The aim of the study was to determine the prognostic significance of PLR and NLR ratios in patients operated due to non-small cell lung cancer. Material:The study group consisted of 532 (174 women, 358 men) patients with non-small cell lung cancer (NSCLC) staged IA-IIIA. The mean age was 63.6 years (range 36 to 84 years). Together with platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR), the following factors were included in the statistical analysis: age, sex, smoking history, the number of leukocytes, neutrophils, and platelets, histopathology, T-stage, N-stage, concomitant diseases according to the Charlson Comorbidity Index (CCI), type of operation, adjuvant chemotherapy, and overall survival. Results: Univariate analysis showed an association between the value of PLR and NLR and the length of survival. Multivariate analysis found that the stage of advancement of the neoplastic disease (p=0.00003), adjuvant chemotherapy (p=0.009), CCI > 4 (0.00008), and PLR > 144 (p=0.001) were negative prognostic factors for survival > 2 years; however, this effect diminishes in patients surviving more than 5 years. Conclusion: PLR might serve as a prognostic factor in patients affected by NSCLC with expected two-year overall survival.
Background: The aim of the study was to determine a survival prognostic value of selected blood morphological rates of patients, operated on due to non-small cell lung cancer (NSCLC). Methods: The study was conducted on 532 patients, surgically treated due to NSCLC, in stages IA-IIIA, 174 females and 358 males, mean age 63.6 years (36-84 years) were included in the study. Blood parameters and clinical factors were included in statistical analysis, in order to determine potential prognostic values of red blood cell distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV) of red cell and hemoglobin. Factors contained: age, sex, smoking history, histopathological diagnosis , T category, N category, age-adjusted Charlson Comorbidity Index (CCI), number of lymphocytes, neutrophils, monocytes, platelets, the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR), kind of surgery, patient survival. Results:The univariate analysis revealed a dependence of the value of RDW-SD and CCI values, the number of monocytes, NLR and PLR values, neoplasia stage and the overall survival. The multivariate analysis confirmed that not only N2 category and the value of CCI above 4 are negative prognostication factors, but also RDW-SD above 43 fL (P=0.00007) and PLR above 138 (P=0.001) are such negative factors of survival prognosis. Conclusions: RDW-SD is an independent and significant prognostic factor of patients' survival operated on due to NSCLC.
IntroductionOver 80% of patients with esophageal cancer are qualified only for palliative treatment. The main goal of the therapy is to eliminate symptoms of dysphagia.AimTo analyze complications after insertion of prostheses and stents in patients with inoperable cancer of the esophagus/cardia.Material and methodsFrom 1996 to 2015 prostheses of the esophagus were implanted in 1309 patients. In the strictures of the lower part of the esophagus, Barbin-Mousseau prostheses (102 cases) and Häring prostheses (324 cases) were placed. In the strictures of the upper and middle part of the esophagus, Wilson-Cook prostheses (65 cases) and Sumi prostheses (51 cases) were implanted using rigid oesophagoscopy. Since 2001, 867 esophageal stents have been implanted.ResultsComplications occurred in 146 (11%) patients, including 7 (0.6%) cases of death. The most common complication was the recurrence of swallowing disorders (74 patients). In 51 patients, tumor overgrowth over the stent/prosthesis was responsible for that symptom, and in 23 patients its clogging. A fistula (22 cases) and the passage of the prosthesis/stent (25 cases) were the second most common group of complications. Compression of the trachea, bleeding, and dehiscence of wounds occurred in a total of 18 patients. Complications were mostly treated through the repositioning of the prosthesis/stent or the insertion of an additional one.ConclusionsThe most common complications after esophageal prosthetics are the recurrence of dysphagia, a fistula and the displacement of the prosthesis/stent. The basic treatment of complications is the repositioning or insertion of an additional prosthesis.
Background: Platelets play a vital role in the neoplastic process. Platelet parameters are hence an important source of information concerning ongoing neoplastic disease. The aim of the study is to assess the impact of selected platelet parameters on the survival of patients with non-small cell lung cancer (NSCLC). Methods:The study included 532 (174 female and 358 male) patients aged 36-84 years (mean age 63.6 years) operated on due to NSCLC, staged IA-IIIA. Before the operation, all patients received a blood morphology test. The following parameters were subjected to statistical analysis: platelet count, mean platelet volume (MPV) parameter, platelet distribution width (PDW) parameter, platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation (SII) index. These findings were compared with the clinical data of the patients, and the probability of overall survival was analyzed. Results:The univariate analysis revealed a correspondence between PDW, MPV, PLR and SII index and patient survival. The multivariate analysis including patient clinical data found the following factors to have negative prognostic value for patients operated on due to NSCLC: male sex, advancement stage of neoplastic disease and Charlson Comorbidity Index (CCI) above 4, and PLR >144.Conclusions: PDW value, PLR and SII index are independent prognostic factors. In the multi-factor model, male sex, the advancement stage of the neoplastic disease, CCI above 4 and PLR lower than 144 had the greatest prognostic value.
(I) In patients with the N2 feature, the type of performed surgery, type of tumour and the occurrence of metastases in the lymph nodes of the lung hilum do not affect 5-year survival; (II) involvement of only one nodal group allows to achieve 5-year survival in 20% of patients; (III) involvement of three and more nodal groups with the N2 feature results in decreased 5-year survival.
IntroductionIntramural esophageal tumors (IET) are located between unchanged mucous membrane and muscularis mucosae. They can be both benign and malignant.AimTo evaluate diagnostic and therapeutic difficulties of IET.Material and methodsDuring the years 2010–2015, 11 patients with IET were treated in our clinic. Diagnostics included gastroscopy, computed tomography of the chest, endoscopic ultrasound (EUS) guided fine needle biopsy, and positron emission tomography (PET) of the esophagus in cases with no histopathological confirmation.ResultsBased on the conducted analysis we diagnosed 1 case of gastrointestinal stromal tumor (GIST), 1 case of adenocarcinoma, and 2 cases of esophageal cysts. In another 7 cases radiological images resembled leiomyoma but with no histopathological confirmation. Esophagectomy was performed in 2 cases of malignant tumors and 1 case of a large benign tumor. In other cases surgical enucleation of tumors was performed. Postoperatively we diagnosed 6 cases of leiomyoma, 1 case of schwannoma, 2 esophageal cysts, 1 case of GIST and 1 of esophageal cancer.ConclusionsIntramural esophageal tumors is a very diverse group of tumors, both malignant and benign. In every case of IET we should seek histopathological conformation. Treatment of IET depends on localization, size and histopathological type of lesion.
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