scholarly journals The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jue Wang ◽  
Fen Wei Wang ◽  
Anne Kessinger
Keyword(s):  
Natural History ◽  
Renal Pelvis ◽  
Histological Grade ◽  
Tumor Stage ◽  
Population Based ◽  
Age At Diagnosis ◽  
Cancer Specific Survival ◽  
Entire Cohort ◽  
Undifferentiated Histology ◽  
Almost All

Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry.Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed.Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

The natural history, treatment pattern, and survival of the patients with micropapillary bladder.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15015-e15015
Author(s):  
Jue Wang
Keyword(s):  
Natural History ◽  
Tumor Stage ◽  
Invasive Disease ◽  
Population Based ◽  
Bladder Tumors ◽  
Cancer Specific Survival ◽  
Undifferentiated Histology ◽  
Primary Bladder ◽  
Muscle Invasive ◽  
Population Based Registry

e15015 Background: Micropapillary bladder carcinoma (MPBC) is a rare variant of urothelial carcinoma. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of MPBC using population-based registry. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases of MPBC by tumor site and histology codes. The clinical, demographic characteristics, treatment and survival of MPBC were examined. Results: A total of 98 cases of histology confirmed MPBC were identified between 2001 and 2007, this accounted for approximately 0.01% of all primary bladder tumors during the study period. Median age of the patients was 72 years (range 26-95). Of all the patients with MPBC, 56.1% had muscle invasive disease; 75.5% of patients had poorly or undifferentiated histology. A total of 30.6% of all patients (2.3% superficial disease; 52.7% of muscle-invasive MPBC) had radical or partial cystectomy. By logistic regression analysis, nonmuscle-invasive MPBC (OR 62.5, 95% CI 7.2-542.3) was associated with lower rate of utilization of cystectomy. The 1-, 3- and 5-year overall survival rate of MPBC were 84.5%, 57.3% and 42.3%. In multivariate analysis, tumor stage (HR 4.7, 95% CI 1.0-21.8) was found to be the only significant predictor for cancer-specific survival. Conclusions: The optimal therapy for MPBC remains undermined. Emphasis on early detection is needed to improve the outcome for patients with this malignancy.

scholarly journals Clinical Features of Sarcomatoid Carcinoma (Carcinosarcoma) of the Urinary Bladder: Analysis of 221 Cases

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Jue Wang ◽  
Fen Wei Wang ◽  
Chad A. LaGrange ◽  
George P. Hemstreet III ◽  
Anne Kessinger
Keyword(s):  
Urinary Bladder ◽  
Sarcomatoid Carcinoma ◽  
Tumor Stage ◽  
Population Based ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Primary Tumors ◽  
Undifferentiated Histology ◽  
Primary Bladder

Background. Urinary bladder sarcomatoid carcinoma (carcinosarcoma) is rare. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of urinary bladder carcinosarcoma using population-based registry.Methods. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined.Results. A total of 221 histology confirmed cases were identified between 1973 and 2004, this accounted for approximately 0.11% of all primary bladder tumors during the study period. Median age of the patients was 75 years (range 41–96). Of the patients with a known tumor stage , 72.5% had a regional or distant stage; 98.4% of patients with known histology grade , had poorly or undifferentiated histology. Multiple primary tumors were indentified in about 40% of study subjects. The majority of patients (95.9%) received cancer directed surgery, 35.8% had radical or partial cystectomy, 15.8% of patients received radiation therapy combination with surgery. The median overall survival was 14 months (95% CI 7–21 months). 1-, 5-, and 10-year cancer specific survival rate were 53.9%, 28.4% and 25.8%. In a multivariate analysis, only tumor stage was found to be a significant prognostic factor for disease-specific survival.Conclusions. Urinary bladder carcinosarcoma commonly presented as high grade, advanced stage and aggressive behavior with a poor prognosis. Emphasis on early detection, including identification of risk factors is needed to improve the outcome for patients with this malignancy.

scholarly journals Outcome of Combined Hepatocellular and Cholangiocarcinoma of the Liver

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Jue Wang ◽  
Fenwei Wang ◽  
Anne Kessinger
Keyword(s):  
Logistic Regression ◽  
Proportional Hazards ◽  
Liver Tumors ◽  
Tumor Stage ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cancer Specific Survival ◽  
Primary Liver Tumors ◽  
Combined Hepatocellular And Cholangiocarcinoma ◽  
Undifferentiated Histology

Background. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of combined hepatocellular and cholangiocarcinoma (cHCC-CC) using population-based registry.Methods. The Surveillance, Epidemiology, and End Results Program database (1973–2004) was used to identify cases of cHCC-CC. Multivariable logistic regression was used to evaluate factors associated with cancer-directed surgery (CDS). The influence of CDS on cancer specific survival was evaluated using Kaplan-Meier curves and Cox proportional hazards modeling.Results. A total of 380 cases of cHCC-CC were identified, which account for approximately 0.87% of primary liver tumors. Of all patients, 69.8% of patients had regional or distant stage; 65.6% of patients had poorly or undifferentiated histology. Only 44.9% of patients with localized disease, received CDS. By logistic regression analysis, being widowed, advanced stage, and earlier diagnosis year were associated with lower rate of utilization of CDS. In multivariate analysis, tumor stage, receipt of CDS, and recent year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusions. Patients with localized cHCC-CC who are selected for CDS were strongly associated with improved survival. However, many patients with localized tumors did not receive potentially curative cancer-directed surgery. Further study is warranted to address the barriers to the delivery of appropriate care to these patients.

scholarly journals Reduced Protumorigenic Tumor-Associated Macrophages With Statin Use in Premalignant Human Lung Adenocarcinoma

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Esraa Al Dujaily ◽  
Juvenal Baena ◽  
Madhumita Das ◽  
Marco Sereno ◽  
Claire Smith ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Human Lung ◽  
Statistical Tests ◽  
Histological Grade ◽  
Tumor Stage ◽  
Tumor Associated Macrophages ◽  
Cancer Specific Survival ◽  
Statin Dose ◽  
Dose Dependent ◽  
Statin Use

Abstract Background Statins have anticancer properties by acting as competitive inhibitors of the mevalonate pathway. They also have anti-inflammatory activity, but their role in suppressing inflammation in a cancer context has not been investigated to date. Methods We have analyzed the relationship between statin use and tumor-associated macrophages (TAMs) in a cohort of 262 surgically resected primary human lung adenocarcinomas. TAMs were evaluated by multiplex immunostaining for the CD68 pan-TAM marker and the CD163 protumorigenic TAM marker followed by digital slide scanning and partially automated quantitation. Links between statin use and tumor stage, virulence, and cancer-specific survival were also investigated in a wider cohort of 958 lung adenocarcinoma cases. All statistical tests were two-sided. Results We found a statin dose-dependent reduction in protumorigenic TAMs (CD68+CD163+) in both stromal (P = .021) and parenchymal (P = .003) compartments within regions of in situ tumor growth, but this association was lost in invasive regions. No statistically significant relationship between statin use and tumor stage was observed, but there was a statin dose-dependent shift towards lower histological grade as assessed by growth pattern (P = .028). However, statin use was a predictor of slightly worse cancer-specific survival (P = .032), even after accounting for prognostic variables in a multivariable Cox proportional hazards survival model (hazard ratio = 1.38, 95% confidence interval = 1.04 to 1.84). Conclusions Statin use is associated with reduced numbers of protumorigenic TAMs within preinvasive lung adenocarcinoma and is related to reduced tumor invasiveness, suggesting a chemo-preventive effect in early tumor development. However, invasive disease is resistant to these effects, and no beneficial relationship between statin use and patient outcome is observed.

Multiple primary tumors in patients with carcinosarcoma of bladder: A coincidence or an etiological association? A study of 221 carcinosarcoma of bladder cases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16138-e16138
Author(s):  
J. Wang ◽  
F. Wang
Keyword(s):  
Prognostic Factors ◽  
Natural History ◽  
Tumor Stage ◽  
Population Based ◽  
Primary Tumors ◽  
Multiple Primary Tumors ◽  
Number Of Patients ◽  
Multiple Primary ◽  
Primary Bladder ◽  
Patient’S Outcome

e16138 Background: Carcinosarcoma of the bladder are rare; As a result, few studies of carcinosarcoma of the bladder have included sufficient number of patients to define their natural history and to determine the factors that impact survival. The objective of this study was to examine the epidemiology, natural history, and prognostic factors that affect the survival for carcinosarcoma of the bladder by using population-based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973–2004) was used to identify cases of carcinosarcoma of the bladder by tumor site and histology codes. The association between clinical and demographic characteristics and survival of carcinosarcoma of the bladder was examined. Results: A total of 221 cases of histology confirmed carcinosarcoma of the bladder were identified, this account for approximately 0.11% of primary bladder tumors during same period. By using linked population files, we calculated the incidence of carcinosarcoma of the bladder as a rate 0.22 per 100,000 per year, age-adjusted to year 2000 U.S. standard population. Median age of all patients were 75 years (range 41–96). In about 40% of study population, more than one or multiple primary were also indentified. Majority of (212, 95.9 %) patients received cancer directed surgery. For survival analyses, we excluded the cases that were identified at autopsy or on the basis of death certificates only and the patients have more than one primary. Total 132 patients were included in survival analysis. The median overall survival for all cases was 9 months (range 6–12 months). In multivariate analysis, only tumor stage was found to be significant prognostic factors for disease-specific survival. Conclusions: Carcinosarcoma of the bladder are rare tumors that are challenging, the survival is poor even in patients underwent surgical resection. Better therapy is needed to improve patient's outcome. A significant fraction of carcinosarcoma patients are actually affected by multiple primary tumors, the potential association between carcinosarcoma and other neoplasms remain to be investigated. No significant financial relationships to disclose.

Impact of age at diagnosis on natural history of patients with elderly-onset ulcerative colitis: A French population-based study

2018 ◽  
Vol 50 (9) ◽  
pp. 903-909 ◽  
Author(s):  
Dana Duricova ◽  
Benjamin Pariente ◽  
Hélène Sarter ◽  
Mathurin Fumery ◽  
Ariane Leroyer ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Natural History ◽  
Population Based ◽  
Age At Diagnosis ◽  
French Population ◽  
Population Based Study ◽  
History Of ◽  
Elderly Onset

scholarly journals Surgical Compliance and Survival Outcomes For Patients With Osteosarcoma: A Population-Based Database Study

2021 ◽  
Author(s):  
Chao Tang ◽  
Dongdong Wang ◽  
Hailong Zhang
Keyword(s):  
Logistic Regression Model ◽  
Tumor Stage ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Poor Grade ◽  
Factors Associated ◽  
The Poor ◽  
Kaplan Meier ◽  
Diagnostic Time ◽  
Economic Income

Abstract PurposeWe aimed to determine the effect of surgical compliance on prognosis in patients with osteosarcoma and the risk factors leading to surgical noncompliance.MethodsWe analyzed the date collected 3412 osteosarcoma patients from the Surveillance Epidemiology and End Results (SEER) databases between 1973 and 2015. Cox analyses were used to identify the independent prognostic factors. Logistic regression model was conducted to clear the factors associated to surgical compliance; Kaplan-Meier estimator method was adopted to analyze the Overall survival (OS) and Cancer-specific survival (CSS). ResultsAmong 3412 eligible osteosarcoma patients, the poor surgical compliance of patients with osteosarcoma is associated with the earlier time of diagnosis, advanced age, lower economic income, poor grade, distant stage, accepting radiotherapy and refusing chemotherapy. There were significant differences in the effects of diagnostic time, age, grade, radiotherapy, chemotherapy, tumor stage and economic income on surgical compliance (All P < 0.05). Patients’ compliance was an independent prognostic factor for OS and CSS of osteosarcoma patients. ConclusionsOsteosarcoma patients with good surgical compliance have favorable survival. This can help clinicians effectively realize patients' views on surgery and guide patients to learn the signification of surgery.

scholarly journals Sex-Based Heterogeneity in the Clinicopathological Characteristics and Prognosis of Breast Cancer: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiqun Han ◽  
Jiayu Wang ◽  
Zijing Wang ◽  
Binghe Xu
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Ductal Carcinoma ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Population Based ◽  
Clinicopathological Characteristics ◽  
Clinicopathological Features ◽  
Disease Stage ◽  
Cancer Specific Survival

PurposeTo better understand the differences in clinicopathological features and prognosis between male breast cancer (MBC) and female breast cancer (FBC).Material and MethodsData on patients diagnosed with breast cancer from January 1, 2010, to December 31, 2016, were obtained from the Surveillance, Epidemiology, and End Results database. Selected patients were classified into MBC and FBC, of which population demographics and clinicopathological features at baseline were successively extracted for analysis. Comparative analysis was performed to explore the differences in baseline characteristics, followed by propensity-score matching to calibrate the objective distinctions for adjusted analysis. Survival analysis was carried out to investigate divergences presented in prognosis from the two cohorts, and risk factors for prognosis were successively identified using univariate and multivariate COX regression analyses.ResultsA total of 407341 individuals were eligible, including 3111 MBC (0.7%) and 404230 FBC (99.3%) patients. Comparatively, patients with MBC tended to be older at diagnosis, with a higher confirmation of ductal carcinoma, a higher histological grade, a higher TNM stage, a higher proportion of luminal-like subtype, a higher rate of lung metastasis, a lower incidence of liver involvement, and a lower rate of surgical, radiation, and chemotherapeutic delivery. The overall prognosis of MBC was significantly worse than that of FBC, with a decreasing divergence both in median overall survival (65.5 months vs. 72.7 months, P&lt;0.0001) and median breast cancer-specific survival (75.4 months vs. 77.8 months, P&lt;0.0001). However, these discrepancies were not consistent among patients from different subgroups stratified by molecular subtype, age at diagnosis, or disease stage.ConclusionIn this study, sex-based heterogeneity in clinicopathological characteristics and prognostic profiles was observed in the overall population of patients with breast cancer and was significantly variable among different subgroups. A male-specific design with reasonable endpoints for a clinical trial protocol will be warranted in the future.

Population based study of islet cell carcinoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15103-15103
Author(s):  
J. Mares ◽  
M. P. Eisner ◽  
C. Dagohoy ◽  
A. Phan ◽  
A. Rashid ◽  
...  
Keyword(s):  
Natural History ◽  
Cell Carcinoma ◽  
Median Survival ◽  
Islet Cell ◽  
Advanced Disease ◽  
The United States ◽  
Population Based ◽  
Age At Diagnosis ◽  
Survival Duration ◽  
Islet Cell Carcinoma

15103 Background: Little is known about the epidemiology and natural history of islet cell carcinoma. In this study, we examine the epidemiology, natural history, and prognostic factors impacting survival duration for islet cell carcinoma using population based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973 - 2003 release April 2006) was used to identify cases of islet cell carcinoma using histology codes and tumor site. Results: 1,310 (619 women and 691 men) cases were identified. Median age at diagnosis was 59 years. The annual age-adjusted incidence in the periods covered by SEER 9 (1973–1991), SEER 13 (1992–1999), and SEER 17 (2000–2003) were 0.16, 0.14, and 0.12 per 100,000 respectively. The estimated 28-year limited duration prevalence on January 1, 2003 in the United States was 2,705 cases. Insulinomas (57%), glucagonomas (53%), and VIPomas (64%) were more likely to be located in the tail of the pancreas while gastrinomas were more likely to be located in the head of the pancreas (63%). Classified by SEER stage, localized, regional, and distant stages corresponded to 14%, 23% and 54% of cases. The median survival was 38 months. By stage, median survival for patients with localized, regional, and distant disease were 124 (95% CI, 80–168) months, 70 (95% CI, 54 - 86) months, and 23 (95% CI, 20 - 26) months respectively. By multivariate Cox proportional modeling, stage (P < 0.001), primary tumor location (P = .04), and age at diagnosis (P < 0.001) were found to be significant predictors of survival. Conclusion: Islet cell carcinomas account for approximately 1.3% of cancers arising in the pancreas. Most patients have advanced disease at the time of diagnosis. Despite its reputation of being indolent, survival of patients with advanced disease remains in the range of 2 years. Development of novel therapeutic approaches is needed. No significant financial relationships to disclose.

scholarly journals A Novel Nomogram for Predicting Cancer-Specific Survival in Women with Uterine Sarcoma: A Large Population-Based Study

2021 ◽  
Author(s):  
Yuan-jie Li ◽  
Jun Lyu ◽  
Chen Li ◽  
Hai-rong He ◽  
Jin-feng Wang ◽  
...  
Keyword(s):  
Validation Cohort ◽  
Large Population ◽  
Population Based ◽  
Uterine Sarcoma ◽  
Age At Diagnosis ◽  
Rapid Progression ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Cox Analysis

Abstract Background: Uterine Sarcoma (US) is a rare malignant uterine tumor in women with aggressive behavior and rapid progression. The purpose of this study was to perform a comprehensive nomogram to predict the cancer-specific survival (CSS) for US based on the Surveillance, Epidemiology, and End Results (SEER) database.Methods: Retrospetive population-based study was conducted using the data of patients with US between 2010 and 2015 from SEER database. They were randomly divided into a training cohort and a validation cohort in a 7-to-3 ratio. Multivariate Cox analysis was performed to identify independent prognostic factors. Subsequently, nomogram was established to predict the patients’ CSS. The discrimination and calibration of the nomogram were evaluated by concordance index (C-index) and the area under the curve (AUC). Finally, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), calibration plotting, and decision-curve analysis (DCA) were used to evaluate the benefits of the new prediction model.Results: A total of 3861 patients with US were included in our study. As revealed in multivariate Cox analysis, age at diagnosis, race, marital status, insurance record, tumor size, pathology grade, histological type, SEER stage, AJCC stage, surgery status, radiotherapy status, and chemotherapy status were found to be independent prognositic factors. In our nomogram, pathology grade has the highest risk on CSS in US, followed by age at diagnosis, then surgery status. Comparing to the AJCC staging system, the new nomogram showed better predictive discrimination with higher C-index in both training and validation cohort (0.796 and 0.767 vs0.706 and 0.713, respectively) . Furthermore, AUC value, calibration plotting, NRI, IDI, and DCA also demonstrated better performance than the traditional system.Conclusion: Our study validated the first comprehensive nomogram for US which could provide more accurately and individualized survival predictions for US patients in clinical practice.

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