Would screening benefit 75- to 84-year-old patients with non-small cell lung cancer (NSCLC)?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7055-7055
Author(s):  
Jessica Lake ◽  
John Charles Flickinger ◽  
John M. Varlotto ◽  
Abram Recht ◽  
Malcolm M. DeCamp ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cox Regression ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Chi Square ◽  
Old Patients ◽  
Aggressive Therapy ◽  
Significant Difference ◽  
The Usa ◽  
Chi Square Test

7055 Background: The Lung Cancer Screening Trial has shown an overall survival (OS) benefit and reduced lung cancer mortality in the 55-74 age group (gp). We chose to evaluate whether NSCLC patients aged 75-84 are increasing in the USA and whether they would benefit from aggressive therapy. Methods: SEER-17 was used to calculate NSCLC rates during the years 2000-2008. SEER-9 was used to estimate the proportional change in both 55-74 and 75-84 gp from 1973-2008. OS was analyzed in a modern population from SEER-17 (2004-2008) to assess the effects of increasingly aggressive therapy (observation(Ob), radiation (RT) or lobectomy (LB)) for a proposed screening population with T1N0 tumors. Chi-square test and Cox Regression (CR) were used to evaluate OS. Paired T-tests assessed changes in rates and proportions over time. Results: The 55-74 gp rose from 64.4% in 1973 to 67.25% in 1984, but fell to 58.8% by 2008, while the 75-84 gp rose from 12.1% in 1973 to 24% in 2008 (p<0.01), similar in both sexes. The rates/100,000 have been increasing in the 75-84 gp (p=0.02), mainly in females (p=0.003) while the rates in the 55-74 gp did not vary, but fell for men (p=0.03). In the Ob gp (n=1344), NSCLC was the most common cause of death (COD) in the 55-74 (29.8%) and 75-84 gp (40.6%), more than all other CODs combined (median survival (MS) = 11mn). CR revealed that OS was associated with the 55-74 gp (0.59) and females (0.62) (p < 0.001). In the RT gp (n=1870), MS was 14mn and lung cancer was the most common COD at 27.7% (55-74) and 28.8% (75-84), again more than all other CODs combined. CR found that females (0.68) and black race (0.72) had better OS (p<0.017), but age was not. MS was 24 mn in the LB group (n=9384). COD from NSCLC and all other CODs was 8.2% and 6.1% (55-74) and 10.9% and 11.4% (75-84). CR showed that 55-74 (0.36), females (0.58), and Asians (0.73) had lower death rates (all p<0.015). Mean OS between the 55-74 (26.0) and 75-84 (24.2) gp showed a small yet significant difference. Conclusions: Rates and proportions of NSCLC have been steadily increasing in the 75-84 gp. These data show that COD by lung cancer decreased significantly with increasingly aggressive treatment and treatment reduced the effects of age gp on survival. We feel that screening may be of benefit to the 75-84 gp.

Lung cancer: Significance of place of diagnosis.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 60-60
Author(s):  
Rohit Bishnoi ◽  
Chintan Shah ◽  
Jacobo Hincapie Echeverri ◽  
Katherine Robinson ◽  
Yu Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Emergency Department ◽  
Cox Regression ◽  
Health Care Cost ◽  
Small Cell ◽  
Cost Of Care ◽  
Chi Square ◽  
Kaplan Meier ◽  
Therapy Cost ◽  
Chi Square Test

60 Background: Patients who are diagnosed with lung cancer through emergency department tend to do poorly. We conducted a retrospective study to examine the effect of place of diagnosis on various cancer outcomes including survival, health care cost, and end-of-life (EOL) care. Methods: Patients who died from lung cancer between January 2015 and July 2017 were reviewed. Initial place of diagnosis was determined (Emergency Department/Urgent clinic (ED/UC) or Outpatient). Descriptive statistics, exact Pearson chi-square test, Kaplan-Meier method, and multivariable Cox regression model were used to compare the two groups. Results: 227 patients were included in the analysis. Median age at diagnosis was 65 years. 52% were male; 85% were white. 57% of patients were diagnosed through ED/UC, whereas 43% were diagnosed as part of an outpatient workup. Age, gender, race, and histology (small cell vs. non-small cell) did not vary significantly between the two groups. Rates of palliative care intervention and advance directives were similar. Patients diagnosed through ED/UC were more likely to be metastatic, have symptoms, and not receive any cancer directed therapy. Cost of care was similar between the two groups. Median survival in those who presented to ED/UC was significantly shorter (2.5 vs. 6.5 mo; p<0.001) with a hazard ratio of 1.7 (95% CI:1.3-2.3), even after adjusting for potential confounding factors (age, metastasis, insurance, smoking, treatment). Conclusions: Patients diagnosed with lung cancer through the ED/UC have worse outcomes than those diagnosed as an outpatient. Despite similar cost of care, survival outcomes are worse. This variable remains significant despite controlling for confounders in multivariate analysis.[Table: see text]

RADT-31. TREATMENT TRENDS AND SURVIVAL OUTCOMES IN ATYPICAL MENINGIOMA

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi48-vi48
Author(s):  
Yusef Syed ◽  
Manali Rupji ◽  
Jeffrey Switchenko ◽  
Bree Eaton ◽  
Jeffrey Olson ◽  
...  
Keyword(s):  
Survival Data ◽  
Cox Regression ◽  
Atypical Meningioma ◽  
Rank Test ◽  
Chi Square ◽  
Who Grade ◽  
Treatment Type ◽  
Significant Difference ◽  
Chi Square Test ◽  
Atypical Meningiomas

Abstract BACKGROUND WHO grade II (atypical) meningiomas are treated with surgical resection, often followed by adjuvant fractionated radiation therapy (FRT). The increased availability of frameless stereotactic radiosurgery (SRS) presents an opportunity to offer patients a high biological effective dose over fewer fractions. Here we study the patterns of care and outcomes of these two forms of adjuvant RT. METHODS Patients with atypical meningioma were abstracted from the National Cancer Database (NCDB). Descriptive statistics were reported, and differences between treatment groups were assessed using either a chi-square test or ANOVA. Patients were grouped by treatment type and Kaplan Meier (KM) analysis was performed to compare overall survival (OS) using a log rank test. Univariable (UVA) and multivariable (MVA) cox regression analyses were completed. RESULTS Of 10,015 cases diagnosed from 2004-2016, 7,153 received surgery alone, 2,059 received surgery and adjuvant FRT (S+RT), and 362 received adjuvant SRS (S+SRS). The use of adjuvant RT increased by 71.8% for S+RT and 97.8% for S+SRS. In 2004, 15.1% of 443 registered patients received S+RT and 2.26% received S+SRS, while in 2016 these figures were 26.0% and 4.47%, respectively, for the 1051 registered patients (p&lt; 0.001 and 0.022, respectively). For the 8,636 patients with survival data there was no significant difference in median OS between S+RT and S+SRS (130 months vs. 125 months, log rank p=0.935). On UVA, S+RT conferred better survival compared to surgery alone (HR 0.81 [0.72-0.91], p&lt; 0.001) while S+SRS trended towards better survival (HR 0.82 [0.64-1.06], p=0.124). On MVA, no significant OS benefit was seen with S+RT (HR 0.96 [0.85-1.08], p=0.491) or S+SRS (HR 0.90 [0.69-1.16], p=0.413) versus surgery alone. CONCLUSIONS While the use of adjuvant RT for atypical meningioma has increased substantially since 2004, OS is comparable between FRT and SRS. The data presented here support further prospective investigation of adjuvant SRS.

scholarly journals Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007

2014 ◽  
Vol 17 (1) ◽  
pp. 175-188 ◽  
Author(s):  
Mirian Carvalho de Souza ◽  
Ana Glória Godoi Vasconcelos ◽  
Marise Souto Rebelo ◽  
Paulo Antonio de Paiva Rebelo ◽  
Oswaldo Gonçalves Cruz
Keyword(s):  
Lung Cancer ◽  
National Cancer Institute ◽  
Multiple Correspondence Analysis ◽  
Smoking Status ◽  
Lung Cancer Mortality ◽  
Two Dimensions ◽  
Chi Square ◽  
Data Variability ◽  
Chi Square Test

INTRODUCTION: Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. OBJECTIVE: To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. METHODS: An observational study was conducted using INCA's database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance - pertaining to smokers and non-smokers - were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. RESULTS: There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages. CONCLUSION: Smoking cessation must be stimulated in a disseminated manner in the population in order to avoid new cases of lung cancer. The Tumors in Initial Stages Group stood out with greater chances of cure.

scholarly journals Contemporary issues in the implementation of lung cancer screening

2021 ◽  
Vol 30 (161) ◽  
pp. 200288
Author(s):  
Stephen Lam ◽  
Martin Tammemagi
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Population Level ◽  
Lung Cancer Mortality ◽  
Cost Effective ◽  
Resource Utilisation ◽  
Healthcare Resource Utilisation ◽  
The Usa ◽  
Screening Sensitivity

Lung cancer screening with low-dose computed tomography can reduce death from lung cancer by 20–24% in high-risk smokers. National lung cancer screening programmes have been implemented in the USA and Korea and are being implemented in Europe, Canada and other countries. Lung cancer screening is a process, not a test. It requires an organised programmatic approach to replicate the lung cancer mortality reduction and safety of pivotal clinical trials. Cost-effectiveness of a screening programme is strongly influenced by screening sensitivity and specificity, age to stop screening, integration of smoking cessation intervention for current smokers, screening uptake, nodule management and treatment costs. Appropriate management of screen-detected lung nodules has significant implications for healthcare resource utilisation and minimising harm from radiation exposure related to imaging studies, invasive procedures and clinically significant distress. This review focuses on selected contemporary issues in the path to implement a cost-effective lung cancer screening at the population level. The future impact of emerging technologies such as deep learning and biomarkers are also discussed.

scholarly journals Oro-facial malignancy in north of Iraq: a retrospective study of biopsied cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sura Ali Ahmed Fuoad ◽  
Dena Nadhim Mohammad ◽  
Marwa Abdul-Salam Hamied ◽  
Balkees Taha Garib
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Demographic Data ◽  
Chi Square ◽  
Old Patients ◽  
Significant Difference ◽  
Chi Square Test ◽  
Oral Malignancies

Abstract Background Identifying the prevalence of orofacial malignancies is essential to provide health-care programs and services for a specific population. This study aimed to specify the prevalence, clinical and histopathological features of oral malignancies in Sulaimani for over 12 years. Methods All archived reports for orofacial specimens from 2008 to 2019 were collected from three major centers in Sulaimani governorate. The demographic data, date, type of surgery, lesion's site, and diagnosis were recorded. The ICD-10 coding was specified for each case. A Chi-square test was used to assess differences between genders. A one-way ANOVA test was applied to analyze the differences in mean age distributions among different sites of oral malignancies and oral squamous cell carcinoma histopathological grades. P < 0.05 was considered significant. Results Orofacial malignant lesions account for 14.53% of the total sample. Patients' mean age was (55.46 ± 18.48) years, and they were predominantly males (M: F ratio = 1.15:1). The tongue was the frequently affected site (14.8%). A Chi-square test showed no significant difference between genders concerning age (P = 0.118), years of registration (P = 0.28), and site (P = 0.29). The C06 (represents; cheek mucosa C06.0, the vestibule of mouth C06.1, retromolar area C06.2, and other unspecified parts of mouth C06.8) was the most frequent topographical ICD-code (18.1%). Carcinoma was a frequent malignancy (63.2%). OSCC was the most common lesion (56.4%). It commonly affects males, and the tongue was the frequent site (24.1%) followed by lip (17.8%). Conclusions There is a slight increase in the registered oral malignancies in Sulaimani city over 12 years; they were predominated in males, in 61–70 years old patients, and being oral squamous cell carcinoma types.

scholarly journals Prognostic Analysis and Clinical Characteristics of Dual Primary Lung Cancer: A Population Study Based on Surveillance, Epidemiology, and End Results (SEER) Database

2021 ◽  
Author(s):  
Guanghui Wang ◽  
Yukai Zeng ◽  
Haotian Zheng ◽  
Xiaogang Zhao ◽  
Yadong Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Clinical Characteristics ◽  
Prognostic Model ◽  
Cox Regression ◽  
Primary Lung Cancer ◽  
Chi Square ◽  
Training Cohort ◽  
Cox Regression Analysis ◽  
Chi Square Test

Abstract Background: The peculiarity and the lack of clinical studies of dual primary lung cancer (DPLC) led to limited knowledge about its clinical characteristics and prognosis. The current study performed a retrospective analysis and established a prognostic nomogram to assess the prognostic factors and clinical characteristics of DPLC.Methods: A total of 1419 DPLC patients with pathological confirmation from SEER were selected and analyzed by univariate and multivariable Cox regression analyses. The independent prognostic factors were included to establish a nomogram. The accuracy and reliability of prognostic model were evaluated by C-indexes, calibration plots, receiver operating characteristic (ROC) curves, decision curve analyses (DCA) and integrated discrimination improvement (IDI) scores. Chi-square test was used to assess the differences between DPLC and single primary lung cancer (SPLC) or synchronous DPLC (sDPLC) and metachronous DPLC (mDPLC).Results: Cox regression analysis showed that age, sex, histological type, stage, LN metastasis, surgery, chemotherapy were independent prognostic factors, we included these factors to establish a prognostic model. In the training cohort, the C-index was 0.690, and the area under curves (AUC) of 3- and 5-year survival time were 0.720 and 0.723. The calibration plots in training cohort and validation cohort were in excellent agreement. DCA and IDI showed that the predictive effect of the novel prognostic model was better than the model based on 8th AJCC TNM system. Chi-square test indicated that DPLC and SPLC had statistical differences on pathological and clinical features.Conclusions: The clinical and pathological characteristics of DPLC were different from the SPLC. The nomogram based on significant factors could provide accurate and individualized survival predictions for DPLC.

A comparison of two models of multidisciplinary lung cancer care within a community-based healthcare system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 36-36
Author(s):  
Meghan Meadows ◽  
Meredith Ray ◽  
Matthew Smeltzer ◽  
Nicholas Faris ◽  
Carrie Fehnel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Cox Regression ◽  
Care Delivery ◽  
Smoking Status ◽  
Multidisciplinary Care ◽  
Chi Square ◽  
Community Healthcare ◽  
Lung Cancer Patients ◽  
Chi Square Test

36 Background: The Multidisciplinary Thoracic Oncology Conference (MTOC) model is easier to implement than the Multidisciplinary Clinic (MDC) model, but does not directly involve patients in decision-making. We compared the processes and outcomes of lung cancer care between patients discussed in a weekly MTOC versus those seen in a MDC. Methods: Prospective observational study of thoroughness of staging, stage confirmation (defined as biopsy of the stage-defining lesion), National Comprehensive Cancer Network guideline-concordant treatment, overall (OS) and event-free (EFS) survival of lung cancer patients in a community healthcare system’s MDC and MTOC from 2014-2019. We used the chi-square test and multivariable logistic regression to evaluate guideline-concordant treatment and stage confirmation; Kaplan-Meier curves and multivariable Cox regression were used to evaluate OS and EFS. We adjusted models for age, sex, race, insurance, smoking status, and histology. Results: 614 patients received care in MDC; 571 in MTOC. MDC patients were older (median age: 69 vs. 67); less likely to be active smokers (44% vs. 47%; p=0.03); more likely to have bimodal (98% v 95%, p=0.02) and trimodal staging (60% v 46%, p<0.0001). The stage-confirmation rate (OR: 1.55; 95% CI: 1.22-1.96) and mediastinal stage confirmation rate (OR: 1.55; 95% CI: 1.23-1.95) were both significantly higher in MDC, even after adjustment (aOR: 1.60; 95% CI: 1.25-2.03); (aOR: 1.58, 95% CI: 1.25-2.00). A higher proportion of patients received guideline-concordant treatment in MDC than in MTOC (82% vs. 73%; OR: 1.63; 95% CI: 1.21-2.20) even after adjustment (aOR: 1.64; 95% CI: 1.20-2.24). However, MTOC patients had significantly better OS (p=0.03) and EFS (p=0.001) than MDC patients and a lower hazard of death (HR: 0.81; 95% CI: 0.67-0.98), even after adjusting for confounding variables (aHR: 0.79 95%CI: 0.66-0.95). Conclusions: Although the processes of lung cancer care delivery were better in MDC than in MTOC, survival was better in MTOC. Patient selection may have played a role in these survival differences. The MTOC model, as implemented, seems competitive with the MDC model and is worthy of further exploration as a more feasible model of multidisciplinary care. [Table: see text]

The Influence of Age and Gender on Mandibular Indices among the Libyan Population

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Negative Correlation ◽  
Bone Mineralization ◽  
Age Groups ◽  
T Test ◽  
Chi Square ◽  
Age And Gender ◽  
Significant Difference ◽  
Chi Square Test ◽  
And Gender ◽  
Libyan Population

Radiographic Mandibular Indices serve as easy and relatively cheap tools for evaluating bone mineralization. Objectives: To examine the effect of age and gender on three mandibular indices: the panoramic mandibular index (PMI), the mandibular ratio (MR) and the mandibular cortical index (MCI), among Libyan population. Methods: The three indices were measured on 317 digital (OPGs) of adult humans (155 males, 162 females). The sample was divided into six age groups (from 18-25 years through 56-65 years). The measurements were analyzed for interactions with age and sex, using SPSS (Statistical Package for Social Studies) software version no. 22. The tests employed were two way ANOVA, the unpaired T-test and chi-square test. Results: The mean PMI fluctuated between 0.37 s.d. 0.012 and 0.38 s.d. 0.012. among the sixth age groups. One-way ANOVA statistical test revealed no significant of age on PMI. On the other hand gender variation has effect on PMI, since independent sample t-test disclosed that the difference between the male and female PMI means statistically significant. ANOVA test showed that the means of MR among age groups showed a negative correlation i.e. MR mean declined from 3.01 in 18-25 age groups to 2.7 in 55-65 age groups. In contrary, the gender showed no effect on MR according two sample t-test at p> 0.05. In regards with MCI, statistical analysis showed that it affected by age that is C1 was decreasing by age while C2 and C3 were increased by age. Using chi square test the result indicated that there is a significant difference among the different age group and the two genders in MCI readings. Conclusion: PMI was influenced significantly by age but minimally by the gender. MR is not affected by gender but has a negative correlation with age. MCI is affected by both age and gender

scholarly journals Prognostic significance of peritoneal cytology in low-risk endometrial cancer: comparison of laparoscopic surgery and laparotomy

2021 ◽  
Author(s):  
Satoe Fujiwara ◽  
Ruri Nishie ◽  
Shoko Ueda ◽  
Syunsuke Miyamoto ◽  
Shinichi Terada ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Prognostic Significance ◽  
Low Risk ◽  
Peritoneal Cytology ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Positive Peritoneal Cytology

Abstract Background There is uncertainty surrounding the prognostic value of peritoneal cytology in low-risk endometrial cancer, especially in laparoscopic surgery. The objective of this retrospective study is to determine the prognostic significance of positive peritoneal cytology among patients with low-risk endometrial cancer and to compare it between laparoscopic surgery and conventional laparotomy. Methods From August 2008 to December 2019, all cases of pathologically confirmed stage IA grade 1 or 2 endometrial cancer were reviewed at Osaka Medical College. Statistical analyses used the Chi-square test and the Kaplan–Meier log rank. Results A total of 478 patients were identified: 438 with negative peritoneal cytology (232 who underwent laparotomy and 206 who undertook laparoscopic surgery) and 40 with positive peritoneal cytology (20 who underwent laparotomy and 20 who received laparoscopic surgery). Survival was significantly worse among patients with positive peritoneal cytology compared to patients with negative peritoneal cytology. However, there was no significant difference among patients with negative or positive peritoneal cytology between laparoscopic surgery and laparotomy. Conclusion This retrospective study suggests that, while peritoneal cytology is an independent risk factor in patients with low-risk endometrial cancer, laparoscopic surgery does not influence the survival outcome when compared to laparotomy.

scholarly journals Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ye Wu ◽  
Zhen Zhang ◽  
Meng Liao ◽  
Qi Li ◽  
Xue Lin Tang ◽  
...  
Keyword(s):  
Binocular Vision ◽  
Refractive Surgery ◽  
Visual Symptom ◽  
Chi Square ◽  
Visual Symptoms ◽  
Significant Difference ◽  
Symptom Scores ◽  
Chi Square Test ◽  
Corneal Refractive Surgery ◽  
Normal Binocular Vision

Abstract Background To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population. Methods One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33 ± 4.60 years) were enrolled, the mean preoperative SE was − 1.51 ± 1.15 D (range: − 1.00- − 5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64 ± 3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision. Results No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P = 0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P = 0.094; BD: P = 0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001). Conclusions CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.

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