Factors associated with overall survival in patients with squamous carcinoma of esophagus compared to adenocarcinoma of esophagus.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e15061-e15061
Author(s):  
Feng Ming Kong ◽  
Julie George ◽  
Ling Li ◽  
Paul Stanton ◽  
Ahmad Albasheer ◽  
...  
Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3598
Author(s):  
Ga Hee Kim ◽  
Kee Don Choi ◽  
Yousun Ko ◽  
Taeyong Park ◽  
Kyung Won Kim ◽  
...  

Background/Aim: We investigated the oncologic outcomes in elderly patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) by focusing on the impact of comorbidities, sarcopenia, and nutritional status. Methods: Between 2005 and 2016, 280 patients aged ≥ 80 years with 289 EGCs underwent ESD at a tertiary care center. The short- and long-term survival outcomes were assessed. Cox regression analysis was used to identify factors associated with survival, including clinicopathologic factors and abdominal muscle area measured by computed tomography. Results: The rates of en bloc, R0, and, curative resection were 99.3%, 90.0%, and 69.2%, respectively. The rates of post-ESD bleeding and perforation rates were 2.1% and 3.1%, respectively, and no cases showed significant life-threatening adverse events. Over a median follow-up period of 70.5 months, the 3- and 5-year overall survival (OS) rates were 89.5% and 77.1%, respectively; of the114 patients who died, only four (3.5%) were due to gastric cancer. A total of 173 (61.8%) had sarcopenia, and they had lower rates of 3-year (88.4% vs. 91.4%) and 5-year (73.1% vs. 84.0%; p = 0.046) OS than did those without sarcopenia. In multivariable analyses, prognostic nutritional index (hazard ratio [HR], 0.93; 95% confidence interval [CI]: 0.90–0.98; p = 0.002) and Charlson comorbidity index (HR 1.19; 95% CI: 1.03–1.37; p = 0.018) were significant factors associated with overall survival. Conclusions: ESD was a feasible and safe therapeutic method to use in elderly patients, whose long-term survival was significantly associated with nutritional status and comorbidities. These results suggest the need for a possible extension of the curative criteria for ESD in elderly patients with EGC.


2021 ◽  
Vol 8 (2) ◽  
pp. 27-33
Author(s):  
Jiping Zeng ◽  
Ken Batai ◽  
Benjamin Lee

In this study, we aimed to evaluate the impact of surgical wait time (SWT) on outcomes of patients with renal cell carcinoma (RCC), and to investigate risk factors associated with prolonged SWT. Using the National Cancer Database, we retrospectively reviewed the records of patients with pT3 RCC treated with radical or partial nephrectomy between 2004 and 2014. The cohort was divided based on SWT. The primary out-come was 5-year overall survival (OS). Logistic regression analysis was used to investigate the risk factors associated with delayed surgery. Cox proportional hazards models were fitted to assess relations between SWT and 5-year OS after adjusting for confounding factors. A total of 22,653 patients were included in the analysis. Patients with SWT > 10 weeks had higher occurrence of upstaging. Using logistic regression, we found that female patients, African-American or Spanish origin patients, treatment in academic or integrated network cancer center, lack of insurance, median household income of <$38,000, and the Charlson–Deyo score of ≥1 were more likely to have prolonged SWT. SWT > 10 weeks was associated with decreased 5-year OS (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.15–1.33). This risk was not markedly attenuated after adjusting for confounding variables, including age, gender, race, insurance status, Charlson–Deyo score, tumor size, and surgical margin status (adjusted HR, 1.13; 95% CI, 1.04–1.24). In conclusion, the vast majority of patients underwent surgery within 10 weeks. There is a statistically significant trend of increasing SWT over the study period. SWT > 10 weeks is associated with decreased 5-year OS.


2003 ◽  
Vol 21 (24) ◽  
pp. 4572-4578 ◽  
Author(s):  
Véronique Laithier ◽  
Jacques Grill ◽  
Marie-Cécile Le Deley ◽  
Marie-Madeleine Ruchoux ◽  
Dominique Couanet ◽  
...  

Purpose: To evaluate a strategy aimed at avoiding radiotherapy during first-line treatment of children with progressive optic pathway tumors (OPT), by exclusively administering multiagent chemotherapy during 16 months. Patients and Methods: Between 1990 and 1998, 85 children with progressive OPT were enrolled onto this multicenter nationwide trial. Chemotherapy alternating procarbazine plus carboplatin, etoposide plus cisplatin, and vincristine plus cyclophosphamide was given every 3 weeks. At the time of relapse or progression, second-line chemotherapy was authorized before recourse to radiotherapy. Results: Objective response rate (partial response [PR] + complete response [CR]) to chemotherapy was 42%. Five-year progression-free survival (PFS) and overall survival rates were 34% and 89%, respectively. The 5-year radiotherapy-free survival rate was 61%. In the multivariate analysis of the 85 patients that entered onto the study, factors associated with the risk of disease progression were age younger than 1 year at diagnosis (P = .047) and absence of neurofibromatosis type 1 (P = .035). In the multivariate analysis of the 74 patients that remained on study after the first cycle of chemotherapy, factors associated with the risk of disease progression were age younger than 1 year at diagnosis (P = .0053) and no objective response to chemotherapy (P = .0029). Three-year PFS was 44% in infants ≤ 1 year versus 66% in children older than 1 year. Three-year PFS was 53% in the absence of an objective response to chemotherapy versus 68% after a PR or CR. Conclusion: A significant proportion of children with OPT can avoid radiotherapy after prolonged chemotherapy. Deferring irradiation with chemotherapy protocols did not compromise overall survival of the entire population or visual function.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jiajia Liu ◽  
Weiming Zhu ◽  
Zhexuan Li ◽  
Gengming Cai ◽  
Juncheng Wang ◽  
...  

Abstract The link between differences in molecular expression and survival among advanced laryngeal (LSCC) and hypopharyngeal squamous carcinoma (HPSCC) remains unclear. Here, we applied the Surveillance, Epidemiology, and End Results (SEER) program, Isobaric tag for relative and absolute quantitation (iTRAQ) with Liquid chromatography-mass spectrometry (LC–MS/MS) proteomics data and The Cancer Genome Atlas (TCGA) related data to discover the possible disparities between HPSCC and LSCC. Our results showed a significantly worse 5-year overall-survival in HPSCC compared with LSCC before and after adjusting for clinical parameters. 240 differentially expressed proteins were enriched in molecular networks of cytoskeleton remodeling and antigen presentation. Moreover, HPSCC consisted of less T-central-memory cells, T-follicular-helper cells, TGF-β response, and CD4 +  T memory resting cells, but more wound healing than LSCC. Furthermore, 9 mRNAs expression were  significantly and independently correlated to overall survival in 126 HPSCC and LSCC patients, which was further validated in another cohort of head and neck cancers. These findings support that Immunity signatures as well as pathway networks that include cytoskeleton remodeling and antigen presentation may contribute to the observed differences in survival between HPSCC and LSCC.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4652-4652
Author(s):  
Vassiliki I. Pappa ◽  
George Mantzios ◽  
Christina Economopoulou ◽  
Theofanis Economopoulos ◽  
Efstathios Papageorgiou ◽  
...  

Abstract Introduction: Mature T cell lymphomas are a rare and heterogeneous group of malignancies characterized by a poor prognosis. They usually present with advanced-stage disease and generally have a significantly worse outcome compared with aggressive B-cell lymphomas. The aim of the present study was the retrospective analysis of clinical and laboratory characteristics of patients with mature T cell lymphomas with the view to identify factors of prognostic significance. Patients and Methods: 39 patients with mature T cell lymphoma, classified according to WHO classification, diagnosed in our institution within a 17 year period were analyzed. Cases with anaplastic and cutaneous lymphomas were excluded. There were 25 males and 14 females with a median age of 61 (26–80). 3 patients had stage I,. 7 stage II, 10 stage III and 19 stage IV disease. B symptoms were present in 28/39 cases and bulky disease in 6/39 cases. All cases were risk stratified according to the International Prognostic Index (IPI). 9 patients had IPI 0/1, 9 had IPI 2, 10 had IPI 3 and 8 IPI 4/5. In 3 cases the IPI could not be defined. 21 patients were treated with CHOP like therapy, 11 with COP and 7 with other treatment. The size and the immunophenotype of the neoplastic cell population in the diagnostic biopsy (Τ4, Τ8 or mixed), the patients’ clinical characteristics and their laboratory findings were analyzed to identify factors of prognostic significance. Results. 17/39 patients (47.6%) achieved CR, 7/39 PR, while 6 had stable and 7 progressive disease. 2 patients died during induction treatment. 21/39 patients developed recurrent disease and the median disease free survival (DFS) was 78 months. Factors associated with significantly worse DFS were age above 60 (p=0.0005) and the presence of hepatomegaly at diagnosis (3 vs 78 months, p=0.0219), while the presence of extranodal disease was of borderline significance (p=0.0629). The patients’ median survival was 24 months. Factors associated with significantly shorter survival were female gender (14 vs 61 months, p=0.0396), the presence of supradiaphragmatic disease (p=0.0337) and eosinophilia at diagnosis (p=0.0467). Τhe IPI scoring system could distinguish between groups with a significant difference both in DFS and overall survival. DFS for IPI 4/5 was significantly shorter vs IPI 0-3 (p=0.0009). Patients with IPI 0/1 had a median survival 271 months, with IPI 2/3 24 months and with IPI 4/5 8 months (p=0.002). Histological characteristics like cell size or immunophenotype of the neoplastic cell were not important for prognosis. Conclusions. Mature T cell lymphomas constitute an heterogenous group of aggressive lymphomas that can be prognostically evaluated using clinical parameters. The IPI scoring system can identify subgroups with significant differences both in terms of DFS and overall survival. The analysis of larger number of cases or of histological characteristics may be helpful in the identification of other clinical or laboratory parameters that will increase the discriminative capacity of the IPI scoring system in this group of aggressive lymphomas.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7102-7102
Author(s):  
Mohammad Mozayen ◽  
Anteneh A. Tesfaye ◽  
Manas ranjan Sarangi ◽  
Jyothsna Talluri ◽  
Khalil Katato

7102 Background: Lung cancer is a major risk factor of venous thromboembolism (VTE). The incidence of VTE in different histological patterns of lungs cancer and its impact at the disease outcome is not well studied. We aim to evaluate the incidence rate of VTE in lung cancer and its effect on survival. Methods: Patients (pts) with lung cancer diagnosis from cancer database of community hospital were reviewed. Pts’ medical records were checked for VTE over 3 years after diagnosis. Pts’ demographics, pathology, TNM stage and overall survival were studied. Development of VTE was primary outcome and 3 year overall survival was the secondary outcome. Results: A total 2,164 pts with lung cancer between 1995 and 2008 were included. Median age of the study population was 70 years. Males were 53%, African Americans were 7%. 200 pts (9%) were diagnosed with VTE. Out of 1783 pts with non-small cell lung cancer (NSCLC), 176 pts (9.9%) had VTE whereas out of 381 pts with small cell lung cancer (SCLC) 24 pts (6.3%) had VTE (p=0.015). Among NSCLC pts, 13.5% of pts with adenocarcinoma had VTE, whereas 6.6% of pts with squamous cell carcinoma had VTE (p<0.05). The incidence of VTE in stages I, II, III, IV of all pts were (8.4%, 7.3%, 13%, 7.5%) (p=0.007) respectively. In NSCLC, three years overall survival of pts with and without VTE was 22% and 24% respectively (p=0.34). In SCLC, three years overall survival of pts with and without VTE was 21% and 11% respectively (p=0.09). Conclusions: There is a higher incidence of VTE in non-small cell lung cancer than in small cell lung cancer. Among the NSCLC, VTE’s incidence was higher in adenocarcinoma than squamous carcinoma. VTE maybe higher at advanced stages (stage III) in both NSCLC and SCLC combined. There was no significant difference in the 3 years overall survival of lung cancer patients with and without VTE.


2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 635-635
Author(s):  
Brittney Cotta ◽  
Stephen Ryan ◽  
Ahmed Eldefrawy ◽  
Reith Sarkar ◽  
Aaron Bradshaw ◽  
...  

635 Background: Optimal timing for surgical treatment of localized renal cell carcinoma (RCC) remains undefined. We sought to determine the survival impact of time to definitive surgical treatment for Stage 1 RCC and elucidate factors associated with a delay in surgical care utilizing the National Cancer Database (NCDB). Methods: The NCDB was queried for Stage 1 RCC cases (cT1N0M0) from 2004-2013 treated with partial or radical nephrectomy. Quartiles were formed from the range of time to surgery of the entire cohort in days: early defined as the first two quartiles and delayed as the fourth. Descriptive analyses were conducted between early and delayed groups. Overall survival (OS) between early and delayed groups was calculated with Kaplan-Meier analysis. Multivariable analysis was performed to determine factors associated with delay in surgical care. Results: 38,859 patients were analyzed. Median time to treatment was 40 days (IQR 22-68). Early (≤40 days, n = 23,712) and delayed ( > 68 days, n = 15,147) groups had a median follow-up of 44.8 and 41 months, respectively (p < 0.001). Delayed surgery was more frequent with African-Americans (14.8% vs. 9.1%, p < 0.001), patients with government or no insurance (53.7% vs. 45.1%, p < 0.001), males (60.7% vs. 58.3%, p = 0.001), and Charlson Comorbidity Index (CCI) ≥2 (9.7% vs. 6.7%, p < 0.001). Kaplan-Meier analysis demonstrated survival benefit to the earlier treatment group, with 5 year OS of 85.5% and 80.9% (p < 0.001; Figure). On multivariable analysis, increasing age (OR = 1.001, p = 0.015), African-American race (OR = 1.5, p < 0.001), increasing distance from treatment center (OR = 1.005, p = 0.001), residence in areas with low high school graduation rates (OR = 1.42, p < 0.001), residence in an area of > 1 million population (OR = 1.6, p < 0.001), and CCI ≥2 (OR = 1.4, p < 0.001) were independently associated with increasing time to surgery. Conclusions: Surgery of T1 RCC carried out beyond 9 weeks after diagnosis is associated with reduced overall survival compared to patients treated within 6 weeks. Time to definitive surgical treatment should be a quality of care metric, with special attention given to populations most at risk for delays in care.


2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 228-228
Author(s):  
Niamh Peters ◽  
John Gaffney ◽  
Emma Connolly ◽  
Richard Bambury ◽  
Derek Gerard Power ◽  
...  

228 Background: Radium 223 (Ra-223) has been successfully utilised in the trial setting for the treatment of men with metastatic castrate resistant prostate cancer (mCRPC). To date, no real world outcomes from its use in the Irish population have been described. Methods: From September 2016 to March 2019, data from men referred for Ra-223 treatment at our institution was retrospectively collected. We recorded patient characteristics, treatments received and outcomes. Overall Survival (OS) was analysed using the Kaplan-Meier method. Results: 81 men were referred for Ra 223. Complete data was available for 56 men. Median age was 75. 79%(45/56) had over 6 bone metastases and 21%(12/56) had lymph node involvement. The median number of prior systemic treatments for mCRPC was 2. 84%(47/56) of patients were previously treated with Androgen deprivation therapy (ADT); 48%(27/56) Abiraterone, 36%(20/56) Docetaxel, 45%(25/56) Enzalutamide and 9%(5/56) Cabazitaxel. All patients were receiving bone protection agents; 57%(32/56) Zolendronic acid and 43%(24/56) Denosumab. Median ECOG was 1 at the start of treatment and 2 at completion. The median number of treatments received was 4 with 36%(20/56) completing all 6 treatments. The most common toxicity seen was grade1 fatigue occurring in10% (6/56). 17% (10/56) required a blood transfusion during their treatment course. 53%(30/56) required opioid analgesia prior to Ra 223 treatment. 76% of these men (22/30) described improved pain following Rad-223. At a median follow up of 13 months,41%(23/56) were alive. The median OS for the entire group was 7 months. Factors associated with improved OS included ECOG 0-1,fewer than 6 bone metastases, normal alkaline phosphatase level at start of treatment and no prior chemotherapy use. Median OS for those who had not received prior chemotherapy was significantly better than those who had (9 vs 5 months p=0.04). Conclusions: This real world study demonstrates Ra 223 is a well tolerated palliative treatment amongst Irish men with mCRPC. Good performance status, lower alkaline phosphatase, chemotherapy naivety and a low burden of metastatic disease are factors associated with an improved overall survival.


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