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We hypothesized that gross tumor volume (GTV) of primary tumor (GTV) and nodal volumes (GTV) were predictors of first failure site in non-small cell lung cancer (NSCLC). We aimed at also comparing the prognostic model's complexity to its ability to generate absolute risk predictions with emphasis on variables available at the time of diagnosis. Three hundred and forty-two patients treated with definitive chemoradiotherapy (CRT) for adenocarcinoma (AC) or squamous cell carcinoma (SCC) in 2009-2017 were analyzed. Clinical data, standardized uptake values on FDG-PET/CT, GTV and GTV were analyzed using multivariate competing risk models. One hundred and thirty-seven patients had SCC. As first site of failure 49 had locoregional failure (LRF), 40 had distant metastasis (DM) and 24 died with no evidence of disease (NED). In 205 patients with AC, 34 had LRF, 118 had DM as first failure site and 17 died with NED. Performance status predicted LRF ( = .02) and UICC stage risk of DM ( = .05 for stage 3, < .001 for stage 4). Adding histopathology changed predictions with much reduced risk of LRF in AC compared to SCC (HR = 0.5, 95%
(0.3-0.75), = .001). Conversely, AC had a higher rate of DM than SCC (HR = 2.1, 95%
(1.5-3.0], < .001). Addition of FDG metrics and tumor/nodal volume data predicted DM risk ( = .001), but with smaller impact on absolute risk compared to histopathology. Separation of GTV in nodal and tumor lesions did not improve risk predictions. We quantified the effect of adding volumetric and quantitative imaging to competing risk models of first failure site, but did not find tumor volume components to be important. Histopathology remains the simplest and most important factor in prognosticating failure patterns in NSCLC.
This article was published in the following journal.
Name: Acta oncologica (Stockholm, Sweden)
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Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her.
Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.
In vivo methods of screening investigative anticancer drugs, biologic response modifiers or radiotherapies. Human tumor tissue or cells are transplanted into mice or rats followed by tumor treatment regimens. A variety of outcomes are monitored to assess antitumor effectiveness.
Investigative techniques used in pre-clinical and clinical research, epidemiology, chemistry, immunology, genetics, etc. They do not include techniques specifically applied to DIAGNOSIS; THERAPEUTICS; anesthesia and analgesia; SURGICAL PROCEDURES, OPERATIVE; and DENTISTRY.
A procedure whereby the body is stimulated to generate extra soft tissue by the application of stretching forces that stimulate new growth of tissue which, over a period of time, results in a 2-dimensional expansion of the tissue. The procedure is used in reconstructive surgery for injuries caused by trauma, burns, or ablative surgery. Various types of TISSUE EXPANSION DEVICES have been developed that exert stretching forces.
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There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal cell carcinoma Basal cell carcinoma, or BCC, is a cancer of the basal cells at the bottom of the epidermis. It’s very common ...