent epithelial ovarian cancer patients: a MITO24 retrospective study Alberto Farolfi, Emanuela Scarpi, Filippo Greco, Alice Bergamini, Lucia Longo, Sandro Pignata, Claudia Casanova, Gennaro Cormio, Alessandra Bologna, Michele Orditura, Laura Zavallone, Laura Attademo, Valentina Gallà, Elisena Franzese, Eva Pigozzi, Vera Lo Scientific Reports.2020;[Epub] CrossRef
Pertinence des marqueurs tumoraux, scores (cliniques et biologiques) et algorithmes à visée diagnostique et pronostique devant une masse ovarienne suspecte d’un cancer épithélial. Article rédigé sur la base de la recommandation nationale de bonnes pratiqu S. Bendifallah, G. Body, E. Daraï, L. Ouldamer Gynécologie Obstétrique Fertilité & Sénologie .2019; 47(2): 134. CrossRef
Development of Web-Based Nomograms to Predict Treatment Response and Prognosis of Epithelial Ovarian Cancer Se Ik Kim, Minsun Song, Suhyun Hwangbo, Sungyoung Lee, Untack Cho, Ju-Hyun Kim, Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Dae-Shik Suh, Taesung Park, Yong-Sang Song Cancer Research and Treatment.2019; 51(3): 1144. CrossRef
Ji Yun Lee, Sung Hee Lim, Min-Young Lee, Haesu Kim, Moonjin Kim, Sungmin Kim, Hyun Ae Jung, Insuk Sohn, Won Ho Gil, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Jin Seok Ahn, Young-Hyuck Im, Yeon Hee Park
Cancer Res Treat. 2015;47(4):765-773. Published online January 13, 2015
Purpose The purpose of this study is to evaluate the role of regular postoperative surveillance to improve the prognosis of patients with breast cancer after curative surgery. Materials and Methods We retrospectively analyzed the medical records of 4,119 patients who received curative surgery for breast cancer at Samsung Medical Center between January 2000 and September 2008. Patients were divided into two groups (group I, regular postoperative surveillance; group II, control group) according to their post-therapy follow-up status for the first 5 years after surgery. Results Among the 3,770 patients selected for inclusion, groups I and II contained 3,300 (87%) and 470 (13%) patients, respectively. The recurrence rates at 5 years for groups I and II were 10.6% and 16.4%, respectively (hazard ratio, 0.85; 95% confidence interval [CI], 0.67 to 1.09; p=0.197). The 10-year mortality cumulative rates were 8.8% for group I and 25.4% for group II (hazard ratio, 0.28; 95% CI, 0.22 to 0.35; p < 0.001). In multivariate analysis for recurrence-free survival (RFS), age over 40 years (p < 0.001), histologic grade 1 (p < 0.001), and pathologic stage I (p < 0.001) were associated with longer RFS but not with follow- up status. Multivariate analysis for overall survival (OS) revealed that patients in group I showed significantly improved OS (hazard ratio, 0.29; 95% CI, 0.23 to 0.37; p < 0.001). Additionally, age over 40 years, histologic grade I, and pathologic stage I were independent prognostic factors for OS. Conclusion Regular follow-up for patients with breast cancer after primary surgery resulted in clinically significant improvements in patient OS.
Citations
Citations to this article as recorded by
Follow-up strategy and survival for five common cancers: A meta-analysis Boris Galjart, Diederik J. Höppener, Joachim G.J.V. Aerts, Christiaan H. Bangma, Cornelis Verhoef, Dirk J. Grünhagen European Journal of Cancer.2022; 174: 185. CrossRef
Clinical Features and Outcomes of Invasive Breast Cancer: Age-Specific Analysis of a Modern Hospital-Based Registry Ji-Yeon Kim, Danbee Kang, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Jong Han Yu, Se Kyung Lee, Young-Hyuck Im, Jin Seok Ahn, Eliseo Guallar, Juhee Cho, Yeon Hee Park Journal of Global Oncology.2019; (5): 1. CrossRef
Follow-Up Recommendations after Curative Resection of Well-Differentiated Neuroendocrine Tumours: Review of Current Evidence and Clinical Practice Angela Lamarca, Hamish Clouston, Jorge Barriuso, Mairéad G McNamara, Melissa Frizziero, Was Mansoor, Richard A Hubner, Prakash Manoharan, Sarah O’Dwyer, Juan W Valle Journal of Clinical Medicine.2019; 8(10): 1630. CrossRef
Analysis of patient-detected breast cancer recurrence Trishul Kapoor, Sean Wrenn, Peter Callas, Ted A. James Breast Disease.2017; 37(2): 77. CrossRef