• Title/Summary/Keyword: poor prognosis

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Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

  • Keane, Kevin N;Ye, Yun;Hinchliffe, Peter M;Regan, Sheena LP;Dhaliwal, Satvinder S;Yovich, John L
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.178-188
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    • 2019
  • Objective: To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis. Methods: A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (-)GH group) and 809 patients with good prognosis (as control, (-)Adj (Good) group). Results: The poor-prognosis women were significantly older, with a lower ovarian reserve than the (-)Adj (Good) group, and demonstrated lower chances of CP (p< 0.005) and LB (p< 0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (-)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p< 0.028). This was further confirmed in age-matched analyses. Conclusion: The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.

High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis

  • Shin, Hyeong Chan
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.169-174
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    • 2021
  • Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid-Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and paired box gene 8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

One Year Follow-up Evaluation of Metastatic Brain Tumors - with Relevant to the Poor Prognosis (전이성 뇌종양의 1년간 추적 관찰연구-불량한 예후와의 연관성)

  • Yi, Hyeong Joong;Kim, Choong Hyun;Kim, Jae Min;Bak, Koang Hum;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1108-1114
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    • 2001
  • Objective : Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. Patients and Methods : The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0$^{(R)}$. A p-value of less than 0.05 was considered clinically significant. Result : Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis ; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years ; 10 patients), gender(male ; 20 patients), type of primary cancer(primary undefined ; 6 patients, lung cancer ; 15 patients), location(infratentorial ; 9 patients, sellar ; 5 patients), number of lesion(multiple ; 12 patients), and number of operation(multiple craniotomy ; 7 patients) were not related to the poor prognosis. Conclusions : The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.

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Clinical and Pathological Factors Related to the Prognosis of Chinese Patients with Stage Ⅰb To Ⅱb Cervical Cancer

  • Xie, Xiu-Zhen;Song, Kun;Cui, Baoxia;Jiang, Jie;Zhang, You-Zhong;Wang, Bo;Yang, Xing-Sheng;Kong, Bei-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5505-5510
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    • 2012
  • Objective: The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. Methods and Results: 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). Conclusion: Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.

FACTORS AFFECTING 6 MONTHS' SHORT-TERM PROGNOSIS OF CONDUCT DISORDER IN THE ADOLESCENTS II -RELATION TO DEPRESSION/ANXIETY AND ADHD INVENTORY- (청소년 품행장애의 6개월 단기 예후에 영향을 미치는 변인 II - 우울 및 불안척도와 주의력결핍 과잉활동 척도를 중심으로 -)

  • Bang, Yang-Won;Chae, Jeong-Ho;Chin, Tae-Won;Lee, Chung-Kyoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.161-166
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    • 1996
  • The major goals of this study are to investigate the correlation between the cormorbid symptom and the prognosis of conduct disorder in the adolescents. for this purpose, according to the result of 6-month follow-up of discharged patient who met the criteria of conduct disorder in admission, good-prognosis group(n=37) and poor-prognosis group(n=36) were selected. Authors applied Children's Depression Inventory and Trait Anxiety Inventory, Conners Parenting Rating Scale. Yale Children's Inventory to two groups. The results are summarized as follows : 1) Using CDI, the mean scores of poor-prognosis group were significantly higher compared with those of good prognosis group. 2) Using TAI, CPRS, YCI, the mean scores of poor-prognosis group were insignificantly higher compared with those of good prognosis. 3) The limitation of our study is that number of subjects is small, definition of prognosis is ambiguous, and period of 6 month follow-up is short.

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Modeling of Breast Cancer Prognostic Factors Using a Parametric Log-Logistic Model in Fars Province, Southern Iran

  • Zare, Najaf;Doostfatemeh, Marzieh;Rezaianzadeh, Abass
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1533-1537
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    • 2012
  • In general, breast cancer is the most common malignancy among women in developed as well as some developing countries, often being the second leading cause of cancer mortality after lung cancer. Using a parametric log-logistic model to consider the effects of prognostic factors, the present study focused on the 5-year survival of women with the diagnosis of breast cancer in Southern Iran. A total of 1,148 women who were diagnosed with primary invasive breast cancer from January 2001 to January 2005 were included and divided into three prognosis groups: poor, medium, and good. The survival times as well as the hazard rates of the three different groups were compared. The log-logistic model was employed as the best parametric model which could explain survival times. The hazard rates of the poor and the medium prognosis groups were respectively 13 and 3 times greater than in the good prognosis group. Also, the difference between the overall survival rates of the poor and the medium prognosis groups was highly significant in comparison to the good prognosis group. Use of the parametric log-logistic model - also a proportional odds model - allowed assessment of the natural process of the disease based on hazard and identification of trends.

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

  • Somi, Mohammad Hossein;Ghojazadeh, Morteza;Bagheri, Masood;Tahamtani, Taraneh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.853-857
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    • 2015
  • Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829, p<0.001) followed by presence of distant metastases (RR=1.607, p<0.001), poor differentiation (RR=1.408, p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

  • Cheng, Wei-Hong;Kao, Chen-Yi;Hung, Yu-Shin;Su, Po-Jung;Hsieh, Chia-Hsun;Chen, Jen-Shi;Wang, Hung-Ming;Chou, Wen-Chi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2861-2866
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    • 2012
  • Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

Involvement of MicroRNA-198 Overexpression in the Poor Prognosis of Esophageal Cancer

  • Qi, Bo;Yao, Wen-Jian;Zhao, Bao-Sheng;Qin, Xiu-Guang;Wang, Yi;Wang, Wen-Ju;Wang, Tian-Yun;Liu, Shang-Guo;Li, Han-Chen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5073-5076
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    • 2013
  • Objective: This study aimed to investigate whether the miR-198 expression level is related to clinicopathological factors and prognosis of esophageal cancer. Methods: MicroRNA was extracted from esophageal cancer patients who underwent surgery for assessment using the Taqman@ MicroRNA assay. The correlation between miR-198 expression and clinicopathological features was analyzed, and the significance of miR-198 as a prognostic factor and its relationship with survival was determined. Results: MicroRNA-198 (miR-198) expression was higher in patients with poor prognosis than those with good prognosis (P<0.05). Kaplan-Meier analysis results showed that the miR-198 expression level had a significant correlation with survival time (P=0.030) and that patients with a higher expression of miR-198 had a shorter survival time. Cox multi-factor model analysis showed that patient prognosis (P=0.014), tumor length (P=0.040) and expression (P=0.012), and survival time had a significant correlation; the corresponding risks were 7.268, 1.246, and 3.524, respectively. Conclusion: miR-198 overexpression is involved in the poor prognosis of esophageal cancer and can be used as a biomarker for selection of cases requiring especial attention.

Association of Poor Prognosis Subtypes of Breast Cancer with Estrogen Receptor Alpha Methylation in Iranian Women

  • Izadi, Pantea;Noruzinia, Mehrdad;Fereidooni, Foruzandeh;Nateghi, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4113-4117
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    • 2012
  • Breast cancer is a prevalent heterogeneous malignant disease. Gene expression profiling by DNA microarray can classify breast tumors into five different molecular subtypes: luminal A, luminal B, HER-2, basal and normal-like which have differing prognosis. Recently it has been shown that immunohistochemistry (IHC) markers including estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2), can divide tumors to main subtypes: luminal A (ER+; PR+/-; HER-2-), luminal B (ER+;PR+/-; HER-2+), basal-like (ER-;PR-;HER2-) and Her2+ (ER-; PR-; HER-2+). Some subtypes such as basal-like subtype have been characterized by poor prognosis and reduced overall survival. Due to the importance of the ER signaling pathway in mammary cell proliferation; it appears that epigenetic changes in the $ER{\alpha}$ gene as a central component of this pathway, may contribute to prognostic prediction. Thus this study aimed to clarify the correlation of different IHC-based subtypes of breast tumors with $ER{\alpha}$ methylation in Iranian breast cancer patients. For this purpose one hundred fresh breast tumors obtained by surgical resection underwent DNA extraction for assessment of their ER methylation status by methylation specific PCR (MSP). These tumors were classified into main subtypes according to IHC markers and data were collected on pathological features of the patients. $ER{\alpha}$ methylation was found in 25 of 28 (89.3%) basal tumors, 21 of 24 (87.5%) Her2+ tumors, 18 of 34 (52.9%) luminal A tumors and 7 of 14 (50%) luminal B tumors. A strong correlation was found between $ER{\alpha}$ methylation and poor prognosis tumor subtypes (basal and Her2+) in patients (P<0.001). Our findings show that $ER{\alpha}$ methylation is correlated with poor prognosis subtypes of breast tumors in Iranian patients and may play an important role in pathogenesis of the more aggressive breast tumors.