scholarly journals Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhao Ding ◽  
Deshun Yu ◽  
Hefeng Li ◽  
Yueming Ding
Keyword(s):  
Marital Status ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Cox Regression ◽  
Group Analysis ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Prognostic Effect ◽  
The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

scholarly journals Trends of incidence and prognosis of primary adenocarcinoma of the bladder

2021 ◽  
Vol 13 ◽  
pp. 175628722110180
Author(s):  
Haowen Lu ◽  
Weidong Zhu ◽  
Weipu Mao ◽  
Feng Zu ◽  
Yali Wang ◽  
...  
Keyword(s):  
Prediction Model ◽  
Marital Status ◽  
Cox Regression ◽  
Tnm Staging ◽  
Primary Site ◽  
Primary Adenocarcinoma ◽  
Cancer Specific Survival ◽  
Training Cohort ◽  
Cox Regression Analysis ◽  
Ajcc Stage

Background: Primary adenocarcinoma of the bladder (ACB) is a rare malignant tumor of the bladder with limited understanding of its incidence and prognosis. Methods: Patients diagnosed with ACB between 2004 and 2015 were obtained from the SEER database. The incidence changes of ACB patients between 1975 and 2016 were detected by Joinpoint software. Nomograms were constructed based on the results of multivariate Cox regression analysis to predict overall survival (OS) and cancer-specific survival (CSS) in patients with ACB, and the constructed nomograms were validated. Results: The incidence of ACB was trending down from 1991 to 2016. A total of 1039 patients were included in the study and randomly assigned to the training cohort (727) and validation cohort (312). In the training cohort, multivariate Cox regression showed that age, marital status, primary site, histology type, grade, AJCC stage, T stage, SEER stage, surgery, radiotherapy, and chemotherapy were independent prognostic factors for OS, whereas these were age, marital status, primary site, histology type, grade, AJCC stage, T/N stage, SEER stage, surgery, and radiotherapy for CSS. Based on the above Cox regression results, we constructed prognostic nomograms for OS and CSS in ACB patients. The C-index of the nomogram OS was 0.773 and the C-index of CSS was 0.785, which was significantly better than the C-index of the TNM staging prediction model. The area under the curve (AUC) and net benefit of the prediction model were higher than those of the TNM staging system. In addition, the calibration curves were very close to the ideal curve, suggesting appreciable reliability of the nomograms. Conclusion: The incidence of ACB patients showed a decreasing trend in the past 25 years. We constructed a clinically useful prognostic nomogram for calculating OS and CSS of ACB patients, which can provide a personalized risk assessment for ACB patient survival.

scholarly journals Survival predictors of metastatic angiosarcomas: a surveillance, epidemiology, and end results program population-based retrospective study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shihong Ren ◽  
Yucheng Wang ◽  
Zhan Wang ◽  
Jinxiang Shao ◽  
Zhaoming Ye
Keyword(s):  
Tumor Size ◽  
Cox Regression ◽  
Radiation Treatment ◽  
Tumor Grade ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Metastatic Sites ◽  
Survival Predictors ◽  
End Results

Abstract Background Angiosarcomas (AS) have poor prognosis and often metastasize to distant sites. The potential predictors of metastatic angiosarcomas (MAS) have not been extensively investigated. The main objective of this study was to identify survival predictors of MAS. Methods Surveillance, Epidemiology, and End Results (SEER) datasets were used to identify patients with MAS from 2010 to 2016. Risk predictors were determined with the aid of Kaplan-Meier and Cox regression model analyses. Results A total of 284 MAS patients met the study entry criteria. Among these, 121 patients (42.6%) were diagnosed with metastasis in bone, 26 in brain (9.2%), 86 in liver (30.3%) and 171 in lung (60.2%). Overall, 96 patients (33.8%) had two or more metastatic sites. The 1- and 3-year overall survival (OS) rates were 20.8 and 3.8% while 1- and 3-year cancer-specific survival (CSS) rates were 22.0 and 5.2%, respectively. Cox regression analysis revealed chemotherapy, radiation treatment (RT) and tumor size ≤10 cm as independent favorable predictors of OS. In terms of CSS, tumor grade IV, tumor size > 10 cm and absence of chemotherapy were independent adverse predictors. Surgery did not prolong survival outcomes (both OS and CSS) in the current cohort. Conclusion MAS is associated with extremely poor survival. Chemotherapy, RT, and tumor size are independent predictors of OS. Chemotherapy and tumor size are independent prognostic factors of CSS. Chemotherapy is therefore recommended as the preferred treatment option for MAS patients.

Effect of Postoperative Radiotherapy in Thymoma Patients: A SEER-Based Study

2020 ◽  
pp. 1-7
Author(s):  
Haibo Mou ◽  
Yiyao Kong ◽  
Yingfang Wu ◽  
Ying Wu ◽  
Lanfang Yu
Keyword(s):  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
Population Based ◽  
Conditional Inference ◽  
Postoperative Radiation Therapy ◽  
Cancer Specific Survival ◽  
Prognostic Effect ◽  
Conditional Inference Tree ◽  
Masaoka Stage ◽  
Inference Tree

<b><i>Introduction:</i></b> The role of postoperative radiation therapy (PORT) for thymoma is under debate, especially in patients aged ≥60 years with an advanced stage (Masaoka stages III and IV). We aimed to evaluate the efficacy of PORT for thymoma in a population-based registry. <b><i>Methods:</i></b> A retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database was conducted to compare the outcomes of thymoma patients with or without PORT. The primary outcomes were overall survival (OS) and cancer-specific survival (CSS). Conditional inference tree analyses were performed for risk classification according to the study variables. Cox regression was performed to evaluate the prognostic effect of PORT in the specific subgroups. <b><i>Results:</i></b> A total of 2,236 patients were included. The conditional inference tree analysis identified that an age ≥60, a Masaoka stage ≥3, and the year of diagnosis were important factors when classifying patients into prognostic subgroups. PORT was found to be a protective predictor of OS in patients aged ≥60 years, those with a Masaoka stage III—IV, and those diagnosed after 2005. Further subgroup analyses revealed that PORT was significantly associated with a better OS (HR = 0.77) in patients aged ≥60 years, whereas it was not significantly associated with CSS. <b><i>Conclusions:</i></b> An older age (≥60 years) is critical for predicting survival outcomes in thymoma patients. Moreover, patients aged ≥60 years could benefit from PORT in terms of OS.

Adverse Prognostic Factors for Testicular Cancer–Specific Survival: A Population-Based Study of 27,948 Patients

2011 ◽  
Vol 29 (8) ◽  
pp. 963-970 ◽  
Author(s):  
Sophie D. Fosså ◽  
Milada Cvancarova ◽  
Linlin Chen ◽  
Annie L. Allan ◽  
Jan Oldenburg ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Marital Status ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Fold Increase ◽  
Population Based ◽  
Retroperitoneal Lymph Node Dissection ◽  
Cancer Specific Survival ◽  
Increased Risk ◽  
Specific Mortality

Purpose The prognostic significance of age at testicular cancer (TC) diagnosis, socioeconomic status (SES), race, and marital status on TC-specific mortality is not well-characterized. In a cancer that is so curable, it is important to identify any influence that confers an increased risk of TC-specific mortality. Patients and Methods Using multivariate cause-specific Cox regression models that accounted for competing risks, hazard ratios (HRs) were calculated for 10-year TC-specific mortality among 27,948 patients with TC reported to the Surveillance, Epidemiology and End Results program (1978 to 2006). Independent predictors were age at diagnosis, SES, race, marital status, extent of disease (EOD), calendar year of diagnosis, radiotherapy, and retroperitoneal lymph node dissection (RPLND). Results Compared with younger patients, diagnostic age 40+ was associated with increased mortality (seminoma, HR, 2.00, P < .001; nonseminoma, HR, 2.09; P < .001; most evident in metastatic disease, HR, 8.62; P < .001; HR, 6.35; P < .001, respectively). Unmarried men had two-to three-fold excess mortality compared to married men (HR, 2.97; P < .001; HR, 1.54; P < .001, respectively). Among nonseminoma patients, decreasing SES (P trend < .001) and nonwhite race (HR, 2.11; P < .001) increased mortality. Diagnosis after 1987 resulted in reduced mortality compared to earlier calendar years (HR, 0.58; P = .001; HR, 0.74; P = .001, respectively). Lack of RPLND was associated with seven-fold increase in death (P < .001). Conclusion TC-specific mortality is doubled among US patients diagnosed with seminoma or nonseminoma after age 40, even when initial treatment and EOD are taken into account. Among men with nonseminoma, nonwhite race and lower SES also significantly increase TC-specific mortality. Additional research is needed, enabling the development of interventional strategies and preventive approaches, as applicable.

scholarly journals Prognostic Models for Patients With Gleason Score 9 Prostate Cancer: A Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jianhui Qiu ◽  
Desheng Cai ◽  
Zixin Wang ◽  
Jingcheng Zhou ◽  
Yanqing Gong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Marital Status ◽  
Gleason Score ◽  
Cox Regression ◽  
Population Based ◽  
Competing Risk ◽  
Age At Diagnosis ◽  
Population Based Study ◽  
Cox Regression Analysis ◽  
Gleason Pattern

Purpose: Gleason score (GS) system is one of the most widely used histological grading methods for prostate cancer (PCa) all over the world. GS can be obtained by adding the primary Gleason pattern (GP) and secondary GP. Different proportions of GP 4 and GP 5 in prostate specimens can both lead to GS 9. In this study, we explored whether GP 5 + 4 or GP 4 + 5 was associated with different prognoses among patients with GS 9 PCa.Materials and methods: A retrospective population-based study was conducted on 10,124 subjects diagnosed with GS 9 PCa between 2004 and 2009 from the Surveillance, Epidemiology, and End Results program. A 1:1 propensity-score matching (PSM) was performed to balance the baseline characteristics between the GP 4 + 5 and 5 + 4 groups and to compare the prognoses between the two groups. Cox regression analysis and Fine-Gray competing risk regression models were adopted to screen the covariates significantly associated with all-cause mortality (ACM) and cancer-specific mortality (CAM).Results: GP 5 + 4 was associated with higher risks of ACM and CSM before or after PSM than GP 4 + 5. In the original cohort, there were eight independent predictors for ACM, which were age at diagnosis, race, AJCC NM stage, PSA levels, treatments, GP, and marital status, confirmed by the Cox analysis; and nine independent predictors for CSM, which were age at diagnosis, race, AJCC TNM stage, PSA levels, treatments, GP, and marital status, confirmed by the competing-risk model.Conclusion: GP 5 + 4 was associated with a poorer overall survival and cancer-specific survival compared with GP 4 + 5.

Kleinzelliges Lungenkarzinom: Interdisziplinär für oder wider eine Operation entscheiden

2020 ◽  
Vol 8 (6) ◽  
pp. 322-323
Author(s):  
Khosro Hekmat
Keyword(s):  
Lung Cancer ◽  
Tumor Size ◽  
Cox Regression ◽  
Population Based ◽  
Kleinzelliges Lungenkarzinom ◽  
Matched Cohort ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Patient Groups

<b>Background:</b> The role of surgery for small cell lung cancer (SCLC) is not clear. We aimed to evaluate this issue using a population-based database. <b>Methods:</b> Patients diagnosed between 2004 and 2014 with SCLC staged T1–4 N0–2 M0 disease were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM) was used to reduce bias between the surgical and nonsurgical patient groups. The Kaplan-Meier method and Cox regression analysis were used to compare overall survival (OS) for the matched patients. <b>Results:</b> A total of 8,811 patients were retrieved, including 863 patients who underwent surgical resection. After 1: 1 PSM, a matched cohort with 1,562 patients was generated. In the matched cohort, surgery was associated with 5-year OS improvement (from 16.8 to 36.7%, <i>p</i> &#x3c; 0.001) and lung cancer-specific survival improvement (from 21.6 to 43.2%, <i>p</i> &#x3c; 0.001). Survival benefits of surgery were significant in all subgroups, including N1–2 disease, except for patients with a tumor size &#x3e;5.0 cm or T3 disease. <b>Conclusions:</b> Patients with SCLC of limited stage can benefit from surgery, including N1–2 disease. However, patients with a tumor size &#x3e;5.0 cm or advanced T stage may be unable to benefit from surgery.

scholarly journals Comparison of risk factors for ischemic stroke and coronary events in a population-based cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iram Faqir Muhammad ◽  
Yan Borné ◽  
Suneela Zaigham ◽  
Martin Söderholm ◽  
Linda Johnson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Inflammatory Markers ◽  
Cox Regression ◽  
Population Based ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
The Difference ◽  
Coronary Events ◽  
Traditional Risk Factors

Abstract Background Although coronary events (CE) and ischemic stroke share many risk factors, there are also some important differences. The aim of this paper was to assess the association of risk factors in relation to incident CE and ischemic stroke and to evaluate the heterogeneity in patterns of risk factors between the two outcomes. Method Traditional risk factors and inflammatory markers associated with coronary events and ischemic stroke were measured in the Malmö Diet and Cancer Cohort (MDCS, n = 26 519), where a total of 2270 incident ischemic stroke and 3087 incident CE occurred during a mean follow up time 19 ± 6 years, and in relation to inflammatory markers in the cardiovascular sub-cohort (MDC-CV, n = 4795). Cox regression analysis was used to obtain hazard ratios. A modified Lunn-McNeil competing risk analysis was conducted to assess the significance of any differences in risk profiles of these outcomes. Results Most cardiovascular risk factors were associated both with incident CE and ischemic stroke. However, current smoking, ApoB, low ApoA1, male sex and education level of ≤ 9 years of schooling were preferentially associated with CE compared to ischemic stroke. Conversely, age showed a stronger association with ischemic stroke than with CE. Conclusion CE and ischemic stroke have broadly similar risk factors profiles. However, there are some important differential associations, as well as substantial differences in the magnitude of the association. These could reflect the distinct biology of atherogenesis in different vascular beds. The difference in the determinants highlights the importance of looking at CE and ischemic stroke, two manifestations of cardiovascular disease, separately.

scholarly journals Survival among cancers screened at the first stage of Dispanserization of certain groups of the adult population: a population-based epidemiological analysis

2021 ◽  
Vol 67 (4) ◽  
pp. 501-510
Author(s):  
Ludmila Valkova ◽  
Vakhtang Merabishvili ◽  
Aleksandra Pankratyeva ◽  
Anna Agaeva ◽  
Anton Ryzhov ◽  
...  
Keyword(s):  
Cox Regression ◽  
Cox Model ◽  
Adult Population ◽  
Treatment Method ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Before And After

Objective: to evaluate trends of survival in nine index malignant neoplasms (iMNs), which are screened at the first stage of the Dispanserization of certain groups of the adult population (DCGAP), on data of the Arkhangelsk regional cancer registry over a period 2006-2019. Materials and methods. We compared two seven-year periods 2006-2012 and 2013-2019, before and after the introduction of the DCGAP. The 1- and 5-year cancer-specific survival (CSS) rate was calculated using the life table and Kaplan-Meier methods with an assessment of the differences by log-rank. Cox regression analysis with sequential input was used to identify possible causes of differences in survival between periods and independent prognostic factors. Results. 37197 cases were selected for analysis. 5-year CSS estimates in 2013-2019 compared with the previous seven-year period significantly increased for all nine iMNs, by from 2.5% [2006-2012, 12.5% ​​(95% confidence interval (CI) 11.4-13.6%) vs 2013-2019, 15.0 (95% CI 13.7-16.5%)] in lung cancer up to 12.6% [2006-2012, 31.0% (95% CI 28.6-33.4%) vs 2013-2019, 43.6 (95% CI 40.8-46.2%)]. Correction for the stage (possible effect of screening) in the Cox model has led to a decrease in the hazard ratio (HR) of death from cancer of the colon, rectum, breast, kidney by 38-64%, no change for other iMNs; while for cervical cancer, it has increased. Adjustment for the variable "treatment method" led to a 34-100% decrease in the HR in the Cox model for all iMNs, except for prostate cancer. Conclusion. The increase in survival estimates for nine iMNs in 2013-2019 can be explained to a large extent by improved access to cancer-directed treatment and its quality; the contribution of DCGAP is possible in renal, breast and colorectal cancer. Key words: malignant neoplasms, screening, dispensarization of certain groups of the adult population, survival

scholarly journals Time to secondary progression in patients with multiple sclerosis who were treated with first generation immunomodulating drugs

2012 ◽  
Vol 19 (6) ◽  
pp. 765-774 ◽  
Author(s):  
H Tedeholm ◽  
J Lycke ◽  
B Skoog ◽  
V Lisovskaja ◽  
J Hillert ◽  
...  
Keyword(s):  
First Generation ◽  
Cox Regression ◽  
Disease Onset ◽  
Population Based ◽  
Time Interval ◽  
Period Effect ◽  
Disease Modifying Drugs ◽  
Cox Regression Analysis ◽  
Immunomodulating Therapy ◽  
The Difference

Background: It is currently unknown whether early immunomodulatory treatment in relapsing–remitting MS (RRMS) can delay the transition to secondary progression (SP). Objective: To compare the time interval from onset to SP in patients with RRMS between a contemporary cohort, treated with first generation disease modifying drugs (DMDs), and a historical control cohort. Methods: We included a cohort of contemporary RRMS patients treated with DMDs, obtained from the Swedish National MS Registry (disease onset between 1995–2004, n = 730) and a historical population-based incidence cohort (onset 1950–64, n = 186). We retrospectively analyzed the difference in time to SP, termed the “period effect” within a 12-year survival analysis, using Kaplan-Meier and Cox regression analysis. Results: We found that the “period” affected the entire severity spectrum. After adjusting for onset features, which were weaker in the contemporary material, as well as the therapy initiation time, the DMD-treated patients still exhibited a longer time to SP than the controls (hazard ratios: men, 0.32; women, 0.53). Conclusion: Our results showed there was a longer time to SP in the contemporary subjects given DMD. Our analyses suggested that this effect was not solely driven by the inclusion of benign cases, and it was at least partly due to the long-term immunomodulating therapy given.

scholarly journals The prognostic value of fat invasion and tumor expansion in the hilar veins in pT3a renal cell carcinoma

2021 ◽  
Author(s):  
Viktoria Stühler ◽  
Steffen Rausch ◽  
Katharina Kroll ◽  
Marcus Scharpf ◽  
Arnulf Stenzl ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Value ◽  
Cox Regression ◽  
Tnm Classification ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
The Difference ◽  
Risk Of Cancer

Abstract Purpose The 7th TNM classification summarizes renal cell carcinoma (RCC) with perirenal (PFI) and/or sinus fat invasion (SFI) as well as hilar vein involvement (RVI) as pT3a tumors. In this study, we aimed to determine the prognostic value of fat invasion (FI) in the different compartments and RVI for medium-term cancer-specific-survival (CSS) in pT3a RCC. Materials and methods Patients with pT3a RCC were identified using an institutional database. All original pathological reports were reclassified according to the 7th TNM edition. The prognostic value of FI as well as divided into PFI, SFI, combined PFI + SFI, and RVI for CSS was assessed using univariate and multivariate Cox-regression analysis. Survival was estimated using the Kaplan–Meier method. Results Median follow-up in 184 pT3a tumors was 38 months. FI was detectable in 153 patients (32.7% PFI, 45.1% SFI, 22.2% PFI + SFI), 31 patients showed RVI alone. Combined PFI + SFI increased the risk of cancer-related death compared to PFI (HR 3.11, p < 0.01), SFI (HR 1.84, p = 0.023) or sole RVI (HR 2.12, p = 0.025). In multivariate analysis, a combined PFI + SFI vs. PFI or SFI as the only compartment involved was confirmed as independent prognostic factor (HR 1.83, p = 0.029). Patients with FI and simultaneous RVI had significantly shorter CSS (HR 2.63, p < 0.01). In an unweighted model, the difference between patients with combined PFI + SFI and RVI and those with PFI alone was highest (HR 4.01, p = 0.029). Conclusions These results underline the subdivision of pT3a RCC depending on the location of FI and RVI for patient stratification.

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