Trends in Incidence and Survival of Patients with Pancreatic Neuroendocrine Neoplasm, 1987–2016

Background. Pancreatic neuroendocrine neoplasm (pNEN), with the lowest 5-year survival rates in neuroendocrine tumors (NETs), exerts great threat to human health. Because large-scale population research aimed at pNEN is rare, we aimed to explore the tendencies and differences of changes in incidences and survival rates of pNEN in each decade from 1987 to 2016 and evaluate the impacts of age, sex, race, socioeconomic status (SES), and grade. Methods. Data on pNEN cases from 1987 to 2016 were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Kaplan–Meier, Cox proportional hazards regression analyses, and relative survival rates (RSRs) were used to identify risk factors for pNEN. Results. The incidence and survival duration of pNEN increase every decade due to medical developments. The disparities of long-term survival in different age, sex, and grade groups expanded over time while that in race and SES groups narrowed. Older age and higher grade are independent risk factors for poorer survival. Females have lower incidence and longer survival than males. Prognosis of Black patients and poor (medium and high poverty) patients improved. Conclusions. This study depicted changes in incidence and survival rates of pNEN over the past three decades and evaluated potential risk factors related to pNEN, benefiting future prediction of vulnerable and clinical options.

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FRI0485 RISK OF PROGRESSION OF IDIOPATHIC PULMONARY FIBROSIS TO CONNECTIVE TISSUE DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1376 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 840-841

Author(s):

B. Ghang ◽

S. H. Nam ◽

Y. G. Kim ◽

B. Yoo ◽

C. K. Lee

Keyword(s):

Risk Factors ◽

Idiopathic Pulmonary Fibrosis ◽

Connective Tissue ◽

Pulmonary Fibrosis ◽

Rheumatoid Factor ◽

Connective Tissue Disease ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Survival Duration ◽

Citrullinated Protein

Background:Connective tissue disease (CTD) may be observed during the course of idiopathic pulmonary fibrosis (IPF). However, clinical factors associated with the development of CTD in patients with IPF have not yet been identified. These factors might be valuable clues for determining the pathogenesis of pulmonary fibrosis in patients with CTD. We hypothesize that some IPF patients have a clinically significant association with autoimmunity, and that autoantibodies are important biomarkers for identifying these patients.Objectives:Based on this hypothesis, we investigated whether the serology criteria (anti-neutrophil cytoplasmic antibody (ANCA) or autoantibodies that met the serology criteria for interstitial pneumonitis with autoimmune features (IPAF)) were associated with the development of CTD during the clinical course of IPF in the patients from our previous study(1), with a particular focus on which antibodies have a significant association with the development of CTD.Methods:We retrospectively reviewed the records of 527 patients with a first diagnosis of IPF between January 2007 and March 2014, and investigated the length of time from first visit to the clinic for IPF diagnosis (baseline) to CTD diagnosis by an expert rheumatologist in patients with IPF. Multivariable Cox proportional-hazards models with backward elimination were used to investigate the risk factors for the development of CTD.Results:CTD developed in 15 patients at a median of 2.1 years (range 1.2 to 4.8) after IPF diagnosis. All these patients had ANCA or autoantibodies that met the serology criteria for IPAF. A significant number of IPF patients with high titers of RF, ACPA or MPO-ANCA tested at first visit to the clinic progressed to CTD(Figure 1). Survival duration for IPF patients with progression to CTD was 5.3 [3.8; 6.7] years, which was significantly longer than for the IPF patients without progression to CTD (2.9 [1.7; 4.8], p = 0.001). Independent risk factors for development of CTD in IPF patients included female gender (adjusted hazard ratio (HR) 5.319, p = 0.0082), titer of rheumatoid factor (RF) (adjusted HR 1.006, p = 0.022), titer of anti-citrullinated protein antibody (ACPA) (adjusted HR 1.009, p = 0.0011), and titer of myeloperoxidase (MPO) ANCA (adjusted HR 1.02, p < 0.0001).Figure 1.Connective tissue disease development in each autoantibody positive IPF patient. ACPA = anti–citrullinated protein antibody; ANA = antinuclear antibody; CTD = connective tissue disease; MPA = microscopic polyangiitis; PAN = polyarteritis nodosa; RA = rheumatoid arthritis; RF = rheumatoid factor; UCTD = Undifferentiated connective tissue disease; SjS = Sjögren’s syndrome.Conclusion:We observed development of CTD in IPF patients with ANCA or autoantibodies that met the IPAF serology criteria. Among these autoantibodies, RF, ACPA, and MPO-ANCA were significantly associated with the development of CTD in IPF patients. Progression to CTD is uncommon in IPF patients, but a significant number of IPF patients with high titers of RF, ACPA or MPO-ANCA progressed to connective tissue disease. IPF with high titers of RF, ACPA or MPO-ANCA might be the initial clinical manifestation of connective tissue disease. Further studies are needed to investigate the role of RF, ACPA, and MPO-ANCA in development of pulmonary fibrosis.References:[1]Ghang B, Lee J, Chan Kwon O, Ahn SM, Oh JS, Hong S, et al. Clinical significance of autoantibody positivity in idiopathic pulmonary fibrosis. Respir Med. 2019;155:43-8.Disclosure of Interests:None declared

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Is more aggressive lymph node assessment associated with improved survival in stage II-III colorectal cancer? Evidence from the Surveillance, Epidemiology and End Results (SEER) cancer registry

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.4048 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 4048-4048

Author(s):

Y. Yeh ◽

Q. Cai ◽

J. Chao ◽

M. Russell

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Stage Ii ◽

Rank Test ◽

Stage Iiia ◽

Nccn Guidelines ◽

Cox Proportional Hazards Models

4048 Background: NCCN guidelines recommend assessment of =12 lymph nodes (LN) to improve accuracy in colorectal cancer (CRC) staging. Previous studies have used various cut-points to assess the relationship between the number of LN sampled and survival. The association between NCCN guideline-compliant nodal sampling and survival is assessed, while controlling for other risk factors. Methods: We selected 145,485 adult patients newly diagnosed with stage II or III from SEER during 1990–2003. Kaplan-Meier curves were compared using the log-rank test. Cox proportional hazards models were constructed to determine the effect of sampling ≥ 12 LN on survival. Results: Median patient follow-up was 5.7 years. The table shows overall survival rates in CRC patients with < 12 versus =12 LN assessed: After adjusting for age, sex, tumor size and grade, sampling ≥ 12 LN was independently associated with improved survival. For patients with =12 versus <12 LN assessed, survival increased by 13% for stage IIa [HR=0.75; 95%CI 0.72–0.78; p< .001], 16% for stage IIb [HR=0.69; 95%CI 0.67- 0.71; p< .001], 12% for stage IIIb [HR=0.75; 95%CI 0.72–0.77], and 10% for stage IIIc [HR=0.85, 95%CI 0.81–0.89]. The association was not statistically significant for stage IIIa patients. Conclusion: Consistent with previous reports, this analysis found that optimal nodal sampling increased survival across stage II and III, specifically when ≥ 12 LN are sampled and when controlling for other risk factors. Furthermore, the results underscore the need for adhering to the NCCN guidelines. The lack of a statistically significant association in stage IIIa patients may be due to small cohort size. [Table: see text] [Table: see text]

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Disparities in receipt of radiotherapy and survival by age, sex, and race among patients with nonmetastatic squamous cell carcinoma of the anus.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.721 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 721-721

Author(s):

Doug Baughman ◽

Krishna Bilas Ghimire ◽

Binay Kumar Shah

Keyword(s):

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Relative Survival ◽

Population Based ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

P Value ◽

Hazards Model ◽

To Receive

721 Background: Combination chemoradiotherapy is the standard of care for treatment of non-metastatic squamous cell carcinoma of the anus (SCCA). This population-based study evaluated disparities in receipt of radiotherapy (RT) and its effect on survival in patients with localized and regional SCCA in the United States. Methods: The Surveillance, Epidemiology, and End Results (SEER) 18 database was used to identify patients with localized and regional SCCA diagnosed between 1998 and 2008. We used univariate and multivariate logistic regression to model the relationships between receipt of RT and age, sex, marital status, stage, and race. Relative survival rates were calculated and compared using two sample z-tests. A Cox proportional hazards model was used to find adjusted hazard ratios (HR). Results: A total of 3,971 patients with localized or regional SCCA as the only primary malignancy were included in the study, of which 3,278 (82.6%) received RT. After adjusting for covariates, those 65 years and older (adjusted OR 0.82, p=0.029) were less likely to receive RT. Females were more likely to receive RT compared to males (adjusted OR 1.54, p<0.001). We found no difference in receipt of RT by race. Comparisons of 1- and 5-year relative survival rates showed lower survival for blacks (p-value <0.01 at 1-year and <0.0001 at 5-years), those 65 years and older, and males. A 1-year survival disparity was found for those not receiving RT (p-value <0.0001 at 1-year), but no difference was observed at 5-years. A Cox proportional hazards model adjusting for all covariates showed greater hazard for blacks (adjusted HR 1.36, p=0.001), those not receiving RT (adjusted HR 1.23, p=0.03), patients 65 years or older, and males. Conclusions: This population based study identified older patients as less likely to receive RT and females as more likely to receive RT. Survival analysis identified blacks, males, older patients, and those not receiving RT as having lower rates of survival.

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Poor Renal and Cardiovascular Outcomes in Patients with Biopsy-Proven Diabetic Nephropathy

Kidney & Blood Pressure Research ◽

10.1159/000505919 ◽

2020 ◽

Vol 45 (3) ◽

pp. 378-390 ◽

Cited By ~ 1

Author(s):

Yiyun Wang ◽

Ting Zhou ◽

Qiming Zhang ◽

Yang Fei ◽

Ze Li ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Nephropathy ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Survival Rates ◽

Left Ventricular ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Diabetic Patients ◽

Family History Of Diabetes

Background: Despite the high mortality of cardiovascular disease (CVD) in diabetic patients with renal injury, few studies have compared cardiovascular characteristics and outcomes between patients with diabetic nephropathy (DN) and non-diabetic renal disease (NDRD). Methods: A total of 326 type 2 diabetes mellitus patients with renal biopsy were assigned to DN and NDRD groups. Echocardiography and Doppler ultrasound were performed to evaluate left ventricular hypertrophy (LVH) and peripheral atherosclerosis disease (PAD). Renal and cardiovascular survival rates were compared between the DN and NDRD groups by Kaplan-Meier analysis. Risk factors for renal and cardiovascular events in DN patients were identified by a Cox proportional hazards model. Results: In total, 179 patients entered the DN group (54.9%) and 147 made up the NDRD group (45.1%). The presence of diabetic retinopathy, family history of diabetes, and dependence on insulin therapy were associated with the presence of DN. DN patients had more CVD with more severe LVH and PAD. Poorer renal (log-rank χ2 = 26.534, p < 0.001) and cardiovascular (log-rank χ2 = 16.257, p < 0.001) prognoses were seen in the DN group. DR (HR 1.539, 95% CI 1.332–1.842), eGFR (HR 0.943, 95% CI 0.919–0.961), and 24-h proteinuria (HR 1.211, 95% CI 1.132–1.387) were identified as risk factors for renal endpoints. Age (HR 1.672, 95% CI 1.487–1.821), HbA1C (HR 1.398, 95% CI 1.197–1.876), and 24-h proteinuria (HR 1.453, 95% CI 1.289–1.672) were associated with cardiovascular endpoints. Conclusion: Patients with DN had more severe CVD along with poorer renal and cardiovascular prognoses than those with NDRD.

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Spatial variability of Middle East respiratory syndrome coronavirus survival rates and mortality hazard in Saudi Arabia, 2012–2019

PeerJ ◽

10.7717/peerj.9783 ◽

2020 ◽

Vol 8 ◽

pp. e9783

Author(s):

Khalid Hussain Al-Ahmadi ◽

Mohammed Hussain Alahmadi ◽

Ali Saeed Al-Zahrani ◽

Maged Gomaa Hemida

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Middle East ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Middle East Respiratory Syndrome ◽

Elderly Age ◽

The Impact ◽

Overall Mortality

About 83% of laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) cases have emerged from Saudi Arabia, which has the highest overall mortality rate worldwide. This retrospective study assesses the impact of spatial/patient characteristics for 14-and 45-day MERS-CoV mortality using 2012–2019 data reported across Saudi regions and provinces. The Kaplan–Meier estimator was employed to estimate MERS-CoV survival rates, Cox proportional-hazards (CPH) models were applied to estimate hazard ratios (HRs) for 14-and 45-day mortality predictors, and univariate local spatial autocorrelation and multivariate spatial clustering analyses were used to assess the spatial correlation. The 14-day, 45-day and overall mortality rates (with estimated survival rates) were 25.52% (70.20%), 32.35% (57.70%) and 37.30% (56.50%), respectively, with no significant rate variations between Saudi regions and provinces. Nationally, the CPH multivariate model identified that being elderly (age ≥ 61), being a non-healthcare worker (non-HCW), and having an underlying comorbidity were significantly related to 14-day mortality (HR = 2.10, 10.12 and 4.11, respectively; p < 0.0001). The 45-day mortality model identified similar risk factors but with an additional factor: patients aged 41–60 (HR = 1.44; p < 0.0001). Risk factors similar to those in the national model were observed in the Central, East and West regions and Riyadh, Makkah, Eastern, Madinah and Qassim provinces but with varying HRs. Spatial clusters of MERS-CoV mortality in the provinces were identified based on the risk factors (r2 = 0.85–0.97): Riyadh (Cluster 1), Eastern, Makkah and Qassim (Cluster 2), and other provinces in the north and south of the country (Cluster 3). The estimated HRs for the 14-and 45-day mortality varied spatially by province. For 45-day mortality, the highest HRs were found in Makkah (age ≥ 61 and non-HCWs), Riyadh (comorbidity) and Madinah (age 41–60). Coming from Makkah (HR = 1.30 and 1.27) or Qassim province (HR = 1.77 and 1.70) was independently related to higher 14-and 45-day mortality, respectively. MERS-CoV patient survival could be improved by implementing appropriate interventions for the elderly, those with comorbidities and non-HCW patients.

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Survival Analysis: Comparing Peritoneal Dialysis and Hemodialysis in Taiwan

Peritoneal Dialysis International ◽

10.1177/089686080802803s04 ◽

2008 ◽

Vol 28 (3_suppl) ◽

pp. 15-20 ◽

Cited By ~ 4

Author(s):

Chiu-Ching Huang ◽

Kuang-Fu Cheng ◽

Hong-Dar Isaac Wu

Keyword(s):

Peritoneal Dialysis ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Diabetic Patients ◽

Term Survival ◽

Asian Populations ◽

Diabetes Status ◽

Subgroup Analyses ◽

Stage Renal Disease

⋄ Objectives Comparisons of survival in patients on peritoneal dialysis (PD) and on hemodialysis (HD) have been conducted in many Western countries, but publications on this subject in Asian populations are scarce. The present study estimated the survival and the relative mortality hazard for HD and PD patients in Taiwan. ⋄ Methods Incident end-stage renal disease patients reported to the Taiwan Renal Registry during 1995 – 2002 were included in the study. Patients had to be 20 years of age or older and had to have survived for the first 90 days on dialysis. A total of 45 820 incident HD and 2809 incident PD patients formed the study population. Patients on PD were treated mainly with traditional glucose-based solutions. Using an intent-to-treat analysis, the Cox proportional hazards (CPH) model was applied to identify the factors that predict survival by treatment modality. Subgroup analyses were conducted by stratifying patients according to sex, comorbidity, age, and diabetes status. Kaplan–Meier estimates were used to explore the survival of HD and PD patients. Adjustments were implemented using the CPH model. ⋄ Results The overall 1-year, 2-year, 3-year, 5-year and 10-year survival rates for PD patients were 89.8%, 77.6%, 67.6%, 55.5%, and 35% respectively. The equivalent survival rates for HD patients were 87.5%, 76.6%, 68.1%, 54.3%, and 33.8%. The differences were not statistically significant ( p = 0.125). The CPH analysis stratified by diabetes status and age revealed that PD patients 55 years of age or younger and nondiabetic had a lower mortality ratio (MR) of 0.94. But the MR increased to 1.31 for nondiabetic patients older than 55. The MR for PD versus HD further increased to 1.72 for diabetic patients 55 years of age or younger, and to 1.99 for diabetic patients older than 55. ⋄ Conclusions After adjusting for both demographic and clinical case-mix differences, PD and HD patients were observed to have similar long-term survival. Subgroup analyses revealed that, among diabetic patients and patients older than 55, those on HD experienced better survival than did those on PD.

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Prognostic interaction between age and sex on outcomes following carotid endarterectomy

VASA ◽

10.1024/0301-1526/a000957 ◽

2021 ◽

pp. 1-9

Author(s):

Mario D’Oria ◽

Barbara Ziani ◽

Marco Damiano Pipitone ◽

Paolo Manganotti ◽

Roberta Pozzi Mucelli ◽

...

Keyword(s):

Carotid Endarterectomy ◽

Carotid Stenosis ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Term Survival ◽

Symptomatic Carotid ◽

Asymptomatic Patients ◽

Symptomatic Carotid Stenosis ◽

Age And Sex

Summary: Background: The aim of this study was to assess the prognostic interaction between age and sex on peri-operative and follow-up outcomes following elective carotid endarterectomy (CEA) for asymptomatic and symptomatic carotid stenosis. Patients and methods: A retrospective review of all patients admitted to a single vascular unit who underwent elective CEA between January, 2015 and December, 2019 was performed. The primary endpoints of the study were overall survival (from index operation) and cumulative stroke rate at thirty days. Results: A total of 383 consecutive patients were included in this study; of these 254 (66.4%) were males. At baseline, males were younger (mean age 73.4±11 vs. 76.3±10 years, p=.01) and with lower proportion of octogenarians (20.4% vs. 28.7%, p=.05). The rate of stroke in symptomatic and asymptomatic patients (males vs. females) were as follows: a) whole cohort 1.9% vs. 2% (p=1.00) and 2.7% vs. 1.3% (p=.66), respectively; b) ≥80 years old 3.7% vs. 0% (p=1.00) and 4% vs. 5.9% (p=1.00), respectively; c) <80 years old 1.2% vs. 3.3% (p=.47) and 2.5% vs. 0% (p=.55), respectively. The 3-year survival estimates were significantly lower for males (84% vs. 92%, p=.03). After stratification by age groups, males maintained inferior survival rates in the strata aged <80 years (85% vs. 97%, p=.005), while no differences were seen in the strata aged ≥80 years (82% vs. 79%, p=.92). Using multivariate Cox proportional hazards, age (HR: 2.1, 95% CI: 1.29–3.3, p=.002) and male gender (HR: 2.5, 95% CI: 1.16–5.5, p=.02) were associated with increased hazards of all-cause mortality. Conclusions: In this study of elective CEA for asymptomatic and symptomatic carotid stenosis, similar peri-operative neurologic outcomes were found in both males and females irrespective of age. Despite being usually older, females have superior long-term survival rates.

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Cardiovascular Toxicity after Therapy for Diffuse Large B Cell Lymphoma Occurs Early and Results in Decreased Overall Survival.

Blood ◽

10.1182/blood.v128.22.105.105 ◽

2016 ◽

Vol 128 (22) ◽

pp. 105-105 ◽

Cited By ~ 1

Author(s):

Sabarish Ram Ayyappan ◽

Akiva Diamond ◽

Vinita Gupta ◽

Brenda Cooper ◽

Ben K. Tomlinson ◽

...

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Chronic Renal Failure ◽

Cardiovascular Events ◽

Proportional Hazards ◽

Statistical Significance ◽

B Cell Lymphoma ◽

Cox Proportional Hazards ◽

Term Survival ◽

History Of

Abstract Diffuse large B cell lymphoma (DLBCL) is the most frequent non-Hodgkin lymphoma, with increasing incidence in the elderly population. Anthracycline-containing chemo immunotherapy can achieve high response rates and improved survival, but can result in cardiovascular toxicity, which can negatively affect short and long term survival, particularly in older patients. We conducted a retrospective analysis to determine the incidence of cardiovascular events after DLBCL and the effect these complications have on outcomes. Methods: The Hematologic Malignancies Database of University Hospitals Seidman Cancer Center was accessed to identify newly diagnosed DLBCL patients between 2002 and 2014. Data on patient characteristics including cardiovascular risk factors, disease characteristics, baseline cardiac function, treatment details, and outcomes including response, relapse and cardiovascular events was collected. Univariate Cox proportional hazards analysis was conducted on risk factors and those reaching statistical significance (p < 0.05) were selected for inclusion in multivariate proportional hazards model to help identify predictors for cardiovascular events. Cumulative incidence (with death as competing risk) was used to estimate the incidence of cardiovascular events. Overall survival (OS) and progression free survival (PFS) was calculated using the Kaplan-Meier method, and comparison between groups was done with the log rank test. Results: Four hundred DLBCL patients were included for analysis. Median age at diagnosis was 63 years, with 139 patients above the age of 70. 237 patients (59.3 %) had advanced disease (Ann Arbor stage III/IV) at diagnosis and 28 (7 %) patients had left ventricular ejection fraction less than 50 % at baseline. Other baseline characteristics are listed in Table 1. Treatment included an anthracycline-based regimen in 319 (86.3%) patients and 338 (92%) patients received rituximab. 274 (81%) patients achieved complete remission and 39 (11.5%) patients had progressive disease. After a median follow up of 33 months, 190 patients had relapsed and 140 died. The overall 3-year PFS for the cohort was 57.6 % (95 % CI 52.4- 62.7 %) and 3-year OS 69.8 % (95 % CI 65-74.7%). Seventy four patients developed cardiovascular events, with 1-year and 3-year cumulative incidence of 9.7% (95 % CI 7.1-13.2) and 14.7 % (95 % CI 11.5 -18.9), respectively. Fifty-two patients (13 %) developed congestive heart failure, nine (2.25 %) were diagnosed with new coronary artery disease requiring revascularization and six patients (1.5 %) suffered new cerebrovascular accident. Table 2 summarizes the results of Cox proportional hazards analysis. Univariate analysis showed age > 60 years, previous history of congestive heart failure, coronary artery disease, arterial hypertension, COPD, chronic renal failure and BMI > 30 were significantly associated with cardiovascular events (p<0.05). In multivariate analysis, only age > 60 years, BMI >30 and history of chronic renal failure showed statistical significance (p = 0.016, 0.002, 0.031 respectively). Patients who presented a cardiovascular event less than 1 year after DLBCL diagnosis had an estimated 3-year OS of 49.2% (95 % CI 31-67.5 %) vs. 71.7% (95 % CI 66.8-76.6 %) in patients who did not experience early cardiovascular events (p=0.002) (Figure 1). Conclusions. DLBCL patients have an elevated incidence of cardiovascular events after diagnosis. Most cardiac complications occur early, within 1 year of diagnosis and treatment, and have a significant effect on long-term survival. Identification of the patients at highest risk is important for guiding risk-adapted monitoring, preventive measures and early intervention. In addition to known history of cardiac disease, we identified advanced age, increased BMI and history of chronic renal failure as additional risk factors that should be incorporated in cardiac risk stratification of patients receiving therapy for DLBCL. Disclosures Caimi: Roche: Research Funding; Gilead: Consultancy; Genentech: Speakers Bureau; Novartis: Consultancy.

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Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

International Journal of Colorectal Disease ◽

10.1007/s00384-021-04005-6 ◽

2021 ◽

Author(s):

Claudius E. Degro ◽

Richard Strozynski ◽

Florian N. Loch ◽

Christian Schineis ◽

Fiona Speichinger ◽

...

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Blood Level ◽

Proportional Hazards ◽

Survival Rates ◽

Cox Proportional Hazards ◽

Stage I ◽

Cancer Stage ◽

Single Center ◽

Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

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7 Prognostic factors for overall survival in patients with advanced melanoma treated with Anti-PD-1 therapy – the melimmune score

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0007 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A7-A7

Author(s):

Soraia Lobo-Martins ◽

Diogo Martins-Branco ◽

Patrícia Miguel Semedo ◽

Cecília Melo Alvim ◽

Ana Maria Monteiro ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

Poor Prognosis ◽

Proportional Hazards ◽

Checkpoint Inhibitors ◽

Prognostic Score ◽

Daily Practice ◽

Cox Proportional Hazards ◽

Time To Death ◽

Line Setting

BackgroundImmune checkpoint inhibitors (ICI) have changed the paradigm of advanced malignant melanoma (MM). Several prognostic factors, mostly linked to inflammation, have been under scope to better select patients for such therapies. We aimed to build and apply a prognostic score in this setting.MethodsBaseline characteristics and outcomes on 147 patients with advanced MM treated with an anti-PD1 (nivolumab or pembrolizumab) in monotherapy, between Jan-2016 and Oct-2019, in the 1st, 2nd or 3rd line setting were collected from two centres in Portugal. Data cut-off for follow-up was May-2020. Cox proportional hazards regression was used to identify independent prognostic factors for OS.ResultsWith a median FU of 28.93 months (95% CI [22.52–33.54]), mOS for the whole cohort was 14.75 months (95% CI, [10.80–18.71]). Overall, 43 and 104 patients were treated with nivolumab and pembrolizumab, respectively. We identified four adverse prognostic factors that were independent predictors of bad prognosis: number of metastatic sites >2 (p<0.001), baseline PS-ECOG =1 (p<0.001), presence of baseline lymphopenia (over lower limit of normal) (p=0.002) or very high baseline LDH (>2x upper limit of normal) (p<0.001).Patients were separated into three risk categories according to the number of risk factors present: favourable prognosis (no risk factors; n=34), intermediate prognosis (one risk factor; n=65) and poor prognosis (two or more risk factors; n=48). mOS was 43.41 (95% CI [32.13–54.69], 14.39 (95% CI [6.78–22.01]) and 6.53 months (95% CI [3.61–9.44]), for favourable, intermediate, and poor prognosis group, respectively (p<0.001; figure 1). AUC of ROC curve for OS was 0.737 (95% CI [0.654–0.819], p<0.001).Abstract 7 Figure 1Time to death - Kaplan-Meier survival plotConclusionsUsing easily accessible parameters from our daily practice, we propose the MELImmune prognostic score for advanced MM patients treated with anti-PD1 in monotherapy that could be incorporated to the daily clinical practice and clinical trials. We further aim to validate this score in an independent larger sample.Ethics ApprovalThe study was approved by both institutions’ Ethics Committee.

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