Impact of Mesothelioma Histologic Subtype and Use of Cancer-Directed Surgery on Outcomes in the National Cancer Database

Author(s):  
A. Mansur ◽  
A. Potter ◽  
R. Meyerhoff ◽  
M. Lanuti ◽  
C.F.J. Yang
2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A773-A773
Author(s):  
Lifen Cao ◽  
Kavin Sugumar ◽  
Ankit Mangla ◽  
Megan Miller ◽  
Luke Rothermel

BackgroundImmune checkpoint inhibitors (ICI) and targeted therapies (TT) have improved the survival outcomes in patients with advanced melanoma. However, less is known about their impact on Asian patients with melanoma. In this study, we hypothesize that patients of Asian ancestry would have improved survival for advanced melanoma since the introduction of ICI and TT in 2011.MethodsAsian patients with melanoma were identified in the National Cancer Database (NCDB) from 2004–2016. Patient, tumor, and treatment characteristics were compared for populations treated before and after 2011 using Chi-square analyses. Overall survival (OS) was analyzed using Kaplan-Meier estimates.Results1,411 Asian patients with melanoma were identified. Overall, 21% were melanoma in situ, and 79% were invasive melanomas. 62% of patients did not have a documented histologic subtype. The most common reported histologies were superficial spreading (14%) and acral lentiginous (10%) melanomas. Primary locations included 41% lower extremity, 17% upper extremity, and 11% head and neck. The age at diagnosis has increased during the study period - 38% over 60 years old in 2004, to 54% in 2016 (P<0.002). Kaplan-Meier survival estimates were performed for the whole Asian melanoma population and showed worse OS for all patients diagnosed after 2011 compared with patients diagnosed before 2011 - 83% vs 84% at 24 months (P=0.0033), 71% vs 76% at 48 months (P<0.001), respectively. However, the OS for those stage IV melanomas diagnosed after 2011 is better compared to patients diagnosed before 2011 - 52% vs. 26% at 24 months (P<0.001), and 20% vs. 13% at 48 months (P<0.001), respectively. (table 1) The worse OS trend seen for all patients was driven by those with early stage disease and likely does not reflect melanoma specific survival. Utilization rates of ICI and TT in Stage IV melanoma in Asian populations was significantly higher after 2011 (9% versus 30% before and after 2011 respectively, p=0.026). This was comparable to the utilization rates of 12% vs 34% for all patients (all races) with stage IV melanomas captured in the NCDB for the periods from 2004–2011 and 2012–2016.Abstract 729 Table 1Survival for stage IV asian melanoma*Longest follow up time in group 2 (Asian Melanoma diagnosed 2012 and after)ConclusionsAsian patients with melanoma are receiving diagnoses at older ages. Despite decreases in OS for all Asian patients with melanoma, advanced stage IV of the diseases have improved outcomes for the group treated in the era of ICI and TT. Further investigation is warranted to understand the treatment, patient, and tumor characteristics that predict response in this demographic of patients.


2016 ◽  
Vol 55 (03) ◽  
pp. 77-89 ◽  
Author(s):  
Wolfgang Eschner ◽  
Frank Grünwald ◽  
Michael Lassmann ◽  
Frederik Verburg ◽  
Markus Luster ◽  
...  

ZusammenfassungDie Verfahrensanweisung zur Radioiodtherapie beim differenzierten Schilddrüsenkarzinom (Version 4) wurde von einer repräsentativen Expertengruppe im informellen Konsens verabschiedet und entspricht damit einer Leitlinie der ersten Stufe (S1) nach den Kriterien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Die Verfahrensanweisung ergänzt die S2-Leitlinie zur operativen Behandlung maligner Schilddrüsenerkrankungen um die nuklearmedizinischen Aspekte. Bezüglich der Indikationsstellung zur ablativen Radioiodtherapie beim kleinen papillären Schilddrüsenkarzinom und beim minimal invasiven follikulären Schilddrüsenkarzinom ohne Angioinvasion, bezüglich der empirischen Bemessung der 131I-Therapieaktivität sowie bezüglich der exogenen versus endogenen TSH-Stimulation bei der ablativen Radio-iodtherapie werden Handlungskorridore beschrieben. Der Text enthält die Auswertungen aus der National Cancer Database und der SEER-Database (jeweils USA), wonach die ablative Radioiodtherapie bereits in einer Niedrig-Risiko Konstellation die Überlebensrate verbessert. Der statistische Nachweis eines solchen Nutzens setzt ein nationales Krebsregister mit Langzeitdaten voraus.


2018 ◽  
Vol 09 (02) ◽  
pp. 90-91
Author(s):  
Kretzschmar Alexander

Ältere Patienten mit operablem nicht kleinzelligem Bronchialkarzinom (NSCLC) profitieren von einer extrakraniellen Stereotaxie (Stereotactic Body RadioTherapy; SBRT) mehr als von einer chirurgischen Resektion. In einem großen retrospektiven Propensity-gematchten und altersstratifizierten Vergleich von Patienten aus der US National Cancer Database (n = 27 200) verzeichneten die Patienten nach SBRT eine signifikant niedrigere Mortalität 30 und 90 Tage nach der Intervention (p < 0,001). Die Unterschiede waren am größten bei Patienten > 70 Jahre.


2020 ◽  
Author(s):  
Khodayar Goshtasbi ◽  
Brandom M. Lehrich ◽  
Arash Abiri ◽  
Tyler Yasaka ◽  
Frank P. Hsu ◽  
...  

2019 ◽  
Vol 7 (4) ◽  
pp. 391-399
Author(s):  
Roshan S Prabhu ◽  
Christopher D Corso ◽  
Matthew C Ward ◽  
John H Heinzerling ◽  
Reshika Dhakal ◽  
...  

Abstract Background Adult intracranial ependymoma is rare, and the role for adjuvant radiotherapy (RT) is not well defined. Methods We used the National Cancer Database (NCDB) to select adults (age ≥ 22 years) with grade 2 to 3 intracranial ependymoma status postresection between 2004 and 2015 and treated with adjuvant RT vs observation. Four cohorts were generated: (1) all patients, (2) grade 2 only, (3) grade 2 status post–subtotal resection only, (4) and grade 3 only. The association between adjuvant RT use and overall survival (OS) was assessed using multivariate Cox and propensity score matched analyses. Results A total of 1787 patients were included in cohort 1, of which 856 patients (48%) received adjuvant RT and 931 (52%) were observed. Approximately two-thirds of tumors were supratentorial and 80% were grade 2. Cohorts 2, 3, and 4 included 1471, 345, and 316 patients, respectively. There was no significant association between adjuvant RT use and OS in multivariate or propensity score matched analysis in any of the cohorts. Older age, male sex, urban location, higher comorbidity score, earlier year of diagnosis, and grade 3 were associated with increased risk of death. Conclusions This large NCDB study did not demonstrate a significant association between adjuvant RT use and OS for adults with intracranial ependymoma, including for patients with grade 2 ependymoma status post–subtotal resection. The conflicting results regarding the efficacy of adjuvant RT in this patient population highlight the need for high-quality studies to guide therapy recommendations in adult ependymoma.


2019 ◽  
Vol 229 (4) ◽  
pp. S270-S271
Author(s):  
Tommy Ivanics ◽  
Shravan Leonard-Murali ◽  
Xiaoxia Han ◽  
Christopher P. Steffes ◽  
Rupen A. Shah ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3465
Author(s):  
Aya Saleh ◽  
Ruth Perets

Mutations in tumor suppressor gene TP53, encoding for the p53 protein, are the most ubiquitous genetic variation in human ovarian HGSC, the most prevalent and lethal histologic subtype of epithelial ovarian cancer (EOC). The majority of TP53 mutations are missense mutations, leading to loss of tumor suppressive function of p53 and gain of new oncogenic functions. This review presents the clinical relevance of TP53 mutations in HGSC, elaborating on several recently identified upstream regulators of mutant p53 that control its expression and downstream target genes that mediate its roles in the disease. TP53 mutations are the earliest genetic alterations during HGSC pathogenesis, and we summarize current information related to p53 function in the pathogenesis of HGSC. The role of p53 is cell autonomous, and in the interaction between cancer cells and its microenvironment. We discuss the reduction in p53 expression levels in tumor associated fibroblasts that promotes cancer progression, and the role of mutated p53 in the interaction between the tumor and its microenvironment. Lastly, we discuss the potential of TP53 mutations to serve as diagnostic biomarkers and detail some more advanced efforts to use mutated p53 as a therapeutic target in HGSC.


2021 ◽  
pp. 983-988
Author(s):  
Daniel Cirotski ◽  
Jyoti Panicker

Osteosarcoma is the most common primary bone cancer in all age groups. Metastasis mostly occurs with high-grade tumors disseminating to the lungs and other bones. Spread to the pancreas is rare and undocumented in the low-grade subtypes. Additionally, it is uncommon for the disease course of low-grade subtypes to involve multiple relapses. We present a 35-year-old woman with parosteal osteosarcoma who has experienced an atypical metastasis to the pancreas as well as multiple local and pulmonary relapses. The lesion was identified incidentally on routine imaging, and the patient underwent resection. We compare our case to the other reports of pancreatic metastasis in the literature. Despite being especially rare, clinicians ought to be aware of pancreatic metastasis of osteosarcoma. Furthermore, despite parosteal osteosarcoma’s less aggressive disease course, it can uncommonly lead to multiple relapses. We present a rare case exemplifying these phenomena in the prognostically favorable histologic subtype of parosteal osteosarcoma.


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