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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 649 records · Page 36
All sourcesNASA NTRSDOE OSTI
DOE OSTI2017

Peripheral Stent Thrombosis Leading to Acute Limb Ischemia and Major Amputation: Incidence and Risk Factors in the Aortoiliac and Femoropopliteal Arteries

PurposeTo report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit.Materials and MethodsMedical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia. Cases were stratified between aortoiliac and femoropopliteal anatomy. Cox regression analysis was employed to adjust for baseline clinical and procedural confounders and identify predictors of stent thrombosis and major limb loss.Results256 patients (n = 277 limbs) were analysed over a 5-year period (2009–2014) including 117 aortoiliac stents (34 CNS; 12.8 ± 5.0 cm and 83 BNS; 7.8 ± 4.0 cm) and 160 femoropopliteal ones (60 CNS; 21.1 ± 11.0 cm and 100 BNS; 17.5 ± 11.9 cm). Median follow-up was 1 year. Overall stent thrombosis rate was 6.1% (17/277) after a median of 43 days (range 2–192 days) and affected almost exclusively the femoropopliteal segment (12/60 in the CNS cohort vs. 4/100 in the BNS; p = 0.001). Annualized stent thrombosis rates (per 100 person-years) were 12.5% in case of CNS and 1.4% in case of BNS (HR 6.3, 95% CI 2.4–17.9; p = 0.0002). Corresponding major amputations rates were 8.7 and 2.5%, respectively (HR 4.5, 95% CI 2.7–27.9; p = 0.0006). On multivariable analysis, critical leg ischemia and CNS placement were the only predictors of stent thrombosis. Diabetes, critical leg ischemia, femoropopliteal anatomy, long stents and CNS were independent predictors of major amputations.ConclusionsPlacement of long femoropopliteal covered nitinol stents is associated with an increased incidence of acute stent thrombosis and ensuing major amputation. Risks are significantly lower in the aortoiliac vessels and with use of bare nitinol stents.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Predictive Factors of Tumor Response After Neoadjuvant Chemoradiation for Locally Advanced Rectal Cancer

Purpose: Neoadjuvant chemoradiation followed by surgery is the standard of care for locally advanced rectal cancer. The aim of this study was to correlate tumor response to survival and to identify predictive factors for tumor response after chemoradiation. Methods and Materials: From 1998 to 2008, 168 patients with histologically proven locally advanced adenocarcinoma treated by preoperative chemoradiation before total mesorectal excision were retrospectively studied. They received a radiation dose of 45 Gy with a concomitant 5-fluorouracil (5-FU)-based chemotherapy. Analysis of tumor response was based on lowering of the T stage between pretreatment endorectal ultrasound and pathologic specimens. Overall and progression-free survival rates were correlated with tumor response. Tumor response was analyzed with predictive factors. Results: The median follow-up was 34 months. Five-year disease-free survival and overall survival rates were, of 44.4% and 74.5% in the whole population, 83.4% and 83.4%, respectively, in patients with pathological complete response, 38.6% and 71.9%, respectively, in patients with tumor downstaging, and 29.1and 58.9% respectively, in patients with absence of response. A pretreatment carcinoembryonic antigen (CEA) level of <5 ng/ml was significantly independently associated with pathologic complete tumor response (p = 0.019). Pretreatment small tumor size (p = 0.04), pretreatment CEA level of <5 ng/ml (p = 0.008), and chemotherapy with capecitabine (vs. 5-FU) (p = 0.04) were significantly associated with tumor downstaging. Conclusions: Downstaging and complete response after CRT improved progression-free survival and overall survival of locally advanced rectal adenocarcinoma. In multivariate analysis, a pretreatment CEA level of <5 ng/ml was associated with complete tumor response. Thus, small tumor size, a pretreatment CEA level of < 5ng/ml, and use of capecitabine were associated with tumor downstaging.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Hydroacoustic Assessment of Behavioral Responses by Fish Passing Near an Operating Tidal Turbine in the East River, New York

An important environmental issue facing the marine and hydrokinetic energy industry is whether fish that encounter underwater energy devices are likely to be struck and injured by moving components, primarily rotating turbine blades. The automated analysis of nearly 3 weeks of multibeam hydroacoustics data identified about 35,000 tracks of fish passing a tidal turbine in the East River, New York. These tracks included both individual fish and schools during periods with the turbine absent, the turbine present and operating, and the turbine present but not operating. The density of fish in the sampled area when the turbine was absent was roughly twice the density observed when the turbine was in place, particularly when the turbine was operating. This suggests that some avoidance occurred before fish were close enough to the turbine to be observed by the hydroacoustics system. Various measures of swimming behavior (direction, velocity, and linearity) were calculated for each track and evaluated for indication of behavioral responses to turbine presence and operation. Fish tracks were grouped based on tidal cycle, current velocity, and swimming direction and were evaluated with respect to turbine presence and operation and with respect to distance from the turbine. Nonparametric tests (Kolmogorov–Smirnov test) and multivariate analysis (canonical discriminant analysis) found significant differences among groups with respect to turbine presence and operation, suggesting that some fish responded to the turbine by adjusting swimming behavior, such as making small adjustments to swimming direction and velocity as they passed near the turbine. We found no evidence that fish were being struck by rotating blades, but there did appear to be large-scale avoidance initiated out of the range of the hydroacoustics detection system. Furthermore, more study is needed to determine whether such avoidance behavior has significant ramifications for normal fish movement patterns, bioenergetics, seasonal migrations, and predator exposure.

13 HYDRO ENERGY↗
DOE OSTI2015

Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients

Purpose: Radiation oncologists rely on available clinical information (biopsy Gleason score and prostate-specific antigen [PSA]) to determine the optimal treatment regimen for each prostate cancer patient. Existing published nomograms correlating clinical to pathologic extent of disease were based on patients treated in the 1980s and 1990s at select academic institutions. We used the Surveillance, Epidemiology, and End Results (SEER) database to examine pathologic outcomes (Gleason score and cancer stage) in early prostate cancer patients based on biopsy Gleason score and PSA concentration. Methods and Materials: This analysis included 25,858 patients whose cancer was diagnosed between 2010 and 2011, with biopsy Gleason scores of 6 to 7 and clinical stage T1 to T2 disease, who underwent radical prostatectomy. In subgroups based on biopsy Gleason score and PSA level, we report the proportion of patients with pathologically advanced disease (positive surgical margin or pT3-T4 disease) or whose Gleason score was upgraded. Logistic regression was used to examine factors associated with pathologic outcomes. Results: For patients with biopsy Gleason score 6 cancers, 84% of those with PSA <10 ng/mL had surgical T2 disease with negative margins; this decreased to 61% in patients with PSA of 20 to 29.9 ng/mL. Gleason score upgrading was seen in 43% (PSA: <10 ng/mL) to 61% (PSA: 20-29.9 ng/mL) of biopsy Gleason 6 patients. Patients with biopsy Gleason 7 cancers had a one-third (Gleason 3 + 4; PSA: <10 ng/mL) to two-thirds (Gleason 4 + 3; PSA: 20-29.9 ng/mL) probability of having pathologically advanced disease. Gleason score upgrading was seen in 11% to 19% of patients with biopsy Gleason 4 + 3 cancers. Multivariable analysis showed that higher PSA and older age were associated with Gleason score upgrading and pathologically advanced disease. Conclusions: This is the first population-based study to examine pathologic extent of disease and pathologic Gleason score upgrading based on clinically available information in modern patients. These data inform the selection of radiation therapy strategies and an understanding of whether prostatectomy alone is likely to be curative for patients with early prostate cancers.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

1 H NMR metabolomics study of metastatic melanoma in C57BL/6J mouse spleen

Melanoma is a malignant tumor of melanocytes. Although extensive investigations have been done to study metabolic changes in primary melanoma in vivo and in vitro, little effort has been devoted to metabolic profiling of metastatic tumors in organs other than lymph nodes. As such, in this work, NMR-based metabolomics combined with multivariate data analysis is used to study metastatic B16-F10 melanoma in C57BL/6J mouse spleen. Principal Component Analysis (PCA), an unsupervised multivariate data analysis method, is used to detect possible outliers, while Orthogonal Projection to Latent Structure (OPLS), a supervised multivariate data analysis method, is employed to find important metabolites responsible for discriminating the control and the melanoma groups. Two different strategies, i.e., spectral binning and spectral deconvolution, are used to reduce the original spectral data before statistical analysis. Spectral deconvolution is found to be superior for identifying a set of discriminatory metabolites between the control and the melanoma groups, especially when the sample size is small. OPLS results show that the melanoma group can be well separated from its control group. It is found that taurine, glutamate, aspartate, O-Phosphoethanolamine, niacinamide ,ATP, lipids and glycerol derivatives are decreased statistically and significantly while alanine, malate, xanthine, histamine, dCTP, GTP, thymidine, 2'-Deoxyguanosine are statistically and significantly elevated. Furthermore, these significantly changed metabolites are associated with multiple biological pathways and may be potential biomarkers for metastatic melanoma in spleen.

1H NMR metabolomics↗
DOE OSTI2023

Switchgrass sward establishment selection is consistent across multiple environments and fertilization levels

Strong selection can occur during switchgrass sward establishment. Differences in establishment selection due to environment or management could provide information on genotype-by-environment variation and could influence strategies for breeding perennial grasses. Leaf samples were collected before sward establishment and from 3-year-old swards for two breeding groups (lowland and hybrid) at three locations. Within two locations, samples were collected from paired fertilized (112 kg N ha –1 ) and unfertilized plots. Allele frequencies from pooled DNA samples were studied through multivariate analysis of variance, genomewide trait predictions (heading date and winter survivorship), and genomically estimated breeding values (GEBVs) for individual sward survival within an independent data set. This study found only minor variations in selection due to location or management. Predicted heading dates of the hybrid population had significant changes due to fertilization and location. There were strong correlations among sward establishment survival GEBVs between growing environments (hybrid r = 0.77; gulf r = 0.97). Interestingly, this study found a small number of genotypes that were over-represented in established swards across all growing environments. This study reinforces a prior report of selection during sward establishment and indicates that only a small degree of establishment selection is location-specific within these diverse growing conditions.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2017

Quark-gluon discrimination in the search for gluino pair production at the LHC

Here, we study the impact of including quark- and gluon-initiated jet discrimination in the search for strongly interacting supersymmetric particles at the LHC. Taking the example of gluino pair production, considerable improvement is observed in the LHC search reach on including the jet substructure observables to the standard kinematic variables within a multivariate analysis. In particular, quark and gluon jet separation has higher impact in the region of intermediate mass-gap between the gluino and the lightest neutralino, as the difference between the signal and the standard model background kinematic distributions is reduced in this region. We also compare the predictions from different Monte Carlo event generators to estimate the uncertainty originating from the modelling of the parton shower and hadronization processes.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2025

Search for diphoton resonances in the 66 to 110 GeV mass range using pp collisions at $\sqrt{s}$ = 13 TeV with the ATLAS detector

A search is performed for light, spin-0 bosons decaying into two photons in the 66 to 110 GeV mass range, using 140 fb −1 of proton-proton collisions at $\sqrt{s}$ = 13 TeV produced by the Large Hadron Collider and collected by the ATLAS detector. Multivariate analysis techniques are used to define event categories that improve the sensitivity to new resonances beyond the Standard Model. A model-independent search for a generic spin-0 particle and a model-dependent search for an additional low-mass Higgs boson are performed in the diphoton invariant mass spectrum. No significant excess is observed in either search. Mass-dependent upper limits at the 95% confidence level are set in the model-independent scenario on the fiducial cross-section times branching ratio into two photons in the range of 8 fb to 53 fb. Similarly, in the model-dependent scenario upper limits are set on the total cross-section times branching ratio into two photons as a function of the Higgs boson mass in the range of 19 fb to 102 fb.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2025

Measurement of the inclusive $\textrm{t}\overline{\textrm{t}}$ cross section in final states with at least one lepton and additional jets with 302 pb −1 of pp collisions at $\sqrt{\textrm{s}}$ = 5.02 TeV

A measurement of the top quark pair ($ \textrm{t}\overline{\textrm{t}} $) production cross section in proton-proton collisions at a centre-of-mass energy of 5.02 TeV is presented. The data were collected at the LHC in autumn 2017, in dedicated runs with low-energy and low-intensity conditions with respect to the default configuration, and correspond to an integrated luminosity of 302 pb$^{−1}$. The measurement is performed using events with one electron or muon, and multiple jets, at least one of them being identified as originating from a b quark (b tagged). Events are classified based on the number of all reconstructed jets and of b-tagged jets. Multivariate analysis techniques are used to enhance the separation between the signal and backgrounds. The measured cross section is $ 62.5\pm 1.6{\left(\textrm{stat}\right)}_{-2.5}^{+2.6}\left(\textrm{syst}\right)\pm 1.2\left(\textrm{lumi}\right) $ pb. A combination with the result in the dilepton channel based on the same data set yields a value of 62.3 ± 1.5 (stat) ± 2.4 (syst) ± 1.2 (lumi) pb, to be compared with the standard model prediction of $ {69.5}_{-3.7}^{+3.5} $ pb at next-to-next-to-leading order in perturbative quantum chromodynamics.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2021

Search for charged Higgs bosons decaying into a top quark and a bottom quark at $\sqrt{s}$ = 13 TeV with the ATLAS detector

A search for charged Higgs bosons decaying into a top quark and a bottom quark is presented. The data analysed correspond to 139 fb -1 of proton-proton collisions at $\sqrt{s}$ = 13 TeV, recorded with the ATLAS detector at the LHC. The production of a heavy charged Higgs boson in association with a top quark and a bottom quark, pp → tbH + → tbtb, is explored in the H + mass range from 200 to 2000 GeV using final states with jets and one electron or muon. Events are categorised according to the multiplicity of jets and b-tagged jets, and multivariate analysis techniques are used to discriminate between signal and background events. No significant excess above the background-only hypothesis is observed and exclusion limits are derived for the production cross-section times branching ratio of a charged Higgs boson as a function of its mass; they range from 3.6 pb at 200 GeV to 0.036 pb at 2000 GeV at 95% confidence level. The results are interpreted in the hMSSM and M$_{h}^{125}$ scenarios.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2019

Search for the production of four top quarks in the single-lepton and opposite-sign dilepton final states in proton-proton collisions at $\sqrt{s}$ = 13 TeV

A search for the standard model production of four top quarks (pp$\to\mathrm{t\overline{t}t\overline{t}}$) is reported using single-lepton plus jets and opposite-sign dilepton plus jets signatures. Proton-proton collisions are recorded with the CMS detector at the LHC at a center-of-mass energy of 13 TeV in a sample corresponding to an integrated luminosity of 35.8 fb$^{-1}$. A multivariate analysis exploiting global event and jet properties is used to discriminate $\mathrm{t\overline{t}t\overline{t}}$ from $\mathrm{t\overline{t}}$ production. No significant deviation is observed from the predicted background. An upper limit is set on the cross section for $\mathrm{t\overline{t}t\overline{t}}$ production in the standard model of 48 fb at 95% confidence level. When combined with a previous measurement by the CMS experiment from an analysis of other final states, the observed signal significance is 1.4 standard deviations, and the combined cross section measurement is 13$^{+11}_{-9}$ fb. The result is also interpreted in the framework of effective field theory.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2012

Measurement of the single-top-quark t-channel cross section in pp collisions at $ \sqrt{s}=7 $ TeV

A measurement of the single-top-quark t-channel production cross section in pp collisions at sqrt(s) = 7 TeV with the CMS detector at the LHC is presented. Two different and complementary approaches have been followed. The first approach exploits the distributions of the pseudorapidity of the recoil jet and reconstructed top-quark mass using background estimates determined from control samples in data. The second approach is based on multivariate analysis techniques that probe the compatibility of the candidate events with the signal. Data have been collected for the muon and electron final states, corresponding to integrated luminosities of 1.17 and 1.56 inverse femtobarns, respectively. The single-top-quark production cross section in the t-channel is measured to be 67.2 +/- 6.1 pb, in agreement with the approximate next-to-next-to-leading-order standard model prediction. Using the standard model electroweak couplings, the CKM matrix element abs(V[tb]]) is measured to be 1.020 +/- 0.046 (meas.) +/- 0.017 (theor.).

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2018

Resonant di-Higgs production at gravitational wave benchmarks: a collider study using machine learning

We perform a complementarity study of gravitational waves and colliders in the context of electroweak phase transitions choosing as our template the xSM model, which consists of the Standard Model augmented by a real scalar. We carefully analyze the gravitational wave signal at benchmark points compatible with a first order phase transition, taking into account subtle issues pertaining to the bubble wall velocity and the hydrodynamics of the plasma. In particular, we comment on the tension between requiring bubble wall velocities small enough to produce a net baryon number through the sphaleron process, and large enough to obtain appreciable gravitational wave production. For the most promising benchmark models, we study resonant di-Higgs production at the high-luminosity LHC using machine learning tools: a Gaussian process algorithm to jointly search for optimum cut thresholds and tuning hyperparameters, and a boosted decision trees algorithm to discriminate signal and background. The multivariate analysis on the collider side is able either to discover or provide strong statistical evidence of the benchmark points, opening the possibility for complementary searches for electroweak phase transitions in collider and gravitational wave experiments.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗
DOE OSTI2013

Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 {+-} 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 {+-} 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 {+-} 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N{sub FR}) were 269 Gy cm{sup 2}, 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N{sub FR} overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis {>=} 90 % increased the risk of N{sub FR} overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis {>=} 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2024

Data-Driven Insights into the Structural Essence of Plasticity in High-Entropy Alloys

The heterogeneous mechanical response of a crystalline alloy with multiple principal elements was investigated using molecular dynamics simulations. The local configuration of the alloy in its quiescent state was characterized by the variables derived from the gyration tensor and the atomic electronegativity. A multivariate analysis identified the geometric and chemical factors that influenced the atomic packing variations. Further, upon straining, the non-affine displacement exhibited spatial heterogeneity. A statistical correlation was established between the local yield events and the specific features of the local configuration. Our findings, validated by the performance metrics analysis, provided a structural criterion for the instability mechanisms in high-entropy alloys (HEAs) and enhanced the understanding of their plasticity.

36 MATERIALS SCIENCE↗
DOE OSTI2019

The roles of PTEN, cMET, and p16 in resistance to cetuximab in head and neck squamous cell carcinoma

There is no established biomarker for cetuximab efficacy in recurrent head and neck squamous cell carcinoma (HNSCC). The aim of the present study was to evaluate the prognostic and predictive impact of PTEN, cMET, and p16 expression in recurrent HNSCC. In this retrospective study, 112 patients with recurrent HNSCC received chemotherapy (CT) alone (n = 37) or chemotherapy with cetuximab (n = 75). PTEN, cMET, and p16 protein expression were evaluated by immunohistochemistry. The median overall survival (mOS) for the patients treated with cetuximab + CT versus CT alone was 11.4 months and 7.0 months, (p = 0.949). The median progression-free survival (mPFS) was 6.2 months versus 3.0 months (p = 0.154). Patients with PTEN loss exhibited a mOS of 5.8 months versus 10.5 months (p = 0.002) and a mPFS of 3.2 months versus 4.7 months (p = 0.019). A multivariate analysis identified an independent association between PTEN loss and OS (HR 2.27; 95% confidence 95% CI 1.27–4.08; p = 0.006) and with PFS (HR 1.85; 95% CI 1.09–2.99; p = 0.022). A negative prognostic impact of PTEN loss was observed in the patients treated with cetuximab + CT, and not in the CT only group. Expression of cMET and p16 showed no impact on OS or PFS. The present findings confirm that PTEN is a prognostic factor for metastatic HNSCC and they support further studies of PTEN expression to evaluate its predictive value to cetuximab response.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Characteristics and impact of programmed death-ligand 1 expression, CD8+ tumor-infiltrating lymphocytes, and p16 status in head and neck squamous cell carcinoma

Background: No predictive biomarker of immune checkpoint inhibitors in head and neck squamous cell carcinoma (HNSCC) has been well established. The impact of programmed death-ligand 1 (PD-L1) expression, CD8+ tumor-infiltrating lymphocytes (TILs), and p16 status in HNSCC is unclear and may vary according to ethnicity. Methods: HNSCC patients treated between 2007 and 2013 were reviewed. Archival tissues were retrieved for PD-L1, CD8+ TILs, and p16 analyses. PD-L1 expression was evaluated by using the validated SP142 assay on the VENTANA platform. CD8+ TILs were defined by using semiquantitative scoring. Results: A total of 203 patients were analyzed. PD-L1 expression was observed in 80% of patients and was significantly associated with older age (P < 0.001). A high CD8+ TIL score (≥ 6) was significantly associated with never-smoking (P = 0.020), oral cavity cancer (P < 0.001), and stage M0 at presentation (P = 0.025). The p16 status was positive in 12% of patients. Patients with a high TIL score had a significantly longer OS (P = 0.032). Patients with PD-L1 expression of 1–49% and ≥ 50% were associated with a significantly shorter OS compared with those with PD-L1 < 1% (P = 0.027 and P = 0.011, respectively). Multivariate analysis showed that PD-L1 ≥ 50% was significantly associated with a poor OS. (HR 2.98 [95% CI 1.2–7.39]; P = 0.019.) Conclusions: A high prevalence of PD-L1 expression was observed in HNSCC using the validated SP142 assay. PD-L1 expression was associated with older age, while highly PD-L1 expression (≥ 50%) was an independent prognostic factor for poor OS in anti-PD1/PD-L1 untreated HNSCC patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Factors that impact the outcomes in testicular germ cell tumors in low–middle-income countries

Germ cell tumors (GCTs) are one of the most common tumors in adolescents and young adults. There is paucity of data on GCT from low–middle-income countries (LMIC). The present study was conducted to assess the demographic features, clinical manifestations, pathology, and outcomes of GCT patients treated at our center. Patients with testicular GCT above the age of 18 years, treated at our center from 2001 to 2015 were included in the study. Data were extracted retrospectively from the case records. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan–Meier method and the variables were compared using the log-rank test. The study included 421 patients among whom 128 (30%) had a histological diagnosis of seminoma and 293 (70%) had non-seminomatous germ cell tumor (NSGCT). Metastatic disease at presentation was observed in 83/128 (65%) with seminoma and 254/293 (87%) with NSGCT. According to the International Germ Cell Cancer Collaborative Group (IGCCCG) risk stratification for metastatic disease, good- and intermediate-risk seminoma were observed in 55/83 (66%) and 28/83 (34%) patients, respectively, and good-, intermediate-, and poor-risk NSGCT were observed in 82/254 (32%), 76/254 (30%), and 96/254 (38%) patients, respectively. The median follow-up was 32.3 months (range 0.03–200 months). The 3-year OS for the entire cohort was 80.3%. The 3-year OS for seminoma was 91.4%, and for NSGCT was 75.3%. Factors significantly associated with inferior EFS and OS on multivariate analysis included poor performance status, scrotal orchidectomy, carboplatin-based regimen, NSGCT histology, and treatment default. Patients with testicular GCT in India present in an advanced stage and higher IGCCCG risk compared to Western data. Factors unique to LMIC like treatment default, bulky disease, dose compromise, and scrotal orchidectomy have a negative impact on the outcome.

62 RADIOLOGY AND NUCLEAR MEDICINE↗