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Conventional Prognostic Factors (conventional + prognostic_factor)
Selected AbstractsIncreased Expression of Laminin-5 and Its Prognostic Significance in Hypopharyngeal Cancer,THE LARYNGOSCOPE, Issue 7 2004Meijin Nakayama MD Objectives: We investigated the clinicopathologic significance of laminin-5 ,2 chain (LN,2) expression in 26 surgically removed hypopharyngeal cancers and compared the results with conventional prognostic factors elicited from hematoxylin-eosin (H&E) stained whole-mount laryngeal sections. Study Design: Stainability of LN,2 was mainly evaluated at the invasive front of the cancer nests. Scoring was performed on the basis of a semiquantitative scale defined according to the number of immunopositive cancer cells (score 3, 2, 1, and 0). Stainability of LN,2 was also evaluated macroscopically at different tumor locations such as surface center, interstitial space, and invasive front. Status of cartilage and vascular invasion and patterns of tumor extension were evaluated from H&E stained sections. The results of LN,2 expression correlated with the tumor stages, neck node status, pathologic differentiation, and prognoses. Results: Among the 26 cases, 24 demonstrated positive LN,2 expression. Of these cases, 1, 14, 9, and 0 showed scores of 3, 2, 1, and 0, respectively. Positive expression of LN,2 at the invasive front was more prominent in the high-expression group, and surface center was often positive in the cases of low-expression group. Among the H&E stained prognostic factors, vascular invasion and infiltrative pattern demonstrated significant correlations with clinical outcome. Vascular invasion and infiltrative pattern were also closely related to positive LN,2 expression. Five-year survival rates of patients who showed high LN,2 expression were significantly poorer than in patients with low expression. Conclusion: Hypopharyngeal cancers positive for LN,2 indicate a considerable risk for cancer progression and are closely related to prognosis. Increased LN,2 expression might be a prognostic indicator for squamous cell carcinomas of the hypopharynx. [source] Expression of potential molecular markers in renal cell carcinoma: impact on clinicopathological outcomes in patients undergoing radical nephrectomyBJU INTERNATIONAL, Issue 7 2009Iori Sakai OBJECTIVES To evaluate the expression levels of several potential molecular markers in renal cell carcinoma (RCC), to clarify the significance of these markers as prognostic predictors in patients undergoing radical nephrectomy (RN). PATIENTS AND METHODS The study included 153 patients with clinically organ-confined RCC undergoing RN. Expression levels of 12 proteins, including Aurora-A, Bcl-2, Bcl-xL, clusterin, heat-shock protein 27 (HSP27), HSP70, HSP90, Ki-67, matrix metalloproteinase (MMP)-2 and -9, p53 and vascular endothelial growth factor, in RN specimens obtained from these 153 patients were measured by immunohistochemical staining. RESULTS Of the 12 markers, clusterin, HSP27, Ki-67, MMP-2 and -9 expression were significantly associated with several conventional prognostic factors. Univariate analysis also identified these five markers as significant predictors of disease recurrence, while mode of presentation, pathological stage, grade and microvascular invasion were also significant. Of these significant factors, Ki-67 expression, pathological stage and microvascular invasion appeared to be independently related to disease recurrence. Furthermore, there were significant differences in recurrence-free survival according to positive numbers of these three independent factors, i.e. disease recurred in four of 56 patients who were negative for risk factors (7%), 17 of 71 positive for one risk factor (24%), and 20 of 26 positive for two or three risk factors (77%). CONCLUSIONS Combined evaluation of Ki-67 expression, pathological stage and microvascular invasion would be particularly useful for further refinement of the system for predicting the outcome after RN for patients with RCC. [source] Prognostic value of the expression of Ki-67, CD44 and vascular endothelial growth factor, and microvessel invasion, in renal cell carcinomaBJU INTERNATIONAL, Issue 7 2004E. Yildiz OBJECTIVE To determine if use of cell proliferation, cell adhesion, level of angiogenesis-related factors and presence of microscopic vascular invasion (MVI) could better predict the biological behaviour of renal cell carcinoma (RCC), which has a widely variable clinical outcome despite the use of conventional prognostic factors (staging and grading). MATERIALS AND METHODS The expression of Ki-67, CD44H and vascular endothelial growth factor (VEGF) were assessed immunohistochemically in formalin-fixed, paraffin-embedded tissues from 48 RCCs, using a Ki-67 labelling index (LI), CD44 LI and level of VEGF expression, respectively. In addition all the pathological slides were reviewed retrospectively for the presence and absence of MVI. The prognostic value of all the variables assessed was then evaluated, and correlated with the usual prognostic variables and cancer-specific survival. RESULTS Univariate analysis of cancer-specific survival showed that tumour stage (P < 0.001), tumour size (P = 0.005), metastasis, MVI, Ki-67 LI, CD44H LI and VEGF expression (all P < 0.001) were predictors of tumour-related death. There was a statistical correlation between CD44H LI and each of Ki-67 LI (r = 0.61), expression level of VEGF (r = 0.72) and presence of MVI (r = 0.71). Independent predictors of cancer-specific survival in a multivariate analysis were: in all patients with RCC, the MVI (P = 0.003) and VEGF expression (P = 0.01); in those with no metastases, MVI (P = 0.01); in patients with no MVI, VEGF (P = 0.04); and in patients with MVI, Ki-67 LI (P = 0.003). No independent predictor was identified in patient with metastases. CONCLUSION This study suggests that cell proliferation, cell adhesion, the level of VEGF expression and the presence of MVI represent a complex tumour-host interaction that may favour the progression of RCC. Cell proliferation, CD44H and VEGF expression appear to be powerful markers for identifying patients with an adverse prognosis. [source] Time to disease recurrence in basal-type breast cancers,CANCER, Issue 21 2009Effects of tumor size, lymph node status Abstract BACKGROUND: Basal-like breast cancers are a subgroup of breast cancers defined by the absence of staining for estrogen-receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2/neu) and by positive staining for the cytokeratins (CKs) expressed in the myoepithelial cells of the ducts and lobules (CK5/CK6, CK14) and for epidermal growth factor receptor (EGFR). This class of tumors has an unusually aggressive course, and it is not clear whether conventional prognostic factors for breast cancers also predict outcome for patients who have the basal phenotype. METHODS: A panel of 962 breast cancers was stained for 5 markers (ER, PR, HER-2/neu, CK5/CK6, and EGFR). The patients were followed for clinical outcomes for up to 15 years from diagnosis, and the rates of distant disease recurrence and death were compared by tumor size (,2 cm or >2 cm) and by lymph node status within the subgroups of women with basal and nonbasal cancers. RESULTS: Of the 962 women with breast cancer, 116 cancers were basal (12%), 845 were nonbasal (88%), and 1 could not be classified as either basal or nonbasal and was excluded. In total, 426 tumors measured ,2 cm (45%), and 530 tumors measured >2 cm (55%). Among women with nonbasal cancers, large tumor size was an adverse prognostic factor. Among women with basal cancers, a transient adverse effect of size on disease recurrence was observed; however, after 10 years, mortality rates were equal for women with small tumors and women with large tumors. CONCLUSIONS: Among women with basal breast cancers, the long-term prognosis was similar for women with large tumors and women with small tumors. However, women with large basal tumors appeared to develop recurrent disease sooner. Cancer 2009. © 2009 American Cancer Society. [source] | ||||||||||