A computer program designed to assist in NSCLC adjuvant therapy decision making

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7230-7230 ◽  
Author(s):  
P. M. Ravdin ◽  
G. J. Davis
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Computer Program ◽  
Nsclc Patient ◽  
Low Grade ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Stage 1 ◽  
Efficacy Estimate ◽  
Disease Specific

7230 Background: The goal the computer program, Adjuvant! for NSCLC, is provide the health professional, and the NSCLC patient with information that might be helpful when deciding about adjuvant chemotherapy for completely resected Stage 1 to Stage 3A disease. The 4 elements of this decision are: estimates of prognosis, estimates of the efficacy of adjuvant chemotherapy, estimates of completing mortality, and estimates of toxicity. Methods: Estimates of prognosis are based on an analysis of 17, 130 patients in the SEER registry. Estimates for 5 year disease specific mortality for Stage 1A, 1B, 2A, 2B, and 3A disease are 22%, 37%, 51%, 63%, and 70%. Multivariate analysis justifies using tumor size, histologic grade, and BAC histology for refinement of prognostic estimates for Stage 1 patients. A small subgroup of Stage 1 patients (with tumors < 10mm, low grade, BAC histology) could be identified with a 5 year disease specific mortality risk of <10%. Estimates of the efficacy of chemotherapy were derived from meta-analyses. A proportional risk reduction of 20% is used by the program as the default efficacy estimate for platinum-based therapy. Pop-ups and help files discuss areas of uncertainty and controversy. The user has the option to adjust the default efficacy estimate to the more optimistic efficacy estimates of some of the recent trials, or to take into account some of the uncertainty as to whether adjuvant chemotherapy works as well in Stage 1 disease. SEER data shows the average NSCLC patient has competing mortality rates higher than would be suggested by chronologic age. Regimen specific risks of treatment related toxicity is given by the program. In the over 100 pages of help files there is a detailed discussion of the clinical evidence, adjuvant therapy guidelines, ongoing clinical trials, and corollary areas (radiotherapy, neoadjuvant therapy, biomarkers, etc.) Results: The program projects that for patients with favorable Stage 1 tumors the absolute OS benefit of therapy may be as low as 1% (of the same size as the risk of treatment related mortality), but for patients with Stage 2 and 3A disease the 5 yr OS benefit may be ∼10%. Conclusions: The impact of this tool on physician and patient knowledge about the adjuvant therapy of NSCLC will be presented. [Table: see text]

scholarly journals Gender Differences in Prognosis after Primary Resection for Retroperitoneal Liposarcoma

2021 ◽  
Author(s):  
Cheng-Xin Weng ◽  
Yu-Han Qi ◽  
Ji-Chun Zhao ◽  
Ding Yuan ◽  
Yi Yang ◽  
...  
Keyword(s):  
Survival Rates ◽  
Radical Resection ◽  
Primary Resection ◽  
Low Grade ◽  
Retroperitoneal Liposarcoma ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Abstract Background: Current evidence regarding gender difference in retroperitoneal liposarcoma (RLPS) is scarce, we sought to investigate whether gender may affect prognosis after primary resection of RLPS.Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify RLPS patients from January 1973 to December 2015. Multivariate cox proportional hazards analysis was adopted to generate adjusted hazard ratio (AHR) and 95% confidence intervals (CI) of survival outcomes.Results: In total, 2108 RLPS patients, including 971 women and 1137 men, were identified, with a median follow-up of 45.0 (17.0-92.0) months. The 5-year and 10-year overall survival rates were 50.5% and 31.5% for men, and 60.4% and 42.5% for women. The 5-year and 10-year disease-specific survival rates for men and women were 71.5%, 57.3% and 76.3%, 62.1%, respectively. We found men were associated with an increased risk of all-cause mortality (AHR 1.3, 95%CI 1.0-1.6, P=.017) but not disease-specific mortality (AHR 1.2, 95%CI 0.9-1.6, P=.246). The subgroup analyses revealed that men were associated with an increased risk of all-cause mortality in patients with low-grade tumors (AHR 1.8, 95%CI 1.3-2.5) or patients received non-radical resection (AHR 1.6, 95%CI 1.2-2.1). Besides, in the subgroup of low-grade tumors, men were also associated with an increased risk of disease-specific mortality (AHR 2.0, 95%CI 1.2-3.3).Conclusion: Men may have worse survival after primary resection of RLPS compared with women, especially in patients with low-grade tumors or patients received non-radical resection. Gender-based disparities may deserve more attention in patients with RLPS.

scholarly journals Increased neutrophil-to-lymphocyte ratio is associated with disease-specific mortality in patients with penile cancer

BMC Cancer ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Kasuga ◽  
Takashi Kawahara ◽  
Daiji Takamoto ◽  
Sachi Fukui ◽  
Takashi Tokita ◽  
...  
Keyword(s):  
Penile Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

scholarly journals Systematic review and meta-analysis on outcomes of salvage therapy in patients with tumour recurrence during ‘watch and wait’ in rectal cancer

2019 ◽  
Vol 101 (7) ◽  
pp. 441-452 ◽  
Author(s):  
J On ◽  
J Shim ◽  
EH Aly
Keyword(s):  
Rectal Cancer ◽  
Relative Risk ◽  
Salvage Therapy ◽  
Meta Analysis ◽  
Salvage Treatment ◽  
Watch And Wait ◽  
Conventional Surgery ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific

Introduction The ‘watch and wait’ approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence. Materials and methods A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Study quality was assessed using the Newcastle–Ottawa assessment scale. The main outcome was relative risks for overall and disease specific mortality in salvage therapy. Results Nine eligible studies were included in the meta-analysis. Of 248 patients who followed the watch and wait strategy, 10.5% had salvage therapy for recurrent disease. No statistical heterogeneity was found in the results. The relative risk of overall mortality in the salvage therapy group was 2.42 (95% confidence interval 0.96–6.13) compared with the group who had conventional surgery, but this was not statistically significant (P > 0.05). The relative risk of disease specific mortality in salvage therapy was 2.63 (95% confidence interval 0.81–8.53). Conclusion Our findings demonstrated that there was no significant difference in overall and disease specific mortality in patients who had salvage treatment following recurrence of disease in the watch and wait group compared with the standard treatment group. However, future research into the oncological safety of salvage treatment is needed.

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