scholarly journals Plasma MicroRNA Levels Following Resection of Metastatic Melanoma

2017 ◽  
Vol 11 ◽  
pp. 117793221769483 ◽  
Author(s):  
Nicholas Latchana ◽  
Zachary B Abrams ◽  
J Harrison Howard ◽  
Kelly Regan ◽  
Naduparambil Jacob ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Inflammatory Responses ◽  
Expression Profiles ◽  
Stage Iv ◽  
Principal Component ◽  
Stage Iii ◽  
Disease Stage ◽  
Stage Iv Disease ◽  
Group A ◽  
Group B

Melanoma remains the leading cause of skin cancer–related deaths. Surgical resection and adjuvant therapies can result in disease-free intervals for stage III and stage IV disease; however, recurrence is common. Understanding microRNA (miR) dynamics following surgical resection of melanomas is critical to accurately interpret miR changes suggestive of melanoma recurrence. Plasma of 6 patients with stage III (n = 2) and stage IV (n = 4) melanoma was evaluated using the NanoString platform to determine pre- and postsurgical miR expression profiles, enabling analysis of more than 800 miRs simultaneously in 12 samples. Principal component analysis detected underlying patterns of miR expression between pre- vs postsurgical patients. Group A contained 3 of 4 patients with stage IV disease (pre- and postsurgical samples) and 2 patients with stage III disease (postsurgical samples only). The corresponding preoperative samples to both individuals with stage III disease were contained in group B along with 1 individual with stage IV disease (pre- and postsurgical samples). Group A was distinguished from group B by statistically significant analysis of variance changes in miR expression ( P < .0001). This analysis revealed that group A vs group B had downregulation of let-7b-5p, miR-520f, miR-720, miR-4454, miR-21-5p, miR-22-3p, miR-151a-3p, miR-378e, and miR-1283 and upregulation of miR-126-3p, miR-223-3p, miR-451a, let-7a-5p, let-7g-5p, miR-15b-5p, miR-16-5p, miR-20a-5p, miR-20b-5p, miR-23a-3p, miR-26a-5p, miR-106a-5p, miR-17-5p, miR-130a-3p, miR-142-3p, miR-150-5p, miR-191-5p, miR-199a-3p, miR-199b-3p, and miR-1976. Changes in miR expression were not readily evident in individuals with distant metastatic disease (stage IV) as these individuals may have prolonged inflammatory responses. Thus, inflammatory-driven miRs coinciding with tumor-derived miRs can blunt anticipated changes in expression profiles following surgical resection.

scholarly journals Predictors of Survival in Adrenocortical Carcinoma: An Analysis From the National Cancer Database

2018 ◽  
Vol 103 (9) ◽  
pp. 3566-3573 ◽  
Author(s):  
Sri Harsha Tella ◽  
Anuhya Kommalapati ◽  
Subhashini Yaturu ◽  
Electron Kebebew
Keyword(s):  
Surgical Resection ◽  
Adrenocortical Carcinoma ◽  
Poor Prognosis ◽  
Stage Iv ◽  
Tumor Grade ◽  
Disease Stage ◽  
Survival Outcomes ◽  
National Cancer Database ◽  
Stage Iv Disease ◽  
Comorbidity Index

Abstract Context Adrenocortical carcinoma (ACC) is rare; knowledge about prognostic factors and survival outcomes is limited. Objective To describe predictors of survival and overall survival (OS) outcomes. Design and Patients Retrospective analysis of data from the National Cancer Database (NCDB) from 2004 to 2015 on 3185 patients with pathologically confirmed ACC. Main Outcome Measures Baseline description, survival outcomes, and predictors of survival were evaluated in patients with ACC. Results Median age at ACC diagnosis was 55 (range: 18 to 90) years; did not differ significantly by sex or stage of the disease at diagnosis. On multivariate analysis, increasing age, higher Charlson-Deyo comorbidity index score, high tumor grade, and no surgical therapy (all P &lt; 0.0001); and stage IV disease (P = 0.002) and lymphadenectomy during surgery (P = 0.02) were associated with poor prognosis. Patients with stage I-III disease treated with surgical resection had significantly better median OS (63 vs 8 months; P &lt; 0.001). In stage IV disease, better median OS occurred in patients treated with surgery (19 vs 6 months; P &lt; 0.001), and postsurgical radiation (29 vs 10 months; P &lt; 0.001) or chemotherapy (22 vs 13 months; P = 0.004). Conclusion OS varied with increasing age, higher comorbidity index, grade, and stage of ACC at presentation. There was improved survival with surgical resection of primary tumor, irrespective of disease stage; postsurgical chemotherapy or radiation was of benefit only in stage IV disease.

Clinical pathways implementation in a community-based oncology practice: Real-world outcomes in patients with non-small cell lung cancer segmented by disease stage at diagnosis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18719-e18719
Author(s):  
Natalie R. Dickson ◽  
Karen Beauchamp ◽  
Toni S. Perry ◽  
Ashley Roush ◽  
Deborah Goldschmidt ◽  
...  
Keyword(s):  
Treatment Initiation ◽  
Clinical Pathways ◽  
Stage Iv ◽  
Treatment Patterns ◽  
Stage I ◽  
Stage Iii ◽  
Disease Stage ◽  
Stage At Diagnosis ◽  
Small Cell Lung ◽  
Stage Iv Disease

e18719 Background: Clinical pathways have been introduced as tools to optimize cancer care delivery, but evidence of their value in the real world is limited. This retrospective study was performed to assess treatment patterns and clinical outcomes in patients with non-small cell lung cancer (NSCLC) before and after pathway implementation at Tennessee Oncology (TO). Methods: Chart data were abstracted for patients (≥18 years) diagnosed with Stage I-IV NSCLC who initiated first-line (1L) systemic treatment at a TO clinic and had follow-up for ³6 months or until death. Patients were divided into two cohorts: pre-pathways (treatment initiation 2014–2015) and post-pathways (treatment initiation 2016–2018). Patient characteristics, treatment patterns, and outcomes were described and compared across cohorts. An exploratory study endpoint was the evaluation of outcomes based on disease stage at diagnosis. Results: Among 501 patients (251 pre-pathways and 250 post-pathways), most had advanced or metastatic NSCLC at diagnosis (Stage III: 40%; Stage IV: 42%). Chemotherapy comprised almost all 1L systemic therapy used pre-pathways (Stage I/II: 100%; Stage III: 96%; Stage IV: 83%). Post-pathways, chemotherapy remained the most common 1L therapy in patients with Stage I/II (89%) and Stage III (72%) disease, but among patients with Stage IV disease, use of chemotherapy decreased (47%) and immuno-oncology (IO) therapy alone or in combination became common (45%). Median duration of 1L therapy was longer post-pathways in patients with Stage III (2.1 months vs 1.4 months pre-pathways; P < 0.01) and Stage IV disease (3.3 months vs 2.3 months pre-pathways; P < 0.01) but did not differ among Stage I/II patients. Median progression-free survival was significantly longer post-pathways in patients with Stage IV disease (7.0 months vs 4.2 months pre-pathways; P < 0.05), but not in other disease-stage subgroups. Median overall survival increased non-significantly post-pathways for all disease stage subgroups (Stage I/II: 26 months vs 20 months pre-pathways; Stage III: 26 months vs 20 months; Stage IV: 10 months vs 9 months). For each disease stage, rates of severe adverse events were similar between cohorts. Conclusions: While outcomes for patients diagnosed with Stage III/IV NSCLC were generally improved following the implementation of clinical pathways, this change coincided with a dramatic shift in available treatment options. Improvements post-pathways were mainly observed in patients diagnosed with advanced disease. Thus, differences in outcomes between pre-pathways and post-pathways cohorts in our study are more likely attributable to other evolving practices in cancer care, particularly the availability of newer, more effective treatments such as IO therapy as part of standard practice, than implementation of the clinical pathways.

Carboplatin and paclitaxel versus cisplatin, paclitaxel and doxorubicin for frontline chemotherapy of advanced ovarian carcinoma (AOC): A Hellenic Cooperative Oncology Group Study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5074-5074
Author(s):  
G. Aravantinos ◽  
G. Fountzilas ◽  
H. P. Kalofonos ◽  
D. V. Skarlos ◽  
P. Kosmidis ◽  
...  
Keyword(s):  
Residual Disease ◽  
Randomized Study ◽  
Stage Iv ◽  
Figo Stage ◽  
Severe Toxicity ◽  
Treatment Groups ◽  
Stage Iv Disease ◽  
Group A ◽  
Intent To Treat ◽  
Group B

5074 Background: Carboplatin combined with paclitaxel are considered treatment of choice as initial chemotherapy for AOC. We compared this combination with a regimen combining cisplatin plus paclitaxel and doxorubicin. In the pre-taxane era the addition of doxorubicin to the cisplatin-based regimens appeared to improve survival. Therefore, there was a significant interest in assessing the role of a taxane/platinum/ anthracycline combination therapy in a randomized study. Methods: Patients with AOC after the initial cytoreductive surgery were stratified according to the FIGO stage and the presence of residual disease and randomized to either 6 courses of paclitaxel 175 mg/m2 as 3h infusion plus carboplatin 7AUC (group A) or paclitaxel at the same dose plus cisplatin 75 mg/m2 plus doxorubicin 40 mg/m2 and G-CSF (Lenograsim) 0.263 mg sc from day 7 to day 11 (group B). Primary endpoint was overall survival (OS). At alpha = 5%, 400 patients were required, to detect with power of 80%, a ±15% difference to a baseline survival rate of 50% at the 3-year time point. Results: Intent to treat analysis was performed on 432 patients (group A: 210, B: 222). The treatment groups were well balanced in terms of major patient and tumor characteristics. 70% of the patients had stage III and 23% stage IV disease. Significantly more patients developed febrile neutropenia in group B (p = 0.01). No other significant differences were observed in terms of severe toxicity and no difference was found between the two groups in complete and overall response rate. With a median follow up of 44 months, median survival was 37.2 months in group A and 45.2 months in group B (p = 0.33). Conclusions: Both regimens are well tolerated and effective as first line chemotherapy of AOC. Combination of cisplatin, paclitaxel and doxorubicin does not seem to improve survival as compared with the standard carboplatin/paclitaxel regimen. No significant financial relationships to disclose.

Predictors of survival in pancreatic squamous cell carcinoma (PSCC): An analysis from the National Cancer Database (NCDB).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 399-399
Author(s):  
Anuhya Kommalapati ◽  
Sri Harsha Tella ◽  
Gaurav Goyal ◽  
Amit Mahipal
Keyword(s):  
Surgical Resection ◽  
Primary Tumor ◽  
Multivariable Analysis ◽  
Group Analysis ◽  
Stage Iv ◽  
The United States ◽  
Stage I ◽  
Stage Iii ◽  
Dismal Prognosis ◽  
Stage Iv Disease

399 Background: PSCC is a rare form of exocrine pancreatic malignancy with a dismal prognosis. Using the NCDB, we determined the prognostic factors and survival outcomes of PSCC in the United States. Methods: We performed a retrospective analysis of patients with histologically confirmed PSCC from 2004-2015 using NCDB. Kaplan-Meier method and log-rank test were used to perform overall survival (OS) analysis. Hazard Ratios were calculated using the Cox-proportional hazard method. Results: Of the 654 cases included in our analysis, 46% were female. Median age at diagnosis was 70 years and did not differ by sex (p = 0.19). The proportion of patients with stage I, II, III and IV diseases were 5%, 18%, 12%, and 54%, respectively (10%, unknown stage). Among these, 23% (35 of 150) of stage I and II disease, 10% (8 of 78) of stage III, and 2% (7 of 353) received surgical resection of the primary tumor. The rate of R0 resection was 74% in stage I and II; 38% in stage III; 29% in stage IV disease. Median OS for the entire cohort was 4 months and was significantly higher in patients who received surgical resection of the primary tumor (17 vs. 4 months, p < 0.001). On stage wise sub-group analysis, stage I-II patients had OS benefit from surgery (21 vs. 5 months, p < 0.001) as opposed to stage III (7 vs. 6 months, p = 0.31) and IV disease (5 vs. 3 months, p = 0.17). Adjuvant chemotherapy had no role in prolonging survival in stage I-II disease (20 vs 24 months, p = 0.6). Stage IV patients treated with chemotherapy had a better median OS than those without (5 vs. 2 months, p < 0.0001). On Cox multivariable analysis, stage IV disease (HR: 1.92 CI: 1.46-2.52, p < 0.001) and advanced patient age (HR: 1.02; CI:1.01-1.03, p < 0.001 were associated with poor OS, whereas OS was not dependent on the sex, race, grade, insurance status, surgery, and chemotherapy. Conclusions: This is the largest registry-based study on PSCC to date. PSCC had a diverse OS varied significantly according to increasing age and stage of the disease at presentation. Surgical resection of primary tumor was associated with improved OS in stages I-II, whereas chemotherapy improved OS in stage IV disease. The results of our study may aid the prognostication of patients and in treatment decision making.

scholarly journals Application of clinical genomic sequencing among Chinese advanced cancer patients to guide precision medicine decisions

2018 ◽  
Author(s):  
Shunchang Jiao ◽  
Yuxian Bai ◽  
Chun Dai ◽  
Xiaoman Xu ◽  
Xin Cai ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Stage Iv ◽  
Genomic Sequencing ◽  
Advanced Cancer Patients ◽  
Clinical Recommendation ◽  
Stage Iv Disease ◽  
Group A ◽  
Group B ◽  
Chinese Cancer Patients ◽  
The Impact

AbstractPurposeA number of studies have suggested that high-throughput genomic analyses might improve the outcomes of cancer patients. However, whether integrative information about genomic sequencing and related clinical interpretation may benefit Chinese cancer patients with stage IV disease to date has not investigated.MethodsTargeted gene panel and whole exome of tumor/blood samples in > 1,000 Chinese cancer patients were sequenced. Then we provided patients and their oncologists with the sequencing results and a clinical recommendation roadmap based on evidence-based medicine, defined as CWES. Only patients with stage IV disease who failed the previous treatment upon receiving the CWES reports were included for analyzing the impact of CWES on clinical outcomes in 1-year follow-ups.ResultsWe identified the mutational signatures of 953 Chinese cancer patients, with some being unique. Approximately 88.6% of patients had clinically actionable somatic genomic alterations. We successfully followed up 22 stage IV patients. Of these, 11 patients treatment followed the CWES reports defined as group A. Eleven patients received the next treatment, but did not follow the CWES suggestions, and are defined as group B. The types of therapies before CWES were similar in the two groups. The median PFS of group A was 12 months and 45% patients failed this round of therapy. The median PFS of group B was 4 months and 91% of patients failed the treatment.ConclusionThe current study suggested that CWES has the potential to help explore the clinical benefits in multiple line therapies among advanced stage tumor patients.

scholarly journals The Effects of Radiation Therapy (RT) and Surgical Resection on Overall Survival in Gastric Lymphoma

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4415-4415
Author(s):  
Henry Vuong ◽  
Gurinder Sidhu ◽  
Vaibhav Verma
Keyword(s):  
Overall Survival ◽  
Native American ◽  
Surgical Resection ◽  
Gastric Lymphoma ◽  
Stage Iv ◽  
Stage I ◽  
Stage Iii ◽  
Asian Pacific Islander ◽  
Stage Iv Disease ◽  
Asian Pacific

Abstract Introduction: Lymphoma of the stomach is an uncommon tumor. However, it is the most common extra-nodal manifestation of Non-Hodgkin lymphoma. Over the last few decades, preferred treatment for gastric lymphoma has shifted from surgical resection to non-surgical methods involving chemotherapy and RT. The current standard treatment is chemo-immunotherapy. The role of RT and surgery, if any, is unclear. Methods: We reviewed data which was obtained from the Surveillance, Epidemiology and End Results (SEER) data registry for patients with gastric lymphoma from 1973 until 2011. The data was analyzed using Microsoft Excel and statistical analysis was performed using SPSS statistical software. The SEER registry does not provide information about chemotherapy (CT) administered. Results: We analyzed 13,659 patients with the diagnosis of gastric lymphoma in the SEER database. The three most prevalent subtypes were diffuse large B-cell lymphoma (DLBCL) with 6,134 (44.9%) cases, extranodal marginal zone lymphoma (MZL) with 4,318 (31.6%) cases and chronic lymphocytic leukemia (CLL/SLL) with 352 (2.5%) cases. In the DLBCL group, the median (range) age was 71 (4 – 105) years, of which 44.7% were female and 55.3% male. Of the group, 4,992 (81%) patients were White, 447 (7%) Black, and the remainder were Asian, Pacific Islander, or Native American. The median overall survival (OS) in patients who did and did not receive RT was 63 vs. 34 months (p<0.01). Analysis by stage shows median OS with and without RT was 108 vs. 65 months in Stage I disease (p<0.01), 71 vs. 62 months (p=0.41) in Stage II disease, 59 vs. 25 months in Stage III disease (p=0.52), and 8 vs. 8 months in Stage IV disease (p=0.46). The median OS in patients who underwent surgical resection, at least partial gastrectomy, is 76 months compared to 28 months in patients who did not undergo resection (p<0.01) (Fig.1). Analyzed by stage, the median OS in patients who did and who did not undergo surgery was 114 vs. 59 months in Stage I disease (p<0.01), 70 vs. 54 months in Stage II disease (p=0.03), 50 vs. 22 months in Stage III disease (p=0.63), and 10 vs. 8 months in Stage IV disease (p=0.85). Since widespread use of rituximab started in 2001, we analyzed patients treated before and after that year. Among patients with DLBCL, 2,719 (44%) were diagnosed prior to 2001 and 3,415 (56%) were diagnosed in 2001 or afterwards. Median OS with and without RT was 43 months vs. 31 months prior to 2001 and 97 months vs. 39 months after 2001 (p<0.01). The median OS with and without surgery is 81 vs. 12 months prior to 2001 (Fig. 2) and 57 vs. 51 months after 2001 (Fig. 3) (p<0.01). In the MZL group, the median (range) age was 68 (10 – 101) years of which 50.5% were female and 49.5% male. Of the group, 3,457 (80%) patients were White, 392 (9%) Black, and the remainder were Asian, Pacific Islander, or Native American. The median OS of patients with MZL who had surgery and who did not was 146 vs. 145 months (p=0.372). Analysis by stage shows no significance difference in OS either. The median OS of patients who did not undergo RT was 132 months and was not yet reached in patients who underwent RT (p<0.01). Analysis by stage shows RT significantly benefitted patients with Stage I and II disease but not stage III and IV disease. Conclusion: Our analysis shows that patients with DLBCL who undergo RT have improved median OS. The benefit is limited to Stage I disease. Improved median OS is seen in patients with DLBCL who undergo surgical resection which is contrary to recent data. The benefit of surgical resection is seen only in Stage I and II but not in Stage III and IV. The benefit of surgery was present prior to 2001 but not seen after 2001 - after the widespread use of rituximab. In MZL, surgical resection has no impact on median OS; whereas RT improves OS, particularly in Stage I and II disease. While our analysis is limited due to the lack of data regarding chemotherapy administered, this large population based analysis supports the benefit of RT and surgery in select disease stages. Prospective clinical trials may better address the benefits of each modality independently. Fig 1. KM Curve of DLBCL gastric lymphoma, all cases, who did and did not undergo surgery (p<0.01) Fig 1. KM Curve of DLBCL gastric lymphoma, all cases, who did and did not undergo surgery (p<0.01) Fig 2. KM Curve of DLBCL gastric lymphoma of cases diagnosed before 2001 (p<0.01) Fig 2. KM Curve of DLBCL gastric lymphoma of cases diagnosed before 2001 (p<0.01) Fig 3. KM Curve of DLBCL gastric lymphoma for cases diagnosed after 2001. Fig 3. KM Curve of DLBCL gastric lymphoma for cases diagnosed after 2001. Disclosures No relevant conflicts of interest to declare.

Prognostic implications of lymph node metastasis in advanced ovarian cancer: Analysis of National Cancer Database.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5567-5567
Author(s):  
Sukamal Saha ◽  
Sabarina Ramanathan ◽  
Suresh Mukkamala ◽  
Hayman S. Salib ◽  
Rajen Oza ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Bowel Resection ◽  
Advanced Ovarian Cancer ◽  
Stage Iv ◽  
Stage Iii ◽  
National Cancer Database ◽  
Group A ◽  
Prognostic Implications ◽  
Group B

5567 Background: During debulking surgery (Surg) for advanced ovarian cancer (OvCa), lymph node (LN) sampling are not routinely performed. Hence, prognostic implications of LN involvement following debulking surg and chemotherapy (ChemoRx) were analyzed from National Cancer Database (NCDB). Methods: Only Stage III and Stage IV patients (pts) from 2004 –2014 NCDB pts undergoing Debulking surg. and ChemoRx were included. Group A included pts with debulking surg without bowel resection; Group B with major bowel resection and Group C with bowel and bladder resection. Pts were further subdivided according to the use of 1) NeoAdjuvant (NeoAdj) 2) Adjuvant (Adj) and 3) Neo Adj and Adj ChemoRx. Survival analysis was done based on -ve or +ve LN status. using Pearson Chi Square testing. Results: Out of 10,737 Stage III and 3,102 Stage IV pts, there were 6828 Group A, 6413 Group B and 598 Group C pts. Five year overall survival (OS) for all pts in Stage III with LN-ve vs LN +ve was 59.9% vs 53.9% and Stage IV was 48.7% vs 41.2%. In Group A, B, and C, the 5 yr OS was better in LN – ve than LN +ve pts (Table1). The OS for both LN –ve and LN +ve groups were better in Adjuvant chemoRx in all 3 groups. OS was slightly better in Stage III vs Stage IV pts. Conclusions: Even though LN dissection are not routinely done during debulking surg, overall pts with LN metastasis do worse than LN –ve pts irrespective of the timing of ChemoRx. Hence, LN sampling during debulking surg should be strongly considered as it may provide important prognostic information. [Table: see text]

Prognostic implications of lymph node metastasis in advanced ovarian cancer: Analysis of the National Cancer Database 2006 to 2014.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17042-e17042
Author(s):  
Mohamed Elgamal ◽  
Sukamal Saha ◽  
Meghan Cherry ◽  
Vishesh Saharan ◽  
Robin Buttar ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bowel Resection ◽  
Advanced Ovarian Cancer ◽  
Stage Iv ◽  
Stage Iii ◽  
National Cancer Database ◽  
Debulking Surgery ◽  
Group A ◽  
Prognostic Implications ◽  
Group B

e17042 Background: During debulking surgery (Surg) for advanced ovarian cancer (OvCa), lymph node (LN) sampling is not routinely performed. Hence, prognostic implications of LN involvement following debulking surg and chemotherapy (ChemoRx) were analyzed from the National Cancer Database (NCDB). Methods: Only Stage III and IV patients (pts) from NCDB 2006–2014 undergoing debulking surg and ChemoRx were included. Group A: pts with debulking surg without bowel resection; Group B: pts with major bowel resection and Group C: pts with bowel and bladder resection. Pts were further subdivided according to the use of 1) NeoAdjuvant (NeoAdj) 2) Adjuvant (Adj) and 3) NeoAdj and Adj ChemoRx. Survival analysis was done based on -ve or +ve LN status. Pearson Chi Square testing was used to evaluate the survival between -ve and +ve LN pts. Results: A total of 13839 Pts were included. There were 5757 Pts (41.59%) with -ve LN status, versus 8082 Pts (68.4%) with +ve LN status. Out of 10,737 Stage III and 3,102 Stage IV pts, there were 6,828 in Group A, 6,413 in Group B and 598 in Group C pts. For all patients in Groups A, B, and C, the 5 yr overall survival was better in LN -ve than LN +ve pts. The overall survival for both LN -ve and LN +ve pts was better in Adjuvant chemoRx in all 3 groups, except for Stage III Group C LN-ve pts, where NeoAdj was better (75% vs 37.5%). Overall survival was also slightly better in Stage III vs Stage IV pts. (Table-1). Conclusions: Even though LN dissection is not routinely done during debulking surgery, overall pts with LN metastasis do worse than LN -ve pts irrespective of the timing of ChemoRx. Hence, LN sampling during debulking surg should be strongly considered, as it may provide important prognostic information. Table-1: 5 yr Survival by LN status [Table: see text]

Trends in demographics and survival for patients (pts) with advanced non-small cell lung cancer (NSCLC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7114-7114
Author(s):  
K. Kubota ◽  
H. Masuhara ◽  
K. Hosoya ◽  
K. Yoh ◽  
S. Niho ◽  
...  
Keyword(s):  
Kinase Inhibitors ◽  
Statistical Significance ◽  
Performance Status ◽  
Stage Iv ◽  
Stage Iii ◽  
Smoking History ◽  
Rank Test ◽  
Cancer Center ◽  
Group A ◽  
Group B

7114 Background: In clinical trials, concurrent chemoradiotherapy improves survival of pts with inoperable stage III NSCLC compared with sequential chemoradiotherapy or radiotherapy alone, and platinum doublets with third-generation chemotherapy prolong survival of pts with stage IV NSCLC. Epidermal growth factor receptor antagonist is active as second-line chemotherapy. Few outcomes research regarding demographics and survival trends in advanced NSCLC has been conducted. Methods: The National Cancer Center Hospital East Database was searched for all pts with inoperable stage III and IV NSCLC. Data was recorded for histology, age, sex, smoking history, tumor location, stage, performance status (PS), and treatment modality. Pts were divided into two groups; group A: newly registered pts from July 1992 to December 1997, group B: from January 1998 to June 2004. Survival curves were evaluated using the Kaplan-Meier methods, and statistical significance was estimated by the log-rank test. Results: 2,135 pts (771 pts group A vs. 1364 pts group B) were identified. Pts demographics of each group (% group A/B) were as follows; male; 74/77, non-smoker; 19/19, PS 0–1; 79/85, squamous cell histology; 26/24, stage III; 45/44. Median age was 63 years old in group A and 64 in group B. Median survival (MS), 1-year survival rate (1ys), 2ys and 3ys were 8 months (M), 33%, 12% and 7% in group A, 10M, 42%, 23% and 14% in group B, respectively (P < .0001). In pts with stage III, MS, 1ys, 2ys, 3ys were 12M, 46%, 20%, 12% in group A and 15M, 56%, 34%, 20% in group B (P < .0001). In non-smoker, MS, 1 ys, 2 ys were 11 M, 46%, 19% in group A and 15 M, 56%, 30% in group B (P < .0001). In females, MS, 1 ys, 2 ys were 10 M, 39%, 16% in group A and 15 M, 55%, 31% in group B (P < .0001). Conclusion: Although there were no apparent differences in demographics between the two groups, survival was significantly improved chronologically. The improvement was prominent in stage III, non-smokers and females suggesting the benefit of chemoradiotherapy and tyrosine kinase inhibitors. [Table: see text]

scholarly journals International Study of Primary Mucinous Ovarian Carcinomas Managed at Tertiary Medical Centers

2018 ◽  
Vol 28 (5) ◽  
pp. 915-924 ◽  
Author(s):  
Jennifer J. Mueller ◽  
Henrik Lajer ◽  
Berit Jul Mosgaard ◽  
Slim Bach Hamba ◽  
Philippe Morice ◽  
...  
Keyword(s):  
Early Stage ◽  
Statistical Tests ◽  
Stage Iv ◽  
Stage I ◽  
Stage Iii ◽  
Oncologic Outcomes ◽  
Disease Stage ◽  
Ovarian Carcinomas ◽  
Early Stage Disease ◽  
Medical Centers

ObjectiveWe sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes.MethodsThis was a retrospective review spanning 1976–2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis. Data were abstracted from medical records, and a deidentified dataset was compiled and processed at a single institution. Appropriate statistical tests were performed.ResultsTwo hundred twenty-two patients with PMOC were identified; all had undergone primary surgery. Disease stage distribution was as follows: stage I, 163 patients (74%); stage II, 8 (4%); stage III, 40 (18%); and stage IV, 10 (5%). Ninety-nine (45%) of 219 patients underwent lymphadenectomy; 41 (19%) of 215 underwent fertility-preserving surgery. Of the 145 patients (65%) with available treatment data, 68 (47%) had received chemotherapy—55 (81%) a gynecologic regimen and 13 (19%) a gastrointestinal regimen. The 5-year progression-free survival (PFS) rates were 80% (95% confidence interval [CI], 73%–85%) for patients with stage I to II disease and 17% (95% CI, 8%–29%) for those with stage III to IV disease. The 5-year PFS rate was 73% (95% CI, 50%–86%) for patients who underwent fertility-preserving surgery.ConclusionsMost patients (74%) presented with stage I disease. Nearly 50% were treated with adjuvant chemotherapy using various regimens across institutions. The PFS outcomes were favorable for those with early-stage disease and lower but acceptable for those who underwent fertility preservation.

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