scholarly journals Sidedness determines clinical characteristics and survival outcomes in medullary adenocarcinoma of the colon

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew M. Blakely ◽  
Rebecca A. Nelson ◽  
Stanley A. Hamilton ◽  
Lily L. Lai

AbstractColon medullary adenocarcinoma (MAC) is a rare histologic subtype. Clinical presentation and cancer outcomes of MAC, compared to colon adenocarcinoma (AC), remain incompletely described. Annual age-adjusted incidence rates were computed using Surveillance, Epidemiology, and End Results (2002–2017). A cohort analysis using the National Cancer Database (2010–2016) compared patient characteristics in an unmatched dataset and prognostic characteristics in a 1:1 matched subset. Reported annual age-adjusted incidence of MAC has significantly increased, with an average annual percent change (APC) increase of 23.8% (95% CI: 19.2–28.6); concurrent AC incidence declined (APC: − 2.8, 95% CI: − 3.1 to − 2.8). Analyses of 1018 MAC and 210,784 AC unmatched patients showed that MAC patients were more often older, female, and white, with higher disease stage, poorly-differentiated tumors, right-sided laterality, and lymphovascular invasion (all p < 0.0001). Among those with known microsatellite status, instability was more prevalent among MAC than AC patients (82% vs. 24%, p < 0.0001). Multivariate analyses of the matched dataset revealed that MAC histology was not independently associated with overall survival. However, when stratifying by laterality, left-sided MAC was associated with shorter survival when compared to right-sided MAC (HR 1.66, 95% CI 1.16–2.38) and right-sided AC (HR 1.54, 95% CI 1.12–2.12). The reported incidence of MAC is increasing, in contrast to the declining incidence of AC. MAC clinical and molecular features are distinct from AC and likely account for outcome differences. Overall, left-sided MAC was associated with the shortest OS. Molecular profiling may improve treatment guidelines for MAC.

2021 ◽  
Author(s):  
Andrew M. Blakely ◽  
Rebecca A. Nelson ◽  
Stanley A. Hamilton ◽  
Lily L. Lai

Abstract Background: Colon medullary adenocarcinoma (MAC) is a rare histologic subtype. Clinical presentation and cancer outcomes of MAC, compared to colon adenocarcinoma (AC), remain incompletely described.Methods: Annual age-adjusted incidence rates were computed using Surveillance, Epidemiology, and End Results (2002–2017). A cohort analysis using the National Cancer Database (2010–2016) compared patient characteristics in an unmatched dataset and prognostic characteristics in a 1:1 matched subset. Results: Reported annual age-adjusted incidence of MAC has significantly increased, with an average annual percent change (APC) increase of 23.8% (95% CI: 19.2–28.6); concurrent AC incidence declined (APC: -2.8, 95% CI: -3.1– -2.8). Analyses of 1,018 MAC and 210,784 AC unmatched patients showed that MAC patients were more often older, female, and white, with higher disease stage, poorly-differentiated tumors, right-sided laterality, and lymphovascular invasion (all p<0.0001). Among those with known microsatellite status, instability was more prevalent among MAC than AC patients (82% vs. 24%, p<0.0001). Multivariate analyses of the matched dataset revealed that MAC histology was not independently associated with overall survival. However, when stratifying by laterality, left-sided MAC was associated with shorter survival when compared to right-sided MAC (HR 1.62, 95% CI: 1.13–2.32) and right-sided AC (HR 1.53, 95% CI: 1.12–2.11).Conclusions: The reported incidence of MAC is increasing, in contrast to the declining incidence of AC. MAC clinical and molecular features are distinct from AC and likely account for outcome differences. Overall, left-sided MAC was associated with the shortest OS. Molecular profiling may improve treatment guidelines for MAC.


2021 ◽  
Author(s):  
Yufeng Wang ◽  
Xueying Huang ◽  
Huan Ma ◽  
Suru Yue ◽  
Jie Liu ◽  
...  

Abstract Background Migraine is a common disorder of the nervous system in China, imposing heavy burdens on individuals and societies. Optimal healthcare planning requires understanding the magnitude and changing trend of migraine incidence in China. However, the secular trend of migraine incidence in China remains unclear. Methods Data were collected from the Global Burden of Disease Study 2019 in China from 1990 to 2019 to investigate changes in the incidence rate of migraine. The average annual percent change and relative risk were calculated using joinpoint regression and an age–period–cohort model, respectively. Results From 1990 to 2019, the age-standardized incidence rates of migraine in China increased by 0.26% (95% CI: 0.22 to 0.31) and 0.23% (95% CI: 0.19 to 0.28) per year in males and females, respectively. The age effect exerted the most significant impact on the incidence of migraine. The period effect showed a slightly decreasing trend in the incidence of migraine. In terms of the cohort effect, people born after the 1960s presented a higher risk of migraine as compared with the total cohort, with the occurrence risk of migraine increasing with birth cohorts. Conclusion Migraine incidence shows an overall increasing trend in China, with a significant gender difference. An intensive understanding of the risk characteristics and disease pattern of migraine could allow the early detection of persons with a high risk of developing migraine and promote the development of timely intervention measures to relieve this burden effectively.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18104-18104
Author(s):  
A. Wong ◽  
S. W. Lim ◽  
T. M. Chin ◽  
R. Soong ◽  
R. A. Soo

18104 Background: Asian NSCLC patients are known to have higher response rates to the EGFR TKI gefitinib (G) and erlotinib (E). Anecdotal reports suggest some activity for a second EGFR TKI after failure of the first. Methods: A retrospective review of the electronic pharmacy records, clinical and radiographic records of patients with advanced NSCLC at the National University Hospital who received both G and E in the previous 2 years was conducted. Objectives were to assess the disease control (response/stable disease) of the second TKI after failure of the first and characterize the clinical, pathological and molecular features of patients benefiting from a 2nd TKI. Results: 14 patients with advanced NSCLC who received a 2nd EGFR TKI after progression on the 1st TKI were identified. Patient characteristics: Chinese 12, female 10, and non-smokers 13. Histologic subtype: adenocarcinoma 7, bronchioloalveolar carcinoma (BAC) 3, squamous-cell carcinoma 1, NSCLC unspecified 3. 12 patients received cytotoxic chemotherapy with a median of 2 lines, (range 1–5). G and E was used as 1st/2nd/3rd/=4th line treatment in 8/2/2/2 and 0/4/2/8 patients respectively. G was used before E in 13 cases and disease control was seen in 8/14 (57%) patients. With a 2nd TKI after disease progression, disease control was seen 4/14 (28%) patients. Patient characteristics were: adenocarcinoma 3, BAC 1, all were never smokers and all received and responded to prior G. Median duration of control in these 4 patients for G was 8 (range 7–12) months, and subsequently to E was 2.5 (range 2–8) months. Disease control was associated with symptomatic improvement. Conclusion: This study documents disease control in 28% of Asian NSCLC patients treated with a second EGFR TKI after failure of a first. The molecular basis for these observations is currently being investigated. No significant financial relationships to disclose.


2020 ◽  
Vol 9 (11) ◽  
pp. 3396
Author(s):  
Sebastian Podlipnik ◽  
Cristina Carrera ◽  
Aram Boada ◽  
Nina Richarz ◽  
Joaquim Marcoval ◽  
...  

The incidence of melanoma has been increasing worldwide during recent decades. The objective of the study was to analyse the trends in incidence for in situ and invasive melanoma in the Spanish region of Catalonia during the period of 2008–2017. We designed a cross-sectional study with an age-period-cohort analysis of melanoma patient data from the Network of Melanoma Centres in Catalonia. Our database covered a population of over seven million and included a total of 8626 patients with incident melanoma. The main outcome measures were crude and age-standardised incidence rates to the European 2013 standard population. Joinpoint regression models were used to evaluate the population trends. We observed an increase in the age-standardised incidence rate (per 100,000 population) of all melanoma subtypes from 11.56 in 2008 to 13.78 in 2017 with an average annual percent change (AAPC) of 3.5%. This incidence increase was seen exclusively in the older population. Moreover, the stratified analysis showed a statistically significant increase in the age-standardised incidence rate for invasive (AAPC 2.1%) and in situ melanoma (AAPC 6.5%). In conclusion, the incidence of melanoma has continued to increase in the elderly population over recent decades, with a rapidly increasing trend of in situ melanomas and the lentigo maligna subtype.


2014 ◽  
Vol 8 (7-8) ◽  
pp. 247 ◽  
Author(s):  
Giorgio Gandaglia ◽  
Praful Ravi ◽  
Firas Abdollah ◽  
Abd-El-Rahman M. Abd-El-Barr ◽  
Andreas Becker ◽  
...  

Introduction: This is a timely update of incidence and mortality for renal cell carcinoma (RCC) in the United States.Methods: Relying on the Surveillance, Epidemiology, and End Results (SEER) database, we computed age-adjusted incidence, mortality rates and 5-year cancer-specific survival (CSS) for patients with histologically confirmed kidney cancer between 1975 and 2009. Long-term (1975–2009) and short-term (2000–2009) trends were examined by joinpoint analysis, and quantified using the annual percent change (APC). The reported findings were stratified according to disease stage.Results: Age-adjusted incidence rates of RCC increased by +2.76%/year between 1975 and 2009 (from 6.5 to 17.1/100 000 person years, p < 0.001), and by +2.85%/year between 2000 and 2009 (p < 0.001). For the same time points, the corresponding APC for the incidence of localized stage were +4.55%/year (from 3.0 to 12.2/100 000 person years, p < 0.001), and +4.42%/year (p < 0.001), respectively. The incidence rates of regional stage increased by +0.88%/year between 1975 and 2009 (p < 0.001), but stabilized in recent years (2000–2009: +0.56%/year, p = 0.4). Incidence rates of distant stage remained unchanged in long- and short-term trends. Overall mortality rates increased by +1.72%/year between 1975 and 2009 (from 1.2 to 5.0/100 000 person-years, P<0.001), but stabilized between 1994 and 2004 (p = 0.1). Short-term mortality rates increased in a significant fashion by +3.14%/year only for localized stage (p < 0.001).Interpretation: In contemporary years, there is a persisting upward trend in incidence and mortality of localized RCC.


2020 ◽  
Author(s):  
Paul Wekesa ◽  
Angela McLigeyo ◽  
Kevin Owuor ◽  
Jonathan Mwangi ◽  
Linda Isavwa ◽  
...  

Abstract Background Retention of patients who did not to initiate antiretroviral therapy (ART) has been persistently low compared to those initiated ART. Understanding the temporal trends in clinical outcomes prior to ART initiation is important to inform interventions targeting patients who do not initiate ART immediately after diagnosis. Methods A retrospective cohort analysis of known HIV-infected patients who did not initiate ART from healthcare facilities in Central Kenya was done to investigate temporal trends in characteristics, retention, and mortality outcomes. The data were sourced from the Comprehensive Care Clinic Patient Application Database (CPAD) and IQ care electronic patient-level databases for those enrolled between 2004 and 2014. Results A total of 13,779 HIV-infected patients were assessed, of whom 30.7% were men.There were statisitically significant differences in temporal trends relating to marital status, WHO clinical stage, and tuberculosis (TB) status from 2004 to 2014. The proportion of widowed patients decreased from 9.1–6.0%. By WHO clinical stage at enrollment in program, those in WHO stage I increased over time from 8.7–43.1%, while those in WHO stage III and IV reduced from 28.5–10.8% and 4.0–1.1% respectively. Those on TB treatment during their last known visit reduced from 8.3–3.9% while those with no TB signs increased from 58.5–86.8%. Trends in 6 and 12 month retention in the program, loss to follow-up (LTFU) and mortality were statistically significant. At 6 months, program retention ranged between 36.0% in 2004 to a high of 54.1% in 2013. LTFU at six months remained around 50.0% for most of the cohorts, while mortality at 6 months was 7.5% in 2004 but reduced to 3.8% in 2014. At 12 months, LTFU was above 50.0% across all the cohorts while mortality rate reached 3.9% in 2014. Conclusion Trends in pre ART enrollment suggested higher enrollment among patients who were women and at earlier WHO clinical stages. Retention and mortality outcomes at 6 and 12 months generally improved over the 11 year follow-up period, though dipped as enrollment in asymptomatic disease stage increased.


2020 ◽  
Author(s):  
Paul Wekesa ◽  
Angela McLigeyo ◽  
Kevin Owuor ◽  
Jonathan Mwangi ◽  
Linda Isavwa ◽  
...  

Abstract Background Retention of patients who did not to initiate antiretroviral therapy (ART) has been persistently low compared to those initiated ART. Understanding the temporal trends in clinical outcomes prior to ART initiation is important to inform interventions targeting patients who do not initiate ART immediately after diagnosis. Methods A retrospective cohort analysis of known HIV-infected patients who did not initiate ART from healthcare facilities in Central Kenya was done to investigate temporal trends in characteristics, retention, and mortality outcomes. The data were sourced from the Comprehensive Care Clinic Patient Application Database (CPAD) and IQ care electronic patient-level databases for those enrolled between 2004 and 2014. Results A total of 13,779 HIV-infected patients were assessed, of whom 30.7% were men.There were statisitically significant differences in temporal trends relating to marital status, WHO clinical stage, and tuberculosis (TB) status from 2004 to 2014. The proportion of widowed patients decreased from 9.1% to 6.0%. By WHO clinical stage at enrollment in program, those in WHO stage I increased over time from 8.7% to 43.1%, while those in WHO stage III and IV reduced from 28.5% to 10.8% and 4.0% to 1.1% respectively. Those on TB treatment during their last known visit reduced from 8.3% to 3.9% while those with no TB signs increased from 58.5% to 86.8%. Trends in 6 and 12 month retention in the program, loss to follow-up (LTFU) and mortality were statistically significant. At 6 months, program retention ranged between 36.0% in 2004 to a high of 54.1% in 2013. LTFU at six months remained around 50.0% for most of the cohorts, while mortality at 6 months was 7.5% in 2004 but reduced to 3.8% in 2014. At 12 months, LTFU was above 50.0% across all the cohorts while mortality rate reached 3.9% in 2014. Conclusion Trends in pre ART enrollment suggested higher enrollment among patients who were women and at earlier WHO clinical stages. Retention and mortality outcomes at 6 and 12 months generally improved over the 11 year follow-up period, though dipped as enrollment in asymptomatic disease stage increased.


Author(s):  
Ravit Bassal ◽  
Lital Keinan-Boker ◽  
Dani Cohen

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19 and is mostly person-to-person transmitted through respiratory droplets. The implications of the strategies implemented to prevent COVID-19 transmission on other infectious diseases are unclear. We aimed to appraise trends in the incidence of salmonellosis, shigellosis and campylobacteriosis in Israel during COVID-19 pandemic. Positive stool samples for Salmonella, Shigella and Campylobacter are reported on a monthly basis to the Israel Center for Disease Control from sentinel laboratories, within the framework of a surveillance network of bacterial culture-proven enteric diseases. Age-adjusted incidence rates per 100,000 of shigellosis, salmonellosis and campylobacteriosis were calculated. Mean rates before and after the local onset of COVID-19 pandemic in Israel were compared and Relative Risk Reduction (RRR) was calculated. Joinpoint was used to evaluate secular trends. The mean age-adjusted incidence rate of shigellosis in March–July 2020 was lower than the rate observed in March–July 2018–2019 (RRR = 86.6%), but also decreased for salmonellosis (RRR = 33.0%) and campylobacteriosis (RRR = 30.0%). Using Joinpoint we have shown that the decrease observed for shigellosis was significantly sharper (Annual Percent Change (APC) = −77.7) between February 2020 and May 2020 than for salmonellosis (APC = −14.0) between July 2019 and April 2020 and for campylobacteriosis (APC = −1.1) between January 2018 and July 2020. The preventive measures applied to reduce transmission of COVID-19, including social distancing and hand washing, were ecologically associated with a decreased risk of bacterial enteric diseases in Israel. The association was strongest for shigellosis, a disease that is mostly person-to-person transmitted, as compared to salmonellosis and campylobacteriosis which are mostly foodborne transmitted.


2009 ◽  
Vol 25 (5) ◽  
pp. 1046-1053 ◽  
Author(s):  
Rejane de Souza Reis ◽  
Marceli de Oliveira Santos ◽  
Katia Vergetti Bloch

The aim of this study was to describe the incidence distribution of colorectal cancer in Fortaleza, Ceará State, and Porto Alegre, Rio Grande do Sul State, Brazil, and the time trend in the disease from 1990 to 1999. Mean annual age-adjusted incidence rates and estimated annual percent change were calculated by gender, using population-based cancer registries. EAPC showed an increase in the rates in Porto Alegre and Fortaleza for men, +4.2% (p = 0.14) and +9.3% (p < 0.001), and women, +4.6% (p = 0.11) and +5.3% (p = 0.15), respectively. The mean adjusted incidence rates were three times higher in Porto Alegre than in Fortaleza both for men (25.1 vs. 8.6/100 thousand) and women (19.9 vs. 7.1/100 thousand). This rise in incidence rates may be due to early cancer detection strategies, lifestyle changes, and alterations in the population age structure. A population profile similar to that of developed countries may explain the higher incidence rates in Porto Alegre. However, Fortaleza showed the largest increases during the period studied.


2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 231-231
Author(s):  
Mi Ri Lee ◽  
Cynthia Harris ◽  
Kiwoon Joshua Baeg ◽  
Juan P. Wisnivesky ◽  
Michelle Kang Kim

231 Background: Although multiple studies document a rise in gastroenteropancreatic neuroendocrine tumor (GEP-NET) incidence over the past several decades, there are limited national data regarding recent trends. Using a population-based registry, we evaluated GEP-NET incidence trends in the US population from 1975-2012 by age and calendar year at diagnosis and year of birth. Methods: GEP-NET cases between 1975-2012 were identified from the most recent version of the Surveillance, Epidemiology, and End Results (SEER) registry based on histologic and site codes. We calculated overall annual incidence, age-adjusted incidence (number of cases per 100,000), annual percent change (APC), and average APC by 5 year age intervals. We also evaluated the incidence rates by age, period, and birth year cohorts. Results: We identified 22,744 patients with GEP-NETs. In adults age 25-39 years, GEP-NET incidence rates declined from the mid 1970s to early 1980s, then increased until 2012 (Table 1). In adults age 40 and older and between ages 15-24 years, incidence rates generally increased continuously from 1975 to 2012. Adults age 40-69 years demonstrated the most rapid increases in average APC, approximately 4-6% per year. Overall incidence rates were highest in adults age 70-84 years. Since the late 1880s, GEP-NET incidence has increased in consecutive birth cohorts. Conclusions: Our study demonstrates that more recent generations have had higher incidence rates than more distant generations. In addition, GEP-NETs are more common among older adults and the number of GEP NETs has increased in past decades. [Table: see text]


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