scholarly journals Impact of cancer history on clinical outcome in patients undergoing transcatheter edge-to-edge mitral repair

2020 ◽  
Author(s):  
Noriaki Tabata ◽  
Marcel Weber ◽  
Atsushi Sugiura ◽  
Can Öztürk ◽  
Kenichi Tsujita ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Cancer Patients ◽  
Cancer History ◽  
Lymphocyte Ratio ◽  
Inflammatory Parameters ◽  
Kaplan Meier ◽  
History Of ◽  
One Year ◽  
Worse Prognosis ◽  
History Of Cancer

Abstract Background Little is known about the prevalence of a history of cancer and its impact on clinical outcome in mitral regurgitation (MR) patients undergoing transcatheter mitral valve repair (TMVR). Objectives The purpose of this study is to investigate the prevalence of cancer, baseline inflammatory parameters, and clinical outcome in MR patients undergoing TMVR. Methods Consecutive patients undergoing a MitraClip procedure were enrolled, and the patients were stratified into two groups: cancer and non-cancer. Baseline complete blood counts (CBC) with differential hemograms were collected prior to the procedure to calculate the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). All-cause death within a one-year was examined. Results In total, 82 out of 446 patients (18.4%) had a history of cancer. Cancer patients had a significantly higher baseline PLR [181.4 (121.1–263.9) vs. 155.4 (109.4–210.4); P = 0.012] and NLR [5.4 (3.5–8.3) vs. 4.0 (2.9–6.1); P = 0.002] than non-cancer patients. A Kaplan–Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer (estimated 1-year mortality, 20.2 vs. 9.2%; log-rank P = 0.009), and multivariable analyses of three models showed that cancer history was an independent factor for 1-year mortality. Patients who died during follow-up had a significantly higher baseline PLR [214.2 (124.2–296.7) vs. 156.3 (110.2–212.1); P = 0.007] and NLR [6.4 (4.2–12.5) vs. 4.0 (2.9–6.2); P < 0.001] than survivors. Conclusions In MitraClip patients, a history of cancer was associated with higher inflammatory parameters and worse prognosis compared to non-cancer patients. Graphical Abstract Central Illustration. Clinical outcomes and baseline PLR and NLR values accord-ing to one-year mortality. (Left) Patients who died within the follow-up period had a significantly higher baseline PLR (214.2 [124.2–296.7] vs 156.3 [110.2–212.1]; P = 0.007) and NLR (6.4 [4.2–12.5] vs 4.0 [2.9–6.2]; P < 0.001) than patients who survived. PLR, platelet-to-lymphocyte ratio; NLR, neutrophil-to-lymphocyte ratio (Right) A Kaplan-Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer patients (estimated one-year mortality, 20.2 vs 9.2%; log-rank P = 0.009).

Morphological plaque characteristics and clinical outcomes of acute coronary syndrome patients with a cancer history

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Tanimura ◽  
H Otake ◽  
H Kawamori ◽  
T Toba ◽  
A Nagasawa ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cancer Patients ◽  
Cumulative Incidence ◽  
Cancer History ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
History Of ◽  
One Year ◽  
History Of Cancer

Abstract Background Although previous studies have reported that patients with a history of cancer have 2–3 times higher risks for acute coronary syndrome (ACS), morphological culprit plaque characteristics in ACS patients with a cancer history and their relations with clinical outcomes remain unknown. Methods The Kobe University ACS-OCT registry is a multi-center registry of consecutive ACS patients who underwent OCT-guided emergent PCI in Japanese four centers. All patients were categorized into the patients without a history of cancer (non-cancer), those with a history of cancer who diagnosed more than one year before ACS (historical), and those with ongoing cancer treatment or diagnosis within one year before ACS (current). ACS culprit lesions were classified into plaque rupture (PR), plaque erosion (PE), and calcified nodule (CN) according to morphological features by OCT and clinical events were collected after the onset of ACS. Results Among 436 patients, 63 patients (14.4%) had a history of cancer or ongoing treatment of cancer (cancer patients). Cancer patients were significantly older than non-cancer patients (73.4±9.4 vs. 66.9±12.9, p=0.001), and non-ST segment elevation ACS was more frequently observed in cancer patients than in non-cancer patients (57.1% vs. 43.2%, p=0.039). Regarding the ACS culprit lesion, the frequency of PR was significantly lower and the frequencies of PE and CN were significantly higher in the cancer patients than in the non-cancer patients (Figure A1). The cumulative incidence of major adverse cardiovascular event (MACE: composite of cardiac death, non-fatal myocardial infarction, and any revascularization, stroke, and heart failure with admission) after the onset of ACS in cancer patients was significantly higher than that in the non-cancer patients (Figure B1). When the cancer patients were categorized into the historical and the current cancer patients, the frequency of PE was higher in the current and the historical cancer patients than the non-cancer patients. Also, the incidence of CN was significantly higher in the historical cancer patients than others (Figure A2). The cumulative incidence of MACE was significantly higher in the current cancer patients, followed by historical and non-cancer patients (Figure B2). Cox regression analyses demonstrated that the non-PR lesion (hazard ratio (HR) 0.65, 0.46–0.94, p=0.021), patients with multivessel disease (HR 2.55, 1.79–3.64, p&lt;0.001), older patients (HR 1.02, 1.00–1.03, p=0.043) were independently associated with MACE after ACS. Moreover, multivariate analysis demonstrated that cancer history (HR 4.64, 2.34–9.21, p&lt;0.001) and non-ST segment elevation ACS (HR 0.66, 2.34–9.21, p=0.038) were independently associated with non-PR lesion. Conclusions The present study revealed the difference in morphological plaque characteristics between cancer and non-cancer patients, which might explain potential underlying mechanisms for worse outcomes in cancer patients. Funding Acknowledgement Type of funding source: None

Major Bleeding Events Among Cancer and Non-Cancer Patients Taking Rivaroxaban for Venous Thromboembolism Treatment in a Department of Defense Health System Cohort

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1447-1447 ◽  
Author(s):  
Alok A. Khorana ◽  
Frank Peacock ◽  
Sally G Tamayo ◽  
Zhong Yuan ◽  
Nicholas Sicignano ◽  
...  
Keyword(s):  
Research And Development ◽  
Cancer Patients ◽  
Department Of Defense ◽  
Research Funding ◽  
Cancer Site ◽  
United States Department ◽  
Cancer History ◽  
History Of ◽  
History Of Cancer ◽  
Active Cancer

Abstract Background: Cancer patients are at increased risk of both venous thromboembolism (VTE) and bleeding, but real world bleeding rates with contemporary anticoagulants are not known. Purpose: To describe the incidence of major bleeding (MB) in VTE patients treated with rivaroxaban, and to compare differences in MB incidence and characteristics among patients with active cancer, history of cancer, and no current or past cancer. Methods: We queried over 10 million electronic medical records (EMRs) from the United States Department of Defense healthcare system from November 2, 2012 to September 30, 2015 to identify MB events in VTE patients treated with rivaroxaban. The Cunningham algorithm was used for identifying MB, and VTE was determined by diagnosis codes. Presence of cancer was assessed from 5 years prior to index rivaroxaban exposure through end of study, and categorized by active cancer, history of cancer, and no cancer. Active cancer was defined by one of the following: 1) a metastatic diagnosis code within 6 months prior to or overlapping with rivaroxaban exposure, 2) chemotherapy and/or radiation codes within 6 months prior to rivaroxaban exposure, 3) cancer-related surgery overlapping with rivaroxaban exposure, or 4) leukemia and/or indolent lymphoma codes at any point within the entire assessment window. History of cancer was defined as the presence of any cancer diagnosis within the 5-year baseline period not meeting the definition of active cancer. Patients with active cancer or history of cancer were further categorized by cancer site/type. Incidence, outcomes, demographics, and bleeding risk scores were evaluated by cancer status. A Cox proportional hazard model was used to assess the association between cancer status and rate of MB adjusting for baseline characteristics. Results: The study population comprised 9,638 VTE patients on rivaroxaban, including 1,728 (17.9%) with active cancer, 1,548 (16.1%) with history of cancer and 6,362 (66.0%) with no cancer. Of these, 130 (1.3%) experienced MB. After stratifying by cancer status, MB occurred at a rate of 2.61 (95% CI 1.80-3.78) per 100 person-years in those with active cancer, 3.18 (95% CI 2.17-4.67) per 100 person-years in those with history of cancer, and 2.25 (95% CI 1.80-2.81) per 100 person-years in those with no cancer. No significant difference in the incidence of MB was found between those with cancer (active or history) and those without cancer (HR 1.01; 95% CI 0.70-1.47, p-value 0.94) after adjusting for age, sex, and baseline comorbidities. Neither history of cancer nor active cancer when independently compared to no cancer was significantly associated with MB after multivariate adjustment. MB rates varied notably by cancer site. Additional key findings are presented in Table 1. Conclusion: In this large United States Department of Defense cohort study of rivaroxaban users treated for VTE, incidence of MB is relatively low and not significantly different between cancer and non-cancer patients. Fatal outcomes associated with bleeding hospitalization were also uncommon across all the cancer groups. These data should provide assurance to oncology providers regarding the safety of rivaroxaban use in the real-world setting. Disclosures Khorana: Pfizer: Consultancy, Honoraria; Amgen: Consultancy, Honoraria, Research Funding; Leo: Consultancy, Honoraria, Research Funding; Roche: Consultancy, Honoraria; Bayer: Consultancy, Honoraria; Sanofi: Consultancy, Honoraria; Halozyme: Consultancy, Honoraria; Janssen Scientific Affairs, LLC: Consultancy, Honoraria, Research Funding. Peacock:Phillips: Consultancy; Comprehensive Research Associates LLC: Equity Ownership; Pfizer: Research Funding; Banyan: Research Funding; Cardiorentis: Consultancy, Research Funding; Portola: Consultancy, Research Funding; Abbott: Research Funding; Emergencies in Medicine LLC: Equity Ownership; Ischemia Care: Consultancy; Janssen: Consultancy, Research Funding; Alere: Consultancy, Research Funding; Roche: Research Funding; The Medicine's Company: Consultancy, Research Funding; ZS Pharma: Consultancy, Research Funding; Prevencio: Consultancy. Yuan:Janssen Research and Development: Employment; Johnson & Johnson: Other: Mr. Yuan owns stocks in Johnson & Johnson.. Sicignano:Janssen Research and Development: Other: NMS is an employee of Health ResearchTx LLC, which has a business relationship with Janssen.. Hopf:Janssen Research and Development: Other: KPH is an independent contractor for Health ResearchTx LLC, which has a business relationship with Janssen . Patel:National Heart Lung and Blood Institute: Research Funding; Janssen: Consultancy; Bayer: Consultancy; Otsuka: Consultancy; Johnson & Johnson: Consultancy; AstraZeneca: Consultancy, Research Funding; Heart Flow Technologies: Research Funding; Agency for Healthcare Research and Quality: Research Funding.

scholarly journals Impact of prior cancer history on the survival of patients with larynx cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kaiquan Zhu ◽  
Renyu Lin ◽  
Ziheng Zhang ◽  
Huanqi Chen ◽  
Xingwang Rao
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Protective Factor ◽  
Larynx Cancer ◽  
Prior History ◽  
Second Primary ◽  
Cancer History ◽  
History Of ◽  
The Impact ◽  
History Of Cancer

Abstract Background Patients with a prior history of cancer are commonly excluded from clinical trial. Increasing number of studies implied that a prior cancer did not adversely affect the clinical outcome among various types of cancer patients. However, the impact of prior cancer on survival of larynx cancer patients remains largely unknown. The aim of this study was to evaluate the prevalence of prior cancer and assess its impact on survival of patients diagnosed with larynx cancer. Methods Patients with larynx cancer as the first or second primary malignancy diagnosed from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier method, multivariate Cox proportional hazard model, and multivariate competing risk model were performed for survival analysis. Results A total of 24,812 eligible patients with larynx cancer were included in the study, wherein a total of 2436 patients (9.8%) had a prior history of cancer. Prostate (36%), lung and bronchus (10%), urinary bladder (7%), and breast (6%) were the most common types of prior cancer. A prior cancer history served as a risk factor for overall survival (AHR =1.30; 95% CI [1.21–1.41]; P < 0.001) but a protective factor for cancer-specific mortality (AHR = 0.83; 95% CI [0.72–0.94]; P = 0.004) in comparison with those without prior cancer. The subgroup analysis showed that a prior history of cancer adversely affected overall survival of patients with larynx cancer in most subgroups stratified by timing and types of prior cancer, as well as by different clinicopathologic features. Conclusion Our study indicated an adverse survival impact of a prior history of cancer on patients with larynx cancer. Except for a few particular prior cancer, clinical trials should be considered prudently for laryngeal cancer patients with prior cancers.

The complex comorbidities of uninsured cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19054-e19054
Author(s):  
Shreni Shah ◽  
Madeline MacDonald ◽  
Yuanyuan Lu ◽  
Smitha Pabbathi ◽  
Abu-Sayeef Mirza
Keyword(s):  
Chronic Disease ◽  
Cancer Patients ◽  
Chronic Conditions ◽  
Retrospective Chart Review ◽  
Free Clinics ◽  
Uninsured Patients ◽  
Cancer History ◽  
Patients With Cancer ◽  
History Of ◽  
History Of Cancer

e19054 Background: Uninsured patients diagnosed with cancer receive fewer screenings, frequently present with later-stage cancer, and are often unable to access standard-of-care treatment when compared to insured patients. We previously performed a study demonstrating that uninsured patients with cancer histories have higher levels of comorbidity. However, there is limited data on long-term studies describing comorbid chronic conditions among uninsured cancer patients. Here we examine socioeconomic factors and comorbid chronic conditions in uninsured patients with a cancer history over a period of three years. Methods: A retrospective chart review was conducted from 10 free clinics around the Tampa Bay region. Patients with any documented history of cancer who utilized a free clinic between 2016 and 2018 were included. Patients with no documentation of cancer history were excluded. Demographics, chronic disease parameters, and Charlson Comorbidity Index (CCI) scores were extracted and analyzed. Results: Between 2016 – 2018, a total of 17,003 uninsured patients were treated at 10 free clinics. Of these patients, 455 (2.7%) had a documented history of cancer, 9021 (53.1%) had no history of cancer, and 7527 (44.3%) had no documentation of cancer in their charts. Cancer patients were mostly women (305, 67.0%) and the average age was 55.2 years. Patients with cancer had significantly higher CCI scores compared to patients without cancer in 2016 (3.0 [2.0 SD] versus 0.94 [1.2 SD]), 2017 (2.71 [2.38 SD] versus 0.93 [1.26 SD]), and 2018 (3.27 [2.22 SD] versus 1.08 [1.26 SD]), p < 0.001. Patients with a cancer history were also more likely to be current drinkers (16.9% versus 13.0%) or smokers (17.8% versus 11.0%) compared to patients without a history of cancer. Conclusions: The results demonstrate that uninsured cancer patients consistently have higher levels of chronic disease and comorbidity compared to uninsured patients without a cancer diagnosis. This study increases awareness of the disease burden and mortality risk specific to uninsured cancer survivors which could inform free clinics and volunteer providers to better address the needs of this vulnerable population.

scholarly journals Effect of prior cancer on survival outcomes for patients with advanced prostate cancer

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yechen Wu ◽  
Xi Chen ◽  
Duocheng Qian ◽  
Wei Wang ◽  
Yiping Zhang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Outcomes ◽  
Cancer Diagnosis ◽  
Advanced Prostate Cancer ◽  
Lymphocytic Leukemia ◽  
Cancer History ◽  
Non Hodgkin Lymphoma ◽  
Kaplan Meier ◽  
History Of ◽  
The Impact

Abstract Background A history of prior cancer commonly results in exclusion from cancer clinical trials. However, whether a prior cancer history has an adversely impact on clinical outcomes for patients with advanced prostate cancer (APC) remains largely unknown. We therefore aimed to investigate the impact of prior cancer history on these patients. Methods We identified patients with advanced prostate cancer diagnosed from 2004 to 2010 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan–Meier method and the Cox proportional hazard model were utilized for survival analysis. Results A total of 19,772 eligible APC patients were included, of whom 887 (4.5 %) had a history of prior cancer. Urinary bladder (19 %), colon and cecum (16 %), melanoma of the skin (9 %) malignancies, and non-hodgkin lymphoma (9 %) were the most common types of prior cancer. Patients with a history of prior cancer had slightly inferior overall survival (OS) (AHR = 1.13; 95 % CI [1.02–1.26]; P = 0.017) as compared with that of patients without a prior cancer diagnosis. Subgroup analysis further indicated that a history of prior cancer didn’t adversely impact patients’ clinical outcomes, except in patients with a prior cancer diagnosed within 2 years, at advanced stage, or originating from specific sites, including bladder, colon and cecum, or lung and bronchus, or prior chronic lymphocytic leukemia. Conclusions A large proportion of APC patients with a prior cancer history had non-inferior survival to that of patients without a prior cancer diagnosis. These patients may be candidates for relevant cancer trials.

The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients

Tumor Biology ◽  
2015 ◽  
Vol 37 (1) ◽  
pp. 361-368 ◽  
Author(s):  
Sabine Krenn-Pilko ◽  
Uwe Langsenlehner ◽  
Tatjana Stojakovic ◽  
Martin Pichler ◽  
Armin Gerger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Cancer Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Breast Cancer Patients ◽  
Poor Clinical Outcome ◽  
Lymphocyte Ratio

Outcomes for hospitalized cancer patients with COVID-19 during the height of pandemic in New York City.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10572-10572
Author(s):  
Amelia Sawyers ◽  
Margaret Chou ◽  
Paul Johannet ◽  
Nicholas Gulati ◽  
Yingzhi Qian ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Cancer Patients ◽  
York City ◽  
Measurable Disease ◽  
All Cause Mortality ◽  
History Of ◽  
The Impact ◽  
History Of Cancer ◽  
Active Cancer

10572 Background: Several reports have suggested that cancer patients are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and suffering worse coronavirus disease 2019 (COVID-19) outcomes. However, little is known about the impact of cancer status on presentation and outcome. Here, we report on the association between cancer status and survival in hospitalized patients who tested positive for SARS-CoV-2 during the height of pandemic in New York City. Methods: Of the 6,724 patients who were hospitalized at NYU Langone Health (3/16/20 - 7/31/20) and tested positive for SARS-CoV-2, 580 had either active cancer (n = 221) or a history of cancer (n = 359). Patients were classified as having active malignancy if they either received treatment within six months of their COVID-19 diagnosis or they had measurable disease documented at the time of their hospitalization. Patients were categorized as having a history of cancer if there was no evidence of measurable disease or there were no treatments administered within six months of their COVID-19 diagnosis. We compared the baseline clinicodemographic characteristics and hospital courses of the two groups, and the relationship between cancer status and the rate of admission to the intensive care unit (ICU), use of invasive mechanical ventilation (IMV), and all-cause mortality. Results: There was no differences between the two groups in their baseline laboratory results associated with COVID-19 infection, incidence of venous thromboembolism, or incidence of severe COVID-19. Active cancer status was not associated with the rate of ICU admission ( P = 0.307) or use of IMV ( P = 0.236), but was significantly associated with worse all-cause mortality in both univariate and multivariate analysis with ORs of 1.48 (95% CI: 1.04-2.09; P = 0.028) and 1.71 (95% CI: 1.12-2.63; P = 0.014), respectively. Conclusions: Active cancer patients had worse survival outcomes compared to patients with a history of cancer despite similar COVID-19 disease characteristics in the two groups. Our data suggest that cancer care should continue with minimal interruptions during the pandemic to bring about response and remission as soon as possible. Additionally, these findings support the growing body of evidence that malignancy portends worse COVID-19 prognosis, and demonstrate that the risk may even apply to those without active disease.

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