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]

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]

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 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]

Comparison of tumor size assessments in tumor growth inhibition-overall survival models with second-line colorectal cancer data from the VELOUR study

2018 ◽  
Vol 82 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Laurent Claret ◽  
Christina Pentafragka ◽  
Sanja Karovic ◽  
Binsheng Zhao ◽  
Lawrence H. Schwartz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Tumor Growth ◽  
Growth Inhibition ◽  
Tumor Size ◽  
Survival Models ◽  
Tumor Growth Inhibition ◽  
Second Line ◽  
Cancer Data

Feasibility of sentinel lymph node mapping of the ovary: a systematic review

2019 ◽  
Vol 29 (7) ◽  
pp. 1209-1215 ◽  
Author(s):  
Federica Dell'Orto ◽  
Pim Laven ◽  
Martina Delle Marchette ◽  
Sandrina Lambrechts ◽  
Roy Kruitwagen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Detection Rate ◽  
Sentinel Lymph Node Mapping ◽  
Blue Dye ◽  
Sentinel Lymph Node Detection ◽  
Lymph Node Mapping ◽  
Cancer Data

Pelvic and para-aortic lymphadenectomy is routinely performed in early ovarian cancer to define the stage of the disease. However, it may be associated with increased blood loss, operative time, and length of hospitalization. The sentinel lymph node technique has been shown to be safe and feasible in vulvar, uterine, and cervical cancer. Data detailing feasibility and outcomes of sentinel lymph node mapping in ovarian cancer are scarce.To summarize the studies evaluating the feasibility of sentinel lymph node detection from the ovary, examining the technique and detection rate.A systematic search of the literature was performed using PubMed and Embase from June 1991 to February 2019. Studies describing the sentinel lymph node technique and lymphatic drainage of the ovaries were incorporated in this review. Ten articles were selected, comprising a total of 145 patients. A variety of agents were used, but the primary markers were technetium-99m radiocolloid (Tc-99m), patent blue, or indocyanine green, and the most common injection site was the ovarian ligaments.The overall sentinel lymph node detection rate was 90.3%.We propose a standardized technique sentinel lymph node mapping in ovarian cancer, using indocyanine green, or Tc-99m and blue dye as alternative tracers, injected in both the suspensory and the infundibulopelvic ligament of the ovary.

Analysis of EGFr, VEGF and p53 in serum of head and neck squamous cell cancer (HNSCC) : Preliminary results of the GORTEC 99–02 randomized trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5509-5509
Author(s):  
J. Metges ◽  
D. Guenet ◽  
A. Auperin ◽  
V. Gregoire ◽  
P. Maingon ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prospective Study ◽  
Cox Model ◽  
Cell Cancer ◽  
Serum Levels ◽  
Tnm Staging ◽  
Phase Iii ◽  
Logrank Test ◽  
Concomitant Boost

5509 Background: Predictive and prognostic markers are warranted in HNSCC. We designed a prospective study to analyze EGFr, VEGF and P53 both in the serum and in the tumor of HNSCC patients included in the GORTEC 99–02 prospective phase III trial which compared conventional radiotherapy (RT) plus 5FU and carboplatin (FUP) vs RT with a concomitant boost and FUP vs a very accelerated RT. Methods: This prospective study has been designed to include 820 patients, we present here the results in a sub group of 216 patients for whom the biological markers were analyzed. Association between these markers and TNM staging, age, sex, disease progression and survival was evaluated. Serum analysis was performed for serum EGFr (Oncogene Science), VEGF (R&D systems) and p53 serum-autoantibodies (Immunotech). Statistical analysis were performed using Spearman correlation coefficient, Kruskal-Wallis test for quantitative variables, chi2 and Fischer exact test for qualitative varaibles and Logrank test and cox model for survival analysis. Multivariate analysis of survival took into account T and N status, tumor localisation and the type of treatment. Results: No correlation was found between the serum levels of VEGF and EGFr, neither between EGFr and p53. There was a borderline significant association (p = 0.07) towards higher VEGF serum levels in p53 negative, compared to p53 positive patients. No correlation was found between age, sex, T and N staging and all the serum markers. The VEGF level was significantly higher in laryngeal and hypopharyngeal primaries and lower in oropharyngeal and buccal primaries (p = 0.04). The EGFr level seemed also associated with the tumor localisation (p = 0.055). The median follow up was 2 years. High levels of serum EGFR were associated with better overall survival in univariate and multivariate analysis (p < 0.01). Overall survival was not significantly higher in positive serum p53 patients than in negative p53 patients (p = 0.11 in multivariate analysis). VEGF was not associated with survival. Conclusions: These preliminary resulst suggest that high levels of serum EGFr was associated with a better outcome in this homogenous, prospective series of HNSCC. Work supported by a french PHRC from the National Institutes of Health. No significant financial relationships to disclose.

Effect of primary tumor size in patients with metastatic non-small cell lung cancer (NSCLC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8041-8041
Author(s):  
Bing Xia ◽  
Feng Gao ◽  
Ramaswamy Govindan ◽  
Daniel Morgensztern
Keyword(s):  
Prognostic Factor ◽  
Metastatic Disease ◽  
Tumor Size ◽  
Primary Tumor ◽  
Early Stage ◽  
Tnm Staging ◽  
Significant Prognostic Factor ◽  
Prognostic Impact ◽  
Primary Tumor Size ◽  
N Status

8041 Background: Primary tumor size is a known prognostic factor for patients with early stage NSCLC treated with either surgery or radiation therapy. Although tumor volume has been associated with outcomes in patients with metastatic disease, it is labor intensive and rarely reported outside of a clinical trial. Since the primary tumor size is more commonly described, we evaluated its prognostic impact in patients with metastatic disease. Methods: The SEER was searched for patients with stage M1b NSCLC, with known tumor (T), lymph node (N) status, and diagnosed between 2004 and 2008. Patients with T0 and malignant pleural effusion were excluded. Tumor size is reported as the largest diameter and was subdivided into S1 (0.1-3 cm), S2 (3.1-5 cm), S3 (5.1-7 cm) and S4 (7.1-20 cm), roughly corresponding to T1, T2a, T2b and T3. Overall survival (OS) was estimated by the Kaplan-Meier method, while the hazard ratios (HR) were estimated and compared by Cox proportional hazard models. Results: Tumor size was available in 21879 (84.4%) out of 25919 patients with complete TNM staging. The frequencies of S1, S2, S3 and S4 were 33.4%, 33.8%, 17.1% and 13.7% respectively. 1-year OS rates for S1 to S4 were 34%, 27.9%, 24.0% and 19.0% respectively. Primary tumor size was an independent predictor for OS after adjustment for age, gender, race, histology, T and N status (p < 0.0001). The decreased OS from each subsequent category of tumor size was statistically significant in both univariate and multivariable analyses (Table). Conclusions: Primary tumor size is readily available and represents a significant prognostic factor for survival in patients with stage M1b NSCLC, independently of T and N status. [Table: see text]

Prognostic Value of S-Phase Fraction in 920 Breast Cancer Patients: Focus on T1N0 Status

2003 ◽  
Vol 18 (4) ◽  
pp. 273-279 ◽  
Author(s):  
R. Largillier ◽  
M. Namer ◽  
A. Ramaioli ◽  
J.M. Ferrero ◽  
N. Magné ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Size ◽  
Cox Model ◽  
Univariate Analysis ◽  
S Phase ◽  
Phase Fraction ◽  
Breast Cancer Patients ◽  
Significant Difference

The aim of this study was to reexamine the prognostic role of tumor cell kinetics measured by S-phase fraction (SPF) and to establish its clinically relevant threshold values. SPF was determined by flow cytometry in a group of 920 consecutive breast cancer patients, all followed at our institute for 10 years (1988 to 1998). Mean age was 60.5 years (27–89 years). Median follow-up was 63 months (3–150 months). All patients had initial surgical treatment. SPF quartiles were: Q1=3.08%, median value = 5.98%, Q3=10.22%. A significant difference in overall specific survival was obtained between two populations divided by a cutoff at Q1 (p<0.0001). A multifactorial analysis including SPF and known prognostic factors such as tumor size, node status, histological grade, ER and PR status was performed using the Cox model in a population of 719 patients: univariate analysis showed that each of these factors had significant influence on overall survival. Multivariate analysis selected three of them, ranked by decreasing order of hazard ratio (HR) value: SPF (HR: 3.88, p<0.001), tumor size (HR: 2.49, p<0.001) and nodal status (HR: 2.28, p<0.001). In addition, when tumors were stratified according to SPF quartile values, there were statistically different overall survival curves in patients with small tumors (<2 cm) and in axillary node-negative patients.

The number of lymph node metastases as a prognostic indicator of disease-specific survival in the era of sentinel lymph node mapping in colon cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15000-e15000
Author(s):  
S. Saha ◽  
S. Sirop ◽  
A. Korant ◽  
B. Chakravarty ◽  
N. Krishnaiah ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Stage Iv ◽  
Sentinel Lymph Node Mapping ◽  
Prognostic Indicator ◽  
Colon Resection ◽  
Cancer Specific Survival ◽  
Lymph Node Mapping ◽  
Stage Iv Disease

e15000 Introduction: Sentinel Lymph Node Mapping (SLNM) in colon cancer (CCa) is shown to be successful, sensitive and accurate. We aimed to evaluate the survival of patients (pts) undergoing SLNM in addition to the standard colon resection, compare it to pts without SLNM and correlate it to the number of LN metastasis. Methods: Staging and survival analysis from our prospective database (gpA, 195 pts) were compared to the Surveillance, Epidemiology, and End Results (SEER) database (gpB, 126,484 pts) between 1996–2003. All pts had invasive CCa. GpA pts underwent SLNM plus complete resection. The minimum follow up (F/U) was 5 years. The primary outcome was cancer-specific survival. Exclusion criteria were stage IV disease, 2nd malignancy, or lost to F/U. Cancer specific survival of gpA was then analyzed according to the number of positive LNs. Results: In gpA (195 pts), SLNM was successful in 99.7%, of pts with a sensitivity, negative (-ve) predictive value, and false -ve rates of 86.3%, 91.7% and 14.6% respectively. In 15.1% of node +ve pts, the disease was upstaged because of micrometastasis (0.2–2mm). In gpA, 128 pts were included, of which 17(13.3%) lost to F/U as compared to 89,483 pts included in gpB, of which 47,168 (52.7%) lost to F/U. The average number of LNs examined per pt was 15 in gpA as compared to 12.4 in gpB (p=<0.0001). The 5 year-cancer specific survival of pts in gpA vs gpB was 100% vs 94.9% in stage I, 91.2% vs 83.5% in stage II and 81.8% vs 63% in stage III disease. For gpA pts, the 5 year cancer-specific survival decreased from 95.0% in node -ve disease to 92.8% when 1 LN was +ve, 83.3% when 2 LNs were +ve and 71.4% when 3 or more LNs were +ve (Table). Conclusions: A significant number of pts with CCa are being upstaged and the true node -ve disease is being identified when SLNM is performed at the time of surgery leading to improved survival as compared to conventional surgery. Our study showed that the number of LN metastasis is a predictor of cancer specific survival even after SLNM in CCa. [Table: see text] No significant financial relationships to disclose.

Does the addition of chemotherapy to neoadjuvant radiotherapy impact survival in high-risk extremity and trunk soft tissue sarcoma?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11054-11054
Author(s):  
Mudit Chowdhary ◽  
Akansha Chowdhary ◽  
Neilayan Sen ◽  
Nicholas George Zaorsky ◽  
Kirtesh R. Patel ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Tumor Size ◽  
Primary Site ◽  
High Grade ◽  
Neoadjuvant Radiotherapy ◽  
Cancer Data ◽  
The Impact

11054 Background: Large, high-grade extremity/trunk (ET) non-rhabdomyosarcoma soft-tissue sarcoma (STS) is at high risk for distant recurrence and death. The integration of chemotherapy (C) to standard of care neoadjuvant radiotherapy (RT) remains controversial, even for these patients. This study examines the impact of adding C to neoadjuvant RT on overall survival (OS) in high risk ET-STS. Methods: The National Cancer Data Base (NCDB) was queried for patients ≥18 years with high risk (≥5 cm + high grade) non-rhabdomyosarcoma ET-STS (WHO histology) who received neoadjuvant RT and limb sparing surgery from 2006-2014. Patients were next stratified based upon receipt of C (RT and CRT cohorts). Overall survival (OS) for RT vs CRT cohorts was analyzed using the Kaplan-Meier (KM) method, log-rank test, and Cox proportional hazards models. Propensity score-matched analysis (PSM) was employed to account for potential treatment selection bias between cohorts. Results: A total of 848 (71.1%) and 344 (28.9%) patients received RT and CRT, respectively. Patient cohorts were well-balanced except for the CRT cohort having higher rates of treatment in the West (22.1% vs 10.6%) & Midwest (28.3% vs 22.7%), Charlson-Deyo [CD] score 0 vs ≥1 (85.5% vs 79.4%), younger age (≤50) (45.9% vs 21.7%), synovial sarcoma histology (18.9% vs 3.2%), earlier year of diagnosis (2006-2010) (39.5% vs 32.3%), and positive lymphovascular invasion (2.0 vs 1.51%), (p < 0.05 each). The KM 5-year OS was significantly higher in the CRT vs RT cohort: 69.2% vs 58.1% on univariate (p < 0.0001) and multivariate analysis (Hazard Ratio [HR]: 0.66; 95% Confidence Interval [CI]: 0.52-0.85; p = 0.001) even after adjusting for age, race, income, CD score, histology, tumor size, tumor grade, and primary site (lower extremity; upper extremity; trunk). PSM identified evenly matched cohorts of 300 patients each with respect to age, income, CD score, histology, grade, tumor size, and primary site. The addition of neoadjuvant C remained prognostic for OS on PSM (HR: 0.74 [0.56-0.99], p = 0.042). Conclusions: The addition of C to neoadjuvant RT was associated with improved OS in patients with high risk non-rhabdomyosarcoma ET-STS in the NCDB. These hypothesis generating results support prospective evaluation.

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