Population-based study on the impact of the familial form of Waldenström macroglobulinemia on overall survival

184 Background: A recent study of the SEER database in the United States showed a 5-fold increase in neuroendocrine tumours (NETs) over the last 30 years. An increasing incidence has also been reported in Norway, Sweden, England, Holland, Italy and Japan, but interestingly not in Denmark and Switzerland. The objective of our study is to describe the incidence, anatomical distribution and survival of NETs in Ontario. Methods: A population based study was initiated using the Ontario Cancer Registry, cross-linked with the Registered Persons Database and the Canadian Institute of Health Information Discharge Abstract Database. All cases of NETs were identified in Ontario (> 13 million persons) from 1994 to 2009. Baseline demographic, clinical and outcomes data were abstracted to allow for an analysis of annual incidence rates, and overall survival. Results: A total of N = 5619 cases were identified. The incidence rate increased from 2.46/ 100,000 (95% CI, 2.13-2.83) in 1994 to 5.86/ 100,000 (95% CI, 5.40 – 6.35) in 2009. The median age was 62 with 50.5% female cases. When divided by site, bronchopulmonary NETs where the most common (22%), then jejunum/ileum (17%) and rectal (16%) NETs, while pancreatic NETs (pNETs) and gastric NETs were 10% and 5% respectively. The absolute increase in the study period was most pronounced for pNETs (6-fold), rectal (5-fold) and gastric (5-fold) NETs. Metastatic disease was documented in 45% of the cases; 20% at diagnosis and 25% during follow-up. The 5-and 10-year overall survival (OS) was 61% and 46% respectively, for the entire population. Site specific 5-year OS were: rectal (87.0%), small bowel (73.4%), gastric (67.4%), colon (64.3%) and pancreas (48.8%). 5-year OS was compared for patients with and without metastatic disease after diagnosis (69.0% vs 40.1%, p<0.0001). Conclusions: There appears to be a significant increase of reported cases of NETs in Ontario, Canada, particularly pNETs, rectum NETs and gastric NETs. This supports much of the population-based reports worldwide. Survival appears to vary significantly according to anatomical site and extent of disease. Further research is required to understand the impact of this cancer previously perceived to be rare but clearly increasing.

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A Population-based Study Evaluating the Impact of Sunitinib on Overall Survival in the Treatment of Patients With Metastatic Renal Cell Cancer

Yearbook of Urology ◽

10.1016/s0084-4071(09)79340-6 ◽

2009 ◽

Vol 2009 ◽

pp. 88-89

Author(s):

D.E. Coplen

Keyword(s):

Overall Survival ◽

Renal Cell Cancer ◽

Renal Cell ◽

Cell Cancer ◽

Population Based ◽

Population Based Study ◽

Metastatic Renal Cell Cancer ◽

The Impact

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The impact of time factors on overall survival in patients with nasopharyngeal carcinoma: a population-based study

Radiation Oncology ◽

10.1186/s13014-016-0638-2 ◽

2016 ◽

Vol 11 (1) ◽

Cited By ~ 3

Author(s):

Po-Chun Chen ◽

Wen-Shan Liu ◽

Wei-Lun Huang ◽

Cheng-Jung Wu ◽

Ching-Chieh Yang ◽

...

Keyword(s):

Overall Survival ◽

Nasopharyngeal Carcinoma ◽

Time Factors ◽

Population Based ◽

Population Based Study ◽

The Impact

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Impact of Age and Comorbidity on Multimodal Management and Survival from Colorectal Cancer: A Population-Based Study

Journal of Clinical Medicine ◽

10.3390/jcm10081751 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1751

Author(s):

Ilmo Kellokumpu ◽

Matti Kairaluoma ◽

Jukka-Pekka Mecklin ◽

Henrik Kellokumpu ◽

Ville Väyrynen ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Adjuvant Chemotherapy ◽

Rectal Carcinoma ◽

Population Based ◽

Population Based Study ◽

Comorbidity Burden ◽

Multimodal Management ◽

The Impact ◽

Over Time

This retrospective population-based study examined the impact of age and comorbidity burden on multimodal management and survival from colorectal cancer (CRC). From 2000 to 2015, 1479 consecutive patients, who underwent surgical resection for CRC, were reviewed for age-adjusted Charlson comorbidity index (ACCI) including 19 well-defined weighted comorbidities. The impact of ACCI on multimodal management and survival was compared between low (score 0–2), intermediate (score 3) and high ACCI (score ≥ 4) groups. Changes in treatment from 2000 to 2015 were seen next to a major increase of laparoscopic surgery, increased use of adjuvant chemotherapy and an intensified treatment of metastatic disease. Patients with a high ACCI score were, by definition, older and had higher comorbidity. Major elective and emergency resections for colon carcinoma were evenly performed between the ACCI groups, as were laparoscopic and open resections. (Chemo)radiotherapy for rectal carcinoma was less frequently used, and a higher rate of local excisions, and consequently lower rate of major elective resections, was performed in the high ACCI group. Adjuvant chemotherapy and metastasectomy were less frequently used in the ACCI high group. Overall and cancer-specific survival from stage I-III CRC remained stable over time, but survival from stage IV improved. However, the 5-year overall survival from stage I–IV colon and rectal carcinoma was worse in the high ACCI group compared to the low ACCI group. Five-year cancer-specific and disease-free survival rates did not differ significantly by the ACCI. Cox proportional hazard analysis showed that high ACCI was an independent predictor of poor overall survival (p < 0.001). Our results show that despite improvements in multimodal management over time, old age and high comorbidity burden affect the use of adjuvant chemotherapy, preoperative (chemo)radiotherapy and management of metastatic disease, and worsen overall survival from CRC.

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