An Age-Based Analysis of Pediatric Melanoma: Staging, Surgery, and Mortality in the Surveillance, Epidemiology, and End Results Database

2018 ◽  
Vol 84 (5) ◽  
pp. 739-745 ◽  
Author(s):  
Patrick H. Lam ◽  
Augustine C. Obirieze ◽  
Gezzer Ortega ◽  
Becky S. Li ◽  
Stephanie D. Purnell ◽  
...  

The pediatric melanoma population is not well described, and current guidelines for their management are not well defined. Our study aims to identify this population, treatment modalities, and outcomes using a national population-based database. We reviewed the Surveillance, Epidemiology, and End Results database (2004–2008). Patients ≤21 years old with melanoma were included and grouped into ≤12 years of age, 13 to 18 years, and 19 to 21 years. Clinical characteristics were analyzed across the groups. A total of 1255 patients were included: 52.7 per cent were 19 to 21 years of age, 36.3 per cent were 13 to 18 years of age, and 11.0 per cent were ≤12 years of age. The 19- to 21-year-olds had the highest proportion of stage I (50.5%) versus ≤12 years of age (31.9%); the ≤12-year-olds had the highest proportion of stage IV (3.6%) versus 19 to 21 years of age (0.9%), P < 0.001. The 19- to 21-year-olds had the highest proportion receiving wide local excisions only (34.8%) versus ≤12 years of age (26.4%); the ≤12-year-olds had the highest proportion of patients without any surgeries (16.0%) versus 13 to 18 years of age (9.4%), P = 0.169. On adjusted analysis, the 19- to 21-year-olds had worse survival compared with ≤12 years of age (hazard ratio: 5.26, P = 0.017, 95% confidence interval 1.34–20.65). Disparities were found in the ≤12-year-old melanoma population, as they had later stage melanomas, less invasive surgery, and lower survival. Clearer prognostic factors are needed to better elucidate their management.

2018 ◽  
Vol 18 (1) ◽  
pp. e97-e105 ◽  
Author(s):  
Wei Chen ◽  
Ying Huang ◽  
Gary D. Lewis ◽  
Sean S. Szeja ◽  
Sandra S. Hatch ◽  
...  

2018 ◽  
Vol 66 (8) ◽  
pp. 1133-1140
Author(s):  
Deliang L Liu ◽  
Zhuojun J Zheng

This study sought to explore the prognostic factors in a large retrospective cohort of patients with B-cell primary ocular lymphoma (POL) from the Surveillance, Epidemiology, and End Results database. There were 2778 patients with B-cell POL whose complete clinical information was listed in the Surveillance, Epidemiology, and End Results database between 1997 and 2014. The epidemiology, therapeutic measures, and clinical characteristics were listed as descriptive statistics. Survival analysis was conducted by univariate and multivariable Cox regression models. Multivariate analysis identified age, lymphoma subtype, primary lesion, and radiation status as independent prognostic factors. For indolent lymphoma, radical treatment, especially intravenous chemotherapy, should be avoided. For invasive lymphoma, chemotherapy combined with full orbital irradiation is recommended. Radiotherapy alone or in combination with chemotherapy is superior to chemotherapy alone. These differences were statistically significant (p<0.05). Radiation brings benefits, with tolerable neurotoxicity, to patients with invasive B-cell POL. Radical tumor treatment may not be needed for patients with indolent B-cell POL.


2020 ◽  
Vol 16 (10) ◽  
pp. 573-584
Author(s):  
Yu-Jie Lu ◽  
Han Wang ◽  
Lin-Yan Fang ◽  
Wen-Jie Wang ◽  
Wei Song ◽  
...  

Aim: To establish and validate a nomogram for the estimation of overall survival of patients with uterine leiomyosarcoma (uLMS). Methods: Information on patients diagnosed as uLMS was retrospectively retrieved from the Surveillance, Epidemiology, and End Results database. The patients were randomly assigned into the training and the validation cohorts. Univariate and multivariate analyses were used to determine the independent prognostic factors for building a nomogram for predicting overall survival. The predictive accuracy was evaluated based on the concordance indices and the calibration plots. Results: A nomogram that combined age, marital status, tumor size, Surveillance, Epidemiology, and End Result stage, surgery and radiation was established. The internal and external concordance indices were 0.748 and 0.745, respectively. The calibration plots approached 45 degrees. Conclusion: The nomogram might be an effective tool for predicting the survival of patients with uLMS.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18001-e18001
Author(s):  
Y Zhang ◽  
J Yang ◽  
Qy Li ◽  
Zg Zhang ◽  
MJ Sun ◽  
...  

e18001 Background: To investigate the clinical characteristics and prognostic factors of neuroendocrine carcinoma of the gynecologic tract (NECGT). Methods: Patients with NECGT diagnosed during 2010 to 2019 were enrolled in this retrospective study. Clinical parameters were calculated, including age, childbearing history, initial symptoms, blood indexs, International Federation of Gynaecology and Obstetrics (FIGO) stages, treatment modalities and survival data. The cut-off values of parameters were screened by receiver-operating characteristic (ROC) curves and their significance was assessed by multivariate logistic regression. Results: We indentified forty five NECGT patients available with the median follow-up time of 5.5 months (9.7±1.98 months). 42 cases (93.3%) originated from cervix uteri, 2 cases (4.4%) from vagina and 1 case (2.2%) from fallopian tube. Irregular vaginal bleeding was the most frequent symptom at the first visit accounting for 75.6%. FIGO stages I to IV distributions were 16 (35.6%), 15 (33.3%), 6 (13.3%), and 8 patients (17.8%). Squamous carcinoma (16.7%) and adenocarcinoma (11.9%) were the common mixed pathological types. 66.7% patients underwent radical surgery, almost all of which received 4-6 cycles adjuvant chemotherapy and half followed by radiation therapy. While data analysis showed that adjuvant radiotherapy could not bring additional survival benefits (p = 0.523). The median PFS of enrolled patients was 14 months (1-78months). Pelvic recurrence (66.7%) and lymphatic metastasis (52.6%) were the main failure patterns. In multivariate analysis, leukocyte count (HR = 0.068, 95%CI: 0.007-0.673, p = 0.021), neutrophil-to-leukocyte ratio (HR = 0.151, 95%CI: 0.024-0.95, p = 0.044), lactic dehydrogenase (LDH) (HR = 6.632, 95%CI: 1.31-33.569, p = 0.022) and carbohydrate antigen-ca 125 (CA-125) (HR = 7.173, 95%CI: 1.25-41.06, p = 0.027) were the independent prognostic factors of PFS. In addition, age at natural menopause (ANM) later than 51.5years (p = 0.009) and an optimal maximum diameter > 62.1mm (p = 0.002) were closely related with poor survival. Conclusions: NECGT is a rare malignant tumor of female genital system. Surgery combined with chemotherapy is the essential treatment, addition of adjuvant radiotherapy did not improve survival. More high-quality clinical trials are needed to provide powerful evidence.


Open Medicine ◽  
2011 ◽  
Vol 6 (3) ◽  
pp. 294-299
Author(s):  
P. Uharček ◽  
M. Mlynček ◽  
J. Ravinger ◽  
E. Lajtman ◽  
M. Matejka

AbstractThe purpose of this study was to conduct a clinical and pathologic review of endometrial cancers diagnosed and surgically treated in our institution to evaluate results of treatment in relation to current international recommendations. We retrospectively evaluated the clinical history, treatment and follow-up of patients with histologically confirmed endometrial cancer treated in Faculty Hospital Nitra, Slovakia from 1990 to 2005. Data were abstracted regarding tumor histology, grade, age, parity, stage, diabetes, use of oral contraceptives, BMI, survival and treatment modalities including surgery, radiation therapy, chemotherapy, hormonal therapy, and combinations thereof. One hundred and thirty nine patients received surgical treatment for endometrial cancer: stage I -101 (72,6%), stage II - 9 (6,5%), stage III - 23 (16,6%) and stage IV - 6 (4,3%). Tumors were well differentiated in 87(62,6%), moderately differentiated in 32 (23%) and poorly differentiated in 20 (14,4%). There were 45 (32,4%) premenopausal patients and 94 (67,6%) postmenopausal. In multivariate statistical analysis we identified FIGO stage, tumor type, tumor grade, nodal status and depth of myometrial invasion as independent prognostic factors for overall survival, and FIGO stage, nodal status, and tumor grade as independent prognostic factors for recurrence-free interval.


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