Survival outcomes based on race in gastric carcinoma: A SEER database analysis.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 5-5
Author(s):  
N. Didwaniya ◽  
R. J. Edmonds ◽  
P. T. Silberstein ◽  
S. Subbiah
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Survival Rates ◽  
Tumor Grade ◽  
The United States ◽  
Lymph Node Involvement ◽  
Tnm Staging ◽  
Treatment Modalities ◽  
Seer Database ◽  
Cancer Specific Survival

5 Background: Gastric cancer is one of the leading causes of cancer related deaths worldwide with the incidence declining in the United States. However the prognosis remains poor with variable survivals being reported among different races. We analyzed the effect of race on patterns of disease presentation and survival rates using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: A total of 9,851 patients were diagnosed with gastric cancer from year 2004 to 2007 were identified from SEER database. Age, race, TNM staging, grade, treatment modalities utilized and cancer specific survival was collected. Results: Out of 9,851 patients, 64.63% were white, 12.17% were black, and 13.04% were Asian-Pacific islanders. Median age was 73 years for whites, 70 years in blacks, and 71 years in Asians. Sex distribution amongst races was more or less similar with 58.83% of whites, 59.47% of blacks, and 54.24% of Asians being men. 23.62% of whites had T1 lesions, 28.10% had T2, 19.58% were T3 and 28.70% had T4 lesions. 26.76% of blacks presented with T1 lesions, 26.63% with T2, 16.08% with T3 and 30.53% with T4. 18.69% of Asians had T1 lesions, 26.84% with T2, 23.44% had T3 and 31.03% had T4 lesions. 37.80% of whites, 36.70% of blacks, and 44.44% of Asians had lymph node involvement. Tumor grade was similar among all races. Surgery was performed in 31.49% of whites, 33.13% of blacks, and 40.48% of Asians. 14.68% of whites, 14.10% of blacks, and 19.43 % of all Asians underwent radiation therapy. Median overall survival in localized disease was 44 months, 43 months and 98 months (p < 0.0001) while in regional disease it was 16 months, 15 months and 23 months in whites, blacks and Asians respectively (p < 0.0001). Median survival in distant disease was 4 months in both whites and blacks; it was 5 months in Asians (p < 0.0001). Conclusions: Cancer-specific survival in gastric carcinoma is significantly better in localized, regional and metastatic disease in Asians when compared to whites and blacks independent of T stage, grade, nodal involvement and treatment modalities utilized. The reason for this observation is unclear, exposure and genetic factors are potential causes and this needs to be investigated. No significant financial relationships to disclose.

scholarly journals Study of Human Epidermal Growth Factor Receptor 2 (HER2) Expression in Gastric Carcinoma

2020 ◽  
Vol 7 (47) ◽  
pp. 2747-2751
Author(s):  
Lekshmi Vijayakumaran Nair Lilly ◽  
Geetha Sukumaran
Keyword(s):  
Gastric Cancer ◽  
Growth Factor ◽  
Gastric Carcinoma ◽  
Survival Rates ◽  
Growth Factor Receptor ◽  
Intestinal Type ◽  
Treatment Modalities ◽  
Her2 Overexpression ◽  
Her2 Expression ◽  
Her2 Positive

BACKGROUND Gastric carcinoma is an important cause of cancer related mortality worldwide. Majority of the patients are diagnosed in the advanced stage of the disease. The main treatment modalities are surgery and chemotherapy, but the survival rate of patients with advanced resectable gastric cancer remains poor. For patients with unresectable gastric cancer, chemotherapy remains the treatment of choice. Into this scenario comes the importance of newer targeted therapeutic agents which improve survival rates with acceptable toxicity effects. HER2 is a growth factor implicated in disease initiation and progression, and its expression is associated with a poor prognosis. The aim of this study is detection of HER2 expression in gastric carcinoma and evaluate its relationship with the histopathological characteristics. This would be the stepping stone for patients with tumours that are HER2 positive who could benefit from targeted therapeutical agents like Trastuzumab. METHODS Gastrectomy specimens which were diagnosed as Gastric Carcinoma in the Department of Pathology, Government Medical College, Trivandrum, during a period of two years were included in this study. Routine Haematoxylin and Eosin staining and immunohistochemistry for HER2 were done. RESULTS Thirty eight cases of gastric carcinoma were received during the study period. Intestinal type adenocarcinoma formed the bulk of the tumours (68.42 %), followed by the diffuse type adenocarcinoma (18.42 %). Of the 38 cases, 10 cases showed HER2 positivity. All the positive cases were intestinal type of adenocarcinomas. CONCLUSIONS Our study concluded that 26 % of gastric carcinomas showed positive immunoreaction for HER2 and HER2 overexpression was more in intestinal type adenocarcinomas. HER2 overexpression was also associated with higher stage tumours. There was no association with the patient’s age, gender, location of tumour and tumour differentiation. KEYWORDS Gastric Carcinoma, HER2 expression, Immunohistochemistry, Lauren Classification

scholarly journals Hemangiopericytoma: Incidence, Treatment, and Prognosis Analysis Based on SEER Database

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Kewei Wang ◽  
Fei Mei ◽  
Sisi Wu ◽  
Zui Tan
Keyword(s):  
Retrospective Cohort ◽  
Patient Survival ◽  
Tumor Grade ◽  
Clinicopathological Characteristics ◽  
Clinical Usefulness ◽  
Treatment Modalities ◽  
Study Cohort ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Patient Prognosis

Background. Hemangiopericytomas are rare tumors derived from pericytes surrounding the blood vessels. The clinicopathological characteristics and prognosis of hemangiopericytoma patients remain mostly unknown. In this retrospective cohort study, we assessed the clinicopathological characteristics of hemangiopericytoma patients, as well as the clinical usefulness of different treatment modalities. Material and Methods. We collected the clinicopathological data (between 1975 and 2016) of hemangiopericytoma and hemangioendothelioma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence, treatment, and patient prognosis were assessed. Results. Data from 1474 patients were analyzed in our study cohort (hemangiopericytoma: n = 1243 ; hemangioendothelioma: n = 231 ). The incidence of hemangiopericytoma in 2016 was 0.060 per 100,000 individuals. The overall survival (OS) and cancer-specific survival (CSS) did not differ between patients with hemangioendothelioma and those with hemangiopericytoma ( P = 0.721 , P = 0.544 ). The tumor grade had no effect on the OS of hemangiopericytoma patients. Multivariate analysis revealed the clinical usefulness of surgery in hemangiopericytoma patients ( HR = 0.15 , 95% confidence interval: 0.05-0.41, P < 0.001 ). In contrast, radiotherapy did not improve OS ( P = 0.497 ) or CSS ( P = 0.584 ), and chemotherapy worsened patient survival ( P < 0.001 ). Additionally, the combination of surgery and radiotherapy had a similar effect with surgery alone on hemangiopericytoma patient survival (OS: P = 0.900 ; CSS: P = 0.156 ). Surgery plus chemotherapy provided a worse clinical benefit than surgery alone ( P < 0.001 ). Conclusions. Our findings suggested that hemangiopericytoma had a similar prognosis with hemangioendothelioma. Surgery was the only effective treatment that provided survival benefits in hemangiopericytoma patients, while the clinical usefulness of adjuvant chemotherapy or radiotherapy was limited.

scholarly journals Evaluation of the Eighth Edition of the American Joint Committee on Cancer TNM Staging System for Gastric Cancer: An Analysis of 7371 Patients in the SEER Database

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Long-Long Cao ◽  
Jun Lu ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
Jia-Bin Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rates ◽  
Stage Iv ◽  
Staging System ◽  
Tnm Staging ◽  
Stage Migration ◽  
Seer Database ◽  
Tnm System ◽  
American Joint Committee ◽  
Tnm Staging System

Objective. To investigate the validity of the 8thedition of the American Joint Committee on Cancer (AJCC) TNM staging system for gastric cancer.Methods. The clinicopathologic data of 7371 patients who were diagnosed with gastric cancer and had 16 or more involved lymph nodes (LNs) were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and retrospectively reviewed.Results. Stage migration occurred primarily during stage III between the 7thand 8thedition TNM staging systems. Stages IIIB and IIIC in the 7thedition staging system were divided in the 8thedition and had obvious differences in survival rates (bothP<0.001). The 8thedition TNM stages IIIC and IV showed similar survival rates (P=0.101). The prognosis of patients with T4aN3bM0 was not different from that of patients with TxNxM1 (P=0.433), while the prognosis of patients with T4bN3bM0 was significantly poorer than that of patients with TxNxM1 (P=0.008). A revised TNM system with both T4aN3bM0 and T4bN3bM0 incorporated into stage IV was proposed. Multivariable regression analysis showed that the revised TNM system, but not the 7thand 8theditions, was an independent factor for disease-specific survival (DSS) in the third step of the analysis. Further analyses revealed that the revised TNM system had superior discriminatory ability to the 8thedition staging system, which was also an improvement over the 7thedition staging system.Conclusion. The 8thedition of the AJCC TNM staging system is superior to the 7thedition for predicting the DSS rates of gastric cancer patients. However, for better prognostic stratification, it might be more suitable for T4aN3bM0/T4bN3bM0 to be incorporated into stage IV in the 8thedition TNM staging system.

scholarly journals Development and Validation of Prognostic Nomogram for Patients With Small Intestinal Neuroendocrine Carcinoma

2020 ◽  
Author(s):  
Guangrong Lu ◽  
Limin Wu ◽  
Jiajia Li ◽  
Yushan Xia ◽  
Xuchao Zhang ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Staging System ◽  
Tumor Grade ◽  
Tnm Staging ◽  
Calibration Plot ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Discrimination Power ◽  
Tnm Staging System ◽  
Small Intestinal

Abstract Small intestinal neuroendocrine carcinomas (SI NECs) are diagnosed very rarely, and the prognosis is extremely poor due to the metastatic disease of most patients at the time of diagnosis. This study aimed to establish nomogram models for prognostic evaluation of SI NEC in both overall survival (OS) and cancer-specific survival (CSS). Patients diagnosed with SI NEC between 2010 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and further randomly divided into the training and validating cohorts at a ratio of 7:3. Univariate and multivariate cox analysis was conducted to determine significant variables for construction of nomogram. The performance of the nomogram models were then assessed by concordance index (C-index), calibration plot and the area receiver operating characteristic (ROC) curve (AUC). A total of 1110 patients were retrospectively selected from the SEER database. Multivariate models revealed that age, tumor grade, American Joint Committee for Cancer (AJCC) stage, surgery and chemotherapy all showed a significant association with OS and CSS. The discrimination of nomogram for OS prediction was superior to that of the 7th AJCC Tumor-Node-Metastasis (TNM) staging system (C-index = 0.798, 95% CI, 0.762 - 0.833 vs 0.623, 95% CI, 0.580 - 0.666, P < 0.001). Similar results were also observed in CSS nomogram. Well-corresponded calibration plots were noticed using the nomograms. The comparisons of AUC values showed that the established nomograms exhibited better discrimination power than 7th TNM staging system for OS and CSS prediction. In conclusion, we have successfully established novel nomograms for predicting OS and CSS in patients with SI NEC, which can assist clinicians in making predictions about individual patient survival and provide improved treatment strategies.

scholarly journals Value of Radiotherapy in Primary Gastric Cancer and Establishment of a Prognostic Nomogram Model

2020 ◽  
Author(s):  
Tongchao Jiang ◽  
Nan Li ◽  
Haishuang Sun ◽  
Tongcui Jiang
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cox Regression ◽  
Tumor Grade ◽  
Rank Test ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Primary Tumor Site ◽  
Entire Cohort

Abstract Background: This study aimed to compare the use of radiotherapy (RT) in gastric cancer (GC) patients from the SEER database and established a nomogram to assess cancer-specific survival (CSS).Methods: Patients from the SEER database between 2004 and 2013 were analyzed. Survival was analyzed by Kaplan-Meier curves and log-rank test. Prognostic factors in multivariate Cox analysis were screened to construct a nomogram. The performance the nomogram was validated via concordance index (C-index), calibration plots, and decision curve analyses (DCAs). Results: 9653 GC patients were analyzed totally. In the entire cohort, patients who received pre/postoperative RT had better survival than those who did not receive RT (P = 0.043 and < 0.001, respectively). Similar results were observed in lymph node-positive patients. However, no significant survival benefit was seen in lymph node-negative patients between postoperative RT group and no RT group (P = 0.057), but patients who received postoperative RT and those who did not receive RT experienced better survival than those who received preoperative RT (P < 0.001 and 0.001, respectively). Prognostic factors of GC analyzed by Cox regression model included age, race, tumor grade, tumor histology type, primary tumor site, T stage, lymph node metastasis ratio, RT status, and chemotherapy information independently (P < 0.001). The nomogram was established and showed excellent prediction performance, and its C-index of 0.725 were significantly higher than those of nomograms based AJCC system with C-index at 0.643. In addition, the calibration plots performed good consistency between the predicted and actual survival probabilities, and the DCAs indicated better clinical net benefits than the traditional AJCC system.Conclusions: RT can improve CSS in GC patients, especially those with positive lymph nodes. The construction and verification of a nomogram based on SEER database can effectively predict the survival outcomes of GC patients.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

scholarly journals Clinicopathological characteristics and prognostic factors of cervical adenocarcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Wang ◽  
Bo Yuan ◽  
Zhen-huan Zhou ◽  
Wei-wei Han
Keyword(s):  
Prognostic Factors ◽  
Tumor Size ◽  
Survival Rates ◽  
Tumor Grade ◽  
Figo Stage ◽  
Cervical Adenocarcinoma ◽  
Stage Ii ◽  
Prognostic Indicators ◽  
Rank Test ◽  
Cancer Specific Survival

AbstractWe aimed to assess the clinicopathological features and to determine the prognostic factors of cervical adenocarcinoma (AC). Relevant data were extracted from surveillance, epidemiology and end results database from 2004 to 2015. The log-rank test and Cox proportional hazard analysis were subsequently utilized to identify independent prognostic factors. A total of 3102 patients were identified. The enrolled patients were characterized by higher proportion of early FIGO stage (stage I: 65.9%; stage II: 14.1%), low pathological grade (grade I/II: 49.1%) and tumor size ≤ 4 cm (46.8%). The 5- and 10-year cancer-specific survival rates of these patients were 74.47% and 70.00%, respectively. Meanwhile, the 5- and 10-year overall survival (OS) rates were 71.52% and 65.17%, respectively. Multivariate analysis revealed that married status, surgery as well as chemotherapy were independent favorable prognostic indicators. Additionally, aged > 45, tumor grade III/IV, tumor size > 4 cm, advanced FIGO stage and pelvic lymph node metastasis (LNM) were unfavorable prognostic factors (all P < 0.01). Stratified analysis found that patients without surgery could significantly benefit from chemotherapy and radiotherapy. In addition, chemotherapy could significantly improve the survival in stage II–IV patients and radiotherapy could only improve the survival in stage III patients (all P < 0.01). Marital status, age, grade, tumor size, FIGO stage, surgery, pelvic LNM and chemotherapy were significantly associated with the prognosis of cervical AC.

scholarly journals Molecular genetic changes in gastric carcinoma

2021 ◽  
Vol 6 ◽  
pp. 30-46
Author(s):  
Juhi Singh ◽  
Puneet Kumar ◽  
Khushi Verma ◽  
Satyender Kumar Tiwary ◽  
Gopeshwar Narayan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Wide Spectrum ◽  
Molecular Genetic ◽  
Survival Rates ◽  
High Throughput Analysis ◽  
Genetic Changes ◽  
Genetic Level ◽  
New Biomarkers

Gastric cancer remains highly prevalent and accounts for a notable proportion of global cancer mortality and this is associated with poor survival rates. Understanding the molecular genetic changes of gastric carcinoma may offer an insight into its pathogenesis helps in identifying new biomarkers, aid prognostication, and novel treatment targets. Over a past few decades, advances in technology and high throughput analysis have improved understanding of the molecular genetic aspects of gastric cancer. In this article, hierarchy of the changes at genetic and molecular level including several aspects which are heterogenous and represents a wide spectrum such as tumor suppressor genes, oncogenes, cellcycle regulators, apoptosis, cell-adhesion molecules, loss of heterozygosity, microsatellite instability, and epigenetic changes. The classification of gastric carcinoma at molecular and genetic level as well as hereditary gastric carcinoma is elaborated. The molecular genetic aspects regarding pathogenesis, changes and aberrations of all genes and pathways which are involved in gastric cancer are addressed in this review.

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