Diffuse Reduction of Spleen Density Is an Independent Predictor of Post-Operative Outcomes After Curative Gastrectomy in Gastric Cancer: A Multi-Center Study

Huang, Yueyue; Chen, Xiao; Shi, Mingming; Xu, Liping; Wang, Sujun; Chen, Weisheng; Zhu, Guanbao; Zhang, Weiteng; Shen, Xian

doi:10.3389/fonc.2020.01050

Cited by 9 publications

(11 citation statements)

References 39 publications

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“…The primary tumor of HCC patients can promote tumor progression and metastasis by inducing inflammation and regulating immunosuppression through the spleen (18,19). Wang et al demonstrated that the splenic radiomics model was an independent risk factor for the survival of patients with gastric cancer (17), and spleen density can predict the overall survival of patients with gastric cancer (31). All of the above suggests that the spleen has a close biological relationship with primary tumors' development.…”

Section: Discussionmentioning

confidence: 99%

Spleen Radiomics Signature: A Potential Biomarker for Prediction of Early and Late Recurrences of Hepatocellular Carcinoma After Resection

et al. 2021

Front. Oncol.

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ObjectivesTo explore the usefulness of spleen radiomics features based on contrast-enhanced computed tomography (CECT) in predicting early and late recurrences of hepatocellular carcinoma (HCC) patients after curative resection.MethodsThis retrospective study included 237 HCC patients who underwent CECT and curative resection between January 2006 to January 2016. Radiomic features were extracted from CECT images, and then the spleen radiomics signatures and the tumor radiomics signatures were built. Cox regression analysis was performed to identify the independent risk factors of early and late recurrences. Then, multiple models were built to predict the recurrence-free survival of HCC after resection, and the incremental value of the radiomics signature to the clinicopathologic model was assessed and validated. Kaplan–Meier survival analysis was used to assess the association of the models with RFS.ResultsThe spleen radiomics signature was independent risk factor of early recurrence of HCC. The mixed model that integrated microvascular invasion, tumor radiomics signature and spleen radiomics signature for the prediction of early recurrence achieved the highest C-index of 0.780 (95% CI: 0.728,0.831) in the primary cohort and 0.776 (95% CI: 0.716,0.836) in the validation cohort, and presented better predictive performance than clinicopathological model and combined model. In the analysis of late recurrence, the spleen radiomics signature was the only prognostic factor associated with late recurrence of HCC.ConclusionsThe identified spleen radiomics signatures are prognostic factors of both early and late recurrences of HCC patients after surgery and improve the predictive performance of model for early recurrence.

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Section: Discussionmentioning

confidence: 99%

Spleen Radiomics Signature: A Potential Biomarker for Prediction of Early and Late Recurrences of Hepatocellular Carcinoma After Resection

et al. 2021

Front. Oncol.

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“…Spleen density is a novel indicator of patient prognosis. It has been reported that DROSD is an excellent prognostic predictor in patients with gastric cancer and pancreatitis[ 12 , 13 ]. In our study, the incidence of DROSD was 32.9% in patients with ICC.…”

Section: Discussionmentioning

confidence: 99%

“…NLR is an indicator of immune system activity. Some studies have discussed that since NLR is higher in DROSD gastric patients, it could be an indicator of prognosis in gastric cancer patients[ 12 , 22 ]. Thus, NLR may be one of the factors affecting DROSD.…”

Section: Discussionmentioning

confidence: 99%

“…The CT positioning conditions were as follows: Tube voltage 120 kV, tube rotation time 750 ms, tube current 50 mA, layer spacing 5 mm, and layer thickness 5 mm. A special processing system (version 3.0.11.3 BN1732 bit; INFINITT Healthcare Co. Ltd., Seoul, South Korea) was used to measure the CT values at the levels of the upper pole, hilum, and lower pole of the spleen (Figure 2A-C )[ 12 , 16 ]. On each plane, we took two points as density values for calculations.…”

Section: Methodsmentioning

confidence: 99%

“…The spleen is crucial in regulating immune homeostasis[ 10 ], which is vital for a favorable prognostic outcome[ 11 ]. Studies have reported the occurrence of diffuse reduction of spleen density (DROSD) in patients with gastric cancer and acute pancreatitis, and speculated that DROSD might be associated with poor prognosis[ 12 , 13 ]. We have observed this phenomenon in some ICC patients; however, the predictive value of DROSD in the prognosis of ICC still needs exploration.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse reduction of spleen density is a novel prognostic marker for intrahepatic cholangiocarcinoma after curative resection

Deng¹,

Wang²,

Yang³

et al. 2021

WJGO

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BACKGROUND Diffuse reduction of spleen density (DROSD) is related to cancer prognosis; however, its role in intrahepatic cholangiocarcinoma (ICC) remains unclear. AIM To assess the predictive value of DROSD in the prognosis of ICC after curative resection. METHODS In this multicenter retrospective cohort study, we enrolled patients with ICC who underwent curative hepatectomy between 2012 and 2019. Preoperative spleen density was measured using computed tomography. Overall survival (OS) and recurrence-free survival (RFS) rates were calculated and compared utilizing the Kaplan–Meier method. Univariable and multivariable Cox regression analyses were applied to identify independent factors for OS and RFS. A nomogram was created with independent risk factors to predict prognosis of patients with ICC. RESULTS One hundred and sixty-seven ICC patients were enrolled. Based on the diagnostic cut-off values (spleen density ≤ 45.5 Hounsfield units), 55 (32.9%) patients had DROSD. Kaplan–Meier analysis indicated that patients with DROSD had worse OS and RFS than those without DROSD ( P < 0.05). Cox regression analysis revealed that DROSD, carcinoembryonic antigen level, carbohydrate antigen 19-9 level, length of hospital stay, lymph node metastasis, and postoperative complications were independent predictors for OS ( P < 0.05). The nomogram created with these factors was able to predict the prognosis of patients with ICC with good reliability (OS C-index = 0.733). The area under the curve for OS was 0.79. CONCLUSION ICC patients with DROSD have worse OS and RFS. The nomogram is a simple and practical method to identify high-risk ICC patients with poor prognosis.

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Prognostic value of diffuse reduction of spleen density on postoperative survival of pancreatic ductal adenocarcinoma: A retrospective study

Zheng

Deng

et al. 2023

Asia-Pac J Clncl Oncology

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PurposeIt is difficult to predict the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) before radical operation. The purpose of this study was to explore the connection between the diffuse reduction of spleen density on computed tomography (DROSD) and the postoperative prognosis of patients with PDAC.Patients and methodsA total of 160 patients with PDAC who underwent radical surgery in the First Affiliated Hospital of Wenzhou Medical University were enrolled. Cox regression analysis was used to cast the overall survival (OS) and evaluate the prognostic factors. Nomogram was used to forecast the possibility of 1‐year, 3‐year, and 5‐year OS. The prediction accuracy and clinical net benefit are performed by concordance index (C‐index), calibration curve, time‐dependent receiver operating characteristics (tdROC), and decision curve analysis.ResultsIn multivariable Cox analysis, DROSD is independently related to OS. Advanced age, TNM stage, neutrophil/lymphocyte ratio, and severe complications were also independent prognostic factors. The calibration curves of nomogram showed optimal agreement between prediction and observation. The C‐index of nomogram is 0.662 (95%CI, 0.606–0.754). The area under tdROC curve for a 3‐year OS of nomogram is 0.770.ConclusionDROSD is an independent risk factor for an OS of PDAC. We developed a nomogram that combined imaging features, clinicopathological factors, and systemic inflammatory response to provide a personalized risk assessment for patients with PDAC.

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Diffuse Reduction of Spleen Density Is an Independent Predictor of Post-Operative Outcomes After Curative Gastrectomy in Gastric Cancer: A Multi-Center Study

Cited by 9 publications

References 39 publications

Spleen Radiomics Signature: A Potential Biomarker for Prediction of Early and Late Recurrences of Hepatocellular Carcinoma After Resection

Spleen Radiomics Signature: A Potential Biomarker for Prediction of Early and Late Recurrences of Hepatocellular Carcinoma After Resection

Diffuse reduction of spleen density is a novel prognostic marker for intrahepatic cholangiocarcinoma after curative resection

Prognostic value of diffuse reduction of spleen density on postoperative survival of pancreatic ductal adenocarcinoma: A retrospective study

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