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Prognostic Parameters (prognostic + parameter)
Selected AbstractsThe Intraductal Carcinoma Component Is a Significant Prognostic Parameter in Patients with Invasive Ductal Carcinoma of the PancreasCANCER SCIENCE, Issue 10 2002Hiroshi Kawahira We have sometimes encountered invasive ductal carcinomas (IDCs) of the pancreas containing intraductal carcinoma components in the intra- and/or extra-tumor area. The purpose of this study was to investigate whether intraductal carcinoma components would be useful for predicting the outcome of IDC patients. Forty-seven surgically treated IDCs were examined, and all histological tumor sections were stained with Elastica to accurately confirm intraductal carcinoma components. Well-known clinicopathological parameters that exhibited a significant correlation in the univariate analyses for predicting disease-free survival (DFS) and overall survival (OS) were entered into the Cox proportional hazard multivariate analysis. Since the lowest P -value predicting DFS or OS periods was observed in IDCs with more than 10% intraductal carcinoma components and those with 10% or less intraductal carcinoma components (P=0.028 and P=0.019), we established the cutoff value of intraductal carcinoma components at 10%. In the multivariate analyses for DFS and OS, the presence of more than 10% intraductal carcinoma components showed a marginally significant increase in the hazard rate (HR) of tumor recurrence (P=0.067) and significantly increased the HR of mortality (P=0.040). The present study demonstrated that IDCs with more than 10% intraductal carcinoma components were associated with a significantly better patient outcome than those with 10% or less intraductal carcinoma components. [source] Imbalances of chromosome arm 1p in pediatric and adult germ cell tumors are caused by true allelic loss: A combined comparative genomic hybridization and microsatellite analysisGENES, CHROMOSOMES AND CANCER, Issue 11 2006Susanne Zahn Previous studies on childhood germ cell tumors (GCTs) report highly variable frequencies of losses at chromosome arm 1p. Since deletions at 1p portend a poor prognosis in other embryonal tumors, this study aims to clarify the question of the frequency of true allelic loss at 1p and whether it constitutes a prognostic parameter. We analyzed 13 GCTs from different gonadal and extragonadal sites of children (4 teratomas, 9 malignant GCTs) and 18 GCTs of adolescents and adults (3 teratomas; 15 malignant GCTs) using automated microsatellite analysis with 23 polymorphic markers and chromosomal "high resolution" comparative genomic hybridization (HR-CGH). With this combined approach, we detected loss of heterozygosity (LOH) at 1p in 8/9 childhood malignant GCTs with concordant data from HR-CGH and microsatellite analyses. In contrast, LOH at 1p was not detected in childhood teratomas (0/4) and constituted a rare event in GCTs of adolescence and adulthood (3/18). The commonly deleted region was located at distal 1p36-pter, with a proximal boundary between the markers D1S450 and D1S2870. These data unequivocally demonstrate that deletion at 1p is common in childhood GCTs and results in allelic loss. This observation argues for the presence of a classical tumor suppressor at distal 1p. Considering the high frequency of LOH at 1p and the overall favorable prognosis of childhood GCTs, a prognostic impact of LOH at 1p in childhood GCTs appears unlikely. However, since two postpubertal tumors with LOH at 1p progressed, a prognostic relevance in this age group seems possible, warranting a prospective evaluation. © 2006 Wiley-Liss, Inc. [source] Response to intraarterial induction chemotherapy: A prognostic parameter in oral and oropharyngeal cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2006Adorján F. Kovács MD Abstract Background. Patients with head and neck cancer and good pathologic response to neoadjuvant systemic induction chemotherapy have a better prognosis for survival than do those with stable or progressive disease. Thus, induction chemotherapy could theoretically help in stratifying further treatment, but toxicity is much too high. The prognostic implication of superselective intraarterial high-dose cisplatin administered by a femoral approach, which has much less toxicity, is not yet known. Methods. One hundred eighty-seven unselected consecutive patients with previously untreated oral and oropharyngeal squamous cell carcinoma received intraarterial high-dose cisplatin for induction and were assessed for response by visual examination and palpation. This treatment was followed by surgery and adjuvant radiation with concomitant systemic chemotherapy. Omission of a modality depended on individual contraindications and not on preselection. The consequence of omissions has been the constitution of several treatment arms. The overall and disease-free survival in relation to clinical local response after intraarterial induction chemotherapy was calculated using the Kaplan,Meier method. Additional analysis excluded bias caused by stages and treatment arms. Results. Explorative statistics using the log-rank and chi-square tests demonstrated a strong prognostic relevance of response to intraarterial chemotherapy irrespective of stage and treatment. Conclusions. Our results are encouraging for prospective randomized studies and molecular genetic investigations with intraarterial chemotherapy. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] A fibrotic focus is a prognostic factor and a surrogate marker for hypoxia and (lymph)angiogenesis in breast cancer: review of the literature and proposal on the criteria of evaluationHISTOPATHOLOGY, Issue 4 2007G G Van den Eynden A fibrotic focus is a scar-like area in the centre of a carcinoma and can be regarded as a focus of exaggerated reactive tumour stroma formation. Although modern surgical pathology uses different histopathological and molecular markers to assess the aggressiveness and predict the behaviour of malignant tumours, markers reflecting stromal cell behaviour and interactions between epithelial cells and stromal cells are scarce. In this review we summarize all studies investigating the value of a fibrotic focus as a prognostic factor and as a surrogate marker for hypoxia and (lymph)angiogenesis in patients with breast cancer. These data show that a fibrotic focus can be used as a practical, easily assessable and reproducible integrative histological prognostic parameter in breast cancer. We propose a consensus methodology to assess the fibrotic focus in breast cancer. [source] Possible predictive factors for ICSI?ANDROLOGIA, Issue 4 2003Molecular biology techniques in combination with therapeutic testicular biopsies Summary. Applying intracytoplasmic sperm injection (ICSI), the selection of an unsuccessful spermatozoon results in great emotional consequences for the couple. Therefore, there is a need for a prognostic parameter to estimate their chances for successful fertility treatment. This review summarizes both the main reasons for spermatogenic impairment, and possible predictive factors for successful sperm retrieval applying testicular sperm extraction and outcome of ICSI. While basic sperm parameters, aetiology and type of spermatozoa, and serum follicle-stimulating hormone and inhibin levels have been shown to be unrelated to the outcome of ICSI, Y-chromosome microdeletions are known to have a negative influence on the fertilizing capacity of spermatozoa. Recently, a significant correlation has been reported between the protamine-1 to protamine-2 mRNA ratio in haploid spermatids of testicular biopsies and the ability of spermatozoa for successful fertilization of an oocyte. In future, both the outstanding role of the haploid spermatids and the involvement of molecular biological techniques will improve the role of therapeutic testicular biopsies. [source] Axillary staging during surgery for breast cancerBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2007C. K. Axelsson Background: Axillary lymph node status remains the single most important prognostic parameter in patients with breast cancer. In approximately half of operations sentinel lymph node biopsy cannot be employed and axillary dissection is indicated. Retrieval of ten nodes has hitherto been considered sufficient, but it remains questionable whether the removal of more lymph nodes might improve staging. Methods: Data from 31 679 breast cancer operations in Denmark were analysed. Results: The number of axillary lymph nodes retrieved was an independent and strong predictor of node positivity. The more lymph nodes retrieved, the better the staging of the disease; this was evident for all sizes of tumour. Dissection of 20 or more nodes rather than ten to 14 increased the probability of node positivity from 14·2 to 25·9 per cent for 1,5-mm tumours, from 38·6 to 47·9 per cent for 11,20-mm tumours, and from 80·6 to 90·0 per cent for tumours with diameter greater than 50 mm. Conclusion: The number of metastatic lymph nodes increased as more nodes were retrieved. These findings underline the need for high-quality specialist surgical and pathological services in breast cancer treatment. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Frequency and prognostic relevance of cyclin D1 dysregulation in multiple myelomaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5-6 2001Thomas Rasmussen Abstract:Objective: Cyclin D1 dysregulation has been found with varying frequencies in multiple myeloma (MM) and has been suggested to be associated with a poor prognosis. The aim of this study was to investigate the frequency of cyclin D1 dysregulation in patients being treated for MM and to test whether cyclin D1 dysregulation is a prognostic factor for MM patients. Methods: To achieve the above aims we designed a highly sensitive and reproducible real-time reverse-transcription polymerase chain reaction (RT-PCR) assay for quantitation of cyclin D1 mRNA. Using this assay, 110 diagnostic bone marrow (BM) samples from patients with MM were screened for cyclin D1 dysfuntion. Results: The real-time assay was able to detect the presence of 0.01% cyclin D1 positive cells allowing a safe detection in MM BM samples. In 42% (46/110) of MM BM samples a ,,3-fold increase in cyclin D1 mRNA was observed compared to the cyclin D1 level in normal BM. In the remaining group of MM patients the cyclin D1 mRNA levels were comparable to normal donors. Follow-up of 76 MM patients showed no significant (P = 0.35) difference in survival between cyclin D1 positive and negative MM patients. In addition, cyclin D1 dysregulation did not correlate with known prognostic factors. Conclusion: The developed real-time RT-PCR assay for detection of cyclin D1 mRNA levels offers a fast and safe screening for cyclin D1 dysfunction. When a large cohort of MM patients was screened, the cyclin D1 gene was found to be frequently dysregulated, but there was no significant correlation to survival or known prognostic parameters. [source] Chromatin assembly factor-1 (CAF-1)-mediated regulation of cell proliferation and DNA repair: a link with the biological behaviour of squamous cell carcinoma of the tongue?HISTOPATHOLOGY, Issue 7 2007S Staibano Aims:, Squamous cell carcinoma (SCC) of the tongue shows aggressive behaviour and a poor prognosis. Clinicopathological parameters fail to provide reliable prognostic information, so the search continues for new molecular markers for this tumour. Chromatin assembly factor-1 (CAF-1) plays a major role in chromatin assembly during cell replication and DNA repair and has been proposed as a new proliferation marker. The aim of this study was to investigate its expression in SCC of the tongue. Methods and results:, The immunohistochemical expression of the p60 and p150 subunits of CAF-1 were evaluated in a series of SCCs of the tongue. The findings were correlated with the expression of proliferation cell nuclear antigen (PCNA) and patients' clinicopathological and follow-up data. CAF-1/p60 was expressed in all the tumours, whereas CAF-1/p150 was down-regulated in a number of cases. Overexpression of CAF-1/p60 and down-regulation of CAF-1/p150 identified SCCs with poor outcome, in addition to the classical prognostic parameters. Conclusions:, Simultaneous CAF-1-mediated deregulation of cell proliferation and DNA repair takes place in aggressive SCC of the tongue. Therefore, the evaluation of CAF-1 expression may be a valuable tool for evaluation of the biological behaviour of these tumours. This may be relevant to the introduction of improved follow-up protocols and/or alternative therapeutic regimens. [source] Prognostic relevance of TGF-,1 and PAI-1 in cervical cancerINTERNATIONAL JOURNAL OF CANCER, Issue 6 2004Suzanne Hazelbag Abstract Cervical carcinoma is a human papilloma virus (HPV)-related immunogenic type of malignancy, in which escape of the tumor from the hosts' immune response is thought to play an important role in carcinogenesis. The multifunctional cytokine transforming growth factor-,1 (TGF-,1) is involved in immunosuppression, stroma and extracellular matrix formation and controlling (epithelial) cell growth. The plasminogen activating (PA) system plays a key role in the cascade of tumor-associated proteolysis leading to extracellular matrix degradation and stromal invasion. Changes in expression of components of this system, including plasminogen activator inhibitor-1 (PAI-1), have been associated with poor prognosis in a variety of solid tumors. The present study was undertaken to assess the role of both components on relapse, survival and other clinicopathologic parameters in cervical cancer. The expression of TGF-,1 mRNA in 108 paraffin-embedded cervical carcinomas was detected by mRNA in situ hybridization. Immunohistochemistry was used to investigate the expression of PAI-1 protein. The presence of cytoplasmatic TGF-,1 mRNA in tumor cells was not significantly correlated with the other clinicopathologic parameters investigated or with a worse (disease-free) survival. Expression of the PAI-1 protein in tumor cells was strongly correlated with worse overall and disease-free survival, in addition to well-known prognostic parameters such as lymph node metastasis, depth of tumor infiltration, tumor size and vasoinvasion. In the multivariate analysis, PAI-1 turned out to be a strong independent prognostic factor. In a subgroup of patients without lymph node metastases, PAI-1 was predictive for worse survival and relapse of disease, too. Our results show that the (enhanced) expression of PAI-1 by carcinoma cells is correlated with worse (overall and disease-free) survival of patients with cancer of the uterine cervix. The expression of TGF-,1 in itself is not associated with worse survival in these patients. Although simultaneous presence of the 2 factors was observed in all tumors, induction of PAI-1 by TGF-,1 could not be demonstrated in our group of cervical carcinomas. © 2004 Wiley-Liss, Inc. [source] Perivascular epithelioid cell tumor (PEComa) with perirenal manifestationINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2005SVEN GUNIA Abstract We present the first case report documenting an 8-month post-surgical follow-up of an exceedingly rare perivascular epithelioid cell tumor (PEComa) with a perirenal location. Furthermore, prognostic parameters discussed in the literature are summarized and concise information regarding imaging characteristics on magnetic resonance imaging is provided. In conclusion, our report points toward PEComa as a family of very rare mesenchymal neoplasms that should be included into deliberations concerning the differential diagnosis of perirenal mass lesions. [source] Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis CLIVER INTERNATIONAL, Issue 8 2008Rita Raafat Gad Abstract Objectives: To determine the clinical, biological, virological and histological predictive factors associated with a sustained virological response (SVR) to combined interferon therapy among Egyptian patients infected by genotype 4 hepatitis C virus (HCV). Patients and Methods: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed. The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR. Results: A sustained virological response was achieved among 137/250 (54.8%) patients. Baseline factors independently and negatively associated with SVR were serum ,-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.2,0.8], severe fibrosis (Metavir score >F2) (OR=0.4, 95% CI: 0.2,0.8), presence of steatosis (OR=0.5, 95% CI: 0.3,0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2,0.8). Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR. Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response. [source] Score system for elective tracheotomy in major head and neck tumour surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2005B. Kruse-Lösler Background:, This study was designed to evaluate prognostic parameters for respiratory failure after major oropharyngeal resections in head and neck cancer surgery, focusing on a score system to identify patients requiring an elective tracheotomy and to avoid tracheotomy under emergency conditions. Methods:, One hundred and fifty-two out of 928 patients with oropharyngeal cancers, treated between January 1993 and June 2000 at our hospital, fulfilled the inclusion criteria for a retrospective analysis. This collective underwent tumour resection in different regions of the oropharynx combined with bony resection of the mandible and neck dissection without primary tracheotomy. The reconstruction was accomplished using radial forearm flaps (n1 = 59) or local flaps (n2 = 93). These two groups were subdivided into patients treated post-operatively by tracheotomy due to respiratory failure (n1 = 26; n2 = 12) and those without such treatment (n1 = 33; n2 = 81). The database comprising tumour localization and size, staging, general medical condition, smoking and alcohol consumption was evaluated by logistic regression. Results:, We developed a score system which predicts the likelihood of post-operative respiratory failure. For indication of tracheotomy, tumour size and localization, multimorbidity, alcohol consumption and pathologic chest X-ray findings were identified as significant parameters with different weightings. The predictive value for tracheotomy (yes/no) using the score system was 96.7% for the total collective. Conclusion:, The decision on whether or not an elective tracheotomy in major head and neck tumour surgery is necessary can be facilitated using this score system which is based on objective facts. It may reduce post-operative complications and contribute to safer treatment. [source] Relationship between urinary profile of the endogenous steroids and postmenopausal women with stress urinary incontinenceNEUROUROLOGY AND URODYNAMICS, Issue 3 2003S.W. Bai Abstract Aims The aims of this study were to investigate whether endogenous steroid hormones are (1) related to pathogenesis of stress urinary incontinence after menopause, (2) are related to severity of stress urinary incontinence, and (3) are related to prognostic parameters of stress urinary incontinence. Methods Twenty post-partum women with clinically diagnosed stress urinary incontinence and 20 age-matched postmenopausal women without stress urinary incontinence (control group) were evaluated. We compared urinary profile of the endogenous steroid hormones patients with stress urinary incontinence and controls, and between grade I and grade II of stress urinary incontinence. We also in vestigated the relationship between urinary profile of the endogenous steroid hormones and prognostic parameters of stress urinary incontinence (maximal urethral closure pressure, functional urethral length, Valsalva leak point pressure, cough leak point pressure, posterior urethrovesical angle, bladder neck descent, and stress urethral axis). The ages of the patients and those in the control group were 64.3,±,5.6 and 57.5,±,3.8 years old and the body mass indexes were 24.96,±,3.14 and 22.11,±, 2.73 kg/m2 in patients and in normal subjects, respectively. Nine patients were grade I and 11 were grade II. Estrone and 17,-estradiol only were detected in all subjects, regardless of control or patient group. It is noteworthy that there were no significant differ ences (P,>,0.05) in the levels of estrone and 17,-estradiol in the urine of postmenopausal normal subjects compared with in the urine of postmenopausal patients with urinary incontinence. E2/E1 ratio was not different between the two groups (P,>,0.05). Among the objective steroids, DHEA, ,4 -dione, ,5 -diol, Te, DHT, 16,-DHT, 11-keto An, THDOC, and THB were not detected either in the urine of normal subjects and nor in the urine of the patients. After comparing androgen levels between normal subjects and patients, no significant differences (P>0.05) were detected, except for 5,-THB and 5,-THF. Neither 5,-THB or 5,-THF were detected in the patients' urine. Et/An (11,-OH Et/11,-OH An) concentration ratios were not significantly different between the two groups, either (P,>,0.05). There were not significant differences of concentrations (,mol/g creatinine) of urinary steroids between grade I and grade II of stress urinary incontinence. Pregnanediol was significantly related to bladder neck descent in supine and sitting positions (R,=,0.79, P,=,0.01, and R,=,0.73, P,=,0.03, respectively), and pregnanetriol was significantly related to maximal urethral closure pressure and functional urethral length (R,=,0.68, P,=,0.04, and R,=,,0.79, P,=,0.01, respectively). Androsterone was significantly related to bladder neck descent in supine and sitting positions (R,=,0.68, P,=,0.04, and R,=,0.78, P,=,0.01, respectively). 5-AT was significantly related to bladder neck descent in sitting position and stress urethral axis (R,=,0.72, P,=,0.03, and R,=,,0.71, P,=,0.03). 11-Keto Et was significantly related to bladder neck descent in supine and sitting positions and related to stress ure thral axis (R,=,0.82, P,=,0.01, and R,=,0.81, P,=,0.01, R,=,,0.67, P,=,0.04, respectively). THS was signi ficantly related to bladder neck descent in supine and sitting positions and related to stress urethral axis (R,=,0.76, P,=,0.02, and R,=,0.74, P,=,0.02, R,=,,0.68, P,=,0.04, respectively). THE was significantly related to bladder neck descent in sitting position (R,=,0.67, P,=,0.04).,-Tetrahydrocortisol/,-tetrahydrocortisol (,-THF/,-THF) and ,-cortol were significantly related to maximal urethral closure pressure and functional urethral length (R,=,0.74, P,=,0.02, and R,=,,0.92, P,=,0.01; R,=,0.71, P,=,0.36, and R,=,,0.87, P,=,0.000, respectively). 17,-Estradiol (E2) was significantly related to bladder neck descent in supine position (R,=,,0.62, P,=,0.04) and 17,-estradiol/estrone (E2/E1) was significantly related to cough leak point pressure (R,=,0.79, P,=,0.01). In conclusion, the urinary concentrations of endogenous steroid metabolites in postmenopausal patients with stress urinary incontinence were not significantly different from normal patients and were not significantly different between grade I and grade II patients with stress urinary incontinence. Some endogenous steroid metabolites were positively or negatively significantly related to prognostic parameters of stress urinary incontinence. Neurourol. Urodynam. 22:198,205, 2003. © 2003 Wiley-Liss, Inc. [source] New prognostic histological parameter of invasive ductal carcinoma of the breast: Clinicopathological significance of fibrotic focusPATHOLOGY INTERNATIONAL, Issue 4 2000Takahiro Hasebe Immunohistochemistry, DNA ploidy analysis and molecular genetics have made it possible to predict the outcome of breast cancer more precisely than routine histological examination alone. However, in routine practice, it is difficult to incorporate these methodologies in all cases. If certain histological parameters can accurately predict the outcome of patients with breast cancer, they would be more practical for routine use. We showed that the presence of fibrotic focus (FF) in invasive ductal carcinoma (IDC) is closely associated with c-erbB-2 or p53 protein expression, high proliferative activity, and high angiogenesis of the tumors. Furthermore, multivariate analyses with well-known prognostic parameters for IDC demonstrated that the presence of FF is the most useful independent parameter to predict IDC patient outcome. In addition, our data suggested that the interaction between tumor cells and stromal fibroblasts may play an important role in the formation of FF in IDC based on growth factor and growth factor receptor protein expression in the tumor cells and fibroblasts forming FF. Based on the results of our clinicopathological studies, we propose a new prognostic classification scheme for the prediction of IDC patient outcome, which consists of FF, nuclear atypia, and fat invasion. This classification has superior predicting power to existing prognostic classifications. [source] Telomerase Activity Is Upregulated in Laryngeal Squamous Cell Carcinoma,THE LARYNGOSCOPE, Issue 3 2000Aongus J. Curran MB, FRCSI Objective/Hypothesis The immortalizing enzyme telomerase has been linked to carcinogenesis and is being targeted as a novel molecular marker. This study investigated telomerase expression in patients with laryngeal squamous cell carcinoma and correlated telomerase activity with conventional prognostic parameters. Study Design A consecutive series of patients with laryngeal squamous cell carcinoma undergoing surgical salvage for persistent or progressive disease after failed radiation therapy. Methods Twenty patient samples of laryngeal squamous cell carcinoma and 20 adjacent histologically normal mucosal samples were assayed using the telomeric repeat amplification protocol (TRAP) method for detection of telomerase activity. The leukemic cell line, K562, acted as a positive control and the human fibroblast line, Hs21Fs, as a negative control. A sample was classified as telomerase positive when an RNase-sensitive hexameric repeat ladder was observed. Absence of laddering was considered a negative result. Results Seventeen of 20 (85%) tumor samples and 4 of 20 (20%) adjacent histologically normal samples were telomerase positive. No statistically significant difference was observed when densitometric readings were compared by T category, tumor grade, or site (by ANOVA). Conclusions Although telomerase activity is present in laryngeal cancer, levels of activation do not correlate with conventional parameters used for prognostication. Our study indicates that the marker may be a useful adjunctive method in the diagnosis of malignancy after radiation failure. [source] De novo renal cell carcinoma of native kidney in renal transplant recipientsCANCER, Issue 2 2005Yann Neuzillet M.D. Abstract BACKGROUND The 10-year risk of developing a solid malignancy is 20% for kidney transplant recipients. The goal of the current study was to investigate the epidemiology and the diagnostic and prognostic parameters associated with de novo malignancies of the native kidney among transplant recipients at the authors' institution (Department of Urology and Renal Transplantation, Hôpital Salvator, Marseille, France). METHODS The authors reexamined the follow-up of 933 consecutive transplant recipients at their institution between 1987 and 2003. Immunossupressive therapy was not modified in the event of malignant disease, nor was systematic radiologic monitoring of native kidneys performed. All de novo malignancies of the native kidney were included in the current analysis. RESULTS Among the 933 patients examined, a combined total of 12 malignancies of the native kidney were diagnosed in 11 individuals. For these 11 individuals, the average ages at transplantation and diagnosis were 42.5 and 49.1 years, respectively. Ten malignancies were discovered fortuitously, whereas two were symptomatic. Among the 10 renal echographies performed, there was 1 false-negative result. Tomodensitometry was performed in 11 cases and yielded no false-negative results. The average tumor size was 37 mm. Nephrectomy was performed in 10 cases, and biopsy was performed in 1. Among the 12 kidney malignancies encountered in the current study, there were 7 conventional cell carcinomas, 3 basophilic papillary carcinomas, and 2 chromophobic renal cell carcinomas. Half of all tumors were Furhman Grade 3 lesions, and pT1aN0M0 tumors (2003 TNM staging system) also accounted for half of all malignancies in the current cohort. Two affected transplant recipients died (one due to disease), and the remaining nine are alive without recurrence and with normal renal functioning (median follow-up, 39 months). CONCLUSIONS There appears to be an increased risk of malignancy of the native kidney in renal transplant recipients, with high-grade and papillary tumors being particularly common. Consequently, systematic radiologic follow-up of native kidneys must be performed for individuals who undergo kidney transplantation. Cancer 2005. © 2004 American Cancer Society. [source] Assessing macular edema- prognostic parameters by OCTACTA OPHTHALMOLOGICA, Issue 2009M DE SMET [source] Cytomorphological variations, proliferation and angiogenesis in the prognosis of cutaneous melanomaCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2003N. Jonjic Summary Depth of invasion and stage of the disease are well known prognostic indicators in cutaneous melanoma (CM). However, the role of other parameters, such as the variations in cytomorphology of melanocyte tumours, mitotic activity and angiogenesis is still open to question. The aim of this study was to analyse proliferation by mitotic activity index (MAI) and immunostaining of proliferating cell nuclear antigen (PCNA), and the intensity of neovascularization (microvessel density; MVD) in CM clinical stage I in relation to epithelioid, spindle and nevoid cell type, histological type (superficial spreading melanoma and nodular melanoma), Clark's level and Breslow thickness. Finally, the role of all parameters in the prognosis of CM was evaluated. Statistical analysis demonstrated that cytological characteristics of CM correlate only with Clark's level, while histological types correlate with MAI, PCNA and MVD. MAI and PCNA also showed correlation between groups according to Clark's level and Breslow thickness. Finally, tumour cell PCNA was found to correlate with MVD. Survival of patients with CM correlated significantly with MAI. These results suggest that cytological variation, histological type, PCNA and MVD alone are not independent prognostic parameters, whereas MAI is a potentially important prognostic marker in CM. [source] | ||||||||||||||||||||||||||||