Characterization of neuroblastic tumors as developmental cancers with survival determined by histology, age, and location.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10046-10046
Author(s):  
Karen Elizabeth Effinger ◽  
Lindsey Elizabeth Merrihew ◽  
Paul Graham Fisher
Keyword(s):  
Primary Tumor ◽  
Poor Response ◽  
Tumor Location ◽  
Population Based ◽  
Response To Therapy ◽  
Kaplan Meier ◽  
Chi Squared ◽  
Neuroblastic Tumors ◽  
Cox Proportional Hazard Regression ◽  
Head Neck

10046 Background: Mortality associated with peripheral neuroblastic tumors (pNT), comprising neuroblastoma (NB) and ganglioneuroblastoma (GNB), varies with some tumors spontaneously regressing and others showing poor response to therapy, indicating different biologic mechanisms. We aimed to determine how epidemiologic constructs inform the underlying biology of pNT. Methods: Using the Surveillance Epidemiology and End Results (SEER 18) population-based registry, we identified 3,540 pNT (3,003 NB and 537 GNB) in patients from 1973-2009. Differences in histology (NB vs. GNB), gender, age (<18 months, 18 months-4 years, 5-14 years, or ≥15 years), race (white, black, or other), location of primary tumor (adrenal, abdominal, chest, head/neck, pelvic, or other), and stage (locoregional vs. metastatic) were evaluated with chi-squared tests using SAS 9.3. Kaplan Meier curves with log-rank tests as well as univariate and multivariate Cox proportional hazard regression methods were employed to determine the influence of these factors on survival. Results: NB occurred more frequently in infants (50%), arose in the adrenals (45%), and were metastatic at diagnosis (57%), while GNB more often affected children 18 months-4 years (48%, p <0.001), occurred in the chest (31%, p <0.001), and were locoregional (78%, p <0.001). The 5-year overall survival (OS) rate in NB was 59% compared to 80% in GNB (p <0.001). In NB, the 5-year OS rate was 81% in infants <18 months and 21-39% in the older groups (p <0.001); however, in GNB, the 5-year OS was 40% in subjects >15 years and 81-93% in the younger groups (p <0.001). In multivariate analysis of pNT, neuroblastoma, age >18 months, adrenal site of primary tumor, and metastatic disease were independent poor prognostic factors. Chest (HR 0.27 [0.21-0.35]), head/neck (HR 0.34 [0.20-0.52]), and pelvic (HR 0.35 [0.24-0.52]) tumors had the most improved survival compared to adrenal primaries. Conclusions: Although pNT are often evaluated together, NB and GNB represent two significantly distinct diseases. For each, survival is strongly determined by age, primary tumor location, and stage. These differences may stem from unique developmental mechanisms underlying tumorigenesis.

scholarly journals Epidemiology and outcome of Gram-negative bloodstream infection in children: a population-based study

2010 ◽  
Vol 139 (5) ◽  
pp. 791-796 ◽  
Author(s):  
M. N. AL-HASAN ◽  
W. C. HUSKINS ◽  
B. D. LAHR ◽  
J. E. ECKEL-PASSOW ◽  
L. M. BADDOUR
Keyword(s):  
Incidence Rate ◽  
Bloodstream Infection ◽  
Population Based ◽  
Medical Conditions ◽  
Gram Negative ◽  
Source Of Infection ◽  
Kaplan Meier ◽  
Adjusted Incidence Rate ◽  
Cox Proportional Hazard Regression ◽  
Healthcare Associated

SUMMARYPopulation-based studies of Gram-negative bloodstream infection (BSI) in children are lacking. Therefore, we performed this population-based investigation in Olmsted County, Minnesota, to determine the incidence rate, site of acquisition, and outcome of Gram-negative BSI in children aged ⩽18 years. We used Kaplan–Meier method and Cox proportional hazard regression for mortality analysis. We identified 56 unique children with Gram-negative BSI during the past decade. The gender-adjusted incidence rate of Gram-negative BSI per 100 000 person-years was 129·7 [95% confidence interval (CI) 77·8–181·6]) in infants, with a sharp decline to 14·6 (95% CI 6·0–23·2) and 7·6 (95% CI 4·3–10·9) in children aged 1–4 and 5–18 years, respectively. The urinary tract was the most commonly identified source of infection (34%) and Escherichia coli was the most common pathogen isolated (38%). Over two-thirds (68%) of children had underlying medical conditions that predisposed to Gram-negative BSI. The overall 28-day and 1-year all-cause mortality rates were 11% (95% CI 3–18) and 18% (95% CI 8–28), respectively. Younger age and number of underlying medical conditions were associated with 28-day and 1-year mortality, respectively. Nosocomial or healthcare-associated acquisition was associated with both 28-day and 1-year mortality.

Use of tumor site as a prognosticator: Population-based analysis of rectosigmoid and rectum cancers

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4123-4123
Author(s):  
K. P. Raj ◽  
A. Ziogas ◽  
A. R. Barleben ◽  
M. J. Stamos ◽  
J. A. Zell
Keyword(s):  
Large Population ◽  
Prognostic Significance ◽  
Tumor Location ◽  
Population Based ◽  
Stage Ii ◽  
Clinical Factors ◽  
Distal Rectum ◽  
Kaplan Meier ◽  
Rectal Cancers ◽  
Using Data

4123 Background: The study examines the prognostic significance of tumor location exclusively in rectosigmoid and rectal cancers. Although tumor location has traditionally been regarded as a prognostic determinant, data in support of this claim are lacking. We set out to determine this using data from a large population-based California Cancer Registry (CCR). Methods: A retrospective analysis of surgically treated cancer cases involving the rectum and rectosigmoid from 1994–2006 with a follow-up until January 2008 in CCR was conducted. Sub-site tumor location of the cancers involving the rectum was either defined as rectosigmoid or mid/distal rectum. Site-specific survival analyses were conducted by Kaplan-Meier method and hazard ratio calculated using Cox proportional hazard ratios (HR). Results: A total of 33,418 rectal cancer cases were identified, including 12,407 (37.1%) rectosigmoid cancers and 21,011 (62.9%) mid/distal rectum cancers. No significant differences by tumor location were noticed for age, gender, stage, histological type, grade or socioeconomic status. Fewer rectosigmoid cancers received radiation (81.9% vs. 62.3% p=<0.0001)) compared to mid/distal rectum cancers. After adjustment for treatment and relevant clinical factors, an improved rate of CRC-specific survival was noticed in non-metastatic rectosigmoid cancers when compared to cancers involving the mid/distal rectum. A significant decrease in mortality was observed in Stage-I [HR- 0.74(0.63–0.86)], Stage-II [HR-0.76(0.69–0.85)] and Stage-III [HR- 0.90 (0.83–0.98)] rectosigmoid cancers when compared to mid/distal rectum cancers. Number of lymph nodes examined (>12 vs. <12) was an independent prognostic factor for survival in Stage-II patients [HR-0.74 (0.63–0.87)]. Conclusions: Among locoregional cases, rectosigmoid cancers were found to have an improved CRC-specific survival compared to mid/distal rectum cancers, which was independent of other relevant clinical factors. [Table: see text] No significant financial relationships to disclose.

Prognostic impact of primary tumor location in advanced urothelial carcinoma: The EORTC series.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16034-e16034
Author(s):  
Marco Moschini ◽  
Shahrokh F. Shariat ◽  
Maria De Santis ◽  
Joaquim Bellmunt ◽  
Cora N. Sternberg ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Performance Status ◽  
Distant Metastases ◽  
Tumor Location ◽  
Upper Urinary Tract ◽  
High Dose ◽  
Significant Heterogeneity ◽  
Prognostic Impact ◽  
Primary Tumor Location ◽  
Cox Proportional Hazard Regression

e16034 Background: The prognostic relevance of the primary location of urothelial cell carcinoma (UCC) on outcomes is poorly documented. This parameter has been studied in 3 EORTC trials in advanced UCC that included patients with different initial primary tumor locations. Methods: We used the data prospectively collected in three EORTC advanced UCC studies 30924 (M-VAC versus High dose M-VAC), 30986 (MCAVI versus GC, among patients unfit for CDDP), 30987 (GC-Paclitaxel versus GC, among patients fit for CDDP). Ineligible patients and other tumor locations were excluded. Patients all had measureable distant metastases or unresectable UCC and WHO performance status 0-2. Patients were grouped by primary tumor location as bladder (BCa) versus upper urinary tract (UTUC). PFS and OS by tumor location was tested in Cox proportional hazard regression stratified by study and treatment using at 2-sided α of 0.05. Results: Of the 1,039 patients, 85.3% and 14.7% patients had BCa and UTUC, respectively. Patient and disease characteristics (Table) suggested better performance status and slightly more males among patients with GCa. With a median follow up of 4.8 years (IQR:4.0-6.7), 733 deaths were recorded and 925 had progressed or died. OS and PFS did not differ significantly by tumor location overall (P=0.317 and P=0.685 respectively, Table 1), but there is significant heterogeneity across treatments (heterogeneity P=0.0450 for OS and P=0.0121 for PFS) with a suggestion of differential results in the M-CAVI arm for unfit patients. Conclusions: Primary UTUC location is uncommon in advanced UCC and did not seem to markedly impact PFS or OS. However, the findings may vary according to treatment. [Table: see text]

Small leucine-rich proteoglycans expression in colorectal cancer: Differences by primary tumor location.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 721-721
Author(s):  
Maria Del Pilar Solis Hernandez ◽  
Natalia Perez Lopez ◽  
Yolanda Garcia Mesa ◽  
Ivan Fernandez-Vega ◽  
Olivia García-Suárez ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Primary Tumor ◽  
Core Protein ◽  
Tumor Location ◽  
Small Sample ◽  
Rank Test ◽  
Test Results ◽  
Colorectal Tissue ◽  
Kaplan Meier ◽  
Fresh Frozen

721 Background: SLRP are present in normal and tumor colorectal tissue, with different patterns of expression, being predominant in L CRC. However, due to the small sample the differences observed in survival were no statistically significative. These alterations could be related to interactions at the extracellular matrix level. Further prospective and larger analysis are needed for a better comprehension of tumor microenvironment. Aims: To describe SLRP expression pattern by PTL and survival rate. Methods: 32 tumor specimens and their respective healthy tissue (fresh frozen tissue) from primary tumor surgery from the local biobank: 12 right-sided (R) & 20 left-sided (L) CRC. Transcriptomic approach to analyze SLRP core protein transcriptions using RT-PCR in Those with significative differences were confirmed by immunohistochemistry. Survival analysis was performed using Kaplan-Meier curves and log rank test. Results: Both sides showed BGN 2-fold overexpression (R p = 0.015, L p = 0.001) and OGN decreased 4-3-fold (R p = 0.038, L p < 0.001). PODNL was only expressed in tumor tissue. Additionally, alterations in other 4 genes in L CRC: PODN 2-fold p = 0.003, CHAD 4-fold p = 0.017, DCN 2fold p = 0.047 and PRELP 3-fold p = 0.003. EPYC was only expressed in 50% of L CRC. No difference in ASPN, FMOD, LUM, ECM2, KERA, OMD, TSK. Neither it was in PRELP for L CRC nor EPYC and DCN in R CRC. No expression of OPTC was found. No significative differences in survival were found. Median relapse-free survival (RFS) was 25 months (mo), 10.75 mo R CRC and 19.47mo L CRC. BGN overexpression (44%) was related with worse RFS (14 vs 19mo), better in L CRC (12 vs 19mo). OGN decrease (17%) showed better RFS (40 vs 16mo) favoring L CRC (21 vs 17mo). Overall survival displayed a similar behavior. Conclusions: SLRP are present in normal and tumor colorectal tissue, with different patterns of expression, being predominant in L CRC. However, due to the small sample the differences observed in survival were no statistically significative. These alterations could be related to interactions at the ECM level. Further prospective and larger studies are needed for a better comprehension of tumor microenvironment.

Factors Predicting Survival in ALS Patients - Data from a Population-Based Registry in Rhineland-Palatinate, Germany

2015 ◽  
Vol 44 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Joachim Wolf ◽  
Anton Safer ◽  
Johannes C. Wöhrle ◽  
Frederick Palm ◽  
Wilfred A. Nix ◽  
...  
Keyword(s):  
Rating Scale ◽  
Population Based ◽  
Predictor Variables ◽  
Survival Prognosis ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Bulbar Onset ◽  
Cox Proportional Hazard Regression ◽  
Als Patients ◽  
Population Based Registry

Background: The possibility to survive with amyotrophic lateral sclerosis (ALS) varies considerably and survival extends from a few months to several years. A number of demographic and clinical factors predicting survival have been described; however, existing data are conflicting. We intended to predict patient survival in a population-based prospective cohort of ALS patients from variables known up to the time of diagnosis. Methods: Incident ALS patients diagnosed within three consecutive years were enrolled and regularly followed up. Candidate demographic and disease variables were analysed for survival probability using the Kaplan-Meier method. The Cox proportional hazard regression model was used to assess the influence of selected predictor variables on survival prognosis. Results: In the cohort of 193 patients (mean age 65.8, standard deviation 10.2 years), worse prognosis was independently predicted by older age, male gender, bulbar onset, probable or definite ALS according to El Escorial criteria, shorter interval between symptom onset and diagnosis, lower Functional Rating Scale, diagnosis of frontotemporal dementia, and living without a partner. Conclusions: Taking into account these predictor variables, an approximate survival prognosis of individual ALS patients at diagnosis seems feasible.

Short and long-term survival in metastatic pancreatic adenocarcinoma, 1993-2013.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 232-232 ◽  
Author(s):  
Talia Golan ◽  
Tal Sela ◽  
Ofer Margalit ◽  
Uri Amit ◽  
Naama Halpern ◽  
...  
Keyword(s):  
Marital Status ◽  
Tumor Location ◽  
Population Based ◽  
Phase Iii ◽  
Term Survival ◽  
Modest Improvement ◽  
Kaplan Meier ◽  
Phase Iii Trials ◽  
Study Population ◽  
One Year

232 Background: Over the previous two decades several new agents have been approved for the treatment of metastatic pancreatic cancer (mPDAC). Their efficacy was demonstrated amongst highly selected patients that participate in randomized phase III trials, hence it is not clear to what extent these advances are reflected within the broader mPDAC population. We performed a population-based survival analysis of newly diagnosed patients who presented with mPDAC. Methods: Survival statistics were extracted from the Survival, Epidemiology and End Results (SEER) Database for patients diagnosed with mPDAC between 1993-2013. Demographic variables collected included age, gender, race, and marital status. Tumor characteristics collected included location and grade. Survival was analyzed using the Kaplan-Meier method and proportional hazard models as appropriate. Exclusion criteria included diagnosis at autopsy, unknown histology and pancreatic neuroendocrine tumors. Results: The study population consisted of 57,263 patients diagnosed with mPDAC from 1993-2013, 52% male, median age 69 years (range 15-104). Prognosis correlated with age, gender, race, marital status, tumor location, grade and year of diagnosis. Median overall survival (OS) stayed stable at 2 months between 1993 and 2013. Improvements in OS were seen for all patients, but especially for younger patients ( < 50 years of age) and more recent year of diagnosis group (2009-2013). The percentage of patients who died within two months of initial diagnosis decreased between 1993 and 2013 (from 63.5% to 50.6%, p < 0.0001). The subgroup of patients achieving longer-term survival has increased, with 12-month survival improving from 4.9 % to 12.7% (p < 0.0001) between 1993 and 2013. Conclusions: There has been a continuous but modest improvement in OS of patients diagnosed with mPDAC between 1993 and 2013. The percentage of patients living beyond one year has significantly increased over time; however the percentage of patients dying within 2 months has only slightly decreased.

scholarly journals Impact of the Spinal Instability Neoplastic Score on Surgical Referral Patterns and Outcomes

2018 ◽  
Vol 25 (1) ◽  
pp. 53 ◽  
Author(s):  
M. Dosani ◽  
S. Lucas ◽  
J. Wong ◽  
L. Weir ◽  
S. Lomas ◽  
...  
Keyword(s):  
Spinal Metastases ◽  
Population Based ◽  
Spinal Instability ◽  
Kaplan Meier ◽  
Chi Squared ◽  
Ct Simulation ◽  
Secondary Outcomes ◽  
Student’S T ◽  
Spine Surgeon

Background The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adverse events.Methods We retrospectively reviewed ct simulation scans and charts of consecutive patients receiving palliative spine rt between 2012 and 2013. Data were analyzed using Student’s t-test, Chi-squared, Fisher’s exact, and Kaplan-Meier log-rank tests. Patients were stratified into low (<7) and high (≥7) sins groups.Results We included 195 patients with a follow-up of 6.1 months. The median sins was 7. The score was 0 to 6 (low, no referral recommended), 7 to 12 (intermediate, consider referral), and 13 to 18 (high, referral suggested) in 34%, 59%, and 7% of patients, respectively. Eleven patients had pre-rt referral to spine surgery, with a surgery performed in 0 of 1 patient with sins 0 to 6, 1 of 7 with sins 7 to 12, and 1 of 3 with sins 13 to 18. Seven patients were referred to a surgeon post-rt with salvage surgery performed in two of those patients. Primary and secondary outcomes did not differ between low and high sins groups.Conclusion Higher sins was associated with pre-rt referral to a spine surgeon, but most patients with high sins were not referred. Higher sins was not associated with shorter survival or worse outcome following rt.

scholarly journals MR-guided microwave ablation of hepatocellular carcinoma (HCC): is general anesthesia more effective than local anesthesia?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaonan Li ◽  
Chaoyan Wang ◽  
Jing Li ◽  
Zaoqu Liu ◽  
Dechao Jiao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Microwave Ablation ◽  
Cox Regression ◽  
Tumor Location ◽  
Factors Affecting ◽  
Kaplan Meier ◽  
Main Factors ◽  
Cox Proportional Hazard Regression

Abstract Background Percutaneous magnetic resonance-guided (MR-guided) MWA procedures have traditionally been performed under local anesthesia (LA) and sedation. However, pain control is often difficult to manage, especially in some cases when the tumor is large or in a specific location, such as near the abdominal wall or close to the hepatic dome. This study retrospectively compared the results of general anesthesia (GA) and local anesthesia (LA) for MR-guided microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC ≤ 5.0 cm) to investigate whether different anesthesia methods lead to different clinical outcomes. Methods The results of the analysis include procedure-related complications, imaging response, and the time to complete two sets of procedures. According to the type of anesthesia, the Kaplan-Meier method was used to compare the local tumor progression (LTP) of the two groups who underwent MR-guided MWA. Results All patients achieved technical success. The mean ablation duration of each patient in the GA group and LA group was remarkably different (P = 0.012). Both groups had no difference in complications or LTP (both P > 0.05). Notably, the tumor location (challenging locations) and the number of lesions (2–3 lesions) could be the main factors affecting LTP (p = 0.000, p = 0.015). Univariate Cox proportional hazard regression indicated that using different anesthesia methods (GA and LA) was not associated with longer LTP (P = 0.237), while tumor location (challenging locations) and the number of lesions (2–3 lesions) were both related to shorter LTP (P = 0.000, P = 0.020, respectively). Additionally, multivariate Cox regression further revealed that the tumor location (regular locations) and the number of lesions (single) could independently predict better LTP (P = 0.000, P = 0.005, respectively). Conclusions No correlation was observed between GA and LA for LTP after MR-guided MWA. However, tumors in challenging locations and the number of lesions (2–3 lesions) appear to be the main factors affecting LTP.

scholarly journals Population-Based Survival Analysis of Patients With Limb Rhabdomyosarcoma and Metastasis at Diagnosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chunying Yang ◽  
Haiqing Wang ◽  
Feng Niu ◽  
Lufeng Yao
Keyword(s):  
Poor Prognosis ◽  
Population Based ◽  
Tumor Subtype ◽  
Male Predominance ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Appropriate Treatment ◽  
Younger Age ◽  
Relative Rarity ◽  
Cox Proportional Hazard Regression

Purpose: Given the poor prognosis and the relative rarity of patients diagnosed with limb rhabdomyosarcoma (LRMS) and metastasis at diagnosis, we performed this study to reveal distinctive clinical features and evaluated prognostic factors of this special population in order to provide appropriate treatment.Patients and Methods: We carried out retrospective research of patients diagnosed with LRMS and metastasis from 1975 to 2016 using the Surveillance, Epidemiology, and End Results (SEER) program database. Survival curves were generated by applying the Kaplan–Meier method. In terms of evaluating and determining independent predictors of survival, we conducted univariate and multivariate survival analyses using the Cox proportional hazard regression model.Results: This retrospective analysis contained a series of 245 patients with metastatic LRMS, with male predominance (male vs. female, 1.6:1). Nearly half of the patients were diagnosed with alveolar rhabdomyosarcoma (44.9%). According to the results of the univariate and multivariate analyses, younger age, tumor subtype, and radiotherapy were found to be significantly associated with improved overall survival (OS) and cause-specific survival (CSS).Conclusions: Patients with LRMS and metastasis at diagnosis experienced a quite poor prognosis. Age at diagnosis, tumor subtype, and radiotherapy can help clinicians to better estimate the prognosis. This study indicated that local radiotherapy can provide a survival benefit.

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