scholarly journals A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110279
Author(s):  
Qinping Guo ◽  
Yinquan Wang ◽  
Jie An ◽  
Siben Wang ◽  
Xiushan Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell ◽  
Independent Risk Factors

Background: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). Methods: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. Results: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. Conclusion: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

scholarly journals Prognostic Nomograms for Nonelderly Adults with Gastric Signet Ring Cell Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Hui Wang ◽  
Yao Peng ◽  
Qi Huang ◽  
Jingjing Wu ◽  
Mingjun Zhang
Keyword(s):  
Cell Carcinoma ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Assessment Model ◽  
Survival Prediction ◽  
Cox Regression Analysis ◽  
Calibration Curves ◽  
Signet Ring ◽  
Ring Cell

Background. Nomograms were established to predict the survival for gastric signet ring cell carcinoma (GSRC) in young and middle-aged adults. Material and Methods. Eligible patients with GSRC from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into a training and a testing cohort in proportion. Independent prognostic factors were picked by univariate and multivariate Cox regression analysis to set up nomograms. The predictive effect and clinical value of nomograms were evaluated by the concordance index (C-index), calibration curves, and receiver operating characteristic curve (ROC). Results. A total of 1686 GSRC patients were subsumed into this case for analysis, including a training ( n = 1180 ) and a testing cohort ( n = 506 ). Independent risk factors related to overall survival (OS) and cancer-specific survival (CSS) comprised of race, TNM stage, tumor size, number of positive lymph nodes (PLNE), and chemotherapy. For OS, the C-indexes of the training and testing cohorts were 0.737 and 0.752, while for CSS, C-indexes were, respectively, 0.749 and 0.751. These revealed that nomograms accurately predicted OS and CSS. Calibration curves and ROC demonstrated the apparent superiority of nomograms. Conclusion. We built a well-understood and comprehensive prognostic assessment model for GSRC, which provided an individualized survival prediction in the form of a quantitative score that can be considered for clinical practice.

scholarly journals Anatomic Subsites and Prognosis of Gastric Signet Ring Cell Carcinoma: A SEER Population-based 1:1 Propensity-matched Study

2021 ◽  
Author(s):  
Yangyang Xie ◽  
Xue Song ◽  
Haimin Jin ◽  
Zhongkai Ni ◽  
Xiaowen Li ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Mortality Risk ◽  
Cox Regression ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Dismal Prognosis ◽  
Signet Ring ◽  
Ring Cell

Abstract Background: The dismal prognosis of gastric signet ring cell carcinoma (GSRC) is a global problem. The current study is conducted to comprehensively evaluate clinicopathological features and survival outcomes in GSRC patients stratified by anatomic subsites. Then predictive nomograms are constructed and validated to improve the effectiveness of personalized management.Method: The patients diagnosed with GSRC were recruited from the online SEER database. The influence of anatomic subsites on overall survival (OS) and cancer-specific survival (CSS) was evaluated using multivariate Cox regression and Kaplan-Meier analysis. Then we employed propensity score matching (PSM) technique to decrease selection bias and balance patients’ epidemiological factors. Predictive nomograms were constructed and validated.Results: Multivariate Cox regression demonstrated that the patients with overlapping gastric cancer (OGC) suffered the highest mortality risk for OS (HR, 1.29; 95%CI, 1.23-1.36; P<0.001) and CSS (HR, 1.33; 95%CI, 1.28-1.37; P<0.001). Age, TNM stage, tumor localization, tumor size, surgery and chemotherapy presented a highly significant relationship with OS and CSS. Following subgroup and PSM analysis, OGC patients were confirmed to have the worst OS and CSS. Then nomograms predicting 6 months, 12 months and 36 months OS and CSS were constructed. The calibration curves and reveiver operating characteristic curves demonstrated the great performance of the nomograms.Conclusion: We identified anatomic subsites as a predictor of survival in those with GSRC. Patients with OGC suffered the highest mortality risk. The proposed nomograms allowed a relatively accurate survival prediction for GSRC patients.

Risk Factors for Lymph Node Metastasis in Early Gastric Cancer with Signet Ring Cell Carcinoma

2015 ◽  
Vol 19 (11) ◽  
pp. 1958-1965 ◽  
Author(s):  
Chun Guang Guo ◽  
Dong Bing Zhao ◽  
Qian Liu ◽  
Zhi Xiang Zhou ◽  
Ping Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Node Metastasis ◽  
Signet Ring ◽  
Ring Cell

Effect of signet-ring cell carcinoma histology on bladder cancer outcome.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 275-275
Author(s):  
J. Wang ◽  
F. Wang ◽  
C. A. Enke
Keyword(s):  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
High Grade ◽  
Cancer Specific Survival ◽  
Data Set ◽  
Cox Regression Analysis ◽  
Signet Ring ◽  
Ring Cell

275 Background: Signet-ring cell carcinoma (SRCC) of the urinary bladder is a rare entity. Recent case series of the condition showed inconsistent results. We used a population-based data set to compare the cancer specific survival of patients with signet-ring cell carcinoma vs. transitional cell carcinoma (TCC) of the urinary bladder. Methods: Signet-ring cell carcinoma of the urinary bladder and transitional carcinoma of the urinary bladder were identified in the Surveillance, Epidemiology and End Results program (2001 to 2004). Demographic and pathological characteristics at diagnosis were compared. Differences in cancer specific survival were compared with univariate and multivariate Cox regression analysis. Results: A total of 103 SRCC cases were present in the database from 2001 to 2004. In that time 14,648 cases TCC cases were diagnosed. SRCC was more common in younger than in older patients (p <0.001); more commonly presented with high grade histology (p <0.001) and advanced stage disease (p <0.001). The 3-year cancer specific survival rate was 67.0% and 33.2% for TCC and SRCC, respectively. On multivariate analysis there was an increased mortality risk in patients with SRCC vs TCC (HR 1.42, 95% CI 1.03–1.97, p <0.001). When only high grade cases of SRCC and TCC were compared, the risk was still worse in SRCC (HR 1.430, 95% CI 1.035–1.976, 0.03). When only local stage of SRCC and TCC were compared, the risk was worse in SRCC (HR 4.294, 95% CI 1.035–17.825, 0.045). Limited to patient who underwent cystectomy only, the difference in cancer specific survival disappeared (HR 1.289, 95% CI 0.771–2.155, 0.33). Conclusions: Even after adjusting for demographic, pathological and treatment factors, cancer specific survival is significantly worse in patients with SRCC than TCC. Further research into the biology of this rare tumor is required to explain these results. No significant financial relationships to disclose.

scholarly journals Cox Regression Analysis of 1739 Emergency Trauma Patients

2020 ◽  
Author(s):  
Jun Shen ◽  
Feng Xu ◽  
Du Chen
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Oxygen Saturation ◽  
Cox Regression ◽  
Trauma Patients ◽  
Term Survival ◽  
Cox Regression Analysis ◽  
Revised Trauma Score ◽  
Independent Risk Factors ◽  
Trauma Score

Abstract BACKGROUND: Trauma is a damage caused by physical harm from external source. It has been one of the major causes of mortality. The purpose of this study was to explore the risk factors related to mortality among emergency trauma patients. METHODS: This was a retrospective study in trauma center of the First Affiliated Hospital of Soochow University. The data were obtained from trauma database with patients registered from November 1, 2016 to November 30, 2019.Shapiro–Wilk test, Mann-Whitney test and Likelihood-ratio Chi squared test were used to assess the survival pattern. Cox regressions were performed to calculate the hazard ratios (HRs) of variables for death. RESULTS: The total 1739 emergency trauma patients, 44 (2.53%) died during the study period and 1695 (97.47%) were survival. Through univariable and multivariable Cox regression analysis, three independent risk factors for emergency death were screened out: pulse (Crude HR: 0.97, 95% Confidence Interval [CI]: 0.96-0.98; Adjuste HR: 1.04, 95% CI: 1.02-1.06), pulse oxygen saturation (Crude HR: 0.96, 95% CI: 0.95-0.97; Adjuste HR: 0.94, 95% CI: 0.91-0.97) and Revised Trauma Score (Crude HR: 0.69, 95% CI: 0.65-0.74; Adjuste HR: 0.79, 95% CI: 0.64-0.97).CONCLUSION: The survival outcome of emergency trauma patients was influenced by many factors. Pulse, pulse oxygen saturation (SpO2 ) and Revised Trauma Score (RTS) were the independent risk factors for mortality. Accurate analysis and judgment of the risk factors can improve cure efficiency and long-term survival rate.

scholarly journals Using nomograms to predict prognostic factors in young colorectal mucinous and signet-ring cell adenocarcinoma patients

2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Baochun Wang ◽  
Juntao Zeng ◽  
Yuren Liu
Keyword(s):  
Patient Population ◽  
Cox Regression ◽  
Young Patients ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Signet Ring Cell Adenocarcinoma ◽  
Kaplan Meier ◽  
Signet Ring ◽  
Ring Cell

Abstract Due to insufficient quantitative evaluation of the clinic-pathological features and prognosis of young colorectal cancer (CRC) with mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRC), the aim of our study was to develop a nomogram to identify the prognostic predictors for overall survival (OS) in this patient population. We retrospectively evaluated the patient records of MAC and SRC patients aged ≤ 40 years. Kaplan–Meier analysis and log-rank testing were performed to estimate OS. A nomogram predicting OS was created for risk quantitation and decision tree analysis was performed for patient grouping. With a median follow-up of 36.5 months, we included a total of 90 young CRC patients for analysis. The overall cumulate 5-year OS rate was 57.7% (95% confidence interval (CI): 45.1–68.5%). The estimated 5-year OS was 62.9% (95% CI: 48.5–74.3%) for MAC and 37.3% (95% CI: 14.4–61.2%) for SRC (P=0.021). The recurrence rate was significantly greater in the SRC group compared with the mucinous group (52.4 compared with 26.1%, P=0.047). In the multivariate Cox regression model, preoperative carcinoembryonic antigen (CEA) levels and cycles of adjuvant chemotherapy (CT) were found to be an independent prognostic factor for OS (hazard ratio (HR): 2.43; 95% CI: 1.13–5.62, P=0.024; HR: 0.21; 95% CI: 0.083–0.57, P=0.002, respectively). Nomograms predicting 3- and 5-year OS were established that performed well (concordance index (c-indexes) of 0.636, 95% CI: 0.549–723) for OS. For MAC and SRC disease, a greater proportion of young patients present with advanced disease, and the prognosis for young SRC patients is poorer than MAC. Furthermore, preoperative CEA levels and cycles of adjuvant CT seem to independently affect the OS in this patient population.

Coagulopathy on the first postoperative day predicting the long-term survival of traumatic brain injury patients

2020 ◽  
Author(s):  
Wenxing Cui ◽  
Shunnan Ge ◽  
Yingwu Shi ◽  
Xun Wu ◽  
Jianing Luo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Term Survival ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Independent Risk Factors ◽  
The Relationship ◽  
Underlying Risk

Abstract Objective: The purpose of this study was to identify the relationship between coagulopathy during the perioperative period (before the operation and on the first day after the operation) and the long-term survival of TBI patients undergoing surgery, as well as to explore the predisposing risk factors that may cause perioperative coagulopathy.Methods: This retrospective study included 447 TBI patients who underwent surgery from January 1, 2015 to April 25, 2019. Clinical parameters, including patient demographic characteristics, biochemical tests, perioperative coagulation function tests (before the operation and on the first day after the operation) and intraoperative factors were collected. Log-rank univariate analysis and Cox regression models were conducted to assess the relationship between perioperative coagulopathy and the long-term survival of TBI patients. Furthermore, univariate and multivariate analyses were performed to identify the underlying risk factors for perioperative coagulopathy.Results: Multivariate Cox regression analysis identified age, AIS(head) = 5, GCS ≤ 8, systolic pressure at admission < 90 mmHg and postoperative coagulopathy (all P < 0.05) as independent risk factors for survival following TBI; we were the first to identify postoperative coagulopathy as an independent risk factor. According to multivariate logistic regression analysis, for the first time, abnormal ALT and RBC at admission, preoperative coagulopathy, infusion of colloidal solution > 1100 mL and intraoperative bleeding > 950 mL (all P < 0.005) were identified as independent risk factors for postoperative coagulation following surgery after TBI.Conclusions: Those who suffered from postoperative coagulopathy due to TBI had a higher hazard for poor prognosis than those who did not. Closer attention should be paid to postoperative coagulopathy and more emphasis should be placed on managing the underlying risk factors.

Endoscopic Prediction of Tumor Invasion Depth in Early Gastric Signet Ring Cell Carcinoma

2018 ◽  
Vol 37 (3) ◽  
pp. 201-207
Author(s):  
Sun Hyung Kang ◽  
Hee Seok Moon ◽  
Jae Kyu Sung ◽  
Hyun Yong Jeong ◽  
Sae Hee Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cell Carcinoma ◽  
Scoring System ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Validation Group ◽  
Depth Prediction ◽  
Mucosal Change ◽  
Signet Ring ◽  
Ring Cell

Introduction: Signet ring cell carcinoma (SRC) is a poorly differentiated cancer of the stomach. Recent studies imply that early gastric SRC can be well managed by endoscopic resection. Unfortunately, unlike differentiated cancers, the endoscopic features of early gastric SRC have not been well studied. This study evaluated the endoscopic features of early gastric SRC, as well as the risk factors for submucosal (SM) invasion. Method: The medical records of patients from 7 tertiary hospitals (Daejeon and Chungcheong province) were reviewed to examine endoscopic findings and clinical data. These patients underwent surgery or endoscopic resection between January 2011 and December 2016 and were divided into 2 groups (derivation group and validation group) in order to develop and validate an endoscopic scoring system for SM invasion. Results: In total, 331 patients (129 in the derivation group and 202 in the validation group) were enrolled in this study. In the derivation group, the risk factors for SM invasion, namely, fold convergence, nodular mucosal change, and deep depression, were identified by logistic regression analysis (ORs 3.4, 5.9, and 6.0, p < 0.05). A depth-prediction score was created by assigning 1 point for fold convergence and 2 points for other factors. When validation lesions of 0.5 point or more were diagnosed as SM invasion, the sensitivity and specificity were 76.8–78.6% and 61.6–74.7% respectively. Conclusion: Fold convergence, nodular mucosal change, and deep depression are risk factors for SM invasion in early gastric SRC. Our depth-prediction scoring system may be useful for differentiating SM cancers.

scholarly journals Characteristic and Early Discontinuation of Obsessive-Compulsive Disorder Trials Registered on ClinicalTrials.gov

2021 ◽  
Vol 12 ◽  
Author(s):  
Shanxia Luo ◽  
Qiong Guo ◽  
Liu Yang ◽  
Yifan Cheng ◽  
Youlin Long ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Obsessive Compulsive Disorder ◽  
Cox Regression ◽  
Drug Trials ◽  
Obsessive Compulsive ◽  
Early Discontinuation ◽  
Cox Regression Analysis ◽  
Compulsive Disorder ◽  
Independent Risk Factors

Objective: This study aimed to analyze the characteristics and reasons of early discontinuation of obsessive-compulsive disorder (OCD) trials registered on ClinicalTrials.gov.Methods: OCD trials and relevant publications were searched on ClinicalTrials.gov and PubMed, respectively. The characteristics and details regarding the timely publication of trials were recorded. Cox regression analysis was used to explore factors associated with the early discontinuation of OCD trials.Results: The analysis included 298 OCD therapy trials. Most investigations recruited &lt;100 patients and were more likely to involve adults. Of all OCD studies identified, 67.8% were randomized and 61.4% were blind (single- or double-blind). Universities and hospitals were recorded as the two primary locations in the majority of trials. A total of 155 trials (52%) were completed; however, only 29% of those were published. Of the published trials, &gt;70% were published at least 1 year after completion. Behavioral therapy trials were the most common type of major treatment-aimed OCD trials (39%), followed by drug trials (35.1%) and device/procedure trials (24.7%). The univariate Cox regression analysis indicated that drug trials [hazard ratio (HR) = 2.56, 95% confidence interval (CI): 1.21–5.43], absence of collaborators (HR = 3.87, 95% CI: 1.62–9.26), and sponsorship by industry (HR = 3.97, 95% CI: 1.49–10.53) were risk factors for early discontinuation of OCD trials. Further multivariate Cox regression showed that drug trials (HR = 3.93, 95% CI: 1.71–9.08) and absence of collaborators (HR = 5.17, 95% CI: 1.97–13.54) were independent risk factors for early trial discontinuation of OCD trials. The sensitivity analysis confirmed these results. Non-drug trials (OR = 3.32, 95% CI: 1.21–9.11), absence of collaborators (OR = 3.25, 95% CI: 1.10–9.60), and non-blinded trials (OR = 5.23, 95% CI: 1.05–26.2) were independent risk factors for unreported results in registry.Conclusion: The diagnosis and prevention of OCD are rarely investigated in trials. Underreporting and delayed reporting remain major problems. The type of intervention and participation of collaborators are associated with early discontinuation of OCD trials.

Effect of cumulative dexamethasone dose during concomitant chemoradiation on lymphopenia in patients with newly diagnosed glioblastoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14533-e14533
Author(s):  
Stephen Ahn ◽  
Jae-Sung Park ◽  
Jin Ho Song ◽  
Sin-Soo Jeun ◽  
Yong-Kil Hong
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Cox Regression ◽  
Performance Status ◽  
Multivariate Logistic Regression Analysis ◽  
Newly Diagnosed ◽  
Cox Regression Analysis ◽  
Female Sex ◽  
Concomitant Chemoradiation ◽  
Independent Risk Factors

e14533 Background: Lymphopenia frequently occurs after concomitant chemoradiation (CCRT) in patients with glioblastoma (GBM) and is associated with worse overall survival (OS). A few studies have tried to identify risk factors for lymphopenia; however, the results were not clear. We aimed to identify potential risk factors for lymphopenia, focusing on the use of dexamethasone to control cerebral edema in patients with GBM. Methods: The electronic medical records of 180 patients with newly diagnosed GBM treated at our institution between 2009 and 2017 were retrospectively examined. Acute lymphopenia was defined as TLC (total lymphocyte count) less than 1,000 cells/mm3 at 4 weeks after completion of CCRT. Multivariate logistic regression analysis was used to identify independent risk factors for lymphopenia, and Cox regression analysis was used to identify independent risk factors for OS. Results: Of the 125 eligible patients, 40 patients (32.0%) developed acute lymphopenia. Female sex and median daily dexamethasone dose > 2mg after initiation of CCRT were independent risk factors for acute lymphopenia on multivariate analysis. Acute lymphopenia, extent of surgical resection, and performance status were associated with OS; however, dexamethasone use itself was not an independent risk factor for poor OS. Conclusions: Female sex, median daily dexamethasone dose > 2 mg after initiation of CCRT until four weeks after completion of CCRT may be associated with acute lymphopenia. However, dexamethasone use itself did not affect OS in patients newly diagnosed with GBM. These results should be validated by further prospective studies controlling for other confounding factors.

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