scholarly journals Effect of Marital Status on the Survival of Patients With Adenocarcinoma of the Esophagogastric Junction: A Population-Based, Propensity-Matched Study

2021 ◽  
Vol 28 ◽  
pp. 107327482110663
Author(s):  
Sihan Wang ◽  
Liubo Chen ◽  
Dongdong Chen ◽  
Jian Chao ◽  
Yangliu Shao ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Esophagogastric Junction ◽  
Cox Regression ◽  
Population Based ◽  
Independent Prognostic Factor ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii

Background Marital status has been reported as an independent prognostic factor in various types of malignancies. However, the association between marital status and outcomes of patients with adenocarcinoma of the esophagogastric junction (AEG) has not been fully explored. To this end, we aimed to investigate the effect of marital status on survival of AGE patients. Methods The Surveillance Epidemiology and End Results (SEER) database (2010–2015) was used to extract eligible patients with Siewert type II AEG. Meanwhile, propensity score matching was performed to match 1576 unmarried patients with 1576 married patients. Kaplan–Meier method with log-rank test was used to plot survival curves, univariate and multivariate Cox regression analyses were adopted to investigate the association of marital status with overall survival (OS) and cancer-specific survival (CSS) in AEG patients before and after matching. Results Multivariate analysis in the unmatched cohort revealed that marital status was an independent prognostic factor in patients with Siewert type II AEG. Unmarried patients had poorer OS (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.12–1.29, P < .001) and poorer CSS (HR: 1.19, 95% CI: 1.10–1.29, P < .001) than married patients before matching. Additionally, widowed patients had the poorest OS (HR: 1.26, 95% CI: 1.11–1.44, P < .001) and CSS (HR: 1.29, 95% CI: 1.12–1.48, P < .001) compared with married patients. Furthermore, unmarried status remained as an independent prognostic for both OS (HR: 1.20, 95% CI: 1.10–1.31, P < .001) and CSS (HR: 1.18, 95% CI: 1.08–1.30, P < .001) in 1:1 propensity score-matched analysis. Subgroup analysis further revealed that OS and CSS rates were significantly higher in married patients than unmarried ones in most subgroups stratified by different variables. Conclusions This population-based study identified that marital status was an independent prognostic indicator for AEG patients. Married AEG patients had better prognosis than their unmarried counterparts.

scholarly journals Lymph node ratio is an independent prognostic factor for patients with Siewert type II adenocarcinoma of esophagogastric junction: results from a 10-year follow-up study

2020 ◽  
Author(s):  
Yuling Zhang ◽  
Ditian Liu ◽  
Chunfa Chen ◽  
De Zeng
Keyword(s):  
Regression Analysis ◽  
Lymph Node ◽  
Esophagogastric Junction ◽  
Lymph Node Ratio ◽  
Cox Regression ◽  
Type Ii ◽  
Siewert Type ◽  
Cox Regression Analysis ◽  
Siewert Type Ii ◽  
Node Ratio

Abstract Background Emerging evidences suggest that lymph node ratio (LNR), the number of metastatic lymph node (LN) to the total number of dissected lymph nodes (NDLN), may predict survival in multiple types of solid tumor. However, the prognostic role of LNR in adenocarcinoma of the esophagogastric junction (AEG) remains uninvestigated. The study is intended to determine the prognostic value of LNR in the patients with Siewert type II AEG. Methods A total of 342 patients with Siewert type II AEG who underwent R0 resection were enrolled in this study. The optimal cut-off of LNR was stratified into tertiles using X-tile software. The log-rank test was used to evaluate the survival differences, and multivariate Cox regression analysis were performed to determine the independent prognostic variables. Results The optimal cut-off of LNR were classified as LNR = 0, LNR between 0.01 and 0.40 and LNR > 0.41. Patients with high LNR had a shorter 5- and 10-year disease-specific survival (DSS) rate (8.5%, 1.4%) compared with those with moderate LNR (20.4%, 4.9%) and low LNR (58.0%, 27.5%) ( P < 0.001). Multivariate Cox regression analysis indicated that LNR was an independent factor for DSS after adjusting for confounding variables ( P < 0.05). Furthermore, after stratification by NDLN between NDLN < 15 group and NDLN ≥ 15 group, the LNR remained a significant predictor for DSS ( P < 0.05). Conclusions LNR is an independent predictor for DSS in patients with Siewert type II AEG regardless of NDLN. Patients with higher LNR have significantly shorter DSS.

scholarly journals Marital Status is an Independent Prognostic Factor in 7 Sites of Squamous Cell Carcinoma: A Propensity-Adjusted SEER Database Analysis

2021 ◽  
Author(s):  
Ji-li Xu ◽  
Yong Guo
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Cell Carcinoma ◽  
Propensity Score Matching ◽  
Squamous Cell ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Seer Database

Abstract Background: Marital status has been proved as an independent prognostic factor in many cancer types. However, no detailed investigation of marital status on squamous cell carcinoma (SCC) has been evaluated. The aim of this essay is to explore the relationship between marital status and SCC in 7 tumor sites. Methods: All patients diagnosed with SCC were collected from the SEER database (1975-2016). We analyzed the survival of all included SCC patients in four marital status. We utilized propensity-score matching analysis to balance baseline characteristics between married and unmarried SCC patients in 7 tumor sites. The influence of marital status on overall survival (OS) in each site was performed by Cox regression analysis.Results: A total of 180009 SCC patients were involved in this study. After propensity-score matching, patients in the married group were 1:1 matched with patients in the unmarried group for each sites. Married group exhibited higher 5- year OS rate than unmarried group (27.3% vs 19.8%). More precisely, being divorced and widowed were observed to be related to have worse survival than single patients in most sites. Furthermore, patients with clinical stage IV were more common in the unmarried group which having a lower proportion of receiving treatment. Conclusions: This study indicated that marital status was a significant factor for OS of SCC in 7 tumor sites. Married patients always behaved more favorable than unmarried including single, divorced, and widowed patients.

scholarly journals Short-Term Clinical Efficacy of Neoadjuvant Chemotherapy Combined With Laparoscopic Gastrectomy for Locally Advanced Siewert Type II and III Adenocarcinoma of the Esophagogastric Junction: A Retrospective, Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qing Feng ◽  
Du Long ◽  
Ming-shan Du ◽  
Xiao-song Wang ◽  
Zhen-shun Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Esophagogastric Junction ◽  
Independent Risk Factor ◽  
Locally Advanced ◽  
Type Ii ◽  
Short Term ◽  
Siewert Type ◽  
Siewert Type Ii

BackgroundLaparoscopic gastrectomy (LG) has been increasingly used for the treatment of locally advanced Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). However, whether LG can achieve the same short-term efficacy in the treatment of patients who receive neoadjuvant chemotherapy (NACT) remains controversial. Thus, the aim of this study was to investigate the clinical outcomes of NACT combined with LG for Siewert type II and III AEG.MethodsThis retrospective study identified patients with locally advanced Siewert type II and III AEG diagnosed between May 2011 and October 2020 using the clinical tumor-node-metastasis (cTNM) staging system. The short-term outcomes were compared between the matched groups using a 1:3 propensity score matching (PSM) method, which was performed to reduce bias in patient selection.ResultsAfter PSM, 164 patients were selected, including 41 in the NACT group and 123 in the LG group. The baseline characteristics were similar between the two groups. Compared with the LG group, the NACT group exhibit a smaller tumor size and significantly less advanced pathological tumor classification and nodal classification stages. The time to first flatus of the NACT group was significantly shorter, but the hospital stay was significantly longer than that of the LG group. The NACT group showed similar overall (29.3% vs 25.2%, P=0.683), systemic (24.4% vs 21.1%, P=0.663), local (12.2% vs 9.8%, P=0.767), minor (19.5% vs 19.5%, P=1.000) and major (9.8% vs 5.7%, P=0.470) complications as the LG group. Subgroup analyses showed no significant differences in most stratified parameters. Operation time≥ 300 minutes was identified as an independent risk factor for overall complications. Age≥ 60 years was identified as an independent risk factor for major complications.ConclusionNACT combined with LG for AEG does not increase the risk of postoperative morbidity and mortality compared with LG.

scholarly journals Predictors of Lymph Node Metastasis in Siewert Type II T1 Adenocarcinoma of the Esophagogastric Junction: A Population-Based Study

2021 ◽  
Vol 28 ◽  
pp. 107327482110266
Author(s):  
Liubo Chen ◽  
Kejun Tang ◽  
Sihan Wang ◽  
Dongdong Chen ◽  
Kefeng Ding
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Tumor Grade ◽  
Population Based ◽  
Type Ii ◽  
Population Based Study ◽  
Siewert Type ◽  
Cox Regression Analysis ◽  
Siewert Type Ii ◽  
Positive Nodal Status

Background: Endoscopic resection has been introduced as an alternative treatment for superficial adenocarcinoma of the esophagogastric junction (AEG), but is limited by positive nodal status. We aimed to investigate the predictors of lymph node metastasis (LNM) in patients with Siewert type II T1 AEG. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify eligible patients with Siewert type II T1 AEG. The prevalence of LNM was assessed. Logistic regression analysis with multivariable adjustment was used to determine predictors of LNM. We also performed Cox regression analysis to examine the prognostic value of LNM, which was further confirmed by competing risk analysis and cumulative incidence function (CIF). Results: In total, 2651 patients with T1 AEG were included, with a median age of 69 years and a median follow-up of 28 months. The overall prevalence of LNM was 17.2% in T1 AEG. When stratified by tumor invasion depth, the prevalence of LNM was 8.5% for intramucosal tumors and 22.6% for submucosal tumors. Adjusted logistic regression analysis showed that age, sex, tumor grade, tumor size and tumor infiltration depth were independent predictors of LNM in T1 AEG. Multivariate Cox regression analysis revealed that positive nodal status was significantly associated with worse overall survival and cancer-specific survival (CSS). Subgroup analysis consistently demonstrated that patients with LNM had significantly poorer CSS than those without LNM in most subgroups. Finally, the CIF was calculated, showing that patients with LNM had a significantly higher cancer-specific death rate than those without LNM. Conclusions: This population-based study identified age, sex, tumor grade, tumor infiltration depth and tumor size as independent predictors of LNM in T1 AEG. Considering the high prevalence of LNM in T1 AEG, endoscopic resection for curative aims may only be introduced in patients without high risks of LNM.

scholarly journals Marital Status, An Independent Predictor for Survival of Gastric Neuroendocrine Neoplasm Patients: A Population-based, Propensity Score-matched Study

2020 ◽  
Author(s):  
Yu-Jie Zhou ◽  
Xiao-Fan Lu ◽  
Kenneth I. Zheng ◽  
Qi-Wen Wang ◽  
Jin-Nan Chen ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Protective Factor ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Neuroendocrine Neoplasm ◽  
Prognostic Impact ◽  
Cox Regression Analysis ◽  
Risk Of Death

Abstract Background: Marital status proves to be an independent prognostic factor in a variety of cancers. However, its prognostic impact on gastric neuroendocrine neoplasms (G-NEN) has not been investigated.Methods: We identified 3947 G-NEN patients from the Surveillance, Epidemiology, and End Results (SEER) database. Meanwhile, propensity scores for marital status were used to match 506 unmarried patients with 506 married patients. We used Kaplan–Meier method and multivariate Cox regression to analyse the association between marital status and the overall survival (OS) and G-NEN cause-specific survival (CSS) before matching and after matching.Results: Married patients enjoyed better OS and CSS, compared with divorced/separated, single, and widowed patients. Multivariate Cox regression analysis indicated that unmarried status was associated with higher mortality hazards for both OS and CSS among G-NEN patients. Additionally, widowed individuals had the highest risks of overall and cancer-specific mortality compared to other unmarried groups in both males and females. Furthermore, marital status remained an independent prognostic and protective factor for both OS and CSS in 1:1 propensity score-matched analysis.Conclusion: Marital status was an independent prognostic factor for G-NEN. Meanwhile, widowed patients with G-NEN had the highest risk of death compared with single, married, and divorced/separated patients.

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