Pub Date : 2022-05-26DOI: 10.1080/08941939.2022.2078021
Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu
Abstract Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P<0.05) than those of the AJCC stage (0.631 and 0.633 respectively). Also, the 3-year AUC values of this nomogram were higher than those of the AJCC stage in both the development cohort (0.746 vs. 0.631) and the validation cohort (0.745 vs. 0.640). Using DCA curves, the predictive potential of the currently developed nomogram outperformed the conventional AJCC staging system. Conclusion The nomogram model might be a more reliable tool to predict prognosis accurately in rectal cancer patients receiving preoperative radiotherapy.
{"title":"Constructing and Validating a Prognosis Predictive Nomogram for Cancer-Specific Survival in Rectal Cancer Patients Receiving Preoperative Radiotherapy","authors":"Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu","doi":"10.1080/08941939.2022.2078021","DOIUrl":"https://doi.org/10.1080/08941939.2022.2078021","url":null,"abstract":"Abstract Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P<0.05) than those of the AJCC stage (0.631 and 0.633 respectively). Also, the 3-year AUC values of this nomogram were higher than those of the AJCC stage in both the development cohort (0.746 vs. 0.631) and the validation cohort (0.745 vs. 0.640). Using DCA curves, the predictive potential of the currently developed nomogram outperformed the conventional AJCC staging system. Conclusion The nomogram model might be a more reliable tool to predict prognosis accurately in rectal cancer patients receiving preoperative radiotherapy.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1526 - 1535"},"PeriodicalIF":1.9,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41463486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose To identify candidate factors for predicting high-volume lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC). Methods We retrospectively studied 2981 patients with PTMC who underwent thyroidectomy from 2013 to 2016. LLNM was identified by histopathology. Patients with different LLNM statuses were compared according to clinical, sonographic and pathological parameters. A multivariate logistic model was established to predict high-volume LLNM (number of metastatic lymph nodes >5). Results High-volume LLNM of PTMC was independently associated with age < 40 years (OR = 1.791, P = 0.023), male sex (OR = 2.401, p = 0.001), tumor size > 0.5 cm (OR = 4.839, p < 0.001), extrathyroidal extension (OR = 2.097, p = 0.007) and microcalcification (OR = 2.894, p = 0.002). These five factors were incorporated together to develop a multivariate analysis, which showed good predictive ability (AUC = 0.78, 95% CI 0.72–0.83), with a sensitivity of 80.0% and a specificity of 61.4%. Moreover, more level II or V lateral regions were involved in patients with high-volume LLNM than in those with small-volume LLNM (69.2% vs. 25.0%, p < 0.001; 10.8% vs. 4.7%, p < 0.001). Conclusion Multilevel LLNM tended to be more common in patients with PTMC who had high-volume LLNM. The high-volume LLNM rates of patients with PTMC with age < 40 years, male sex, tumor size > 0.5 cm, extrathyroidal extension and microcalcification were relatively higher than those without. These findings may be useful for identifying patients at higher high-volume LLNM risk who may require more aggressive treatment or intensive follow-up management.
{"title":"What Are the Characteristics of Papillary Thyroid Microcarcinoma Prone to High-Volume Lateral Lymph Node Metastasis? - An Analysis of 2981 Consecutive Cases","authors":"Luying Gao, Xiaoyi Li, Chunhao Liu, Ruifeng Liu, Xinlong Shi, Liyuan Ma, Hao Zhao, Yu Xia, Yuxin Jiang","doi":"10.1080/08941939.2022.2075494","DOIUrl":"https://doi.org/10.1080/08941939.2022.2075494","url":null,"abstract":"Abstract Purpose To identify candidate factors for predicting high-volume lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC). Methods We retrospectively studied 2981 patients with PTMC who underwent thyroidectomy from 2013 to 2016. LLNM was identified by histopathology. Patients with different LLNM statuses were compared according to clinical, sonographic and pathological parameters. A multivariate logistic model was established to predict high-volume LLNM (number of metastatic lymph nodes >5). Results High-volume LLNM of PTMC was independently associated with age < 40 years (OR = 1.791, P = 0.023), male sex (OR = 2.401, p = 0.001), tumor size > 0.5 cm (OR = 4.839, p < 0.001), extrathyroidal extension (OR = 2.097, p = 0.007) and microcalcification (OR = 2.894, p = 0.002). These five factors were incorporated together to develop a multivariate analysis, which showed good predictive ability (AUC = 0.78, 95% CI 0.72–0.83), with a sensitivity of 80.0% and a specificity of 61.4%. Moreover, more level II or V lateral regions were involved in patients with high-volume LLNM than in those with small-volume LLNM (69.2% vs. 25.0%, p < 0.001; 10.8% vs. 4.7%, p < 0.001). Conclusion Multilevel LLNM tended to be more common in patients with PTMC who had high-volume LLNM. The high-volume LLNM rates of patients with PTMC with age < 40 years, male sex, tumor size > 0.5 cm, extrathyroidal extension and microcalcification were relatively higher than those without. These findings may be useful for identifying patients at higher high-volume LLNM risk who may require more aggressive treatment or intensive follow-up management.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1519 - 1525"},"PeriodicalIF":1.9,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41818432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.
{"title":"Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns","authors":"Zhaoxing Liu, Dawei Li, Xinzhu Liu, Bohan Zhang, Yu Zang, Jinglong Ma, Wen Zhang, Yuezeng Niu, Chuan'an Shen","doi":"10.1080/08941939.2022.2073489","DOIUrl":"https://doi.org/10.1080/08941939.2022.2073489","url":null,"abstract":"Abstract Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1510 - 1518"},"PeriodicalIF":1.9,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43705090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1080/08941939.2022.2075495
A. Giannini, O. D’Oria, V. Chiantera, C. Margioula-Siarkou, M. C. Di Donna, S. Terzic, Z. Sleiman, A. Laganà
aDepartment of Medical and surgical sciences and translational Medicine, PhD Course in “translational Medicine and oncology”, sapienza university, rome, Italy; bunit of gynecologic oncology, arnas "Civico – Di Cristina – Benfratelli", Palermo, Italy; cDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical specialties (ProMIse), university of Palermo, Palermo, Italy; d2nd academic Department of obstetrics and gynaecology, Hippokration general Hospital, aristotle university of thessaloniki, thessaloníki, greece; eDepartment of surgical, oncological and oral sciences (Di.Chir.on.s.), university of Palermo, Palermo, Italy; fDepartment of Medicine, school of Medicine, nazarbayev university, nur-sultan, Kazakhstan; gDepartment of obstetrics and gynecology, lebanese american university, Beirut, lebanon
{"title":"Minimally Invasive Surgery for Cervical Cancer: Should We Look beyond Squamous Cell Carcinoma?","authors":"A. Giannini, O. D’Oria, V. Chiantera, C. Margioula-Siarkou, M. C. Di Donna, S. Terzic, Z. Sleiman, A. Laganà","doi":"10.1080/08941939.2022.2075495","DOIUrl":"https://doi.org/10.1080/08941939.2022.2075495","url":null,"abstract":"aDepartment of Medical and surgical sciences and translational Medicine, PhD Course in “translational Medicine and oncology”, sapienza university, rome, Italy; bunit of gynecologic oncology, arnas \"Civico – Di Cristina – Benfratelli\", Palermo, Italy; cDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical specialties (ProMIse), university of Palermo, Palermo, Italy; d2nd academic Department of obstetrics and gynaecology, Hippokration general Hospital, aristotle university of thessaloniki, thessaloníki, greece; eDepartment of surgical, oncological and oral sciences (Di.Chir.on.s.), university of Palermo, Palermo, Italy; fDepartment of Medicine, school of Medicine, nazarbayev university, nur-sultan, Kazakhstan; gDepartment of obstetrics and gynecology, lebanese american university, Beirut, lebanon","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1602 - 1603"},"PeriodicalIF":1.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47997388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1080/08941939.2022.2071507
K. Tsapakidis, M. Liontos, M. Tolia, N. Tsoukalas
aDepartment of oncology, university Hospital of larissa, Medical school, university of thessaly, larissa, greece; bDepartment of Clinical therapeutics, “alexandra” Hospital, national and Kapodistrian university of athens, athens, greece; cDepartment of radiotherapy, school of Medicine, university of Crete, Heraklion, greece; dDepartment of oncology, 401 general Military Hospital of athens, athens, greece
{"title":"A Proposed Nomogram Model for Recurrence of Non-Muscle Invasive Bladder Carcinoma","authors":"K. Tsapakidis, M. Liontos, M. Tolia, N. Tsoukalas","doi":"10.1080/08941939.2022.2071507","DOIUrl":"https://doi.org/10.1080/08941939.2022.2071507","url":null,"abstract":"aDepartment of oncology, university Hospital of larissa, Medical school, university of thessaly, larissa, greece; bDepartment of Clinical therapeutics, “alexandra” Hospital, national and Kapodistrian university of athens, athens, greece; cDepartment of radiotherapy, school of Medicine, university of Crete, Heraklion, greece; dDepartment of oncology, 401 general Military Hospital of athens, athens, greece","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1610 - 1611"},"PeriodicalIF":1.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42015404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.1080/08941939.2022.2071508
D. Castellani
Prostate cancer (PCa) is the second most common cancer worldwide, with an estimated incidence of 30.7 new cases per 100,000 men in 2020 [1]. The highest incidence rates were reported in Northern and Western Europe, the Caribbean, Australia, and New Zealand [2]. PCa shows a steady increase with age but a non-neglectable number of men aged 20–50 years are currently diagnosed and die of PCa, with an estimated worldwide number of deaths of 2770 men in 2020 in this range of age [1]. Li et. al established nomograms to predict overall and cancer-specific survival in PCa patients aged <50 years at diagnosis [3]. The authors used data from The Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. 8259 patients were included and randomly divided into two groups (training and validation group) at a ratio of 7:3. In multivariate analysis, race, marital status, summary stage, American Joint Committee on Cancer (AJCC) stage, lymph node stage, biopsy Gleason score, and treatment were significantly associated with overall survival, whereas AJCC stage, lymph node stage, biopsy Gleason score, and treatment were associated with cancer-specific survival. The above variables were used to build nomograms aiming to predict 5-, 8-, and 10-year overall and cancer-specific survival. Using receiver operating characteristic curve analysis, the authors found that the discriminative ability of their nomograms was moderately accurate in predicting overall survival and highly accurate in predicting cancer-specific survival. The performance of nomograms was confirmed by the validation group. Nomograms are currently widely used in urologic oncology, particularly in the decision-making process and patient counseling [4]. In the diagnostic phase, nomograms using clinical parameters are useful to assess the risk of clinically significant PCa at biopsy [4], and nomograms that include multiparametric magnetic resonance imaging data have been recently introduced [5,6]. Post-diagnosis decision-making is a crucial aspect in PCa patients, mostly to stratify the risk of progression and to offer advice on the possible management of clinically localized disease [4]. Post-treatment prognostic nomograms were also developed for detecting patients at risk of lymph node invasion, presence of positive surgical, margin, extracapsular extension, and biochemical recurrence after radical prostatectomy [7]. Prognostic nomograms are more accurate than staging systems in predicting the progression of PCa. Being continuous prediction methods, nomograms are more appropriate to predict progression compared with staging systems, because grouping patients predisposes to reduce the predictive accuracy of a prognostic model [8]. In fact, Liu et al. confirmed that the constructed nomograms demonstrated to have a better predictive ability in predicting overall and cancer-specific survival than AJCC TNM and Gleason score [3]. Notably, their analysis failed to show any influence of base
{"title":"Prostate Cancer Nomograms Are Still Alive","authors":"D. Castellani","doi":"10.1080/08941939.2022.2071508","DOIUrl":"https://doi.org/10.1080/08941939.2022.2071508","url":null,"abstract":"Prostate cancer (PCa) is the second most common cancer worldwide, with an estimated incidence of 30.7 new cases per 100,000 men in 2020 [1]. The highest incidence rates were reported in Northern and Western Europe, the Caribbean, Australia, and New Zealand [2]. PCa shows a steady increase with age but a non-neglectable number of men aged 20–50 years are currently diagnosed and die of PCa, with an estimated worldwide number of deaths of 2770 men in 2020 in this range of age [1]. Li et. al established nomograms to predict overall and cancer-specific survival in PCa patients aged <50 years at diagnosis [3]. The authors used data from The Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. 8259 patients were included and randomly divided into two groups (training and validation group) at a ratio of 7:3. In multivariate analysis, race, marital status, summary stage, American Joint Committee on Cancer (AJCC) stage, lymph node stage, biopsy Gleason score, and treatment were significantly associated with overall survival, whereas AJCC stage, lymph node stage, biopsy Gleason score, and treatment were associated with cancer-specific survival. The above variables were used to build nomograms aiming to predict 5-, 8-, and 10-year overall and cancer-specific survival. Using receiver operating characteristic curve analysis, the authors found that the discriminative ability of their nomograms was moderately accurate in predicting overall survival and highly accurate in predicting cancer-specific survival. The performance of nomograms was confirmed by the validation group. Nomograms are currently widely used in urologic oncology, particularly in the decision-making process and patient counseling [4]. In the diagnostic phase, nomograms using clinical parameters are useful to assess the risk of clinically significant PCa at biopsy [4], and nomograms that include multiparametric magnetic resonance imaging data have been recently introduced [5,6]. Post-diagnosis decision-making is a crucial aspect in PCa patients, mostly to stratify the risk of progression and to offer advice on the possible management of clinically localized disease [4]. Post-treatment prognostic nomograms were also developed for detecting patients at risk of lymph node invasion, presence of positive surgical, margin, extracapsular extension, and biochemical recurrence after radical prostatectomy [7]. Prognostic nomograms are more accurate than staging systems in predicting the progression of PCa. Being continuous prediction methods, nomograms are more appropriate to predict progression compared with staging systems, because grouping patients predisposes to reduce the predictive accuracy of a prognostic model [8]. In fact, Liu et al. confirmed that the constructed nomograms demonstrated to have a better predictive ability in predicting overall and cancer-specific survival than AJCC TNM and Gleason score [3]. Notably, their analysis failed to show any influence of base","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1591 - 1592"},"PeriodicalIF":1.9,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45984728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/08941939.2022.2069306
Quanhe Long, Ya Xu, G. Ma, Weizheng Mao
Abstract Objective To investigate the prognostic value of tumor deposits (TDs) counts in stage III colorectal cancer (CRC) patients and develop a prognostic nomogram. Methods Data on stage III CRC patients from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier analysis was used to assess differences in survival outcomes among patients. The Cox regression analysis was performed to establish the independent prognostic factors for cancer-specific survival and to establish a nomogram. The nomograms’ performance was evaluated by calibration plots and concordance index (C-index). Decision curve analysis (DCA) was used to assess the clinical utility of the prediction model. Results A total of 23,345 CRC patients were included in this study, and 3,578 (15.3%) had TDs. Cox multivariate regression analyses revealed that age, race, histological tumor grade, the administered chemotherapy, pathological type, T-stage, CEA, N-stage, peripheral nerve invasion, and TDs were independent prognostic factors. Patients with many TDs (=0/1–4, HR: 1.325,/≥5 HR: 2.223) had poorer cancer-specific survival. The prognostic value of the number of TDs was comparable to that of lymph node metastasis. The C-indices of the nomogram were superior to TNM staging in training (0.730 vs 0.646) and validation (0.714 vs 0.636) groups. DCA revealed that the nomogram had a higher clinical net benefit compared to TNM staging. Conclusions TDs count is an adverse prognostic factor for stage III CRC patients. Furthermore, the TDs-based nomogram can accurately predict the prognostic outcomes for stage III CRC.
摘要目的探讨肿瘤沉积物（TDs）计数对Ⅲ期癌症（CRC）患者的预后价值，并建立预后列线图。方法从监测、流行病学和最终结果（SEER）数据库中收集2010年至2015年III期CRC患者的数据。Kaplan–Meier分析用于评估患者之间生存结果的差异。进行Cox回归分析以确定癌症特异性存活的独立预后因素并建立列线图。列线图的性能通过校准图和一致性指数（C指数）进行评估。决策曲线分析（DCA）用于评估预测模型的临床效用。结果本研究共纳入23345例CRC患者，其中3578例（15.3%）有TDs。Cox多元回归分析显示，年龄、种族、组织学肿瘤分级、化疗方案、病理类型、T分期、CEA、N分期、外周神经侵犯和TDs是独立的预后因素。有许多TDs的患者（=0/1-4，HR:1.325，/≥5 HR:2.23）具有较差的癌症特异性存活率。TDs数量的预后价值与淋巴结转移的预后价值相当。列线图的C指数优于训练组（0.730 vs 0.646）和验证组（0.714 vs 0.636）的TNM分期。DCA显示，与TNM分期相比，列线图具有更高的临床净效益。结论TDs计数是III期CRC患者的不良预后因素。此外，基于TDs的列线图可以准确预测III期CRC的预后结果。
{"title":"Prognostic Value of Tumor Deposit Counts in Patients with Stage III Colorectal Cancer: A Population-Based Study","authors":"Quanhe Long, Ya Xu, G. Ma, Weizheng Mao","doi":"10.1080/08941939.2022.2069306","DOIUrl":"https://doi.org/10.1080/08941939.2022.2069306","url":null,"abstract":"Abstract Objective To investigate the prognostic value of tumor deposits (TDs) counts in stage III colorectal cancer (CRC) patients and develop a prognostic nomogram. Methods Data on stage III CRC patients from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier analysis was used to assess differences in survival outcomes among patients. The Cox regression analysis was performed to establish the independent prognostic factors for cancer-specific survival and to establish a nomogram. The nomograms’ performance was evaluated by calibration plots and concordance index (C-index). Decision curve analysis (DCA) was used to assess the clinical utility of the prediction model. Results A total of 23,345 CRC patients were included in this study, and 3,578 (15.3%) had TDs. Cox multivariate regression analyses revealed that age, race, histological tumor grade, the administered chemotherapy, pathological type, T-stage, CEA, N-stage, peripheral nerve invasion, and TDs were independent prognostic factors. Patients with many TDs (=0/1–4, HR: 1.325,/≥5 HR: 2.223) had poorer cancer-specific survival. The prognostic value of the number of TDs was comparable to that of lymph node metastasis. The C-indices of the nomogram were superior to TNM staging in training (0.730 vs 0.646) and validation (0.714 vs 0.636) groups. DCA revealed that the nomogram had a higher clinical net benefit compared to TNM staging. Conclusions TDs count is an adverse prognostic factor for stage III CRC patients. Furthermore, the TDs-based nomogram can accurately predict the prognostic outcomes for stage III CRC.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1502 - 1509"},"PeriodicalIF":1.9,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44427886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2021-10-20DOI: 10.1080/08941939.2021.1988771
Yachong Huo, Dalong Yang, Kaitao Lai, Ji Tu, Yibo Zhu, Wenyuan Ding, Sidong Yang
Intervertebral disk (IVD) degeneration (IVDD) can cause various spinal degenerative diseases. Cumulative evidence has indicated that IVDD can result from inflammation, apoptosis, autophagy, biomechanical changes and other factors. Currently, lack of conservative treatment for degenerative spinal diseases leads to an urgent demand for clinically applicable medication to ameliorate the progression of IVDD. Resveratrol (3,5,4'-trihydroxy-trans-stilbene), a polyphenol compound extracted from red wine or grapes, has shown protective effects on IVD, alleviating the progression of IVDD. Resveratrol has been demonstrated as a scavenger of free radicals both in vivo and in vitro. The antioxidant effects of resveratrol are likely attributed to its regulation on mitochondrial dysfunction or the elimination of reactive oxygen species. This review will summarize the mechanisms of the reactive oxygen species production and elaborate the mechanisms of resveratrol in retarding IVDD progression, providing a comprehensive understanding of the antioxidant effects of resveratrol in IVD.
{"title":"Antioxidant Effects of Resveratrol in Intervertebral Disk.","authors":"Yachong Huo, Dalong Yang, Kaitao Lai, Ji Tu, Yibo Zhu, Wenyuan Ding, Sidong Yang","doi":"10.1080/08941939.2021.1988771","DOIUrl":"https://doi.org/10.1080/08941939.2021.1988771","url":null,"abstract":"<p><p>Intervertebral disk (IVD) degeneration (IVDD) can cause various spinal degenerative diseases. Cumulative evidence has indicated that IVDD can result from inflammation, apoptosis, autophagy, biomechanical changes and other factors. Currently, lack of conservative treatment for degenerative spinal diseases leads to an urgent demand for clinically applicable medication to ameliorate the progression of IVDD. Resveratrol (3,5,4'-trihydroxy-trans-stilbene), a polyphenol compound extracted from red wine or grapes, has shown protective effects on IVD, alleviating the progression of IVDD. Resveratrol has been demonstrated as a scavenger of free radicals both <i>in vivo</i> and <i>in vitro</i>. The antioxidant effects of resveratrol are likely attributed to its regulation on mitochondrial dysfunction or the elimination of reactive oxygen species. This review will summarize the mechanisms of the reactive oxygen species production and elaborate the mechanisms of resveratrol in retarding IVDD progression, providing a comprehensive understanding of the antioxidant effects of resveratrol in IVD.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 5","pages":"1135-1144"},"PeriodicalIF":1.9,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39534418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2021-10-19DOI: 10.1080/08941939.2021.1989728
Moosa Javdani, Abolfazl Barzegar, Pegah Khosravian, Mohammad Hashemnia
Aims:A controlled release drug delivery system loaded with buprenorphine and ketorolac was synthesized and used in the experimental model of bone defect and while evaluating the inflammatory response, the repair process in the defects was investigated.Materials and methods:To determine the effectiveness of the synthesized the mentioned systems, 5 groups were defined; the control group, the chitosan hydrogel receiving group (chitosan group), the ketorolac-loaded chitosan hydrogel group (ketorolac group), the buprenorphine-loaded chitosan hydrogel receiving group (buprenorphine group), and the chitosan hydrogel-loading group loaded with a combination of ketorolac and buprenorphine (ketorolac-buprenorphine group). Results:The results showed that the population of leukocytes (tWBC) and neutrophils on different days of the study in the control group compared to other groups had a significant increase (P < 0.05) while on day 7 of the study in the ketorolac group these parameters decreased significantly compared to other groups (P < 0.05). While examining the histological changes in the experimental defect created in the proximal tibia of rats at different times, some inflammatory indices such as total and differential leukocyte population, plasma concentrations of TNF-α and IL-6 were compared in different groups (P < 0.05). The various evaluated data showed that among the different groups, in the control and ketorolac-buprenorphine groups, there was the lowest and highest control of inflammatory response and bone repair, respectively.Conclusion:In the ketorolac group due to the impact of ketorolac on leukocyte populations the best bone healing can be expected among the different treatment groups.
{"title":"Evaluation of Inflammatory Response Due to Use of Controlled Release Drug Delivery System of Chitosan Hydrogel Loaded with Buprenorphine and Ketorolac in Rat with Experimental Proximal Tibial Epiphysis Defect.","authors":"Moosa Javdani, Abolfazl Barzegar, Pegah Khosravian, Mohammad Hashemnia","doi":"10.1080/08941939.2021.1989728","DOIUrl":"https://doi.org/10.1080/08941939.2021.1989728","url":null,"abstract":"<p><p><b>Aims:</b>A controlled release drug delivery system loaded with buprenorphine and ketorolac was synthesized and used in the experimental model of bone defect and while evaluating the inflammatory response, the repair process in the defects was investigated.<b>Materials and methods:</b>To determine the effectiveness of the synthesized the mentioned systems, 5 groups were defined; the control group, the chitosan hydrogel receiving group (chitosan group), the ketorolac-loaded chitosan hydrogel group (ketorolac group), the buprenorphine-loaded chitosan hydrogel receiving group (buprenorphine group), and the chitosan hydrogel-loading group loaded with a combination of ketorolac and buprenorphine (ketorolac-buprenorphine group). <b>Results:</b>The results showed that the population of leukocytes (tWBC) and neutrophils on different days of the study in the control group compared to other groups had a significant increase (<i>P</i> < 0.05) while on day 7 of the study in the ketorolac group these parameters decreased significantly compared to other groups (<i>P</i> < 0.05). While examining the histological changes in the experimental defect created in the proximal tibia of rats at different times, some inflammatory indices such as total and differential leukocyte population, plasma concentrations of TNF-α and IL-6 were compared in different groups (<i>P</i> < 0.05). The various evaluated data showed that among the different groups, in the control and ketorolac-buprenorphine groups, there was the lowest and highest control of inflammatory response and bone repair, respectively.<b>Conclusion:</b>In the ketorolac group due to the impact of ketorolac on leukocyte populations the best bone healing can be expected among the different treatment groups.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 5","pages":"996-1011"},"PeriodicalIF":1.9,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39557223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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