Frequency, prognosis and treatment modalities of newly diagnosed small bowel cancer with liver metastases

Abstract Background Population-based analysis for the liver metastases of small bowel cancer is currently lacking. This study aimed to analyze the frequency, prognosis and treatment modalities for newly diagnosed small bowel cancer patients with liver metastases. Methods Patients with small bowel cancer diagnosed from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Binary logistic regression analysis was performed to determine predictors for the presence of liver metastases at diagnosis. Kaplan–Meier method and Cox regression analyses were performed for survival analyses. Results A total of 1461 small bowel cancer patients with liver metastases at initial diagnosis were identified, representing 16.5% of the entire set and 63.9% of the subset with metastatic disease to any distant site. Primary tumor with poorer histological type, larger tumor size, later N staging, more extrahepatic metastatic sites, and tumor on lower part of small intestine had increased propensity of developing liver metastases. The combined diagnostic model exhibited acceptable diagnostic efficiency with AUC value equal to 0.749. Patients with liver metastases had significant poorer survival (P < 0.001) than those without liver metastases. In addition, combination of surgery and chemotherapy (HR = 0.27, P < 0.001) conferred the optimal survival for patients with adenocarcinoma, while the optimal treatment options for NEC and GIST seemed to be surgery alone (HR = 0.24, P < 0.001) and chemotherapy alone (HR = 0.08, P = 0.022), respectively. Conclusions The combined predictor had a good ability to predict the presence of liver metastases. In addition, those patients with different histologic types should be treated with distinct therapeutic strategy for obtaining optimal survival.

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Incidence and Prognostic Significance of Liver Metastases for Newly Diagnosed Ovarian Cancer in Relation to Subtypes

10.21203/rs.3.rs-153871/v1 ◽

2021 ◽

Author(s):

Ying Zhu ◽

Yifang Zhang ◽

Lingyun Zhai ◽

Zhigang Zhang ◽

Jianwei Zhou

Keyword(s):

Ovarian Cancer ◽

Liver Metastasis ◽

Liver Metastases ◽

Cancer Patients ◽

Cancer Metastasis ◽

Cox Regression ◽

Prognostic Significance ◽

Newly Diagnosed ◽

Histological Types ◽

Visceral Organs

Abstract Background: Ovarian cancer is a heterogeneous and aggressive malignant tumor, and the liver is one of the most common metastases target visceral organs of ovarian cancer. We aim to analysis the incidence and prognostic relevance of histological subtypes for patients with liver metastases in newly diagnosed ovarian cancer. Methods: In the Surveillance, Epidemiology, and End Results (SEER) database, we identified the ovarian cancer patients from 2010 to 2016. Multivariable logistic regression was used to determine whether histological types were associated with the presence of liver metastases at diagnosis. The Kaplan-Meier method and multivariable Cox regression was performed to identify covariates associated with survival using the histological types. Results: Among 25293 ovarian cancer patients, 1749 cases presented with liver metastases. The incidence proportions were highest among ovarian carcinosarcoma patients (OR=17.76, 95% CI=9.26-34.09), and liver metastasis specificity was the highest in the clear cell type (70.69% of the metastatic subset). The median cancer-specific survival (CSS) for non-metastatic ovarian cancer patients was 77 months, but the ovarian cancer with only liver metastasis was 21 months. The mucinous (5 months; vs nonepithelial subtype, HR=0.26; 95% CI, 0.14-0.49) subtype experienced the shortest median survival among all histologic types. Conclusion: This population-based study provides that liver was one of the most common distant visceral organs for ovarian cancer metastasis, and the incidence proportions of liver metastasis were highest for carcinosarcomas subtype, and the mucinous ovarian cancer with liver metastasis being associated with the poorest survival.

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Incidence and Prognostic Significance of Liver Metastases for Newly Diagnosed Ovarian Cancer in Relation to Subtypes

10.21203/rs.3.rs-153871/v2 ◽

2021 ◽

Author(s):

Ying Zhu ◽

Yifang Zhang ◽

Lingyun Zhai ◽

Zhigang Zhang ◽

Jianwei Zhou

Keyword(s):

Ovarian Cancer ◽

Liver Metastasis ◽

Liver Metastases ◽

Cancer Patients ◽

Cancer Metastasis ◽

Cox Regression ◽

Prognostic Significance ◽

Newly Diagnosed ◽

Histological Types ◽

Visceral Organs

Abstract Background: Ovarian cancer is a heterogeneous and aggressive malignant tumor, and the liver is one of the most common metastases target visceral organs of ovarian cancer. We aim to analysis the incidence and prognostic relevance of histological subtypes for patients with liver metastases in newly diagnosed ovarian cancer. Methods: In the Surveillance, Epidemiology, and End Results (SEER) database, we identified the ovarian cancer patients from 2010 to 2016. Multivariable logistic regression was used to determine whether histological types were associated with the presence of liver metastases at diagnosis. The Kaplan-Meier method and multivariable Cox regression was performed to identify covariates associated with survival using the histological types.Results: Among 25293 ovarian cancer patients, 1749 cases presented with liver metastases. The incidence proportions were highest among ovarian carcinosarcoma patients (OR=17.76, 95% CI=9.26-34.09), and liver metastasis specificity was the highest in the clear cell type (70.69% of the metastatic subset). The median cancer-specific survival (CSS) for non-metastatic ovarian cancer patients was 77 months, but the ovarian cancer with only liver metastasis was 21 months. The mucinous (5 months; vs nonepithelial subtype, HR=0.26; 95% CI, 0.14-0.49) subtype experienced the shortest median survival among all histologic types.Conclusion: This population-based study provides that liver was one of the most common distant visceral organs for ovarian cancer metastasis, and the incidence proportions of liver metastasis were highest for carcinosarcomas subtype, and the mucinous ovarian cancer with liver metastasis being associated with the poorest survival.

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Inflammatory bowel disease and risk of small bowel cancer: a binational population-based cohort study from Denmark and Sweden

Gut ◽

10.1136/gutjnl-2020-320945 ◽

2020 ◽

pp. gutjnl-2020-320945 ◽

Cited By ~ 4

Author(s):

Jordan E Axelrad ◽

Ola Olén ◽

Michael C Sachs ◽

Rune Erichsen ◽

Lars Pedersen ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Cohort Study ◽

Small Bowel ◽

Bowel Disease ◽

Cox Regression ◽

Population Based ◽

Bowel Cancer ◽

Small Bowel Cancer ◽

Increased Risk ◽

Inflammatory Bowel

ObjectiveCrohn’s disease (CD) is associated with increased risk of small bowel cancer (SBC), but previous studies have been small. We aimed to examine the risk of incident SBC and death from SBC in patients with inflammatory bowel disease (IBD).DesignIn a binational, population-based cohort study from Sweden and Denmark of patients with IBD during 1969–2017 and matched reference individuals from the general population, we evaluated the risk of incident SBC and death from SBC. Cox regression was used to estimate adjusted hazard ratios (aHRs).ResultsWe identified 161 896 individuals with IBD (CD: 47 370; UC: 97 515; unclassified IBD: 17 011). During follow-up, 237 cases of SBC were diagnosed in patients with IBD (CD: 24.4/100 000 person-years; UC: 5.88/100 000 person-years), compared with 640 cases in reference individuals (2.81/100 000 person-years and 3.32/100 000 person-years, respectively). This corresponded to one extra case of SBC in 385 patients with CD and one extra case in 500 patients with UC, followed up for 10 years. The aHR for incident SBC was 9.09 (95% CI 7.34 to 11.3) in CD and 1.85 (95% CI 1.43 to 2.39) in UC. Excluding the first year after an IBD diagnosis, the aHRs for incident SBC decreased to 4.96 in CD and 1.69 in UC. Among patients with CD, HRs were independently highest for recently diagnosed, childhood-onset, ileal and stricturing CD. The relative hazard of SBC-related death was increased in both patients with CD (aHR 6.59, 95% CI 4.74 to 9.15) and patients with UC (aHR 1.57; 95% CI 1.07 to 2.32).ConclusionSBC and death from SBC were more common in patients with IBD, particularly among patients with CD, although absolute risks were low.

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