scholarly journals Impact of gender on the survival of patients with glioblastoma

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Minjie Tian ◽  
Wenying Ma ◽  
Yueqiu Chen ◽  
Yue Yu ◽  
Donglin Zhu ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Survival Data ◽  
Cox Regression ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Kaplan Meier ◽  
Male Patients ◽  
Stratified Analysis ◽  
The Impact

Background: Preclinical models have suggested a role for sex hormones in the development of glioblastoma multiforme (GBM). However, the impact of gender on the survival time of patients with GBM has not been fully understood. The objective of the present study was to clarify the association between gender and survival of patients with GBM by analyzing population-based data. Methods: We searched the Surveillance, Epidemiology, and End-Results database who were diagnosed with GBM between 2000 and 2008 and were treated with surgery. Five-year cancer specific survival data were obtained. Kaplan–Meier methods and multivariable Cox regression models were used to analyze long-term survival outcomes and risk factors. Results: A total of 6586 patients were identified; 61.5% were men and 38.5% were women. The 5-year cancer-specific survival (CSS) rates in the male and female groups were 6.8% and 8.3%, respectively (P=0.002 by univariate and P<0.001 by multivariate analysis). A stratified analysis showed that male patients always had the lowest CSS rate across localized cancer stage and different age subgroups. Conclusions: Gender has prognostic value for determining GBM risk. The role of sex hormones in the development of GBM warrants further investigation.

scholarly journals The Role of Chemotherapy in the Survival Benefits of Patients Aged Older Than 40 Years With Osteosarcoma

2021 ◽  
Vol 20 ◽  
pp. 153303382110661
Author(s):  
Zhiyou Cao ◽  
Yuelin Zhang ◽  
Qiang Xu ◽  
Xiaolong Yu ◽  
Xuqiang Liu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Survival Benefit ◽  
Cox Regression ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Stratified Analysis ◽  
The Impact ◽  
Grade Iii

Objectives: The value of chemotherapy in the survival benefits of patients aged > 40 years with osteosarcoma is controversial. We aimed to explore the impact of chemotherapy on the survival benefits of patients aged >40 years with osteosarcoma. Methods: The Surveillance, Epidemiology, and End Results database was used to select eligible patients. The selected patients were divided into the chemotherapy and non-chemotherapy groups. Logistic regression analysis was performed to investigate the potential factors contributing to the selection of chemotherapy. The overall survival (OS) and cancer-specific survival (CSS) of the two groups were compared using the Kaplan–Meier method with a log-rank test. Cox proportional risk models were used to determine the prognostic factors for OS and CSS. Stratified analysis was performed according to tumour grade and stage. Results: A total of 1032 eligible patients were included in our analysis. Of these, 586 and 446 patients were in the chemotherapy and nonchemotherapy groups, respectively. Multivariate logistic analysis indicated that grade III/IV and distant stage were associated with chemotherapy. Kaplan–Meier plots showed that patients did not achieve an improved OS or CSS after receiving chemotherapy. Cox regression analysis indicated that age > 60 years, axial, grade III/IV, and regional and distant stage were independent risk factors for poor prognosis in both OS and CSS. Stratified analysis revealed a survival benefit from chemotherapy in patients with grade III/IV and distant stage. Conclusions: Chemotherapy did not significantly improve OS and CSS in patients aged > 40 years with osteosarcoma. In this age group, survival benefit from chemotherapy was observed in patients with high-grade tumours (grade III/IV) and metastasis (distant stage).

scholarly journals The Effect of Marital Status on Survival of Patients with Gastrointestinal Stromal Tumors: A SEER Database Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Wei Song ◽  
Chuan Tian
Keyword(s):  
Prognostic Factor ◽  
Marital Status ◽  
Gastrointestinal Stromal Tumors ◽  
Cox Regression ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Stromal Tumors ◽  
Kaplan Meier ◽  
Risk Of Cancer ◽  
The Impact

Background. Marital status has been reported to be a prognostic factor in multiple malignancies. However, its prognostic value on gastrointestinal stromal tumors (GISTs) have not yet been determined. The objective of the present analysis was to assess the effects of marital status on survival in patients with GISTs. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze 6195 patients who were diagnosed with GISTs from 2001 to 2014. We also use Kaplan-Meier analysis and Cox regression to analyze the impact of marital status on cancer-specific survival (CSS). Results. Patients in the married group had more frequency in white people, more high/moderate grade tumors, and were more likely to receive surgery. Widowed patients had a higher proportion of women, a greater proportion of older patients (>60 years), and more common site of the stomach. Multivariate analysis demonstrated that marital status was an independent prognostic factor for GISTs (P<0.001). Married patients had better CSS than unmarried patients (P<0.001). Subgroup analysis suggested that widowed patients had the lowest CSS compared with all other patients. Conclusions. Marital status is a prognostic factor for survival in patients with GISTs, and widowed patients are at greater risk of cancer-specific mortality.

scholarly journals Down-Regulation of LncRNA DGCR5 Correlates with Poor Prognosis in Hepatocellular Carcinoma

2016 ◽  
Vol 40 (3-4) ◽  
pp. 707-715 ◽  
Author(s):  
Ruyi Huang ◽  
Xiaochen Wang ◽  
Wenjie Zhang ◽  
Guangyan Zhangyuan ◽  
Kangpeng Jin ◽  
...  
Keyword(s):  
Roc Curve ◽  
Cox Regression ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
High Expression Group ◽  
Negative Prognostic Factor ◽  
Potential Biomarker ◽  
Low Expression

Background/Aims: Long non-coding RNAs (lncRNAs) have been reported to play pivotal roles in multiple tumors and can act as tumor biomarkers. In this study, we explored the association of the expression of an lncRNA, DGCR5 with clinicopathological features and prognosis in HCC. Methods: Expression levels of DGCR5 were detected by quantitative real-time PCR (qRT-PCR) and the clinical data was obtained, including basic information, data of clinicopathology and cancer specific survival rate. Receiver operating characteristic (ROC) curve, Kaplan-Meier methods and multivariable Cox regression models were used to analyze predictive efficiency, long-term survival outcomes and risk factors. Results: DGCR5 was found down-regulated in HCC tissues (P<0.001) and serum (P = 0.0035) and low expression of DGCR5 was correlated with a poor cancer specific survival (CSS) (P = 0.0019), as the overall 5-year CSS rates were 10.3% (low expression group) and 36.6% (high expression group), respectively. A stratified analysis demonstrated that low DGCR5 expression was an independent negative prognostic factor for HCC. In addition, the area under the ROC curve was 0.782 with a sensitivity of 0.633 and a specificity of 0.833. Conclusions: Our results suggest that DGCR5 may be a participator in HCC and can serve as potential biomarker for the diagnosis and prognosis in HCC.

Natural history and outcomes of synchronous and metachronous colorectal cancers (CRC): A population-based analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3593-3593
Author(s):  
Jackson Chu ◽  
Ozge Goktepe ◽  
Winson Y. Cheung
Keyword(s):  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Presenting Symptoms ◽  
Kaplan Meier ◽  
Index Cancer ◽  
Metachronous Tumors

3593 Background: Early data suggest that synchronous and metachronous CRC portend a worse prognosis when compared to solitary CRC. Our aims were to 1) characterize the clinical features and treatment patterns of synchronous and metachronous CRC and 2) compare their survival outcomes with those of solitary CRC. Methods: All patients diagnosed with non-metastatic CRC between 1999 and 2008 and referred to any 1 of 5 regional cancer centers in British Columbia, Canada were reviewed. Synchronous and metachronous CRC were defined as multiple (2 or more) distinct tumors that were diagnosed within and beyond 6 months of the date of index CRC diagnosis, respectively, during the study period. Patients with liver metastases at initial diagnosis were excluded. Kaplan-Meier and Cox regression analyses were used to estimate survival among the different CRC groups. Results: A total of 6360 patients were identified: 6147 (96%) solitary, 178 (3%) synchronous and 35 (1%) metachronous tumors; median age was 68 years (IQR 59-76); 57% were men; and 75% were ECOG 0/1 at the time of index cancer diagnosis. Baseline demographic characteristics were comparable across patients (all p>0.05). Compared with solitary CRC, synchronous and metachronous CRC more commonly affected the colon rather than the rectum (84 vs 85 vs 59%, respectively, p<0.001), but presenting symptoms, treatment approaches, and use of chemotherapy, radiation and surgery were similar among the different tumor groups (all p>0.05). In terms of survival, no differences were observed in 3-year relapse free survival (66 vs 66 vs 56%, p=0.20), 5-year cancer specific survival (69 vs 69 vs 53%, p=0.34) and 5-year overall survival (62 vs 59 vs 49%, p=0.74) for solitary, synchronous and metachronous CRC, respectively. These findings persisted after controlling for known prognostic factors, such as age and ECOG. Conclusions: In this large population-based cohort, there were no differences in survival outcomes among solitary, synchronous and metachronous CRC. Patients who present with multiple tumors in the colon or the rectum should be managed similarly to those who present with an isolated tumor.

Survival among colorectal cancer patients with a history of previous cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16146-e16146
Author(s):  
Sandi Pruitt ◽  
David E. Gerber ◽  
Hong Zhu ◽  
Daniel Heitjan ◽  
Bhumika Maddineni ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Population Based ◽  
Competing Risk ◽  
Cancer Specific Survival ◽  
Risk Of Death ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

e16146 Background: A growing number of patients with colorectal cancer (CRC) have survived a previous cancer. Although little is known about their prognosis, this population is frequently excluded from clinical trials. We examined the impact of previous cancer on overall and cancer-specific survival in a population-based cohort of patients diagnosed with incident CRC. Methods: We identified patients aged ≥66 years and diagnosed with CRC between 2005-2015 in linked SEER-Medicare data. For patients with and without previous cancer, we estimated overall survival using Cox regression and cause-specific survival using competing risk regression, separately by CRC stage, while adjusting for numerous covariates and competing risk of death from previous cancer, other causes, or the incident CRC. Results: Of 112,769 CRC patients diagnosed with incident CRC, 15,935 (14.1%) had a previous cancer – most commonly prostate (32.9%) or breast (19.4%) cancer, with many 7505 (47.1%) diagnosed ≤5 years of CRC. For all CRC stages except IV in which there was no significant difference in survival, patients with previous cancer had modestly worse overall survival (hazard ratios from fully adjusted models range from 1.11-1.28 across stages; see Table). This survival disadvantage was driven by deaths due to previous cancer and other causes. Notably, most patients with previous cancer had improved CRC-specific survival. Conclusions: CRC patients who have survived a previous cancer have generally worse overall survival but superior CRC-specific survival. This evidence should be considered concurrently with concerns about trial generalizability, low accrual, and heterogeneity of participants when determining exclusion criteria. [Table: see text]

scholarly journals The Improved Prognosis of Hypoplastic Left Heart: A Population-Based Register Study of 343 Cases in England and Wales

2021 ◽  
Vol 9 ◽  
Author(s):  
Kate E. Best ◽  
Nicola Miller ◽  
Elizabeth Draper ◽  
David Tucker ◽  
Karen Luyt ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Cox Regression ◽  
Surgical Techniques ◽  
Population Based ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Term Survival ◽  
England And Wales ◽  
Hypoplastic Left Ventricle ◽  
Kaplan Meier

Background: Hypoplastic Left Heart Syndrome (HLHS) is a severe congenital heart defect (CHD) characterised by the underdevelopment of the left side of the heart with varying levels of hypoplasia of the left atrium, mitral valve, left ventricle, aortic valve and aortic arch. In the UK, age 12 survival for cases born between 1991 and 1993 was 21%. UK survival estimates corresponding to cases born between 2000 and 2015 were improved at 56%, but survival was examined up to age five only. Contemporary long-term survival estimates play a crucial role in counselling parents following diagnosis. The aim of this study was to report survival estimates up to age 15 for children born with HLHS or hypoplastic left ventricle with additional CHD in England and Wales between 1998 and 2012.Methods: Cases of HLHS notified to four congenital anomaly registers in England and Wales during 1998–2012, matched to Office for National Statistics mortality information, were included. Kaplan-Meier survival estimates to age 15 were reported. Cox regression models were fitted to examine risk factors for mortality.Results: There were 244 cases of HLHS and 99 cases of hypoplastic left ventricle co-occurring with other CHD, with traced survival status. Kaplan-Meier survival estimates for HLHS were 84.4% at age 1 week, 76.2% at 1 month, 63.5% at age 1 year, 58.6% at age 5 years, 54.6% at age 10 years, and 32.6% to age 15 years. The Kaplan-Meier survival estimates for cases of hypoplastic left ventricle co-occurring with additional CHD were 90.9% at age 1 week, 84.9% at 1 month, 73.7% at age 1 year, 67.7% to age 5 years, 59.2% to age 10 years, and 40.3% to age 15 years. Preterm birth (p = 0.007), low birth weight (p = 0.005), and female sex (p = 0.01) were associated with mortality.Conclusions: We have shown that prognosis associated with HLHS in the twenty first century exceeds that of many previous population-based studies, likely due to improvements in intensive care technologies and advances in surgical techniques over the last few decades.

scholarly journals The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis

2019 ◽  
Vol 8 (3) ◽  
pp. 239-251 ◽  
Author(s):  
Chao-bin He ◽  
Yu Zhang ◽  
Zhi-yuan Cai ◽  
Xiao-jun Lin
Keyword(s):  
Neuroendocrine Tumors ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Study Cohort ◽  
Pancreatic Neuroendocrine Tumors ◽  
Cancer Specific Survival ◽  
Discriminative Ability ◽  
Stage System ◽  
The Impact

Aim The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS) and cancer-specific survival (CSS) based on a large population-based cohort. Methods Patients diagnosed with metastatic PNETs between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively collected. Nomograms for estimating OS and CSS were established based on Cox regression model and Fine and Grey’s model. The precision of the nomograms was evaluated and compared using concordance index (C-index) and the area under receiver operating characteristic (ROC) curve (AUC). Results The study cohort included 1966 patients with metastatic PNETs. It was shown that the surgery provided survival benefit for all groups of patients with metastatic PNETs. In the whole study cohort, 1-, 2- and 3-year OS and CSS were 51.5, 37.1 and 29.4% and 53.0, 38.9 and 31.1%, respectively. The established nomograms were well calibrated, and had good discriminative ability, with C-indexes of 0.773 for OS prediction and 0.774 for CSS prediction. Conclusions Patients with metastatic PNETs could benefit from surgery when the surgery tolerance was acceptable. The established nomograms could stratify patients who were categorized as tumor-node-metastasis (TNM) IV stage into groups with diverse prognoses, showing better discrimination and calibration of the established nomograms, compared with 8th TNM stage system in predicting OS and CSS for patients with metastatic PNETs.

scholarly journals EFFECT OF NATIONAL PROGRAMS IN ONCOLOGY ON SURVIVAL OF PATIENTS WITH RECTAL CANCER: A POPULATION-BASED ANALYSIS

2019 ◽  
Vol 6 (1) ◽  
pp. 10-20
Author(s):  
D. M. Dubovichenko ◽  
M. Yu. Valkov ◽  
V. M. Merabishvili ◽  
A. A. Karpunov ◽  
L. E. Valkova ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Risk Of Death ◽  
Treatment Type ◽  
Time Periods ◽  
National Programs ◽  
The Impact

Objective. Assessment of the impact of National Program «Health» on a rectal cancer (RC) tumor-specific survival in the Arkhangelsk region (AR), Russia over the period 2000–2017 by the data of Arkhangelsk Regional Cancer Registry (ARCR)Materials and methods. Anonymized data on all cases of RC (C19.0–C21.0) in the AR in 2000–2017 were extracted from the database of the ARCR. Over the study period, 4173 cases of the RC were selected. To assess the impact of the National Health Project in 2006 and All-national Dispensarization in 2013, the three time periods were chosen — 2000–2006, 2007–2012 and 2013–2017. Cancer-specific survival (CSS) was calculated. Separate influence of baseline factors on differences in CSS between periods was performed using Cox regression with consecutive input.Results. One- and five year CSS were 62,6% (95% confidence interval (CI) 60,03–65,05%%) and 27,8% (95% CI 25,4–30,2%) in 2000–2006, 65,1% (95% CI 62,5–67,5%) and 32% (95% CI 29,5–34,5%) in 2007–2012, 67,7% (95% CI 65,2–70,1%) and 37,4% (95% CI 33,7–41,1%) in 2013–2017, respectively.In univariate analysis the risk of death in the latest time periods was significantly lower: HR 0.86 (95% CI 0.79–0.95), p < 0.05 and 0.74 (95% CI 0.67–0.82), p<0.0001 for 2007–2012 and 2013–2017, respectively, comparing to 2000–2006. In a multivariate model only correction for treatment type has led to change of the coefficients between time periods: HR 0.94 (95% CI 0.86–1.03) and 0.84 (95% CI 0.75–0.93) for 2007–2012 and 2013–2017, respectively. The CSS was also in­dependently influenced by stage, age at diagnosis, place of residence and type of treatment.Conclusion. Population-based five-year CSS of patients with RC increased by 8% during the analyzed period. Better CSS in the latest time period is associated rather with improvement of treatment than earlier detection of RC.

Natural history and outcomes in a population-based cohort of synchronous and metachronous colorectal cancers (CRC).

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 485-485
Author(s):  
Jackson Chu ◽  
Ozge Goktepe ◽  
Winson Y. Cheung
Keyword(s):  
Cox Regression ◽  
Population Based ◽  
Colorectal Adenomas ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Bowel Movements ◽  
Metachronous Tumors ◽  
Worse Prognosis

485 Background: Early data suggest that synchronous and metachronous CRC may portend a worse prognosis when compared to solitary CRC. Our study objectives were to 1) characterize the clinical features and treatment patterns of synchronous and metachronous CRC and 2) compare their survival outcomes with those of solitary CRC. Methods: All patients diagnosed with either synchronous or metachronous CRC between 1999 and 2008 and referred to 1 of 5 regional cancer centers in British Columbia were reviewed. Synchronous and metachronous CRC were defined as multiple (2 or more) distinct tumors that were diagnosed within and beyond 6 months of the date of index CRC diagnosis, respectively. Patients with liver metastases at initial diagnosis were excluded. Kaplan-Meier and multivariate Cox regression analyses were used to estimate survival for synchronous and metachronous CRC, and to compare outcomes with solitary CRC. Results: A total of 213 patients with 388 synchronous and 69 metachronous cases of CRC were included: median age was 70 (range 26-94), 55% were men, and 30% were ECOG 0 to 1 at index diagnosis. At initial presentaiton, 35% and 51% of patients who manifested with synchronous and metachronous tumors, respectively, were TNM stage III. Concurrent colorectal adenomas were found in 45% of synchronous and 33% of metachronous cases. The most prevalent symptoms experienced by patients included changes in bowel movements and abdominal pain. The majority of patients underwent a curative resection (99% of synchronous and 97% of metachronous). Adjuvant chemotherapy was used to treat 44% of both synchronous and metachronous tumors. Compared to solitary CRC, patients with synchronous and metachronous CRC had similar 3-year relapse-free survival (66 vs. 66 vs. 56%, p=0.20), 5-year cancer-specific survival (69 vs. 67 vs. 53%, p=0.34), and 5-year overall survival (62 vs. 59 vs. 49%), p=0.74. Similar observations persisted in the multivariate Cox regression model. Conclusions: There appears to be no differences in survival outcomes in patients with solitary, synchronous, or metachronous CRC. Patients who present with multiple CRC tumors should be managed similarly to those who only present with an isolated tumor.

Impact of cardiac comorbidity on use and outcomes of adjuvant chemotherapy (ADJ) for colorectal cancer (CRC): A real-world population-based study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 491-491
Author(s):  
Shiru Lucy Liu ◽  
Sharlene Gill ◽  
Winson Y. Cheung
Keyword(s):  
Regression Models ◽  
Cox Regression ◽  
Population Based ◽  
World Population ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Kaplan Meier ◽  
Comorbidity Index ◽  
Resected Stage ◽  
Cardiac Comorbidity

491 Background: Cardiac comorbidities such as myocardial infarction (MI) and congestive heart failure (CHF) may pose challenges in the treatment of CRC. As the population ages, cancer patients (pts) will be increasingly affected by cardiac comorbidities. We performed a population-based analysis of CRC to evaluate the prevalence of MI and CHF, use of ADJ, and survival outcomes. Methods: We evaluated 8601 pts diagnosed with resected stage 2 or 3 CRC from 2004 to 2015 in Alberta, Canada. Baseline patient, tumor, and treatment characteristics were compared between those with and without MI or CHF. Survival analysis was conducted using Kaplan-Meier methods and Cox regression models. Results: In total, 506 (5.9%) patients (pts) had MI and 440 (5.1%) had CHF. CRC patients with prior MI or CHF were older (median 76 and 79 years, respectively) and had worse Charlson Comorbidity Index (median CCI 2 for both) than those without cardiac comorbidities (median age 67 and CCI 0) (p < 0.001). Only 24% and 15% of pts with a MI or CHF history, respectively, received ADJ when compared to their counterparts (52% and 53%, respectively, p < 0.001). Among those who received ADJ (N = 3409), an oxaliplatin-based regimen was used in 26% of MI pts versus 42% of those without MI (p = 0.002), and in 31% of CHF pts versus 42% of those without CHF. Kaplan-Meier analysis revealed significantly worse overall survival (OS) in pts with prior MI (9.1 vs 4.3 years, p < 0.001) or CHF (9.2 vs. 2.7 years, p < 0.001) when compared to those without. However, cancer-specific survival (CSS) was not statistically different with or without MI (p = 0.348) and with or without CHF (p = 0.611). In Cox regression that adjusted for use of ADJ, MI was no longer a significant predictor of OS (HR = 1.01, 95% confidence interval (CI) 0.88-1.15), but CHF remained significant (HR 0.65, 95% CI 0.57-0.74). Neither MI nor CHF were predictors of CSS (HR 1.09, 95% CI 0.98-1.33, and HR 0.94, 95% CI 0.77-1.15). Conclusions: CRC pts with MI or CHF experienced lower use of ADJ and worse OS, but no difference in CSS was observed. ADJ-treated pts with prior MI appeared to benefit while worse outcomes in pts with prior CHF appear to be driven by non-cancer related causes.

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