scholarly journals Annual dialysis data report of the 2018 JSDT Renal Data Registry: dementia, performance status, and exercise habits

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kosaku Nitta ◽  
Shigeru Nakai ◽  
Ikuto Masakane ◽  
Norio Hanafusa ◽  
Shunsuke Goto ◽  
...  
Keyword(s):  
Performance Status ◽  
Age Groups ◽  
Activity Levels ◽  
Age Group ◽  
Dialysis Patients ◽  
Dialysis Therapy ◽  
Exercise Habits ◽  
Exercise Habit ◽  
Annual Survey ◽  
Data Registry

AbstractAccording to the annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) conducted at the end of 2018, there were a total of 339,841 patients receiving dialysis (hereinafter, dialysis patients) in Japan. The survey included questions regarding the presence/absence of dementia, the performance status (PS), and the exercise habits of individual patients. The survey revealed that 10.8% of all dialysis patients had dementia (1.8% in the age group of less than 65 years, 6.8% in the age group of 65–74 years, and 22.7% in the age group of 75 years or older). These prevalences of dementia were approximately equal to those estimated from the survey conducted in 2010. Regarding PS, the percentage of patients with lower activity levels tended to be relatively high among patients who were less than 15 years old and those who were 60 years old or older. Concerning the exercise habits of dialysis patients, the percentage of patients who were classified as “not at all or hardly” in response to the question about exercise habit was the highest (60–80%) of all the exercise habit classifications in each of the age groups analyzed.

P1377ANEMIA MANAGEMENT IN DIALYSIS PATIENTS IN SWITZERLAND

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rebecca Winzeler ◽  
Patrice Max Ambühl
Keyword(s):  
Odds Ratio ◽  
Cox Regression ◽  
Reference Group ◽  
Survival Rates ◽  
Age Groups ◽  
Age Group ◽  
Dialysis Patients ◽  
Public And Private ◽  
Anemia Management ◽  
Kdigo Guidelines

Abstract Background and Aims Anemia is highly prevalent in dialysis patients and is associated with increased morbidity and mortality. The purpose of the present analysis is to evaluate current anemia management in dialysis patients in Switzerland collected from the Swiss Dialysis Registry (srrqap), which covers all dialysis patients in Switzerland. Method All medical establishments in Switzerland (both public and private; N=92) providing chronic treatment by either hemo- and/or peritoneal dialysis, had to provide relevant data for the year 2018. All individuals being on chronic dialytic therapy in the year 2018 were enrolled (N=4646). To calculate survival probabilities, all deaths from incident dialysis patients between 2014 and 2018 were analyzed. Results: 65 percent of all dialysis patients receive iron and EPO. Regardless of anemia management, 82% of patients reach target hemoglobin levels 10 g/dL. In 18% of patients inadequate management to reach Hb targets may be suspected. The distribution of iron and EPO substitution is similar in all age groups. However, 26% of the age group 20-44 years receive EPO, but no iron, compared to only 15% in the other age groups. Survival analysis by Cox regression adjusted for age, Charlson score and treatment modality revealed that patients with Hb levels equal or greater than 11 g/dl have the best survival (reference group). In comparison, patients in the Hb categories below 9, 9-9.9 and 10-10.9 g/dl have an odds ratio of 3.9, 2.0 and 1.3, respectively, to die. Conclusion Anemia management to reach Hb target levels following KDIGO guidelines seems to be adequately implemented among dialysis patients in Switzerland. In 18% of patients treatment might be optimized to achieve Hb targets. As expected, patients with Hb levels equal or greater than 11 g/dl have better survival rates compared to patients with lower Hb values.

Prognostic Significance Of NPM1 mutations In The Absence Of FLT3-ITD in Older Patients With AML: A SWOG Report

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1315-1315 ◽  
Author(s):  
Fabiana Ostronoff ◽  
Megan Othus ◽  
Soheil Meshinchi ◽  
John E. Godwin ◽  
Kenneth J. Kopecky ◽  
...  
Keyword(s):  
Risk Factor ◽  
Relapse Rate ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Prognostic Significance ◽  
Age Groups ◽  
Adverse Outcomes ◽  
Prognostic Impact ◽  
Age Group ◽  
Npm1 Mutation

Abstract Introduction Younger acute myeloid leukemia (AML) patients with a NPM1 mutation but without FLT3-ITD (NPM1+/FLT3-ITD-) have favorable prognosis, but the prognostic significance of these mutations in patients older than 55 years is less clear. Therefore, we evaluated the prognostic impact of the NPM1+/FLT3-ITD- in older AML patients. Methods Samples were obtained from AML patients enrolled onto SWOG trials S9333, S9031, S9500 and S0106 who were ³55 years and received “7+3 like” induction regimens. Cytarabine/daunorubicin (S9031 and S9033) or HiDAC (9500 and S0106) were used for consolidation. Gemtuzumab ozogamicin, either during induction, consolidation, and/or post-consolidation, was administered to some patients enrolled onto S0106. Samples were examined for FLT3, NPM1, DNMT3A, IDH1/2 mutations using previously reported techniques. Results A total of 1,239 patients enrolled in these trials, and pre-treatment samples were available for 156 patients who were older than 55 years (median age of 60 years, range 55-83). NPM1 and FLT3-ITD mutations were present in 33% and 24% of the patients, respectively. The complete remission (CR) rate, 2-year overall survival (OS) and relapse-free survival (RFS) for the entire cohort were 62%, 31% and 32%, respectively. Increased age, unfavorable cytogenetics and FLT3-ITD were associated with a worse OS and RFS. NPM1 mutations were not significantly associated with OS or RFS. Patients were then divided into two age groups, 55-65 and >65 years, based on previous data that favorable prognostic factors such as good-risk cytogenetics have not been shown to be associated with favorable outcomes for AML patients age >65. Both age groups displayed similar patient characteristics (in regards to white blood cell count, bone marrow blast %, cytogenetics, secondary AML, sex and ECOG performance status), with the exception that >65 years group did not include any patients from S0106 or S9500 due to age restrictions for these trials. Patients >65 had a higher relapse rate (P =0.001) and significantly worse OS (P<0.001) and RFS (P=0.007) than those aged 55-65. FLT3-ITD retained its unfavorable prognostic significance for patients age 55-65, while patients >65 years had such a uniformly poor prognosis that this mutation lost much of its prognostic significance. NPM1 mutations were not significantly associated with either OS or RFS in either age group. We then examined the most favorable NPM1+/FLT3-ITD- genotype, which is currently being used to risk-stratify AML patients. NPM1+/FLT3-ITD- was associated with an improved OS in the 55-65 age group (P<0.001), which was similar to previously described results in younger patients (Figure 1A). Additional analyses showed that the favorable impact of this genotype was not due to the inclusion of patients enrolled onto S0106 and S9500 (Figure 1B). In contrast, patients >65 years with the NPM1+/FLT3-ITD- had a low CR rate and high 1-year relapse rate, which translated into a relatively poor 5-year OS (<30%, Figure 1C) that was not significantly different from patients >65 without this genotype (P=0.33). Since mutations in DNMT3A, IDH1/2 have been associated with adverse outcomes for patients with NPM1 mutations, samples with the NPM1+/FLT3-ITD- genotype were examined for these mutations. The frequencies for DNMT3A, IDH1/2 mutations were similar in both age groups, indicating that these mutations were not responsible for the age-dependent findings. Furthermore, multivariate models adjusting for known prognostic covariates showed that the NPM1+/FLT3-ITD- remained independently associated with improved OS for patients age 55-65 but not those >65. Conclusions This study represents one of the largest investigations on the prognostic significance of NPM1+/FLT3-ITD- in older AML patients. The NPM1+/FLT3-ITD- genotype remains a favorable-risk factor for AML patients age 55-65 years but may not be a favorable-risk factor for patients >65 years, at least not for those treated with standard induction followed by conventional consolidation. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Age and Physical Activity among Canadian Women and Men: Findings from Longitudinal National Survey Data

2000 ◽  
Vol 8 (1) ◽  
pp. 1-19 ◽  
Author(s):  
James Curtis ◽  
Philip White ◽  
Barry McPherson
Keyword(s):  
Physical Activity ◽  
Inverse Relationship ◽  
Leisure Time ◽  
Age Groups ◽  
Group Differences ◽  
Activity Levels ◽  
Age Group ◽  
Activity Involvement ◽  
Age Cohorts ◽  
Age Cohort

This study reports on age-group differences in leisure-time sport and physical activity involvement among a large sample of Canadians interviewed at 2 points during the 1980s. Comparisons are made for 5 age cohorts, for men and women, and without and with multivariate controls. The results contradict the usual finding of an inverse relationship between age and level of physical activity. On measures of (a) activity necessary to produce health benefits and (b) energy expenditure. Canadians over 65 were as active as, or more active than, their younger counterparts, and their activities did not decline over the 7 years between interviews. The extent of change varied by age and across women and men. Among women, increases in involvement were greatest in the middle-aged. Among men, the greatest increase was in the oldest age groups. For both genders, the youngest age cohort showed the smallest change over time, and there was evidence of slight declines in activity levels among young men.

Cohort compassionate-use program (CUP) and early access program (EAP) with cabazitaxel (Cbz) plus prednisone (P; Cbz + P) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel (D): Analysis by age group.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 109-109
Author(s):  
Zafar Malik ◽  
Giuseppe di Lorenzo ◽  
Sergio Bracarda ◽  
Alexandros Ardavanis ◽  
Mert Basaran ◽  
...  
Keyword(s):  
Disease Progression ◽  
Group Performance ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Age Groups ◽  
Phase Iii ◽  
World Population ◽  
Age Group ◽  
Castration Resistant Prostate Cancer ◽  
Grade 3

109 Background: Cbz + P demonstrated an overall survival benefit vs mitoxantrone + P in pts with mCRPC in the Phase III TROPIC trial. The CUP (CABAZ_C_05005) and EAP (NCT01254279) (both funded by Sanofi) were established to allow access to Cbz ahead of commercial availability. The programs are also evaluating Cbz safety in a real-world population. Data analyzed by age group (≤75 and >75 years) are presented here. Methods: Expected enrolment across both programs is 1,450 pts from 236 centres worldwide. Pts received Cbz 25 mg/m2 IV Q3W + P 10 mg QD until disease progression, death, unacceptable toxicity or physician/pt decision. G-CSF is administered as per ASCO guidelines. Results: As of May 30, 2012, 1,301 pts have enrolled (≤75 years: 1,061 pts [81.6%]; >75 years: 240 pts [18.4%]). Eastern Cooperative Oncology Group performance status and incidence of visceral metastases were generally balanced between treatment groups. The most frequent reasons for discontinuation were disease progression (46.8%) followed by adverse events (AEs; 24.4%) in pts ≤75 years, and AEs (36.4%) followed by disease progression (31.1%) in pts >75 years. Time from initial diagnosis to inclusion was greater in pts >75 years (median 79.66 months) than in pts ≤75 years (median 53.94 months), but time from mCRPC diagnosis to inclusion was approximately equivalent (>75 years: median 22.6 months; ≤75 years: median 20.94 months). G-CSF use was more frequent in pts >75 years (cycle 1: 62.9% of pts) compared with pts ≤75 years (cycle 1: 52.2% of pts). AEs of clinical concern were more frequent in the older age group (Grade ≥3 AEs: >75 years 64.2%; ≤75 years 54.8%). Grade ≥3 neutropenia was observed in 25.8% of pts >75 years and in 17.0% of pts ≤75 years. Conclusions: We observed several differences between age groups in baseline and on-treatment parameters, suggesting differences in the natural history of mCRPC (faster disease progression in pts ≤75 years than in pts >75 years) and secondary to treatment (AEs more frequent in pts >75 years compared with pts ≤75 years). Clinical trial information: NCT01254279.

Do Results From Clinical Trials in Acute Myeloid Leukemia Reflect Clinical Reality? A Danish National Cohort Study of 813 Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1477-1477
Author(s):  
Lene Sofie Granfeldt Ostgard ◽  
Mette Nørgaard ◽  
Henrik Sengeløv ◽  
Lars Kjeldsen ◽  
Lone S. Friis ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Factors ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Age Groups ◽  
Age Group ◽  
Curative Intent ◽  
Protocol Group ◽  
Co Morbidity ◽  
Underrepresentation Of Women

Abstract Abstract 1477 Previous studies have documented the underrepresentation of women and elderly patients in American clinical trials of leukemia. If, characteristics of patients included in clinical protocols differ markedly from the characteristics of the majority of patients treated outside protocols the external validity of clinical trials may be threatened. Methods: The Danish National Acute Leukaemia Database (ALDB) includes detailed data on a large well-defined non-selected population of 2729 AML patients (covering >95% of AML patients diagnosed since Jan 2000). Since 2000 Danish AML patients have been included in 3 different British protocols (AML15, 16 and 17). We analysed a cohort of 2624 patients diagnosed with AML in Denmark since Jan. 2000 (105 APL-patients were excluded). We compared patients treated with curative intent according to the British protocols with patients treated with curative intent off-protocol with regard to characteristics, possible prognostic factors, CR-rate, and survival. For comparable groups we divided patients into 2 age groups (<60 and ≥60 years) and further excluded patients diagnosed before protocol inclusion was possible for the given age group. Results: 813 patients were treated with curative intent (517 pts < 60 years (96% of all patients <60y) vs. 296 pts ≥60 year, (35 % of all patients >60y). Of these, 391 pts (232 pts <60 years, 44.9 % vs. 159 pts ≥60 years, 53.7 %) were treated according to protocols. For both age groups WHO performance status score (WHO PS) was found to be significantly lower in the on-protocol group. Presence of secondary AML (sAML) was found more frequent in the off-protocol groups, but was only statistically significant in the group under 60 years. In patients 60 years or older, a significantly higher LDH-level and WBC was found in the on-protocol groups. We did not find any difference in distribution of sex, age, cytogenetic changes, presence of extra medullary leukemia (EML) or blast counts. Allogeneic transplantation (alloHCT) was significantly more often performed in the protocol groups (table 1). For patients under 60 years of age overall survival (OS) was superior in the on-protocol group (fig. 1). For the older age group OS was similar in the on- and off-protocol group (fig. 2). After controlling for possible prognostic factors protocol participation seemed to be associated with longer OS in patients under 60 years (HR 0.66, 95%CI 0.48–0.99, p=0.02), but not in patients 60 years or older (HR 1.17, 95%CI 0.87–1.57). The unevenly distributed characteristics; LDH-level, sAML, WHO PS, performance of alloHCT were all found to be of significant importance to OS. Conclusions: AML patients included in the British AML trials in Denmark had a more favorable profile than patients treated with standard regimens. We found a superior survival in on-protocol patients under 60 years. This could not be fully explained by an uneven distribution of prognostic factors. A beneficial effect of the protocol treatments and confounding by co-morbidity are suggested. Population-based studies may thus have an important role in examining some aspects of prognosis in AML. In this context the Danish ALDB has proven to be a valuable data source. Disclosures: No relevant conflicts of interest to declare.

Outcomes in elderly patients with metastatic castration-resistant prostate cancer (mCRPC) treated with the androgen receptor inhibitor enzalutamide: Results from the phase III AFFIRM trial.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 16-16 ◽  
Author(s):  
Cora N. Sternberg ◽  
Johann Sebastian De Bono ◽  
Kim N. Chi ◽  
Karim Fizazi ◽  
Peter Mulders ◽  
...  
Keyword(s):  
Androgen Receptor ◽  
Performance Status ◽  
Specific Antigen ◽  
Age Groups ◽  
Phase Iii ◽  
Double Blind Study ◽  
Age Group ◽  
Castration Resistant Prostate Cancer ◽  
Risk Of Death ◽  
Improved Outcomes

16 Background: Enzalutamide (ENZA) inhibits multiple steps in the androgen receptor signaling pathway (Tran et al, Science. 2009;324:787). The phase III AFFIRM trial demonstrated that ENZA increased median overall survival (OS) by 4.8 months with a 37% reduction in the risk of death (P <0.001, HR 0.63) vs placebo (PBO) in post-docetaxel mCRPC patients (pts) (Scher et al, NEJM 2012; 367:1187). In a post-hoc analysis, the effect of ENZA on outcomes in elderly (≥ 75 yrs) vs younger (< 75 yrs) pts in the AFFIRM trial was assessed. Methods: The AFFIRM trial was a Phase III multinational, randomized, double-blind study in post-docetaxel mCRPC pts. Randomization was 2:1 to ENZA 160 mg/day or PBO, stratified by baseline ECOG performance status and mean pain score. Statistics are presented by age group (≥75, yrs <75 yrs) for efficacy outcomes of OS, radiographic progression-free survival (rPFS), and time to prostate-specific antigen (PSA) progression. Top line safety results are also presented for both age groups. Results: Elderly pts comprised 25% (199/800) of ENZA pts and 26% (104/399) of PBO pts. Improved outcomes with ENZA treatment were observed in both elderly and younger pts, with similar safety profiles in each age group. Conclusions: ENZA significantly improved outcomes in both elderly (≥ 75yrs) and younger pts (< 75yrs). Safety and tolerability findings were comparable between the two age groups. Clinical trial information: NCT00974311. [Table: see text]

scholarly journals 2018 annual dialysis data report of the JSDT Renal Data Registry: patients with hepatitis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kosaku Nitta ◽  
◽  
Shigeru Nakai ◽  
Ikuto Masakane ◽  
Norio Hanafusa ◽  
...  
Keyword(s):  
Medical Information ◽  
Hepatitis B Surface Antigen ◽  
University Hospital ◽  
Hcv Rna ◽  
Dialysis Patients ◽  
Hbsag Positivity ◽  
Annual Survey ◽  
Data Registry ◽  
Dialysis Vintage ◽  
Clinical Trials Registry

Abstract According to the annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) conducted at the end of 2018, a total of 339,841 patients were receiving dialysis (hereinafter, dialysis patients) in Japan. This survey included an investigation of individual test results for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (HCV-Ab), HCV-RNA, and serum alanine aminotransferase (ALT) (glutamic pyruvic transaminase [GPT]). The survey revealed that among dialysis patients in Japan, the prevalence of HBsAg positivity was 1.38% and the prevalence of HCV-Ab positivity was 4.7% at the end of 2018, both of which were markedly lower than the corresponding rates documented in 2007 (9.8% and 4.7%, respectively). The proportion of HCV-RNA-positive patients among all HCV-Ab-positive patients was 37.5%, which was also markedly lower than the percentage recorded in 2007 (64.0%). The prevalence of HBsAg positivity tended to increase as the dialysis vintage increased. The prevalence of HCV-Ab positivity was also not correlated with the dialysis vintage during the first 30 years of dialysis; however, it tended to increase as the dialysis vintage increased beyond the 30th year. Trial registration University hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000018641. The JRDR was approved by the ethics committee of the JSDT (approval number 1-3) and was registered on August 8, 2015 (accessed June 2, 2020).

scholarly journals Ambulatory and Social Performance Status After Transfemoral Prosthetic Rehabilitation Regarding Age, Gender, and Marital Status

2021 ◽  
Vol 19 (4) ◽  
pp. 369-378
Author(s):  
Shafiq ur Rehman ◽  
◽  
Aqeel Ahmed Khan ◽  
Muhammad Kamran ◽  
Ghulam Saqulain ◽  
...  
Keyword(s):  
Marital Status ◽  
Social Performance ◽  
Performance Status ◽  
Age Groups ◽  
Age Group ◽  
Functional Scale ◽  
Ambulatory Status ◽  
Sf 36 ◽  
Gender Association ◽  
Lower Extremity Functional Scale

Objectives: This study aims to determine the association of ambulatory and social performance status of transfemoral prosthetic users with their age, gender, and marital status. Methods: A cross-sectional study was conducted on 400 transfemoral prosthesis users. A sample was recruited from both genders aged 10-60 years using the prosthesis for at least one year. They were selected using the non-probability convenience sampling method from the Pakistan Institute of Prosthetic and Orthotic Sciences from July 2019 to December 2019. Lower extremity functional scale and short form-36 health survey questionnaire (SF-36) were used for data collection, followed by statistical analysis. Results: Ambulatory status (as measured by the total lower extremity functional scale) revealed significant association (P<0.001) with age. The highest score belonged to the 10-30 years age group. Also, there was a significant association (P=0.003) with marital status with the highest scores for unmarried ones. However, no significant (P=0.705) gender association was noted though scores were higher for the male gender. As regards, the social performance was measured by SF-36. The findings revealed a significant association (P<0.05) of most domains of SF-36 with age groups, with the highest scores for the age group of 10-30 years. Also, a significant association with the gender with higher scores in females was noted in most domains. In contrast, no significant association with marital status was reported in most domains. Discussion: Ambulatory status has a significant association with age and marital status with no significant gender association. While social performance has a significant association with gender, most domains had significant associations with age groups. However, no association with marital status was present.

Adjuvant chemotherapy (AC) outcomes in young (YP) and elderly patients (EP) with high-risk stage II colon cancer (CC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3569-3569
Author(s):  
Aalok Kumar ◽  
Hagen F. Kennecke ◽  
Howard John Lim ◽  
Daniel John Renouf ◽  
Sharlene Gill ◽  
...  
Keyword(s):  
High Risk ◽  
Cox Regression ◽  
Performance Status ◽  
Age Groups ◽  
Population Based ◽  
Stage Ii ◽  
Resection Margins ◽  
Age Group ◽  
Entire Cohort ◽  
The Impact

3569 Background: High-risk stage II CC is defined as those presenting with T4 stage, obstruction or perforation, <12 lymph nodes retrieved, positive resection margins, and lymphovascular or perineural invasion. Our prior findings suggest that improved outcomes from AC are limited to specific high risk features, such as T4 disease (Kumar et al, ASCO 2012). It is unclear if this benefit is seen across all ages. Our aim was to compare patterns of AC use and outcomes in YP and EP with high risk stage II CC. Methods: All patients diagnosed with high risk stage II CC from 1999 to 2008 and evaluated at any 1 of 5 regional cancer centers in British Columbia were categorized into YP (age <70 years) or EP (age >/=70 years). Kaplan-Meier methods and Cox regression were used to correlate receipt of AC with overall survival (OS), disease specific (DSS) and relapse free survival (RFS), stratified by age group. Results: A total of 1,236 patients were identified: 636 (51%) YP and 600 (49%) EP among whom 363 (57%) and 85 (14%) received AC, respectively. Individuals who received AC in either age group had better performance status than those who did not (ECOG 0/1 47% vs. 34%, p=0.02). After adjusting for known prognostic factors, a significant advantage in OS, but not DSS or RFS, from AC was observed for both YP and EP (Table). The impact of AC on these outcomes was similar across age groups (p interaction of age and treatment = 0.46, 0.64 and 0.69 for OS, DSS and RFS, respectively). In the entire cohort, individuals with T4 lesions had significantly improved OS (HR 0.50, 95%CI 0.33-0.77, p=0.002), DSS (HR 0.59, 95%CI 0.37-0.93, p=0.03), and RFS (HR 0.63, 95%CI 0.42-0.95, p=0.03). The effect of AC in the T4 subgroup was also similar for both YP and EP in terms of OS, DSS and RFS (p interaction of age and treatment = 0.41, 0.71 and 0.77, respectively). Conclusions: In this population-based cohort of high risk stage II CC, improvements in outcomes from AC were seen mainly in those with T4 disease, regardless of age. [Table: see text]

Outcomes of adjuvant chemotherapy (AC) in young (YP) and elderly patients (EP) with high-risk stage II colon cancer (CC).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 398-398
Author(s):  
Aalok Kumar ◽  
Hagen F. Kennecke ◽  
Howard John Lim ◽  
Daniel John Renouf ◽  
Sharlene Gill ◽  
...  
Keyword(s):  
High Risk ◽  
Cox Regression ◽  
Performance Status ◽  
Age Groups ◽  
Population Based ◽  
Stage Ii ◽  
Resection Margins ◽  
Age Group ◽  
Entire Cohort ◽  
The Impact

398 Background: High-risk stage II CC is defined as those presenting with T4 stage, obstruction or perforation, <12 lymph nodes retrieved, positive resection margins, and lymphovascular or perineural invasion. Our prior findings suggest that improved outcomes from AC are limited to specific high-risk features, such as T4 disease (Kumar et al, ASCO 2012). It is unclear if this benefit is seen across all ages. Our aim was to compare patterns of AC use and outcomes in YP and EP with high-risk stage II CC. Methods: All patients diagnosed with high-risk stage II CC from 1999 to 2008 and evaluated at any 1 of 5 regional cancer centers in British Columbia were categorized into YP (age <70 years) or EP (age >/=70 years). Kaplan-Meier methods and Cox regression were used to correlate receipt of AC with overall survival (OS), disease specific (DSS), and relapse-free survival (RFS), stratified by age group. Results: A total of 1,236 patients were identified: 636 (51%) YP and 600 (49%) EP among whom 363 (57%) and 85 (14%) received AC, respectively. Individuals who received AC in either age group had better performance status than those who did not (ECOG 0/1 47% vs. 34%, p=0.02). After adjusting for known prognostic factors, a significant advantage in OS, but not DSS or RFS, from AC was observed for both YP and EP (Table). The impact of AC on these outcomes was similar across age groups (p interaction of age and treatment = 0.46, 0.64, and 0.69 for OS, DSS, and RFS, respectively). In the entire cohort, individuals with T4 lesions had significantly improved OS (HR 0.50, 95%CI 0.33-0.77, p=0.002), DSS (HR 0.59, 95%CI 0.37-0.93, p=0.03), and RFS (HR 0.63, 95%CI 0.42-0.95, p=0.03). The effect of AC in the T4 subgroup was also similar for both YP and EP in terms of OS, DSS and RFS (p interaction of age and treatment = 0.41, 0.71, and 0.77, respectively). Conclusions: In this population-based cohort of high-risk stage II CC, improvements in outcomes from AC were seen mainly in those with T4 disease, regardless of age. [Table: see text]

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