Survival Disparities by Hospital Volume Among American Women With Gynecologic Cancers

2017 ◽  
pp. 1-15
Author(s):  
Brandon-Luke L. Seagle ◽  
Anna E. Strohl ◽  
Monica Dandapani ◽  
Wilberto Nieves-Neira ◽  
Shohreh Shahabi
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hospital Volume ◽  
Cox Regression ◽  
Gynecologic Cancer ◽  
Stage Ii ◽  
American Women ◽  
Cancer Data ◽  
Cervical Cancers ◽  
Adjuvant Therapies

Purpose We describe survival disparities among women with uterine, ovarian, or cervical cancer by cancer-specific mean annual hospital volume. Methods National Cancer Database 1998-2011 uterine (n = 441,863), ovarian (n = 223,017), and cervical (n = 146,698) cancer data sets were used. Cancer-specific mean annual hospital volumes were calculated. Overall survival (OS) was plotted by hospital volume using restricted mean OS times from Cox regression. Results Uterine, ovarian, and cervical cancers were reported from 1,651, 1,633, and 1,600 hospitals, respectively. Median values of mean annual hospital volumes among hospitals were 8.6 (interquartile range [IQR], 2.6 to 20.8), 4.4 (IQR, 1.4 to 10.3), and 2.4 (IQR, 0.6 to 6.6) for uterine, ovarian, and cervical cancers, respectively. Increased hospital volume was associated with increased OS among women with stage III to IV high-grade serous ovarian cancer, stage II to IV squamous or adenocarcinoma cervical cancer, and stage I to IV endometrioid, clear cell, serous, or carcinosarcoma uterine cancers (all P < .03). Differential OS between women treated at higher- versus lower-volume cancer centers exceeded 5, 5, and 13 months among women with advanced endometrial, ovarian, or cervical cancer, respectively (all P < .001). Hospital volume was not associated with OS among patients with stage II to IV cervical cancer treated with brachytherapy ( P = .17). Use of adjuvant therapies decreased OS disparities by hospital volume among women with advanced ovarian or endometrial cancer. Conclusion Increased delivery of brachytherapy for treatment of cervical cancer may decrease survival disparities by hospital volume. Standardization of adjuvant therapies may diminish survival disparities by hospital volume among women with advanced ovarian or endometrial cancer. In addition, survival of American women with gynecologic cancer may be increased by centralization of care.

scholarly journals Comprehensive Analysis to Identify SPP1 as a Prognostic Biomarker in Cervical Cancer

2022 ◽  
Vol 12 ◽  
Author(s):  
Kaidi Zhao ◽  
Zhou Ma ◽  
Wei Zhang
Keyword(s):  
Cervical Cancer ◽  
Roc Curve ◽  
Immune Cell ◽  
Cox Regression ◽  
Prognostic Biomarker ◽  
R Package ◽  
Cancer Data ◽  
Immune Infiltration ◽  
Pan Cancer ◽  
Geo Database

Background:SPP1, secreted phosphoprotein 1, is a member of the small integrin-binding ligand N-linked glycoprotein (SIBLING) family. Previous studies have proven SPP1 overexpressed in a variety of cancers and can be identified as a prognostic factor, while no study has explored the function and carcinogenic mechanism of SPP1 in cervical cancer.Methods: We aimed to demonstrate the relationship between SPP1 expression and pan-cancer using The Cancer Genome Atlas (TCGA) database. Next, we validated SPP1 expression of cervical cancer in the Gene Expression Omnibus (GEO) database, including GSE7803, GSE63514, and GSE9750. The receiver operating characteristic (ROC) curve was used to evaluate the feasibility of SPP1 as a differentiating factor by the area under curve (AUC) score. Cox regression and logistic regression were performed to evaluate factors associated with prognosis. The SPP1-binding protein network was built by the STRING tool. Enrichment analysis by the R package clusterProfiler was used to explore potential function of SPP1. The single-sample GSEA (ssGSEA) method from the R package GSVA and TIMER database were used to investigate the association between the immune infiltration level and SPP1 expression in cervical cancer.Results: Pan-cancer data analysis showed that SPP1 expression was higher in most cancer types, including cervical cancer, and we got the same result in the GEO database. The ROC curve suggested that SPP1 could be a potential diagnostic biomarker (AUC = 0.877). High SPP1 expression was associated with poorer overall survival (OS) (P = 0.032). Further enrichment and immune infiltration analysis revealed that high SPP1 expression was correlated with regulating the infiltration level of neutrophil cells and some immune cell types, including macrophage and DC.Conclusion:SPP1 expression was higher in cervical cancer tissues than in normal cervical epithelial tissues. It was significantly associated with poor prognosis and immune cell infiltration. Thus, SPP1 may become a promising prognostic biomarker for cervical cancer patients.

scholarly journals Usefulness of Vascular Clips in Surgery for Gynecologic Cancer

2021 ◽  
Author(s):  
Kazuho Nakanishi ◽  
Takashi Yamada ◽  
Shunji Suzuki
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Pelvic Floor ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Pelvic Lymphadenectomy ◽  
Gynecological Surgery ◽  
Gynecologic Malignancies ◽  
Result Analysis ◽  
Titanium Clips

Abstract In gynecological surgery for cervical cancer and endometrial cancer with lymphadenectomy, many lymph vessels are ligated to prevent postoperative lymph leakage and lymphocele, and many blood vessels leading to the pelvic floor are ligated. Therefore, the labors required for ligation are very large. However, no studies have examined ligation methods in gynecologic cancer surgery. Therefore, we retrospectively examined gynecologic cancer patients who had been treated at our hospital by dividing them into a group using absorbent threads and a group using titanium clips. In addition, the surgical procedure was classified into three groups: a group with only pelvic lymphadenectomy, a group with pelvic and para-aortic lymphadenectomy, and a group with radical hysterectomy with pelvic lymphadenectomy. As a result, analysis of all cases clearly showed less complications and less time for surgery in the clip group. Furthermore, the analysis of RH + PLN group showed that surgery time was clearly shorter and less complications tended to occur in the clip group. In conclusion, by using this easily usable device, surgery for gynecologic malignancies will be more comfortable and safer.

scholarly journals Prognostic Values of Platelet-Associated Indicators in Resectable Cervical Cancer

Dose-Response ◽  
2019 ◽  
Vol 17 (3) ◽  
pp. 155932581987419
Author(s):  
Jing-mei Wang ◽  
Ying Wang ◽  
Yue-qing Huang ◽  
Han Wang ◽  
Jie Zhu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Stage Ii ◽  
Analysis Model ◽  
Characteristic Analysis ◽  
Distribution Width ◽  
Cox Regression Analysis ◽  
Gynecology And Obstetrics

Background:Cervical cancer is one of the leading causes of cancer mortality in women, which seriously threatens the health of women worldwide. Platelet (PLT)-related parameters, including PLT count, mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW), are correlated with tumor prognosis.Methods:In total, 110 patients with cervical carcinoma were recruited in this study. The patients were divided into 2 groups according to the receiver operating characteristic analysis cutoff values of PLT, MPV, PCT, or PDW. The post-/preradiotherapy ratios were defined as the rate of preradiotherapy PLT-related parameters counts and the corresponding ones obtained after radiotherapy.Results:Higher pretreatment PLT level was correlated with Higher Federation of Gynecology and Obstetrics (FIGO) stage (II). Higher pretreatment PLT level was correlated with worse progression-free survival (PFS) and overall survival (OS). Increased post-/preradiotherapy ratio of PLT was correlated with worse PFS and OS. Changes in PCT, MPV, or PDW levels had no effects on PFS or OS. Cox regression analysis model indicated that larger tumor size, higher pretreatment PLT level, and increased post-/preradiotherapy PLT ratio were independently associated with worse PFS; higher FIGO stage (II) and increased post-/preradiotherapy PLT ratio were independently associated with worse OS.Conclusion:Pretreatment PLT level and increased post-/preradiotherapy PLT ratio are correlated with outcomes of cervical cancer.

scholarly journals DeMoS: Dense Module based Gene Signature Detection through Quasi-Clique: An Application to Cervical Cancer Prognosis

2020 ◽  
Author(s):  
Suparna Saha ◽  
Saurav Mallik ◽  
Sanghamitra Bandyopadhyay
Keyword(s):  
Cervical Cancer ◽  
Empirical Bayes ◽  
Target Genes ◽  
Cox Regression ◽  
Gene Signature ◽  
The Other ◽  
Cancer Prognosis ◽  
Data Repository ◽  
P Value ◽  
Cancer Data

Abstract Background: Gene signature is useful to represent the molecular alternation in the disease genomes at specified conditions and is often used to distinguish samples into various groups for better research prospective as well as better clinical treatment. There is lack of efficient techniques that can take into account the complex gene expression profile and able to identify the most relevant signatures. Methods: In this article, we presented a new framework to identify Dense Module based gene Signature (DeMoS) and their targeting miRNAs through Quasi-Clique detection algorithm and their application in prognosis survival study. Here we applied a cervical cancer data repository with prognosis clinical data to conduct our experiment. We first performed Empirical Bayes test using Limma method to identify dysregulated genes (or, miRNAs). MiRNA-mediated dysregulated target genes had been extracted from those dysregulated miRNAs. Thereafter, We detected dense co-expressed modules using Quasi-Clique identification technique. The average correlation coefficient was then computed for each resultant module. The module containing the highest correlation was formulated as the resultant gene signature. Next, We applied three well-known classifiers (SVM, PAM and Random Forest (RF)) using 10-fold cross-validation, and obtained AUC. Finally, we performed survival prognosis study for the resultant gene signature. Results: The resultant signature consisted of ten genes, FGF9, FGF18, PPP1R9A, ERBB4, DCDC2, TOX3, ARMC3, DNALI1, RGL3 and ENPP3. In addition, We identified a total of eight dysregulated miRNAs that targeted the aforementioned gene signature. Hsa-mir-34c was found to be strongly associated with the genes signature since its out-degree centrality score was highest. On the other hand, the p-value of the Cox regression in the prognosis study for the resultant gene signature was found to be significant (=4.2e-02). Finally, DeMoS evaluated the highest AUC values (viz., 0.95 for SVM, 0.955 for RF, 0.955 for PAM) for our resultant gene signature in compared to the other state-of-the-art techniques. Conclusions: Our framework estimated most promising gene signature that could classify multiple groups/subtypes of samples with higher AUC as well as statistically significant p-value in regression based prognosis analysis. Our method is useful to determine signature for any RNA-seq profile. Code is available at https://github.com/sahasuparna/DeMoS.

Gynecologic Cancer

2014 ◽  
Author(s):  
Stephen A Cannistra ◽  
Christina I Herold
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Differential Diagnosis ◽  
Endometrial Cancer ◽  
Epithelial Ovarian Cancer ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
The United States ◽  
Improvement In Survival

This chapter focuses on the three types of gynecologic cancer—epithelial cancer of the ovary, cancer of the uterine cervix, and cancer of the endometrium (uterine cancer)—and reviews their epidemiology, diagnosis, differential diagnosis, surgical features, and staging, as well as their risk factors and clinical features. Also discussed are methods of treatment and the management of relapse. Epithelial ovarian cancer occurs at a mean age of 60 years in the United States and is the most lethal of gynecologic tract tumors. However, a recent trial has demonstrated a survival advantage through the use of intraperitoneal chemotherapy for appropriate patients with optimally debulked ovarian cancer. Invasive cervical cancer is uncommon in developed countries, partly because of the effectiveness of Pap smear screening. Nevertheless, cancer of the uterine cervix is the third most common gynecologic cancer diagnosis and cause of death among gynecologic cancers in the United States. However, for women with early-stage cervical cancer, data from several randomized trials indicate an improvement in response rate and survival through the use of combination platinum-based regimens for platinum-sensitive relapse. Also noted is an improvement in survival using combined-modality chemoradiation in appropriate patients with locally advanced cervical cancer. Endometrial cancer is the most frequent tumor of the gynecologic tract; it is estimated that it occurred in over 46,000 women and caused more than 8,000 deaths in the United States in 2011. Recent data indicate improvement in survival using adjuvant platinum-based chemotherapy in appropriate patients with high-risk endometrial cancer. Tables in this chapter review the common histologic types of epithelial ovarian cancer, selected signs and symptoms of ovarian cancer, the International Federation of Gynecology and Obstetrics (FIGO) staging system for epithelial ovarian cancer, differential diagnosis of a complex cyst detected by transvaginal sonography, selected adverse prognostic factors in epithelial ovarian cancer, common chemotherapy agents used in the treatment of epithelial ovarian cancer, the FIGO surgical staging of endometrial cancer, and postoperative management considerations for patients with uterine cancer. Figures illustrate the four histologic subtypes of epithelial ovarian cancer, the intraoperative appearance of stage III epithelial ovarian cancer, and FIGO staging of cervical cancer. This review contains 6 highly rendered figures, 8 tables, and 150 references.

Gynecologic Cancer

2014 ◽  
Author(s):  
Stephen A Cannistra ◽  
Christina I Herold
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Differential Diagnosis ◽  
Endometrial Cancer ◽  
Epithelial Ovarian Cancer ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
The United States ◽  
Improvement In Survival

This chapter focuses on the three types of gynecologic cancer—epithelial cancer of the ovary, cancer of the uterine cervix, and cancer of the endometrium (uterine cancer)—and reviews their epidemiology, diagnosis, differential diagnosis, surgical features, and staging, as well as their risk factors and clinical features. Also discussed are methods of treatment and the management of relapse. Epithelial ovarian cancer occurs at a mean age of 60 years in the United States and is the most lethal of gynecologic tract tumors. However, a recent trial has demonstrated a survival advantage through the use of intraperitoneal chemotherapy for appropriate patients with optimally debulked ovarian cancer. Invasive cervical cancer is uncommon in developed countries, partly because of the effectiveness of Pap smear screening. Nevertheless, cancer of the uterine cervix is the third most common gynecologic cancer diagnosis and cause of death among gynecologic cancers in the United States. However, for women with early-stage cervical cancer, data from several randomized trials indicate an improvement in response rate and survival through the use of combination platinum-based regimens for platinum-sensitive relapse. Also noted is an improvement in survival using combined-modality chemoradiation in appropriate patients with locally advanced cervical cancer. Endometrial cancer is the most frequent tumor of the gynecologic tract; it is estimated that it occurred in over 46,000 women and caused more than 8,000 deaths in the United States in 2011. Recent data indicate improvement in survival using adjuvant platinum-based chemotherapy in appropriate patients with high-risk endometrial cancer. Tables in this chapter review the common histologic types of epithelial ovarian cancer, selected signs and symptoms of ovarian cancer, the International Federation of Gynecology and Obstetrics (FIGO) staging system for epithelial ovarian cancer, differential diagnosis of a complex cyst detected by transvaginal sonography, selected adverse prognostic factors in epithelial ovarian cancer, common chemotherapy agents used in the treatment of epithelial ovarian cancer, the FIGO surgical staging of endometrial cancer, and postoperative management considerations for patients with uterine cancer. Figures illustrate the four histologic subtypes of epithelial ovarian cancer, the intraoperative appearance of stage III epithelial ovarian cancer, and FIGO staging of cervical cancer. This review contains 6 highly rendered figures, 8 tables, and 150 references.

MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

2017 ◽  
Vol 63 (6) ◽  
pp. 843-854
Author(s):  
Olga Novikova ◽  
Yelena Ulrikh ◽  
V. Nosov ◽  
A. Charkhifalakyan
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Hormone Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Menopausal Hormone Therapy ◽  
Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

Prognostic role of aberrant mTOR activation in patients with stage II and III colorectal cancer

2020 ◽  
Vol 14 (12) ◽  
pp. 1127-1137
Author(s):  
Tong-Tong Zhang ◽  
Yi-Qing Zhu ◽  
Hong-Qing Cai ◽  
Jun-Wen Zheng ◽  
Jia-Jie Hao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Poor Prognostic Factor ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Potential Biomarker ◽  
Risk Predictor

Aim: This study aimed to develop an effective risk predictor for patients with stage II and III colorectal cancer (CRC). Materials & methods: The prognostic value of p-mTOR (Ser2448) levels was analyzed using Kaplan–Meier survival analysis and Cox regression analysis. Results: The levels of p-mTOR were increased in CRC specimens and significantly correlated with poor prognosis in patients with stage II and III CRC. Notably, the p-mTOR level was an independent poor prognostic factor for disease-free survival and overall survival in stage II CRC. Conclusion: Aberrant mTOR activation was significantly associated with the risk of recurrence or death in patients with stage II and III CRC, thus this activated proteins that may serve as a potential biomarker for high-risk CRC.

scholarly journals Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christer Borgfeldt ◽  
Erik Holmberg ◽  
Janusz Marcickiewicz ◽  
Karin Stålberg ◽  
Bengt Tholander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Endometrial Cancer ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Surgical Approach ◽  
Open Surgery ◽  
Gynecologic Cancer ◽  
Multivariable Analysis ◽  
Figo Stage

Abstract Background The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). Methods A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. Results In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. Conclusion The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.

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