scholarly journals Survival in patients with radiological diagnoses of glioblastoma: a retrospective study of 115 patients on a best supportive care pathway

2021 ◽  
Vol 23 (Supplement_4) ◽  
pp. iv8-iv8
Author(s):  
James Riley ◽  
James Hodson ◽  
Vladimir Petrik
Keyword(s):  
Corpus Callosum ◽  
Supportive Care ◽  
Survival Time ◽  
Cancer Registry ◽  
Statistical Significance ◽  
Best Supportive Care ◽  
Queen Elizabeth Hospital ◽  
Related Factors ◽  
Clinical Records ◽  
Cerebral Structures

Abstract Aims Glioblastoma multiforme (GBM) is a devastating disease with notoriously poor survival. Studies examining survival in patients given best supportive care (BSC) are few and far between. All patients harbouring brain tumours referred to the Neuro-oncology service at the Queen Elizabeth Hospital in Birmingham are recorded in the Somerset Cancer Registry. We set out to analyse survival times and identify patient and tumour-related factors significantly affecting prognosis. Method We identified 126 patients from 2015 to 2019 in our Somerset Cancer Registry with radiological diagnoses of glioblastoma for whom the Neuro-oncology MDT recommended BSC. We performed a retrospective analysis of clinical records and radiological images. 11 patients were excluded (8 due to insufficient imaging data, 2 who underwent subsequent surgery, 1 patient with brain metastases). Survival was measured in completed weeks since the index MDT decision. Associations between survival time and both patient- and tumour-related factors were assessed using Kaplan-Meier curves and log-rank tests. All analyses were performed using IBM SPSS 22 (IBM Corp. Armonk, NY), with p<0.05 deemed to be indicative of statistical significance throughout. Results Data were available for N=115 patients (69 males, 46 females), with a mean age of 79 ± 8 years. All patients died within 32 weeks of diagnosis, with a median survival time of 8 weeks. Only 8 patients survived for more than 20 weeks. Survival was significantly shorter in those with a greater number of main cerebral structures affected (p=0.044), with a median of 6 vs. 10 weeks for 3 or more vs. 1 structures affected (hazard ratio: 1.61, 95% CI: 0.99-2.62). Bilateral tumours involving the corpus callosum were also associated with shorter survival (p=0.039). None of the other factors considered were found to be significantly associated with survival, including age (p=0.193), gender (p=0.371), performance status (p=0.300) and tumour size (p=0.331). Conclusion With the exception of the number of main cerebral structures affected (frontal, parietal, temporal and occipital lobes, corpus callosum, insula, basal ganglia and brain stem), patient- and tumour-factors traditionally used by the MDT to prognosticate do not correlate with survival time in patients receiving BSC for radiological diagnoses of GBM. With 50% of the cohort dying within 8 weeks it is clear that we must reconsider the timing of referrals to palliative and hospice care. Finally, the fact that some patients survived for more than half a year with no surgical or oncological treatment suggests that the process of selecting patients for BSC vs aggressive treatments needs refinement.

scholarly journals 664 BURDEN OF IN-HOSPITAL CARE IN OESOPHAGEAL CANCER: A NATIONAL POPULATION-BASED STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Gustav Linder ◽  
Fredrik Klevebro ◽  
David Edholm ◽  
Jan Johansson ◽  
Mats Lindblad ◽  
...  
Keyword(s):  
Supportive Care ◽  
Survival Time ◽  
Oesophageal Cancer ◽  
Hospital Care ◽  
Best Supportive Care ◽  
Population Based ◽  
Chronic Obstructive ◽  
First Year ◽  
Factors Associated ◽  
Cancer Management

Abstract   Oesophageal cancer management requires extensive in-hospital care. This cohort study aimed to quantify in-hospital care for esophageal cancer patients in relation to intended treatment and to analyze factors associated with risk of spending a large proportion of survival time in hospital. Methods All patients with oesophageal cancer in three nationwide registers over a ten-year period, were included. In-hospital care during the first year after diagnosis was evaluated and the proportion of survival time spent in hospital, stratified for intended treatment (curative, palliative or best supportive care) calculated. Associations of relevant factors to a greater proportion of survival time in hospital was analyzed by multivariable logistic regression. Results In-hospital care was provided for a median time of 39, 26 and 15 days the first year after diagnosis of oesophageal cancer for curative, palliative and best supportive care groups respectively. Patients receiving curatively intended treatment spent a median of 12% of their survival time in hospital during the first year after diagnosis, while palliative or best supportive care patients spent 19% and 23% respectively. Factors associated with more in-hospital care included higher age, female sex, being unmarried and chronic obstructive pulmonary disease (COPD). Conclusion The burden of in-hospital care during the first year after diagnosis of oesophageal cancer was substantial. Important clinical and socioeconomic factors were identified that predisposed to a greater proportion of survival time spent in hospital.

scholarly journals Clinical Characteristics and Prognosis of Primary Tracheal Cancer: A Single Institution Experience

2018 ◽  
Author(s):  
Rashmi Koul ◽  
Reem Alomrann ◽  
Shrinivas Rathod ◽  
Julian Kim ◽  
Ahmet Leylek ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Registry ◽  
Radiation Treatment ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Palliative Radiotherapy ◽  
Best Supportive Care ◽  
Current Evidence ◽  
Related Factors ◽  
Historical Cohort

Background Primary tracheal cancers (PTCs) are rare and current evidence-based understanding is limited to retrospective reports and national databases. We present single institutional study of a historical cohort of PTC from Canadian provincial cancer registry database. Materials and Methods: After institutional research ethics board approval, all PTC patients diagnosed from 1980 to 2014 were identified through the Canadian provincial cancer registry. Demographic and tumor related factors were evaluated using descriptive statistics. Survival rates were estimated using the Kaplan-Meier method and cox hazard regression analyses were performed to identify predictors of disease-free survival (DFS) and overall survival (OS). Results: A total of 30 patients were included in the study. At presentation, 10 patients (33%) had only local disease, 14 patients (47%) had locoregional disease and the remaining 4 patients (13%) had distant metastasis. The majority of patients underwent primary radiation treatment. The overall survival rate was 30% at 2 years and 16% at 5 years. Patients receiving radical-intent therapy had better 2-year DFS and OS compared to patients managed with palliative radiotherapy and best supportive care (46%, 17% and 0%) (p=<0.001) and (50%, 23% and 0%) (p=<0.001), respectively. Radiotherapy resulted in a better 2-year OS and DFS (32% versus 14%) (p=<0.03) and (32% versus 0%) (p=<0.001), respectively. Conclusion: PTC is an uncommon neoplasm making the study of the disease technically and logistically challenging. Radical radiotherapy alone is curative option in inoperable PTC. Intent of treatment and radiotherapy were associated with superior survival outcomes.

Medicare Fee-for-Service Enrollees with Acute Myelogenous Leukemia: An Analysis of Treatment Patterns and Patient Survival

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 505-505 ◽  
Author(s):  
Juliana Leah Meyers ◽  
Yanni F Yu ◽  
Keith L Davis
Keyword(s):  
Supportive Care ◽  
Survival Time ◽  
Median Survival ◽  
Patient Survival ◽  
Best Supportive Care ◽  
Treatment Patterns ◽  
Myelogenous Leukemia ◽  
Fee For Service ◽  
Over Time

Abstract Abstract 505 Background: Acute myelogenous leukemia (AML) is the most common type of leukemia among adults in the US. The incidence of AML increases with age. Older AML patients, constituting the majority of the AML population, generally have poor outcomes with median survival less than 3 months. Published information on treatment patterns and survival trends in elderly patients with AML is outdated and newer information on treatment patterns and survival is lacking. Objective: The goal of this retrospective database analysis is to examine treatment patterns, overall patient survival, predictors of which patients are likely to receive chemotherapy, and predictors of mortality among Medicare fee-for-service enrollees diagnosed with AML in the most recent available database. Methods: Medicare patients aged 65+ years in the SEER (Survey, Epidemiology, and End Results) cancer registry with a new AML diagnosis between 1/1/1997 and 12/31/2007 were selected for study inclusion. Patients were required to have at least 6 months of pre-AML Medicare Part A and B benefits and no evidence of managed care (Medicare Part C) enrollment post-AML diagnosis. Patients were excluded from the analysis if they had evidence of another tumor (either solid or hematological) in the SEER registry before the first AML diagnosis. Health care claims in the 6 months pre-index were examined, and patients with any diagnosis of a solid tumor (not specified in SEER) were also excluded. Patients were followed until their date of death or end of observation period (i.e., 12/31/2007). Study measures included AML-directed treatments (i.e., chemotherapy, radiation therapy, hematopoietic stem-cell/bone marrow transplants [HSCT/BMT]), best supportive care received, and post-AML diagnosis survival time. Patient survival time was assessed overall and for patients receiving chemotherapy during follow-up versus patients receiving best supportive care only. Temporal changes in treatment utilization and survival were assessed by evaluating these measures separately for AML cases diagnosed in 1997–1999, 2000–2003, and 2004–2007. Multivariate logistic regressions were undertaken to assess predictors of receipt of chemotherapy, including patient demographics, comorbidities, and year of AML diagnosis. Results: 6,888 patients met the study inclusion criteria. Mean (SD) and median age were 78.3 (7.2) and 78.0 years respectively. Over 43% of patients received chemotherapy at any point post-diagnosis. Chemotherapy use increased slightly over time: 40.7%, 42.3%, and 46.0% of patients diagnosed with AML in the periods in 1997–1999, 2000–2003, and 2004–2007, respectively. Fifty-six percent of patients received only best supportive care post-diagnosis, and the percentage slightly decreased over time. Among patients receiving only best supportive care, rates of hospice care increased substantially over time: 32.9%, 42.7%, and 49.1% in each of the respective time periods. Rates of HSCT/BMT procedures were low with an increase over time: 0.67%, 2.06%, and 2.49%. Nearly all patients (97.1%) died during the observable follow-up, and median survival time was 2.6 months. Among patients who received chemotherapy, 93.9% died during follow-up and the median survival was 6.5 months with 5.7, 6.4, and 7.0 months among patients diagnosed in 1997–1999, 2000–2003, and 2004–2007, respectively. Among patients who received only best-supportive care, 99.5% died during follow-up and median survival was 1.5 months with little change over time. Younger patients (65–74 years vs >= 75 years), patients with fewer comorbidities (Charlson Comorbidity Index [CCI] ≤1 vs > CCI >1), patients with a post-AML secondary cancer diagnosis, and patients diagnosed with AML in more recent years were found to be more likely to receive chemotherapy. Conclusions: Findings from our analysis showed an increasing trend in rates of chemotherapy treatment and utilization of hospice care among Medicare patients with AML. However, a large portion of elderly patients remain untreated. Median survival among patients who received chemotherapy was found to increase over time. Patients who received chemotherapy, when compared to those who did not, had a lower mortality rate and an over 3-fold longer median survival. Disclosures: Yu: Boehringer Ingelheim Pharmaceuticals, Inc.: Employment.

Incidence of brain metastasis in esophageal cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 46-46
Author(s):  
Brendan McCann ◽  
Kiran Bhatti ◽  
Vivienne MacLaren
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Supportive Care ◽  
Oesophageal Cancer ◽  
Whole Brain Radiotherapy ◽  
Best Supportive Care ◽  
Diagnostic Techniques ◽  
The West ◽  
Brain Radiotherapy ◽  
Clinical Records

46 Background: Brain metastasis in oesophageal cancer is a rare but often fatal complication. In previous studies the incidence has ranged from 1.4% - 13% with the largest studies from China and Japan that have been retrospectively based over fifteen to twenty years. (Ogawa K, Toita T, Sueyama H. Brain metastases from esophageal carcinoma: natural history, prognostic factors, and outcome. Cancer. 2002 Feb 1;94(3):759-64.) With improving diagnostic techniques and differing histology of oesophageal cancer from Eastern countries we undertook a study to determine the incidence of brain metastases in oesophageal cancers in the West of Scotland. Methods: Data from all the new patients diagnosed with oesophageal cancer was obtained with permission from the Regional Managed Clinical Network from the years 2011 and 2012 yielding a total of 701 patients. The individual clinical records were examined to ascertain if the patient developed brain metastases on CT/MRI scan, their tumour type and management. Results: Of the 701 patients diagnosed with oesophageal cancer, 19 developed brain metastasis demonstrating an incidence of 2.7%. 12 of these patients primary diagnosis was adenocarcinoma. The others were small cell (3), neuroendocrine (2), squamous (1) and no histology (1). At the time of writing 17 out of 19 patients had died from their oesophageal cancer. The 2 surviving patients had a single brain metastasis that was resected and treated with adjuvant radiotherapy. 6 other patients had whole brain radiotherapy, 1 patient had partial brain radiotherapy and 10 were managed with best supportive care. Mean survival from diagnosis of brain metastasis for best supportive care was 26 +/- 14 days versus mean survival for radiotherapy treatment from 100+/- 57 days (p = 0.003) demonstrating a difference between the groups. Conclusions: The incidence of brain metastasis in oesophageal cancer in the West of Scotland was 2.7% with the prognosis generally poor unless resected.

Cholangiokarzinome

Praxis ◽  
2002 ◽  
Vol 91 (34) ◽  
pp. 1352-1356
Author(s):  
Harder ◽  
Blum
Keyword(s):  
Supportive Care ◽  
Evidence Based Medicine ◽  
Best Supportive Care ◽  
Evidence Based ◽  
Systemische Chemotherapie ◽  
Chirurgische Resektion ◽  
Multimodale Therapiekonzepte ◽  
Based Medicine

Cholangiokarzinome oder cholangiozelluläre Karzinome (CCC) sind seltene Tumoren des biliären Systems mit einer Inzidenz von 2–4/100000 pro Jahr. Zu ihnen zählen die perihilären Gallengangskarzinome (Klatskin-Tumore), mit ca. 60% das häufigste CCC, die peripheren (intrahepatischen) Cholangiokarzinome, das Gallenblasenkarzinom, die Karzinome der extrahepatischen Gallengänge und das periampulläre Karzinom. Zum Zeitpunkt der Diagnose ist nur bei etwa 20% eine chirurgische Resektion als einzige kurative Therapieoption möglich. Die Lebertransplantation ist wegen der hohen Rezidivrate derzeit nicht indiziert. Die Prognose von nicht resektablen Cholangiokarzinomen ist mit einer mittleren Überlebenszeit von sechs bis acht Monaten schlecht. Eine wirksame Therapie zur Verlängerung der Überlebenszeit existiert aktuell nicht. Die wichtigste Massnahme im Rahmen der «best supportive care» ist die Beseitigung der Cholestase (endoskopisch, perkutan oder chirurgisch), um einer Cholangitis oder Cholangiosepsis vorzubeugen. Durch eine systemische Chemotherapie lassen sich Ansprechraten von ca. 20% erreichen. 5-FU und Gemcitabine sind die derzeit am häufigsten eingesetzten Substanzen, die mit einer perkutanen oder endoluminalen Bestrahlung kombiniert werden können. Multimodale Therapiekonzepte können im Einzellfall erfolgreich sein, müssen jedoch erst in Evidence-Based-Medicine-gerechten Studien evaluiert werden, bevor Therapieempfehlungen für die Praxis formuliert werden können.

scholarly journals Accuracy of Finnish Cancer Registry colorectal cancer data: a comparison between registry data and clinical records

2021 ◽  
pp. 1-5
Author(s):  
Pipsa Lunkka ◽  
Nea Malila ◽  
Heidi Ryynänen ◽  
Sanna Heikkinen ◽  
Ville Sallinen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Registry ◽  
Registry Data ◽  
Cancer Data ◽  
Clinical Records

scholarly journals Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrés Moreno Roca ◽  
Luciana Armijos Acurio ◽  
Ruth Jimbo Sotomayor ◽  
Carlos Céspedes Rivadeneira ◽  
Carlos Rosero Reyes ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Survival Time ◽  
Univariate Analysis ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Icd 10 ◽  
The Difference ◽  
Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

scholarly journals Long-Term Comparison of Survival and Marginal Bone of Implants with and without Sinus Augmentation in Maxillary Molars within the Same Patients: A 5.8- to 22-Year Retrospective Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1360
Author(s):  
Won-Bae Park ◽  
Ji-Young Han ◽  
Kyung Lhi Kang
Keyword(s):  
Statistical Significance ◽  
Frailty Model ◽  
Implant Failure ◽  
Implant Survival ◽  
Marginal Bone Loss ◽  
Related Factors ◽  
Sinus Augmentation ◽  
Maxillary Molars ◽  
Posterior Maxilla

Maxillary sinus floor augmentation (MSFA) is widely used and considered a predictable procedure for implant placement. However, the influence of MSFA on implant survival and marginal bone loss (MBL) is still inconclusive. The purpose of this retrospective observational study is to evaluate the long-term genuine influence of MSFA on the survival and MBL of implants by comparing those with and without MSFA only in maxillary molars within the same patients. Thirty-eight patients (28 male and 10 female), with a total of 119 implants, received implants with and without MSFA, and were followed up for 5.8 to 22 years. Patient- and implant-related factors were assessed with a frailty model for implant survival and with generalized estimation equations (GEE) for MBL around the implant. No variables showed a statistical significance for implant failure in the frailty model. In GEE analysis for MBL, MSFA did not show any statistical significance. In conclusion, MSFA demonstrated no significant influence on implant failure and MBL in posterior maxilla in this study.

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