The impact of racial disparity on outcomes of patients with early-stage uterine endometrioid carcinoma in an equal-access environment.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5088-5088
Author(s):  
Jared R. Robbins ◽  
Benjamin S. Laser ◽  
Neal Bhat ◽  
Chad Cogan ◽  
Adnan Munkarah ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
African American ◽  
Racial Disparity ◽  
Molecular Mechanisms ◽  
Early Stage ◽  
Uterine Cancer ◽  
Peritoneal Cytology ◽  
Endometrioid Carcinoma ◽  
The Impact ◽  
Disease Specific

5088 Background: To determine if racial disparity exists between African American (AA) and non-African American (NAA) patients with early stage uterine endometrioid carcinoma who had similar multidisciplinary management. Methods: Our prospectively-maintained database of 1,450 uterine cancer patients was reviewed for this IRB-approved study. We identified 766 consecutive patients with endometrioid carcinoma 1988 FIGO stages I-II who underwent hysterectomy between 1987-2009. Patients with non-endometrioid carcinoma, mixed histologies and those who received preoperative treatments were excluded. For the purpose of data analysis, patients were divided into two groups; AA and NAA. Recurrence-free survival (RFS), disease specific (DSS) and overall survival (OS) was calculated from the date of hysterectomy using the Kaplan-Meier method. Cox regression modeling was used to explore the risks of various factors on recurrence. Results: Median follow-up was 5.1 years. 27% were AA and 73% were NAA. All patients underwent hysterectomy and oophorectomy. 80% had peritoneal cytology and 69% underwent lymphadenectomy. AA patients were more likely to have higher grade tumors, and more lymphovascular space involvement (LVSI). Although the two groups were balanced in regards to surgical staging and adjuvant treatment received, the five-year RFS and DSS were significantly lower in AA compared to NAA patients (91% vs 84%, p=0.030; 95% vs 88%, p=0.011, respectively). Between the two groups, OS was not significantly different. On multivariate analysis and after adjusting for other prognostic factors, race (AA vs NAA) was not a significant predictor of outcome. Grade 3 tumors and the presence of LVSI were the only two independent predictors of RFS and DSS with p=<0.001 and p=<0.001, respectively. Conclusions: In this large hospital-based study, AA race was associated with a higher incidence of adverse pathological features and worse recurrence-free and disease-specific survival. However, on multivariate analysis race was not an independent prognostic factor. Further studies are needed to elucidate possible underlying molecular mechanisms for these poorer outcomes.

scholarly journals miR-224 targets BTRC and promotes cell migration and invasion in colorectal cancer

3 Biotech ◽  
2020 ◽  
Vol 10 (11) ◽  
Author(s):  
Qi Zheng ◽  
Jane J. Yu ◽  
Chenggang Li ◽  
Jiali Li ◽  
Jiping Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cell Migration ◽  
Protein Expression ◽  
Molecular Mechanisms ◽  
Early Stage ◽  
Luciferase Assay ◽  
Migration And Invasion ◽  
Cell Migration And Invasion ◽  
Normal Tissues ◽  
The Impact

AbstractOur study aims to investigate the impact of miR-224 on cell migration and invasion in colorectal cancer (CRC) as well as its molecular mechanisms. The results showed that miR-224 was significantly upregulated in CRC compared to normal tissues via the TCGA database. Overexpression of miR-224 promoted CRC cell migration and invasion, while inhibition of miR-224 demonstrated the opposite result via transwell assays. In addition, we found that BTRC was a target gene of miR-224 through the miRecords database and dual-luciferase assay, while western blot together with RT-qPCR showed that inhibition of miR-224 led to elevated BTRC expression in protein level but not in mRNA level, and also decreased the expression of β-catenin. In reference to the Human Protein Atlas, BTRC protein expression was higher in normal tissues than in CRC tissues. In conclusion, miR-224 regulates its target BTRC protein expression and its related Wnt/β-catenin pathway. Its impact on cell migration and invasion in CRC cells suggested that miR-224 could be a prospective therapeutic target for early-stage non-metastatic CRC.

Treatment of Lung Cancer in Medically Compromised Patients

2016 ◽  
pp. e484-e491
Author(s):  
Jeffrey Crawford ◽  
Paul Wheatley-Price ◽  
Josephine Louella Feliciano
Keyword(s):  
Lung Cancer ◽  
Socioeconomic Status ◽  
Clinical Trials ◽  
Molecular Mechanisms ◽  
Early Stage ◽  
Care Delivery ◽  
Advanced Lung Cancer ◽  
Early Stage Disease ◽  
Major Barrier ◽  
The Impact

Outcomes for patients with lung cancer have been improved substantially through the integration of surgery, radiation, and systemic therapy for patients with early-stage disease. Meanwhile, advances in our understanding of molecular mechanisms have substantially advanced our treatment of patients with advanced lung cancer through the introduction of targeted therapies, immune approaches, improvements in chemotherapy, and better supportive care. However, the majority of these advances have occurred among patients with good functional status, normal organ function, and with the social and economic support systems to be able to benefit most from these treatments. The aim of this article is to bring greater attention to management of lung cancer in patients who are medically compromised, which remains a major barrier to care delivery. Impaired performance status is associated with poor outcomes and correlates with the high prevalence of cachexia among patients with advanced lung cancer. CT imaging is emerging as a research tool to quantify muscle loss in patients with cancer, and new therapeutics are on the horizon that may provide important adjunctive therapy in the future. The benefits of cancer therapy for patients with organ failure are poorly understood because of their exclusion from clinical trials. The availability of targeted therapy and immunotherapy may provide alternatives that may be easier to deliver in this population, but clinical trials of these new agents in this population are vital. Patients with lower socioeconomic status are disproportionately affected by lung cancer because of higher rates of tobacco addiction and the impact of socioeconomic status on delay in diagnosis, treatment, and outcomes. For all patients who are medically compromised with lung cancer, multidisciplinary approaches are particularly needed to evaluate these patients and to incorporate rapidly changing therapeutics to improve outcomes.

Contralateral breast cancer: Effect of stage on survival after unilateral breast cancer.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 69-69
Author(s):  
Lori Uyeno ◽  
Carolyn E. Behrendt ◽  
Laura Kruper ◽  
Steven L. Chen ◽  
Courtney Vito
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Breast Cancer Survivors ◽  
Contralateral Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Early Stage ◽  
Contralateral Breast ◽  
Advanced Stage ◽  
The Impact

69 Background: Contralateral breast cancer (CBC) is the most common malignancy among breast cancer survivors. We investigated the impact of CBC on overall survival (OS) after unilateral primary breast cancer (UPBC) in women treated with mastectomy. Methods: Using the Surveillance Epidemiology End Results registry, we identified women age 25-80 diagnosed 1998-2006 with UPBC stage 0-III, treated with mastectomy and free of CBC at 1-year landmark. Subjects were split into test and validation samples. Follow-up continued until the earliest occurrence: death, end of 2008, or age 85. Primary risk factor was incident CBC, a time-dependent variable categorized as advanced-stage (IIB-IV), early-stage (0-IIA), or none. Proportional hazards regression adjusted for primary tumor characteristics, treatment including contralateral prophylactic mastectomy (CPM), demographics, and aging. Results: Subjects (n= 109,411, age 53.7[+12.7] years at UPBC diagnosis) were followed median 51 months. Most UPBC were early stage (63%), moderately/poorly differentiated (78%), ER+PR+ (52%). Few (9.8%) women underwent CPM at primary diagnosis. Incident CBC (n=867, 0.79%) was diagnosed median 23.5 (95% CI 1.2-72) months beyond the 1-year landmark. Test and validation samples did not differ. Only CBC of stage IIB-IV increased mortality; early stage CBC had no effect on OS. Among CBC cases, advanced stage was independently associated with aggressive UPBC (more positive nodes; larger tumor; greater extension), African-American race, and shorter time from UPBC. Conclusions: Among women who undergo mastectomy +/-CPM for UPBC, few develop CBC, which impacts survival only when diagnosed at advanced stage. Efforts to improve survival after UPBC should emphasize earlier detection and prevention of advanced-stage CBC, especially in African-American women and women with more aggressive UPBC. [Table: see text]

scholarly journals Survival Outcomes After Breast-Conserving Therapy Compared With Mastectomy for Patients With Early-Stage Invasive Micropapillary Carcinoma of the Breast: A SEER Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Song Wang ◽  
Yiyuan Zhang ◽  
Fangxu Yin ◽  
Xiaohong Wang ◽  
Zhenlin Yang
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Breast Carcinoma ◽  
Early Stage ◽  
Survival Outcomes ◽  
Invasive Micropapillary Carcinoma ◽  
Seer Database ◽  
Kaplan Meier ◽  
The Impact ◽  
Mastectomy Group

BackgroundInvasive micropapillary breast carcinoma (IMPC) is a relatively rare pathological type of invasive breast cancer. Little is currently known on the efficacy and safety of breast-conserving treatment (BCT, lumpectomy plus postsurgical radiation) compared with mastectomy in women diagnosed with early-stage IMPC. Accordingly, we sought to investigate the long-term prognostic differences between BCT and mastectomy in patients with T1-3N0-3M0 invasive micropapillary breast carcinoma using data from the Surveillance, Epidemiology, and End Results (SEER) database.Materials and MethodsWe retrospectively analyzed 1,203 female patients diagnosed with early-stage IMPC between 2004 and 2015 from the SEER database. The impact of different surgical approaches on patient prognosis was assessed by the Kaplan-Meier method and Cox proportional risk models.ResultsA total of 609 and 594 patients underwent mastectomy and BCT, respectively. Compared with patients who underwent a mastectomy, patients in the BCT group were older and had lower tumor diameters, lower rates of lymph nodes metastasis, and higher rates of ER receptor positivity and PR receptor positivity (p &lt; 0.05). Kaplan-Meier plots showed that the overall survival (OS) and breast cancer-specific survival (BCSS) were higher in the BCT group than in the mastectomy group. In subgroup analysis, patients with T2 stage in the BCT group had better OS than the mastectomy group. Multivariate analysis showed no statistical difference in OS and BCSS for patients in the mastectomy group compared with the BCT group (hazard ratio (HR) = 0.727; 95% confidence interval (95% CI) 0.369–1.432, p = 0.357; HR = 0.762; 95% CI 0.302–1.923, p = 0.565; respectively). During the multivariate analysis and stratifying for the T stage, a better OS was found for patients with T2 stage in the BCT group than the mastectomy group (HR = 0.333, 95% CI: 0.149–0.741, p = 0.007). There was no significant difference in OS for patients with T1 and T3 stages between the BCT and mastectomy groups (p &gt; 0.05).ConclusionIn women with early-stage IMPC, BCT was at least equivalent to mastectomy in terms of survival outcomes. When both procedures are feasible, BCT should be recommended as the standard surgical treatment, especially for patients with T2 disease.

The impact of lymphadenectomy in women with endometrioid uterine cancer: A study of 39,396 women

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5000-5000
Author(s):  
N. Karnik Lee ◽  
H. Wu ◽  
M. K. Cheung ◽  
K. Osann ◽  
A. Husain ◽  
...  
Keyword(s):  
African American ◽  
Uterine Cancer ◽  
Myometrial Invasion ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Stage Ii ◽  
Surgical Staging ◽  
Uterine Cancers ◽  
Grade 3 ◽  
The Impact

5000 Background: To determine the potential benefit of lymphadenectomy (LNX) during surgical staging procedure in women with early and advanced endometrioid uterine cancers. Methods: Demographic and clinico-pathologic information were obtained from the Surveillance, Epidemiology and End Results program from 1988 to 2001. Data were analyzed by using Kaplan-Meier methods and Cox proportional hazards regression. Results: Of 39,396 women (median age: 65; range 19–102) with endometrioid uterine cancers, 12,333 (31.3%) underwent a surgical staging procedure with LNX. The remainder received a hysterectomy and bilateral salpingo-oophorectomy only. 34,871 (88.5%) were Caucasian, 1,742 (4.4%) were African-American, 1,841 (4.7%) were Asian and 942 (2.4%) were other. The 5-year disease-specific survivals (DSS) were 93.3%, 85.4%, 69.3%, and 38.3% in patients with FIGO stage I-IV diseases, respectively. The 5-year DSS of stage I-IV women who underwent LNX were 95.5%, 90.4%, 73.0%, and 53.3% compared to 96.6%, 82.3%, 61.2%, and 28.2% in those without LNX. Those with stage II (p < 0.001), III (p < 0.001), and IV (p < 0.001) diseases after LNX had significantly better survival; however, the benefit of LNX was not demonstrated in stage I disease. The proportion of stage I patients with grade I histology or tumors limited to the endometrium was significantly higher in those who did not receive LNX compared to those who did (54.8% vs. 34.7%; p < 0.001 for grade I disease; 26.6% vs. 15.9%; p < 0.001 for non-myometrial invasion). In stage I grade 3 endometrioid uterine cancer, patients with LNX had a better 5-year DSS than those without LNX (90.0% vs. 84.97%; p = 0.0001); however, these findings were not seen in grade I (p = 0.26) and grade II (p = 0.14) diseases. In the subset of patients with stage IC grade 3 disease, there was a trend toward an improvement in survival associated with LNX (81.7% vs. 76.5%; p = 0.07). In the overall study group, younger age, African-American race, advanced stage disease, grade 3 histology, and lymphadenectomy. Conclusions: Our data suggest that lymphadenectomy improves the survival of women with stage I grade 3, stage II-IV endometrioid uterine cancers. No significant financial relationships to disclose.

The impact of lymphadenectomy on survival endpoints in women with early stage uterine endometrioid carcinoma: A matched analysis

2017 ◽  
Vol 210 ◽  
pp. 225-230 ◽  
Author(s):  
Ahmed I Ghanem ◽  
Nadia T. Khan ◽  
Meredith Mahan ◽  
Ahmed Ibrahim ◽  
Thomas Buekers ◽  
...  
Keyword(s):  
Early Stage ◽  
Endometrioid Carcinoma ◽  
Survival Endpoints ◽  
The Impact

scholarly journals Significance of Malignant Peritoneal Cytology on the Survival of Women with Early-Stage Cervical Cancer: A Japanese Gynecologic Oncology Group Study

2019 ◽  
Vol 8 (11) ◽  
pp. 1822 ◽  
Author(s):  
Koji Matsuo ◽  
Muneaki Shimada ◽  
Shinya Matsuzaki ◽  
Hiroko Machida ◽  
Yoshikazu Nagase ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Odds Ratio ◽  
Systemic Chemotherapy ◽  
Early Stage ◽  
Sensitivity Analyses ◽  
Peritoneal Cytology ◽  
Gynecologic Oncology Group ◽  
Early Stage Disease ◽  
Early Stage Cervical Cancer ◽  
The Impact

This study examined the association between peritoneal cytology and survival in early-stage cervical cancer. This is a nationwide multicenter retrospective study, examining consecutive women with clinical stage IB1-IIB cervical cancer who underwent radical hysterectomy with available peritoneal cytology results from 2004–2008. Propensity score inverse probability of treatment weighting was used to assess the impact of malignant peritoneal cytology on survival. Among 1409 analyzed cases, 88 (6.2%) had malignant peritoneal cytology. On weighted models, malignant peritoneal cytology was associated with decreased disease-free survival (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.36–2.32) and overall survival (OS, HR 1.93, 95% CI 1.44–2.59). On sensitivity analyses, malignant peritoneal cytology was associated with decreased OS in adenocarcinoma/adenosquamous carcinoma, high-risk early-stage disease and those who received concurrent chemo-radiotherapy. However, among women who received postoperative systemic chemotherapy, malignant peritoneal cytology was not associated with OS (HR 1.21, 95% CI 0.72–2.04). A systematic review, including our results, showed that malignant peritoneal cytology was associated with decreased OS (HR 4.03, 95% CI 1.81–8.99) and increased recurrence in squamous carcinoma (odds ratio 1.89, 95% CI 1.05–3.39) and adenocarcinoma (odds ratio 4.30, 95% CI 2.30–8.02). In conclusion, the presence of malignant cells in peritoneal cytology is associated with decreased survival in early-stage cervical cancer. The possible benefit of systemic chemotherapy in this subgroup merits further investigation.

The Impact of Tumor Grade on Survival End Points and Patterns of Recurrence of 949 Patients With Early-Stage Endometrioid Carcinoma: A Single Institution Study

2014 ◽  
Vol 24 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Omar H. Gayar ◽  
Suketu Patel ◽  
Daniel Schultz ◽  
Meredith Mahan ◽  
Nabila Rasool ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Early Stage ◽  
Tumor Grade ◽  
International Federation ◽  
Endometrioid Carcinoma ◽  
End Points ◽  
Gynecology And Obstetrics ◽  
Grade 3 ◽  
The Impact ◽  
Patterns Of Recurrence

ObjectivesThis study aimed to determine the impact of tumor grade on patterns of recurrence and survival end points in patients with endometrioid carcinoma 2009 International Federation of Gynecology and Obstetrics stages I-II.MethodsWe identified 949 patients who underwent hysterectomy between 1988 and 2011. Patients were divided into 3 groups based on tumor grade. Kaplan-Meier plots were generated for each group for recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS).ResultsMedian follow-up was 52 months. Median age was 60 years. All patients underwent total abdominal hysterectomy and salpingo-oophorectomy. Eighty percent of patients underwent lymph node dissection, 83% had peritoneal cytology. There were 76 (8%) patients who developed tumor recurrence. Tumor recurrence rates were significantly higher in patients with grade 3 tumors compared to grade 1 (P = 0.006). Additionally, patients with grade 3 tumors developed significantly more frequent distant metastases compared to patients with grade 1 (P = 0.002). Five-year RFS for the patients with grade 1, 2, and 3 were 95%, 82%, and 68%, respectively (P = <0.001). Five-year DSS was 99%, 93%, and 79%, respectively (P = <0.001). Five-year OS was 89%, 84%, and 63%, respectively (P = <0.001). Lymphovascular space involvement and grade were significant independent predictors of RFS and DSS. For OS age, lymphovascular space involvement, grade, and body mass index were significant predictors.ConclusionsInternational Federation of Gynecology and Obstetrics grade is a strong predictor of clinical survival end points in women with early-stage endometrioid carcinoma. The pattern of recurrence in patients with grade 3 tumors is mainly distant rather than locoregional. Further studies incorporating systemic therapy in the adjuvant settings in these patients are warranted.

The impact of race on outcomes of patients with early stage uterine endometrioid carcinoma

2013 ◽  
Vol 128 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Mohamed A. Elshaikh ◽  
Adnan R. Munkarah ◽  
Jared R. Robbins ◽  
Benjamin S. Laser ◽  
Neil Bhatt ◽  
...  
Keyword(s):  
Early Stage ◽  
Endometrioid Carcinoma ◽  
The Impact

scholarly journals The Connection Between Testicular Cancer, Minority Males, and Planned Parenthood

2018 ◽  
Vol 12 (5) ◽  
pp. 1774-1783 ◽  
Author(s):  
Wesley B. Adams ◽  
Michael J. Rovito ◽  
Mike Craycraft
Keyword(s):  
Health Care ◽  
African American ◽  
Testicular Cancer ◽  
Early Stage ◽  
The United States ◽  
Planned Parenthood ◽  
Black African ◽  
Minority Males ◽  
Screening Services ◽  
The Impact

Testicular cancer (TCa) is the most prevalent neoplasm diagnosed in males aged 15–40 years. Lack of access to care is a key impediment to early-stage TCa diagnosis. Health equity concerns arise, however, as poor access largely manifests within underserved male populations, therefore, placing them at a higher risk to develop late-stage TCa. Planned Parenthood Federation of America (PPFA) offers a myriad of male reproductive/sexual health care options, including TCa screening and referral services. Therefore, expanding these amenities in traditionally underserved communities may address the concern of TCa screening opportunities. An ecological analysis was performed using data from the United States Cancer Statistics, American Community Survey, and PPFA databases to assess the impact of TCa upon minority males, identify associations between PPFA services and minority males, and provide future implications on the role PPFA may play in bridging health-care access gaps pertaining to TCa screenings. Results indicate that states with higher rates of poverty and uninsured individuals, as well as specifically Black/African American males, have lower TCa incidence and limited access to screening services. PPFA service presence and Black/African American, as well as uninsured, males had a negative association but revealed positive correlations with TCa incidence. Considering the emerging TCa outcome disparities among minority males, expanding PPFA men’s health services is crucial in providing affordable options to help identify testicular abnormalities that are early stage or carcinoma in situ. Many at-risk males have limited means to obtain TCa screening services. Expanding this discussion could provide a foundation for future advocacy.

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