Overall death

  • 文章类型: Journal Article
    目的:我们旨在探讨来自循环血液的Grainyhead-like2(GRHL2)表达对复发的预测价值。非小细胞肺癌(NSCLC)患者的转移和总体死亡。材料与方法:我们收集了122例非小细胞肺癌患者的血液样本。结果:校正模型II中的多变量Cox比例风险分析显示,与GRHL2阴性表达相比,NSCLC患者的阳性表达与死亡风险增加(HR=7.0,95%CI:2.1-20.9,p=0.03)和复合终点风险增加相关(HR=8.2,95%CI:4.0-27.1,p<0.01).结论:这项研究支持循环GRHL2表达升高可能被认为是这些NSCLC患者预后不良的候选预后生物标志物。
    [方框:见正文]。
    Aim: We aimed to investigate the predictive value of the Grainyhead-like 2 (GRHL2) expression from circulating blood for recurrence, metastasis and overall death on patients with non-small-cell lung cancer (NSCLC). Materials & Methods: We collected blood samples from 122 patients who were admitted to our hospital for NSCLC. Results: Multivariable Cox proportional-hazards analysis in adjusted Model II showed that compared with GRHL2-negative expression, positive expression in patients with NSCLC was associated with increased death risk (HR = 7.0, 95% CI: 2.1-20.9, p = 0.03) and risk for composite end point (HR = 8.2, 95% CI: 4.0-27.1, p <0.01). Conclusion: This study supported that elevated circulating GRHL2 expression might be considered as a candidate prognostic biomarker for poor prognosis among these NSCLC patients.
    [Box: see text].
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  • 文章类型: Journal Article
    背景:星形细胞瘤是一种成人型弥漫性神经胶质瘤,包括弥漫性星形细胞瘤(DA)和间变性星形细胞瘤(AA)。然而,使用基于人群的研究对DA和AA的风险评估和预后进行全面调查仍然非常缺乏.
    方法:在本研究中,我们开发了两个预测列线图来评估与DA和AA相关的易感性和预后。该研究队列包括2010年至2019年期间从监测中选择的3,837名诊断为DA或AA的个体。流行病学,和结束结果(SEER)数据库。确定了独立的预测因子,并用于构建总体死亡(OD)和癌症特异性死亡(CSD)率的列线图。使用C指数评估模型的性能,校正曲线,和接收器工作特性曲线(ROC),临床适用性采用决策曲线分析(DCA)进行评价。
    结果:本研究中的ROC曲线显示出出色的临床适用性和预测能力。值得注意的是,训练队列和验证队列的曲线下面积(AUC)大于0.80,从而巩固了模型的精度.此外,校准图表明,预期死亡率与测量值非常吻合.这种数字对齐在验证队列中是持续的。此外,决策曲线分析(DCA)证实了模型的平移潜力,加强它们在现实世界临床环境中的相关性。
    结论:所呈现的列线图不仅表现出良好的预测性能,而且还展示了在预测患者预后方面的实用临床效用。重要的是,这无疑将成为肿瘤学家的宝贵资产,促进知情的治疗决定,并促进细致的后续计划。
    BACKGROUND: Astrocytoma is a type of adult-type diffuse gliomas that includes diffuse astrocytoma (DA) and anaplastic astrocytoma (AA). However, comprehensive investigations into the risk assessment and prognosis of DA and AA using population-based studies remain noticeably scarce.
    METHODS: In this study, we developed 2 predictive nomograms to evaluate the susceptibility and prognosis associated with DA and AA. The study cohort comprised 3837 individuals diagnosed with DA or AA between 2010 and 2019 selected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent predictors were identified and used to construct the nomograms for overall death and cancer-specific death rates. The performance of the models was assessed using C-index, calibration curves, and receiver operating characteristic curve, and the clinical applicability was evaluated using decision curve analysis.
    RESULTS: The receiver operating characteristic curves in this study show excellent clinical applicability and predictive power. Notably, the area under the curves of the training and verification queues was higher than 0.80, thereby cementing the models\' precision. Additionally, the calibration plots demonstrate that the anticipated mortality rates strikingly match the measured values. This alignment of figures is sustained in the validation cohort. Furthermore, the decision curve analysis corroborates the models\' translational potential, reinforcing their relevance within real-world clinical settings.
    CONCLUSIONS: The presented nomograms have not only exhibited good predictive performance but also showcased pragmatic clinical utility in prognosticating patient outcomes. Significantly, this will undoubtedly serve as a valuable asset for oncologists, facilitating informed treatment decisions and meticulous follow-up planning.
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    文章类型: Journal Article
    OBJECTIVE: To investigate whether multidisciplinary team (MDT) intervention is associated with improved survival for patients with colorectal adenocarcinoma with liver or lung metastasis (CRA-LLM).
    METHODS: We enrolled 161 consecutive patients with histologically confirmed CRA-LLM at Taipei Medical University-Wan Fang Hospital between January 2007 and December 2017. In total, 75 patients with CRA-LLM received MDT intervention, and 86 patients did not receive MDT intervention. To evaluate prognostic factors for overall death, we performed univariate and multivariate Cox regression analyses of the overall death rate in all patients. Overall survival rates were calculated using the Kaplan-Meier method, and Kaplan-Meier survival curves were compared using the log-rank test (P < .001).
    RESULTS: A multivariate Cox regression analysis of the overall death rate in patients with CRA-LLM showed that age ≤ 65 years, systemic chemotherapy, curative-intent treatments, and MDT intervention are strong prognostic factors. The adjusted hazard ratio of death risk for age ≤ 65 years, systemic chemotherapy, curative-intent treatments, and MDT intervention were 0.60 (95% confidence interval [CI], 0.40-0.92; P = .019), 0.19 (95% CI, 0.12-0.32; P = .001), 0.25 (95% CI, 0.13-0.50; P = .001), and 0.40 (95% CI, 0.25-0.65; P = .001), respectively. The 3-year overall survival rates in patients with CRA-LLM receiving MDT intervention and not receiving MDT intervention were 48.75% and 24.21%, respectively.
    CONCLUSIONS: MDT intervention is associated with improved survival for patients with CRA-LLM.
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  • 文章类型: Journal Article
    The prognostic significance of miR-125b in intermediate-risk acute myeloid leukemia has not been well investigated. The aim of the study was to reveal the relationship between the elevated exosomal miR-125b level and the poor prognosis in adult patients with this disease.
    A total of 154 consecutive patients with intermediate-risk acute myeloid leukemia were enrolled. Exosomes were isolated from blood specimens. The exosomal miR-125b level was determined using quantitative real-time polymerase chain reaction. Patients received standardized therapy and were followed up for 1-24 months. Details about relapse and overall death were recorded.
    Patients were divided into the high miR-125b level group (n = 77) and the low miR-125b level group (n = 77). In the multivariate Cox proportional hazard regression model, the high miR-125b level group was separately associated with increased risks of relapse and overall death in 2 years (hazard ratio [HR] 2.84, 95% CI 1.81-4.33 and HR 2.69, 95% CI 1.87-4.52). Kaplan-Meier analysis also revealed that a high miR-125b level was related to a higher cumulative relapse and overall death rates (p < 0.001 and p < 0.001, respectively).
    Circulating exosomal miR-125b concentration might be an independent prognostic indicator in intermediate-risk acute myeloid leukemia patients. An elevated miR-125b level indicated higher risks of relapse and overall death.
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  • 文章类型: Journal Article
    OBJECTIVE: Use of β-blockers (BBs) in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular diseases is supported by increasing evidence. However, most of these studies focused on the survival outcome and used a non-active comparison, prevalent-user design. We aimed to examine the risk of overall death and cardiovascular outcomes associated with use of cardioselective BBs using an active comparison, incident cohort approach.
    METHODS: We identified COPD patients initiating cardioselective BBs or non-dihydropyridine calcium channel blockers (CCBs) between 2007 and 2011 in the population-based Taiwan database. A Cox regression model was applied to estimate hazard ratios (HRs) for overall death, cardiovascular death, and cardiovascular events comparing cardioselective BBs and non-dihydropyridine CCBs after propensity score matching. We also conducted sensitivity analyses to quantify the unmeasured confounding effect from COPD severity.
    RESULTS: A total of 107,902 patients were included. Cardioselective BBs were associated with a modest, lower risk of overall death (HR, 0.85; 95 % CI, 0.81-0.88). The reduced risk of overall death, however, was vulnerable to distribution of COPD severity and was easily weakened with lower prevalence of severe COPD patients in the initiators of cardioselective BBs and higher prevalence of severe COPD patients in the initiators of non-dihydropyridine CCBs. No excess benefit for cardiovascular death (HR, 1.05; 95 % CI, 0.97-1.13) or cardiovascular events (HR, 0.98; 95 % CI, 0.94-1.03) was detected.
    CONCLUSIONS: The present study demonstrated a potential effect of confounding by COPD severity and therefore did not suggest an association between use of cardioselective BB and survival benefit in COPD patients.
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