The patient burden of opioidinduced bowel dysfunction

Bi, Carr; Akkız, Hikmet; Guerra,; Üsküdar, Oǧuz; Kuran, Sedef; Karaoğullarından, Ümit; Tokmak, Salih; Ballı, Tuğsan; Ülkü, Abdulalh; Akçam, Tolga; Delik, Anıl; Arslan, Burcu Oktay; Doran, Figen; Yalçın, Kendal; Altntaş, E; Özakyol, Ayşegül; Yücesoy, Mehmet; Hi, Bahçeci; Ky, Polat; Ekin, Nazım; Şimşek, Halis; Örmeci, Necati; Sonsuz, Abdullah; Demir, Mehmet; Kılıç, Murat; Uygun, Ahmet; Demir, Ali; Yilmaz, Sezai; Tokat, Yaman

doi:10.4172/clinical-practice.1000409

Cited by 11 publications

(1 citation statement)

References 59 publications

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“…We have recently shown that increased CRP levels are also associated with increased maximum tumor diameter (MTD) in HCC patients [18]. In the present study, we have focused on HCC patients with low AFP and normal AFP levels to examine whether inflammatory markers might also relate to HCC size and possibly have diagnostic usefulness.…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

et al. 2018

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The hepatocellular carcinoma (HCC) tumor marker alpha-fetoprotein (AFP) is only elevated in about half of the HCC patients, limiting its usefulness in following the effects of therapy or screening. New markers are needed. It has been previously noted that the inflammation markers C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR) are prognostically important and may reflect HCC aggressiveness. We therefore examined these 2 markers in a low-AFP HCC cohort and found that for HCCs > 2 cm, both markers significantly rise with an increasing maximum tumor diameter (MTD). We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index value for each marker, and their area-under-the-curve values for each MTD group. Patients were dichotomized into 2 groups based on the CRP and PLR from the receiver-operating characteristic curve analysis. In the logistic regression models of the 4 different MTD patient groups, CRP and PLR levels were statistically significant to estimate MTD in univariate logistic regression models of MTD groups > 2 cm. CRP and PLR were then combined, and the combination was statistically significant to estimate MTD groups of 3-, 4-, and 5-cm cutoffs. CRP and PLR thus have potential as tumor markers for low-AFP HCC patients, and possibly for screening.

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Section: Introductionmentioning

confidence: 99%

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

et al. 2018

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Prediction of overall survival in patients across solid tumors following atezolizumab treatments: A tumor growth inhibition–overall survival modeling framework

Chan¹,

Marchand²,

Yoshida³

et al. 2021

CPT Pharmacom & Syst Pharma

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The objectives of the study were to utilize tumor size data from 10 Phase II/III atezolizumab studies across five solid tumor types to estimate tumor growth inhibition (TGI) metrics and assess the impact of TGI metrics and baseline prognostic factors on overall survival (OS) for each tumor type. TGI metrics were estimated from bi-exponential models and post-treatment longitudinal data of 6699 patients. TGI-OS full models were built using parametric survival regression by including all significant baseline covariates from the Cox univariate analysis, followed by a backward elimination step. The model performance was evaluated for each trial by simulating 1000 times OS distributions and hazard ratio (HR) of the atezolizumab-containing arms vs. respective controls.Tumor growth rate estimate (KG) was the most significant predictor of OS across all tumor types. Several baseline prognostic factors, such as inflammatory status (C-reactive protein, albumin, and/or neutrophil-to-lymphocyte ratio), tumor burden (sum of longest diameters, number of metastatic sites, and/or presence of liver metastases), Eastern Cooperative Oncology Group performance status and lactate dehydrogenase were also highly significant across multiple studies in the final multivariate models. TGI-OS models adequately described the OS distribution. The model-predicted HRs indicate good model performance across the 10 studies, with observed HRs within the 95% prediction intervals for all study arms vs. control.Multivariate TGI-OS models developed for different solid tumor types were able to predict treatment effect with various atezolizumab monotherapy or combination regimens and could be used to support design and analysis of future studies.

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Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict tumor size and survival in HCC patients: Retrospective study

Süner¹,

Carr²

2020

Annals of Medicine and Surgery

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Background Inflammation is a recognized concomitant of hepatocellular carcinoma (HCC) and its indices are prognostically useful. Aims To evaluate two commonly used inflammatory indices, neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), to examine their relationship to maximum tumor diameter (MTD) and to survival. Methods A database of 1024 prospectively-accrued HCC patients was examined, who had full baseline tumor parameter data, including CT scan information on HCC size and whose survival was known. Analyses of NLR and PLR were correlated to MDT and to survival. NLR and PLR cutoffs were calculated from receiver operator characteristic curves. Results Every MTD pair had significantly different PLR values, for MTD groups of groups <2/≥2, <3/≥3, <4/≥4, <5/≥5 cm. However there were few significant differences in NLR values. Logistic regression models of different MTD groups likewise showed significance for PLR. Patients with both low NLR and low PLR had the longest overall survival compared to all the other 3 combinations of NLR and PLR. In a Cox regression analysis, univariate models on NLR (≤3.02/>3.02) and PLR (≤6.82/>6.82) groups, showed significance for PLR, p = 0.034 and approaching significance for NLR, p = 0.057. Conclusions MTD pairs down to <2/≥2 cm showed significance for PLR, survival showed significance for PLR and almost for NLR.

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The patient burden of opioidinduced bowel dysfunction

Cited by 11 publications

References 59 publications

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma

Prediction of overall survival in patients across solid tumors following atezolizumab treatments: A tumor growth inhibition–overall survival modeling framework

Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict tumor size and survival in HCC patients: Retrospective study

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