scholarly journals Incidence and characteristics of death from peptic ulcer among cancer patients in the United States

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pengcheng Yang ◽  
Yongqiang Zheng ◽  
Lei Zhang ◽  
Xiaohua Hou

AbstractMost cancer patients die of non-cancer causes, and peptic ulcer is one cause that deserves attention. To characterize the incidence and risk factors of death from peptic ulcer among cancer patients, we extracted the data of cancer patients registered in the Surveillance Epidemiology and End Results (SEER) program from 1975 to 2016. Out of the 8,471,051 patients extracted from SEER, 4,698 died from peptic ulcer, with a mortality rate of 9.08/100,000 person-years. Meanwhile, the mortality rate in the general population was 5.09/100,000 person-years, giving a standardized mortality ratio (SMR) of 1.78 (95% confidence interval, 1.73–1.84). Patients who are female, of other race, unmarried, and with distant tumor stage have greater SMRs. A higher SMR was associated with a younger age at diagnosis. Among those aged < 40 years at diagnosis, the plurality of fatal peptic ulcers occurred in patients with leukemia and lymphoma, while in patients aged > 40 years, the majority occurred in those with prostate, breast, colorectum, and lung cancer. Patients with upper digestive system malignancies had the highest SMRs and hazard ratios (HRs), which could be ascribed to radiotherapy-induced damage to the gastroduodenum. The risk declined rapidly one year after diagnosis. However, the SMRs in the upper digestive system cancer survivors increased significantly over ten years after diagnosis. Upper digestive system cancers adjacent to the gastroduodenum were associated with higher SMRs and HRs compared with other types of cancer, possibly contributing partially to the damage caused by radiotherapy on the radiosensitive gastroduodenum.

2015 ◽  
Vol 25 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Noori Akhtar-Danesh ◽  
Laurie Elit ◽  
Alice Lytwyn

ObjectiveThe main objective of this article was to investigate the trends in relative survival in women diagnosed with invasive squamous cell vulvar cancer in the United States during the periods of 2004 to 2011 and to examine how these trends are associated with the stage of tumor at diagnosis.MethodsWe identified patients with primary invasive squamous cell vulvar cancer and recorded tumor stage in the Surveillance, Epidemiology, and End Results cancer registry database. Women younger than 40 years were excluded because of small number of patients in this age group. A flexible parametric model was used to estimate 1- and 2-year relative survival ratios and excess mortality rate.ResultsIn total, 4647 women were identified with invasive squamous cell vulvar cancer and known tumor stage in the data set. One- and two-year relative survival ratios increased over time for women with tumors staged I to III but it decreased for women with tumor staged IV. The excess mortality rate was much larger for stage IV compared to the other stages.ConclusionsTrends in relative survival ratio for invasive vulvar cancer patients have opposite directions depending on the stage of tumor. The mechanism of such behavior is not fully known and yet to be examined in future studies. However, this finding highlights the importance of early detection of preinvasive and early stage disease.


2020 ◽  
Vol 34 (6) ◽  
pp. 723-735 ◽  
Author(s):  
Jesper N⊘rgaard Kjær ◽  
Robert Biskin ◽  
Claus Vestergaard ◽  
Povl Munk-J⊘rgensen

Patients with borderline personality disorder (BPD) are known to present frequently in emergency rooms, and they have a high rate of suicide. The mortality rate of patients with BPD is still unclear. The Danish Psychiatric Central Research Register and The Danish Register for Causes of Death were used to identify patients with a first-ever diagnosis of BPD (ICD-10: F60.31) from 1995 through 2011 together with time and cause of death. A total of 10,545 patients with a BPD diagnosis were followed for a mean time of 7.98 years. A total of 547 deaths were registered. The standardized mortality ratio of patients with BPD compared to the general population was 8.3 (95% CI [7.6, 9.1]). More than three inpatient admissions per year or a comorbid diagnosis of substance use disorder correlated with a higher mortality rate. The increased mortality rate in patients with BPD treated in secondary care emphasizes that it is a severe mental disorder.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252304
Author(s):  
Dirk Stefani ◽  
Balazs Hegedues ◽  
Stephane Collaud ◽  
Mohamed Zaatar ◽  
Till Ploenes ◽  
...  

Background Torque teno virus (TTV) is a ubiquitous non-pathogenic virus, which is suppressed in immunological healthy individuals but replicates in immune compromised patients. Thus, TTV load is a suitable biomarker for monitoring the immunosuppression also in lung transplant recipients. Since little is known about the changes of TTV load in lung cancer patients, we analyzed TTV plasma DNA levels in lung cancer patients and its perioperative changes after lung cancer surgery. Material and methods Patients with lung cancer and non-malignant nodules as control group were included prospectively. TTV DNA levels were measured by quantiative PCR using DNA isolated from patients plasma and correlated with routine circulating biomarkers and clinicopathological variables. Results 47 patients (early stage lung cancer n = 30, stage IV lung cancer n = 10, non-malignant nodules n = 7) were included. TTV DNA levels were not detected in seven patients (15%). There was no significant difference between the stage IV cases and the preoperative TTV plasma DNA levels in patients with early stage lung cancer or non-malignant nodules (p = 0.627). While gender, tumor stage and tumor histology showed no correlation with TTV load patients below 65 years of age had a significantly lower TTV load then older patients (p = 0.022). Regarding routine blood based biomarkers, LDH activity was significantly higher in patients with stage IV lung cancer (p = 0.043), however, TTV load showed no correlation with LDH activity, albumin, hemoglobin, CRP or WBC. Comparing the preoperative, postoperative and discharge day TTV load, no unequivocal pattern in the kinetics were. Conclusion Our study suggest that lung cancer has no stage dependent impact on TTV plasma DNA levels and confirms that elderly patients have a significantly higher TTV load. Furthermore, we found no uniform perioperative changes during early stage lung cancer resection on plasma TTV DNA levels.


1983 ◽  
Vol 69 (5) ◽  
pp. 437-443 ◽  
Author(s):  
Claudio Modini ◽  
Mario Albertucci ◽  
Franco Cicconetti ◽  
Donatella Tirindelli Danesi ◽  
Renzo Cristiani ◽  
...  

The classification of bronchogenic carcinoma as a function of the prognosis is still an open field. The evaluation of stage, by use of the TNM system, and histologic cell type is not sufficient to guarantee a correct prognosis. The growth rate of the neoplasm is another important parameter. We propose a classification that takes into account the stage (S), histologic cell type (M), immune status (I) and the growth rate of the primary tumor (G): S.M.I.G. We studied 90 lung cancer patients according to the S.M.I.G. classification and we observed that their prognoses were directly correlated with their S.M.I.G. scores (the higher the score, the higher the 10-month mortality rate). The mortality rates within the first 10 months of follow-up were respectively 0%, 0%, 36.36%, 68%, 90.9% for the 5 groups obtained by S.M.I.G. The difference is statistically significant (P < 0.0075) and there is a linear correlation between the mortality rate and the score assigned to each group (R = 0.943; P < 0.05). The S.M.I.G. classification can predict the prognosis more efficiently than the usual classification (TNM) and histological cell type.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 108s-108s
Author(s):  
T. Pham ◽  
S. Jiang ◽  
A. Rositch

Background: As the life expectancy of Americans becomes longer, the number of individuals who are diagnosed with cancer and other comorbidities increases rapidly. Management of these patients can become increasingly complicated as physicians administer multiple combinations of drugs and therapies. However, the complexities of how age and comorbidities affect receipt of cancer treatment are not well understood. Aim: To explore the association between age, comorbidities, and subsequent cancer treatment in the elderly diagnosed with the four most common types of cancer in the United States. Methods: We used SEER-Medicare data, which covers 28% of the U.S. population, to explore the association between age, comorbidities, and receipt of cancer treatment within 6 months of diagnosis in 727,136 individuals over 65 years old and diagnosed with breast, colorectal, lung, and prostate cancer from 1992-2011. Comorbidity burden was measured using the Charlson Comorbidity Index (CCI) and analyzed as four quantities (Q1: lowest CCI score to Q4: highest CCI score). Poisson regression models were used to assess the associations between comorbidities and cancer treatment, and whether age modified this relationship. Results: Cancer treatment proportion declined rapidly with age for all cancers while median CCI scores increased with age among breast, colorectal, prostate cancer patients and appeared stable among lung cancer patients. For example, individuals aged 76-99 had higher CCI scores ( P < 0.001) and were less likely to be treated (69.8% vs. 81.1% of those age 66-75 year; P < 0.001). After adjustment for potential confounders, we found that high CCI scores (Q3-Q4) were associated with substantially lower cancer treatment rates compared to low CCI score (Q1) in all cancer patients aged 76-99. Regarding individuals aged 66-75, high CCI scores (Q3-Q4) were not associated with lower colorectal cancer treatment rates, and only the highest CCI score group (Q4) was associated with a modest reduction in breast and prostate cancer treatment rates compared to low CCI score (Q1) (PR [95% CI]: 0.97 [0.95-0.99] and 0.91 [0.88-0.93], respectively). Additional multivariable analysis showed that older patients (aged 76-99) with low CCI score (Q1-Q2) had equal or lower treatment rates compared to younger patients (aged 66-75) with the highest CCI scores (Q4). Conclusion: Our findings suggested that among those aged 66-75 years, comorbidities are less likely to influence the receipt of treatment when compared to individuals aged 76-99. The potential harms and benefits of treatment given these age by comorbidity interactions are not clear, but using curative interventions that only have a modest benefit in a highly comorbid aging population could potentially decrease patients' quality of life.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19683-19683
Author(s):  
M. Choi ◽  
W. Chan ◽  
J. Jaiwatana ◽  
T. Khansur

19683 Background: More than 2/3 of lung cancer patients are age = 65 and the proportion of elderly patients are expected to rise in the United States. However data on the use of optimal chemoradiotherapy in this group of patients are limited. Methods: All lung cancer patients = 65 years, who received both chemotherapy and radiation therapy at the G. V. Montgomery VAMC between Jan 2000 to Dec 2005, were analyzed from tumor registry and computerized medical records. Patients who only received palliative radiation therapy for bone and brain metastasis were excluded. Results: Among 652 lung cancer patients diagnose, 46 patients = 65 years received both chemotherapy and radiation therapy over the 6 year study period. The median age was 72 (range:65–84) and 70% of the patients were = 70 years. All patients were male with 65% white and 35% black population. The majority of patients were stage III (85%) while there was one stage I and six stage II patients. 41 patients (89%) were able to complete the planned radiation therapy and median dose delivered was 6140 cGy. The chemotherapy regimen was carboplatin and paclitaxel either weekly during radiation therapy and every three weeks in sequential treatment. There was only 1 treatment related mortality and only 15% of patients survived less than 6 months. The 1, 2, 3 year survival rates were 67%, 24%, and 15% respectively and median survival was 15.3 months. 15 patients were treated sequentially(S) with chemotherapy (median cycle-3) followed by radiation therapy and 31 patients concurrently (C) with chemoradiotherapy. (median- 5 weekly treatment) The survival among the two groups did not differ statistically. (median survival-19.1 month (S) vs. 14 month (C) p=0.78) Conclusions: Both sequential and concurrent chemoradiotherapy is feasible and beneficial in elderly patients with lung cancer. Sequential treatments might be as effective as concurrent chemoradiotherapy in elderly VA patient population. No significant financial relationships to disclose.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18117-e18117
Author(s):  
Shweta Shah ◽  
Joshua Noone ◽  
Christopher Michael Blanchette ◽  
Susan T Arthur

e18117 Background: Lung cancer is the leading cause of cancer death in the United States. It is estimated that 60% of lung cancer patients are afflicted with cancer-associated cachexia syndrome (CACS) and approximately 10% of these patients will die due to CACS. We examined the impact of CACS on survival among lung cancer elderly patients. Methods: We conducted a retrospective study using SEER-Medicare data. Patients were included if diagnosed with first primary lung cancer between January 1, 2005 and December 31, 2010, at least 66 years of age, and continuously enrolled in Medicare Parts A and B in the 12 months prior to diagnosis. We identified cachexia in lung cancer patients using ICD-9 codes. Descriptive statistics were used to identify population characteristics. Propensity score (1:1 nearest neighbor) matching was performed between cachectic and non-cachectic lung cancer patients to compare survival. Results: We identified 84,518 lung cancer patients. Of these, 2,536 (3%) developed CACS after lung cancer diagnosis. The most common comorbid conditions among cachectic and non-cachectic groups were chronic obstructive pulmonary disease (50% versus 45.62%), congestive heart failure (8.56% versus 13.38%), diabetes (7.41% versus 14.75%), peripheral vascular disease (3.82% versus 6.85%), and renal disease (3.63% versus 6.14%). Propensity score 1:1 matching for confounding bias and adjustment for immortal time bias resulted in a cohort of 3734 matched patients. Eighty-eight percent of patients in the cachectic group died during the follow-up period compared to 78% in the non-cachectic group. Median survival time among non-cachectic lung cancer patients was significantly longer than cachectic lung cancer patients (log-rank p < 0.0001). Specifically, median survival in non-cachectic patients was 201 days compared to 92 days among cachectic patients. Conclusions: The occurrence of CACS is independently associated with a significant decrease in survival among lung cancer elderly patients. The results of this study may be useful for identifying healthcare burden and planning treatment modalities for this population.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yanhong Shang ◽  
Xiaofang Li ◽  
Weiwei Liu ◽  
Xiaoliang Shi ◽  
Shaohua Yuan ◽  
...  

AbstractLung cancer is the leading causes of cancer-related death worldwide. Precise treatment based on next-generation sequencing technology has shown advantages in the diagnosis and treatment of lung cancer. This cohort study included 371 lung cancer patients. The lung cancer subtype was related to the smoking status and sex of the patients. The most common mutated genes were TP53 (62%), EGFR (55%), and KRAS (11%). The mutation frequencies of EGFR, TP53, PIK3CA, NFE2L2, KMT2D, FGFR1, CCND1, and CDKN2A were significantly different between lung adenocarcinoma and lung squamous cell carcinoma. We identified the age-associated mutations in ALK, ERBB2, KMT2D, RBM10, NRAS, NF1, PIK3CA, MET, PBRM1, LRP2, and CDKN2B; smoking-associated mutations in CDKN2A, FAT1, FGFR1, NFE2L2, CCNE1, CCND1, SMARCA4, KEAP1, KMT2C, and STK11; tumor stage-associated mutations in ARFRP1, AURKA, and CBFB; and sex-associated mutations in EGFR. Tumor mutational burden (TMB) is associated with tumor subtype, age, sex, and smoking status. TMB-associated mutations included CDKN2A, LRP1B, LRP2, TP53, and EGFR. EGFR amplification was commonly detected in patients with acquired lcotinib/gefitinib resistance. DNMT3A and NOTCH4 mutations may be associated with the benefit of icotinib/gefitinib treatment.


2018 ◽  
Vol 4 (4) ◽  
pp. 00030-2018 ◽  
Author(s):  
Jacobus Adrianus Burgers ◽  
Ronald Alphons Damhuis

Systemic treatment is the standard treatment for unresectable stage III and IV lung cancer. Nevertheless, a 5–10% death rate has been described within 30 days after the last systemic treatment, suggesting that these patient did not benefit. We analysed the 30-day mortality after start of systemic therapy.Data were retrieved from the Netherlands National Cancer Registry. From 2010 to 2015, 26 277 patients were included. 56% were men. The median age was 65 years and 31% of patients were aged ≥70 years. 27% involved small cell lung cancer and 73% nonsmall cell lung cancer. Overall mortality within 30 days after the start of systemic treatment was 6.2%. Multivariable analysis established the prognostic influence of age, histology, number of metastatic sites and type of systemic treatment. Chemotherapy was administered in 77 hospitals, treating each 15–161 lung cancer patients with systemic therapy annually. None of the hospitals had a significantly higher 30-day mortality according to hierarchical multivariable analysis, controlling for case-mix.In the Netherlands, the 30-day mortality rate after start of systemic therapy for lung cancer patients was comparable with earlier reports. Hospital volume did not influence the 30-day mortality rate. 30-day mortality rate is not a meaningful indicator to monitor quality of care.


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