Use of tumor size to predict long-term survival in colon cancer patients: Analysis of National Cancer Data Base (NCDB).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3583-3583 ◽  
Author(s):  
Sukamal Saha ◽  
Mohammed Shaik ◽  
Supriya Kumar Saha ◽  
Alpesh K. Korant ◽  
Gregory Johnston ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Tumor Size ◽  
Cox Model ◽  
Tnm Staging ◽  
Tnm Stage ◽  
Term Survival ◽  
Cancer Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
N Status

3583 Background: Tumor size (TS) is a known prognostic factor in breast, renal, and lung cancers, however, not in colon cancer (CCa). Tumor (T) depth, nodal status (N), and metastasis (M) are used in the TNM staging. Hence, we studied if TS is an independent risk factor for death in CCa. Methods: Data included TS, grade, T-stage, N, and M-status from the NCDB for 298,021 CCa pts (1998-2010). We divided pts into 4 groups by TS (<2cm;2-4cm;4-6cm;>6cm). Data was analyzed using Spearman’s rho correlation (r) and Kaplan-Meier for overall 5-yr survival (5yrOS). Hazard ratios (HR) were calculated using a Cox model adjusting for age, sex, grade, T, N-status and TNM stage. Results: Proportion of pts with TS 0-2, 2-4, 4-6 and >6cm were 13.25%, 38.95%, 29.54%, and 18.26% respectively. Median TS was 4cm. TS was positively correlated with grade, T, N-status and TNM stage (p=0.0001) and negatively correlated with 5yrOS (65.5%, 52.4%, 45.5%, and 41.2% for four sizes respectively) (Table). Cox modeling demonstrated TS of 4-6cm and >6cm had HRs of 1.23 (95%CI 1.14-1.34) and 1.7 (95%CI 1.5-1.8) respectively. Conclusions: A primary TS of 4-6cm and >6cm is associated with a 23% and 70% increased risk of death, respectively, over 5-yrs in CCa. Prospective studies are needed to evaluate the role of primary TS in CCa prognosis. [Table: see text]

Tumor size as a prognostic indicator in colon cancer (CCa) patients undergoing sentinel lymph node mapping (SLNM) versus conventional surgery (CS) in National Cancer Data Base (NCDB).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 411-411
Author(s):  
Mohammed Shaik ◽  
Sukamal Saha ◽  
Supriya Kumar Saha ◽  
Gregory Johnston ◽  
Alpesh K. Korant ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Cox Model ◽  
Sentinel Lymph Node Mapping ◽  
Prognostic Indicator ◽  
Tnm Staging ◽  
Maximum Diameter ◽  
Lymph Node Mapping ◽  
Cancer Data ◽  
N Status

411 Background: Unlike other solid tumors, tumor size (TS) is not included in TNM staging for CCa. We correlated TS with TNM staging and 5-year overall survival (5yrOS) for patients (pts) who underwent SLNM vs CS in NCDB. Methods: A retrospectively review of 312 CCa pts undergoing SLNM compared to 298,021 CCa pts from NCDB undergoing CS between 1996 and 2010 was done. The maximum diameter of the primary tumor as TS, T and Nodal status were reviewed. Pts in each group was subdivided into 4 groups: (<2cm; 2-4cm; 4-6cm; >6cm). Data were analyzed using Spearman’s rho correlation and Kaplan-Meier for 5yrOS. Hazard ratios (HR) were calculated using a Cox model adjusting for age, sex, grade, T, N-status, and TNM stage. Results: Pts with TS <2 cm were mainly T1&T2 (80.7%, 74.8%), whereas for tumors >6cm, majority of pts were T3&T4 (93.2%, 88.8%). T1&T2 percentage consistently decreased as TS increased and T3&T4 percentage consistently increased with TS (Table). Nodal positivity according to tumor size for SLNM were 17%, 49%, 56%, 46% and for CS were 18%, 38%, 48%, 51%, respectively. In both groups, nodal positivity increased as TS increased. The overall nodal positivity in both groups was 46% and 42%. For SLNM and CS, overall survival decreased as TS increased. Overall SLNM pts had better OS when compared to CS pts (65%, 54%). Conclusions: Nodal +vity and overall survival where slightly better in SLMN pts. Vs CS pts. TS had +ve correlation with T staging and N status in 5 yr OS. Hence, TS may be considered a prognostic factor in CCa pts. [Table: see text]

Impact of nodal metastasis on survival of stage IV colon cancer: Analysis of National Cancer Data Base (NCDB).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3582-3582
Author(s):  
Mohammed Shaik ◽  
Alpesh K. Korant ◽  
Supriya Kumar Saha ◽  
Gregory Johnston ◽  
Vikrom K. Dhar ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Stage Iv ◽  
Nodal Metastasis ◽  
National Cancer Data Base ◽  
Node Negative ◽  
Cancer Data ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Increased Risk ◽  
The Impact

3582 Background: Nodal metastasis (mets) is an important prognostic factor in the staging of colon cancer (CCa). However, the significance of nodal mets in stage IV CCa remains undetermined. Therefore, we investigated the impact of nodal mets on 5 year overall survival (5-yr OS) in stage IV CCa. Methods: Patients (pts) from the NCDB who had been diagnosed with histologically confirmed Stage IVCCa from 1998-2010 were divided into two groups: with(+ve) or without(-ve) nodal mets and the 5 yr OS was compared using the Kaplan Meier Curves. Multivariate analysis was performed using CoxProportional regression model. An adjusted hazard ratio(aHR) was calculated for pts with nodal mets compared to those without nodal mets after adjusting for age, grade and tumor size. Results: 70,387 pts from the NCDB with stage IV CCa were included in our analysis. Of these, 12,363(17.5%) had no nodal mets (TN0M1), 23,052(32.7%) had 1-3 nodal mets (TN1M1), and 34,972 (49.69%) had 4 or more nodal mets (TN2M1) involved at the time of diagnosis (Table 1a).The overall nodal positivity was 82.4%. The 5-yrOS of all stage IV pts was 10.7% (Table 1b); 5 yr OS for node -ve pts was 18.4% versus 9.2% for node +ve pts (p<0.0001)(Table1b). The 5 yr OS of N1 and N2 was 12% and 7.2%, respectively. The aHR of pts with nodal mets versus without nodal mets was 1.8 (95% CI of 1.7-1.9), after adjusting other prognostic covariates. Conclusions: Stage IV CCa with nodal mets is associated with an increased risk of death compared to node-negative disease. The number of positive lymph nodes at the time of diagnosis is also an important risk factor. [Table: see text]

Tumor size predicts long term survival in colon cancer: an analysis of the National Cancer Data Base

2014 ◽  
Vol 219 (4) ◽  
pp. e77
Author(s):  
Sukamal Saha ◽  
Mohammed Shaik ◽  
Lindsay Berbiglia ◽  
Supriya K. Saha ◽  
Gregory Johnston ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Data Base ◽  
Tumor Size ◽  
National Cancer Data Base ◽  
Term Survival ◽  
Long Term Survival ◽  
Cancer Data

Tumor size predicts long-term survival in colon cancer: an analysis of the National Cancer Data Base

2015 ◽  
Vol 209 (3) ◽  
pp. 570-574 ◽  
Author(s):  
Sukamal Saha ◽  
Mohammed Shaik ◽  
Gregory Johnston ◽  
Supriya Kumar Saha ◽  
Lindsay Berbiglia ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Data Base ◽  
Tumor Size ◽  
National Cancer Data Base ◽  
Term Survival ◽  
Long Term Survival ◽  
Cancer Data

Prognostic impact of chemoradiation-related lymphopenia in patients with gastric and gastroesophageal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 249-249
Author(s):  
Daniel W Kim ◽  
Grace Lee ◽  
Theodore S. Hong ◽  
Guichao Li ◽  
Eric Roeland ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cox Model ◽  
Gastroesophageal Junction ◽  
Concurrent Chemotherapy ◽  
Rank Test ◽  
Prognostic Impact ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ecog Ps

249 Background: Limited data exists on how chemoradiation (CRT)-induced lymphopenia affects survival outcomes in patients with gastric and gastroesophageal junction (GEJ) cancer. We evaluated the association between severe lymphopenia and its association with survival in gastric and GEJ cancer patients treated with CRT. We hypothesized that severe lymphopenia would be a poor prognostic factor. Methods: We performed a retrospective analysis of 154 patients with stage 1-3 gastric or GEJ cancer who underwent CRT at our institution. Patients underwent photon-based radiation therapy (RT) with a median dose of 50.4 Gy (IQR 45.0-50.4 Gy) over 28 fractions and concurrent chemotherapy (CTX) with carboplatin/paclitaxel, 5-fluorouracil based regimen, or capecitabine. 49% received CTX prior to RT. 84% underwent surgical resection, 57% pre-CRT and 26% post-CRT. Absolute lymphocyte count (ALC) at baseline and at 2 months since initiating RT were analyzed. Severe lymphopenia, defined as Grade 3 or worse lymphopenia (ALC < 0.5 k/μl), was analyzed for any association with overall survival (OS). Results: Median time of follow up was 48 months. Median age was 65. 77% were male and 86% were Caucasian. ECOG PS was 0 or 1 in 90% and 2 in 10%. Tumor location was stomach in 38% and GEJ in 62%. Timing of CRT was preoperative among 68% and postoperative among 32%. The median ALC at baseline for the entire cohort was 1.6 k/ul (range 0.3-7.0 k/ul). At 2 months post-CRT, 49 (32%) patients had severe lymphopenia. Patients with severe lymphopenia post-CRT had a slightly lower baseline TLC compared to patients without severe lymphopenia (median TLC 1.4 k/ul vs. 1.6 k/ul; p = 0.005). There were no differences in disease and treatment characteristics between the two groups. On the multivariable Cox model, severe lymphopenia post-CRT was significantly associated with increased risk of death (HR = 3.99 [95% CI 1.55-10.28], p = 0.004). ECOG PS 2 (HR = 34.97 [95% CI 2.08-587.73], p = 0.014) and postoperative CRT (HR = 5.55 [95% CI 1.29-23.86], p = 0.021) also predicted worse OS. The 4-year OS among patients with severe lymphopenia was 41% vs. 61% among patients with vs. without severe lymphopenia (log-rank test p = 0.041). Conclusions: Severe lymphopenia significantly correlated with poorer OS in patients with gastric or GEJ cancer treated with CRT. CRT-induced lymphopenia may be an important prognostic factor for survival in this patient population. Closer observation in high-risk patients and treatment modifications may be potential approaches to mitigating CRT-induced lymphopenia.

Requirement for Etoposide in the Treatment of Epstein-Barr Virus–Associated Hemophagocytic Lymphohistiocytosis

2001 ◽  
Vol 19 (10) ◽  
pp. 2665-2673 ◽  
Author(s):  
Shinsaku Imashuku ◽  
Kikuko Kuriyama ◽  
Tomoko Teramura ◽  
Eiichi Ishii ◽  
Naoko Kinugawa ◽  
...  
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Epstein Barr Virus ◽  
Cox Model ◽  
Short Interval ◽  
Prognostic Significance ◽  
Rank Test ◽  
Term Survival ◽  
Barr Virus ◽  
Risk Of Death ◽  
Epstein Barr

PURPOSE: We sought to identify the clinical variables most critical to successful treatment of Epstein-Barr virus (EBV)–associated hemophagocytic lymphohistiocytosis (HLH). PATIENTS AND METHODS: Among the factors tested were age at diagnosis (< 2 years or ≥ 2 years), time from diagnosis to initiation of treatment with or without etoposide-containing regimens, timing of cyclosporin A (CSA) administration during induction therapy, and the presence or absence of etoposide. RESULTS: By Kaplan-Meier analysis, the overall survival rate for the entire cohort of 47 patients, most of whom had moderately severe to severe disease, was 78.3% ± 6.7% (SE) at 4 years. The probability of long-term survival was significantly higher when etoposide treatment was begun less than 4 weeks from diagnosis (90.2% ± 6.9% v 56.5% ± 12.6% for patients receiving this agent later or not at all; P < .01, log-rank test). Multivariate analysis with the Cox proportional hazards model demonstrated the independent prognostic significance of a short interval from EBV-HLH diagnosis to etoposide administration (relative risk of death for patients lacking this feature, 14.1; 95% confidence interval, 1.16 to 166.7; P = .04). None of the competing variables analyzed had significant predictive strength in the Cox model. However, concomitant use of CSA with etoposide in a subset of patients appears to have prevented serious complications from neutropenia during the first year of treatment. CONCLUSION: We conclude that early administration of etoposide, preferably with CSA, is the treatment of choice for patients with EBV-HLH.

Tumor size as a prognostic factor for colon cancer patients undergoing sentinel lymph node mapping and conventional surgery.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14046-e14046
Author(s):  
Sukamal Saha ◽  
Mohammed Nawaf Kanaan ◽  
Mohammad Mozayen ◽  
Philip Gafford ◽  
Mohammed Saifullah Shaik ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Prognostic Factor ◽  
Tumor Size ◽  
Sentinel Lymph Node Mapping ◽  
Tnm Staging ◽  
Conventional Surgery ◽  
Lymph Node Mapping ◽  
Adenocarcinoma Of The Colon

e14046 Background: Unlike other solid tumors, tumor size (TS) is not a part of the TNM staging system for colon cancer. Our goal is to correlate TS with TNM staging, nodal positivity (NP), and 5-year overall survival (OS) for patients (pts) with invasive colon cancer undergoing sentinel lymph node mapping (SLNM) vs. conventional surgery (CS). Methods: A retrospective review of 681 pts with invasive adenocarcinoma of the colon were reviewed and divided into two groups of pts (SLNM and CS). These groups were subdivided according to the size of the tumor in four groups (0-2, 2-4, 4-6 and more than 6 cm). 461 pts underwent SLNM between 1996-2010 compared to 220 pts who underwent CS between 1996-2006. The pathology reports reviewed for TS (the maximum diameter of the primary tumor), T staging, and NP. The OS was calculated from the social security database. Then all data was compared between both groups. Results: Pts with tumors <2cm were mainly T1+T2 (72%, 70%), whereas tumors >6 cm, majority of pts wereT3+T4 (94%, 85%). T1+T2 percentage consistently decreased as TS increased, and T3+T4 percentage was increasing consistently with increased TS (Table 1A). NP according to TS for SLNM pts were (16%, 53%, 56%, 48%) NP and for CS pts were (15%, 32%, 34%, 39%). In both groups, NP increased as TS increased compared to 0-2 cm group. The overall NP in both groups was 47% and 31% (Table 1B). OS for SLNM and CS pts were calculated in each group according to TS. Overall SLNM pts had better OS when compared to CS pts (65 %, 54%). Conclusions: Increasing TS was consistent with increasing T staging for both SLNM and CS pts. NP and OS were worse with increased TS for SLNM and CS pts. SLNM pts had higher NP and better outcome in OS when compared to CS pts, hence TS should be considered as a prognostic factor in pts with adenocarcinoma of the colon. [Table: see text] [Table: see text]

Tumor size as a prognostic factor for patients with colon cancer undergoing sentinel lymph node mapping and conventional surgery.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 546-546 ◽  
Author(s):  
Sukamal Saha ◽  
Mohammed Nawaf Kanaan ◽  
Mohammed Shaik ◽  
Benjamin Abadeer ◽  
Alpesh Korant ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Prognostic Factor ◽  
Tumor Size ◽  
Sentinel Lymph Node Mapping ◽  
Tnm Staging ◽  
Maximum Diameter ◽  
Conventional Surgery ◽  
Lymph Node Mapping

546 Background: Unlike other solid tumors, tumor size (TS) is not a part of the TNM staging for colon cancer (CC). Our goal is to correlate TS with TNM staging, nodal positivity(NP), and 5-year overall survival (OS) for patients (pts) with invasive CC undergoing sentinel lymph node mapping (SLNM) vs. conventional surgery (CS). Methods: A retrospective review of 681 pts with invasive CC were reviewed and divided into two groups of pts (SLNM and CS). The pts in these two groups were subdivided according to the TS in four groups (0-2, 2-4, 4-6 and more than 6 cm). 461 pts underwent SLNM between 1996-2010 compared to 220 pts who underwent CS between 1996-2006. The pathology reports reviewed for TS (the maximum diameter of the primary tumor), T staging, and NP. The OS was calculated from the social security database and our hospital cancer registry. Then all data was compared between both groups. Results: Pts with TS <2cm were mainly T1+T2 (72%, 70%), whereas tumors >6 cm, majority of pts wereT3+T4 (94%, 85%). T1+T2 percentage consistently decreased as TS increased, and T3+T4 percentage was increasing consistently with increased TS (Table 1A). NP according to TS for SLNM pts were (16%, 53%, 56%, 48%) NP and for CS pts were (15%, 32%, 34%, 39%). In both groups, NP increased as TS increased compared to 0-2 cm group. The overall NP in both groups was 47% and 31% (Table 1B). OS for SLNM and CS pts were calculated in each group according to TS. Overall SLNM pts had better OS when compared to CS pts (65 %, 54%). Conclusions: Increasing TS was consistent with increasing T staging for both SLNM and CS pts. NP and OS were worse with increased TS for SLNM and CS pts. SLNM pts had higher NP and better outcome in OS when compared to CS pts, hence TS should be considered as a prognostic factor in pts with adenocarcinoma of the colon. [Table: see text]

Prognosis of gastric cancer (GC) patients with positive peritoneal cytology.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 41-41
Author(s):  
Hironori Shiozaki ◽  
Elena Elimova ◽  
Rebecca Slack ◽  
Hsiang-Chun Chen ◽  
Gregg A Staerkel ◽  
...  
Keyword(s):  
Overall Survival ◽  
Diagnostic Laparoscopy ◽  
Cox Model ◽  
Peritoneal Metastases ◽  
Patient Treatment ◽  
Cancer Center ◽  
Peritoneal Cytology ◽  
Term Survival ◽  
Risk Of Death ◽  
One Year

41 Background: Laparoscopic staging of patients with GC can disclose peritoneal metastases. Although this finding is associated with a poor prognosis, some patients achieve a long-term survival. In an attempt to provide explanation we compared the overall survival (OS) of patients with GC peritoneal metastases from two settings: cytology positive only (Cy+) and grossly positive (Gross+). Methods: 146 GC patients with peritoneal metastases were identified between 2000 and 2014. Cox-model regression was used for overall survival (OS) analyses. Results: Patient/treatment characteristics were as follows: males (66%), good ECOG scores (0-1; 89%), metastases confirmed by a diagnostic laparoscopy (84%), poorly differentiated histology(92%), received chemotherapy (89%), received chemoradiation (22%), and received surgery (10%). The median follow-up time for all patients was 12.9 months and median OS was 15 months. Patients with Gross+ were at higher risk of death compared to Cy+ patients (50% vs. 83%1-year OS, respectively). Only diagnostic laparoscopy and metastasis type (Gross+ vs. Cy+) were significant in both univariate and multivariate OS models. With both factors in the same model, patients with Gross+ were more than twice as likely to die when compared to those with Cy+ (HR=2.23; p=0.001) while patients having a diagnostic laparoscopy were half as likely to die (HR=0.52; p=0.01). Conclusions: The one-year OS of patients with Cy+ peritoneal metastases is significantly longer than those with Gross+ findings. As such, novel strategies for Cy+ patients may further prolong their survival. From U. T. M. D. Anderson Cancer Center (UTMDACC), Houston, Texas, USA. (Supported in part by UTMDACC, and CA 138671 and CA172741 from the NCI).

Maximum tumor dimension and tumor volume as prognostic factors in patients with newly diagnosed localized Ewing sarcoma (ES)- a report from the Children’s Oncology Group (COG).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11529-11529
Author(s):  
Leo Mascarenhas ◽  
Allen Buxton ◽  
Steven G. DuBois ◽  
Dian Wang ◽  
Nadia N. Laack ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Prognostic Factors ◽  
Tumor Size ◽  
Tumor Volume ◽  
Cox Model ◽  
Rank Test ◽  
Newly Diagnosed ◽  
Phase 3 ◽  
Increased Risk ◽  
Significant Difference

11529 Background: Maximum tumor dimension > 8 cm. and large tumor volume have been reported to be adverse prognostic factors in patients with ES but have not been prospectively evaluated in the context of a phase 3 clinical trial with interval compressed chemotherapy. Methods: COG AEWS1031 (NCT01231906) was a randomized phase 3 clinical trial comparing interval compressed chemotherapy regimens in patients with newly diagnosed localized ES of bone and soft tissue. A correlative objective of AEWS1031 was to evaluate tumor size and volume as prognostic factors. Institution-reported dimensions of the primary tumor from baseline imaging were prospectively collected. For inclusion in this analysis, patients had to have at least 1 tumor dimension reported for tumor size analyses and dimensions in 3 axes for tumor volume analyses. Maximum dimension was dichotomized as less than vs. > / = 8cm. Tumor volume was dichotomized as less than vs. > / = 200 mL. Event-free (EFS) and overall survival (OS) from enrollment were calculated using Kaplan-Meier methods and compared between groups using a two-sided log-rank test. Hazard ratios (HR) and confidence intervals (CI) were calculated using the Cox model. Results: The 5-year EFS and OS of the 629 eligible patients was 78% (95% CI: 75-81%) and 87% (95% CI: 84-90%) respectively and there was no significant difference in both EFS and OS between the randomized interval compressed chemotherapy arms of AEWS1031. 590 of 629 (94%) patients were evaluable for maximum tumor dimension and 307 (52%) had tumors > / = 8 cm. Patients with tumors > / = 8 cm were at significantly increased risk for EFS events (p = 0.016) with estimated 5-year EFS of 73.7% (95% CI: 68.1 vs.78.4%) vs. 82.9% (95% CI 77.7-87.1%) for patients with tumors < 8 cm [HR: 1.53 (1.08-2.17)]. For tumor volume, 586 of 629 patients (93%) were evaluable and 180 (31%) had tumors > / = 200 mL. Patients with tumor volume > / = 200 mL were at significantly increased risk for EFS events (p = 0.003) with estimated 5-year EFS of 70% (95% CI: 62.3-76.4%) vs. 81.6% (95% CI: 77.2-85.2%) for patients with tumors < 200 mL [HR: 1.69 (1.2-2.39)]. Conclusions: Maximum tumor dimension and tumor volume as defined are both prognostic in patients with newly diagnosed localized ES treated with interval compressed chemotherapy. Clinical trial information: NCT01231906 .

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