Effect of very small tumor size on cancer-specific mortality in node-positive melanoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21059-e21059
Author(s):  
Xinyang Liu ◽  
Zhichao Wang ◽  
Qingfeng Li
Keyword(s):  
Tumor Size ◽  
Reference Group ◽  
Multivariable Analysis ◽  
Hazard Ratio ◽  
Primary Study ◽  
Ratio Test ◽  
Small Tumor ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Small Tumor Size

e21059 Background: Traditionally, larger tumor size and lymph node (LN) involvement have been considered independent predictors of mortality in melanoma. We aimed to characterize the interaction between tumor size and LN involvement in melanoma specific mortality. In particular, we evaluated whether very small tumor size represented a particularly aggressive disease variant compared with larger LN-positive melanoma. Methods: Using Surveillance, Epidemiology and End Results registry data, we identified 57,223 patients (aged 18-85 years) diagnosed between 1998 and 2012 with histologically confirmed nonmetastatic melanoma treated with surgery. Primary study variables were tumor size, LN involvement, and their corresponding interaction term. Kaplan-Meier methods, adjusted Cox proportional hazards models with interaction terms were performed. Potential confounders included age, sex, year of diagnosis, marital status and number of LN dissected. Results: Median follow-up was 48 months. In multivariable analysis, there was significant interaction between tumor size and LN involvement ( P < 0.0001) using the likelihood ratio test and Wald test. In the absence of LN involvement (n = 54,922), the hazard ratio (HR) increased monotonically with increasing tumor size. Among patients with LN involvement (n = 2,301), using the smallest tumors as the reference group, hazard ratio of cancer specific mortality decreased unexpectedly in 0.01-1.00mm tumors (HR 0.61, p = 0.022) and 1.01-2.00mm tumors (HR 0.58, p = 0.007), and reached to a similar level in tumors sized 2.01-4.00mm (HR 0.81, p = 0.280), and subsequently increased in tumors sized larger than 4.00mm (HR 1.57, p = 0.016). Conclusions: In LN positive melanoma, very small tumors may predict for higher mortality compared with larger tumors. These results should be validated in future database studies. Table. Effect of tumor size in LN positive and LN negative melanoma. [Table: see text]

scholarly journals Effect of Very Small Tumor Size on Cancer-Specific Mortality in Node-Positive Breast Cancer

2011 ◽  
Vol 29 (19) ◽  
pp. 2619-2627 ◽  
Author(s):  
Jennifer Y. Wo ◽  
Kun Chen ◽  
Bridget A. Neville ◽  
Nancy U. Lin ◽  
Rinaa S. Punglia
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Multivariable Analysis ◽  
Trend Test ◽  
Primary Study ◽  
Small Tumor ◽  
Node Positive ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Small Tumor Size

PurposeTraditionally, larger tumor size and increasing lymph node (LN) involvement have been considered independent predictors of increased breast cancer–specific mortality (BCSM). We sought to characterize the interaction between tumor size and LN involvement in determination of BCSM. In particular, we evaluated whether very small tumor size may predict for increased BCSM relative to larger tumors in patients with extensive LN involvement.Patients and MethodsUsing Surveillance, Epidemiology and End Results registry data, we identified 50,949 female patients diagnosed between 1990 and 2002 with nonmetastatic T1/T2 invasive breast cancer treated with surgery and axillary LN dissection. Primary study variables were tumor size, degree of LN involvement, and their corresponding interaction term. Kaplan-Meier methods, adjusted Cox proportional hazards models with interaction terms, and a linear trend test across nodal categories were performed.ResultsMedian follow-up was 99 months. In multivariable analysis, there was significant interaction between tumor size and LN involvement (P < .001). Using T1aN0 as reference, T1aN2+ conferred significantly higher BCSM compared with T1bN2+ (hazard ratio [HR], 20.66 v 12.53; P = .02). A similar pattern was seen among estrogen receptor (ER) –negative patients with T1aN2+ compared with T1bN2+ (HR, 24.16 v 12.67; P = .03), but not ER-positive patients (P = .52). The effect of very small tumor size on BCSM was intermediate among N1 cancers, between that of N0 and N2+ cancers.ConclusionVery small tumors with four positive LNs may predict for higher BCSM compared with larger tumors. In extensive node-positive disease, very small tumor size may be a surrogate for biologically aggressive disease. These results should be validated in future database studies.

Association Between Very Small Tumor Size and Increased Cancer-Specific Mortality in Node-Positive Colon Cancer

2016 ◽  
Vol 59 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Vinayak Muralidhar ◽  
Ryan D. Nipp ◽  
David P. Ryan ◽  
Theodore S. Hong ◽  
Paul L. Nguyen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Tumor Size ◽  
Small Tumor ◽  
Node Positive ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Small Tumor Size

Effect of very small tumor size on recurrence-free survival and breast cancer-specific mortality stratified by guideline adherence: An analysis of the BRENDA Study Group.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1096-1096
Author(s):  
Achim Wöckel ◽  
Lukas Schwentner ◽  
Manfred Wischnewsky ◽  
Rolf Kreienberg ◽  
Regine Wolters ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Guideline Adherence ◽  
Tumor Size ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Small Tumor ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Age Grading ◽  
Small Tumor Size

1096 Background: Small tumor size (<5mm, T1a) carry an excellent prognosis, despite a variety of treatment approaches. Controversy exists over the extent of treatment, as to whether less than conventional treatment can be done. We therefore sought to explore the effect of very small tumor size on RFS and BCSM stratified by guideline adherence. Methods: The multicenter study population included 8935 early breast cancer patients diagnosed between 1992-2008, where 614 patients (6.9%) were T1a. T1a-patients were categorized according to guideline adherence and the influence on survival was calculated by Cox proportional hazard analyses (adjusted for age, grading, nodal status, hormonal status and co-existing morbidity). Results: The median age was 61 years and the median follow-up was 55 months. 449 [73.1%] patients were postmenopausal. 13.1% had G1, 61.9% G2 and 25% G3. 81.9% were HR positive and 18.4% HER2/neu-positive. 77.1% were N0, 11.9% had 1-3 and 11% more than 3 affected lymph nodes. Only 262 (42.7%) pts. were guideline adherent. Compared to guideline adherent patients RFS and BCSM were significantly (p< 0.001) worse for guideline-non-adherent patients (RFS: HR=3.88; 95% C.I.: 1.91-7.87) and (BCSM: HR= 4.28; 95% C.I.:2.04-9.00). After adjusting for age, grading, nodal status, hormone receptor status and comorbidity guideline adherence was still the most important variable for RFS and BCSM (RFS: p<0.001; HR=3.71; 95%C.I.: 1.80-7.67) and (BCSM: p<0.001; HR=3.82; 95% C.I.:1.80-8.11).The most important impact on RFS and BCSM had guideline violations of radiation (RFS: p=0.001; HR=3.19;95%C.I.:1.66-6.13) and (BCSM: p=0.009;HR=2.42;95%C.I.:124-4.72) respectively of chemotherapy (RFS: p=0.001;HR=1.43; 95%C.I.:1.43-4.39) and (BCSM: p<0.001;HR=3.17;95%C.I.:1.84-5.46). Conclusions: There is a strong association between guideline adherence and improved recurrence free survival and reduced breast cancer-specific mortality for breast cancer patients with very small tumor size. Violation of treatment guidelines for postoperative irradiation or chemotherapy is clearly associated with a deterioration of prognosis.

scholarly journals Outcome of multidisciplinary treatment of peripheral primitive neuroectodermal tumor

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yidi Liu ◽  
Yan Yuan ◽  
Fuquan Zhang ◽  
Ke Hu ◽  
Jie Qiu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Therapeutic Approach ◽  
Univariate Analysis ◽  
Multidisciplinary Treatment ◽  
College Hospital ◽  
Small Tumor ◽  
Medical College ◽  
Treatment Plans ◽  
Small Tumor Size

Abstract Peripheral primitive neuroectodermal tumors (PNETs) constitute very rare and aggressive malignancies. To date, there are no standard guidelines for management of peripheral PNETs due to the paucity of cases arising in various body sites. Therapeutic approach is derived from Ewing sarcoma family, which currently remains multimodal. Our study retrospectively analyzed 86 PNET patients from February 1, 1998 to February 1, 2018 at Peking Union Medical College Hospital with an additional 75 patients from review of literature. The clinicopathologic and treatment plans associated with survival was investigated. Surgery, chemotherapy, female sex, small tumor size, no lymph node metastasis, R0 surgical resection, (vincristine + doxorubicin + cyclophosphamide)/(isophosphamide + etoposide) regimen, and more than 10 cycles of chemotherapy were associated with improved overall survival in univariate analysis. Surgery, more than 10 cycles of chemotherapy, and small tumor size were independent prognostic factors for higher overall survival. Our data indicates that multimodal therapy is the mainstay therapeutic approach for peripheral PNET.

P31 Prognostic significance of vascular tumor emboli in 1518 breast carcinoma patients with small tumor size (≤3 cm)

1998 ◽  
Vol 34 ◽  
pp. S21
Author(s):  
J.-Y. Pierga ◽  
A. Vincent-Salomon ◽  
M. Cousineau ◽  
B. Zafrani ◽  
B. Asselain ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Tumor Size ◽  
Prognostic Significance ◽  
Vascular Tumor ◽  
Small Tumor ◽  
Tumor Emboli ◽  
Small Tumor Size

The association of very low PSA with increased cancer-specific death in men with high-grade prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 62-62
Author(s):  
Brandon Arvin Virgil Mahal ◽  
Ayal Aaron Aizer ◽  
Jason Alexander Efstathiou ◽  
Paul Linh Nguyen
Keyword(s):  
Prostate Cancer ◽  
Reference Group ◽  
High Grade ◽  
Specific Mortality ◽  
National Cohort ◽  
Poorly Differentiated ◽  
Cancer Specific Mortality ◽  
Prostate Cancers ◽  
Very High

62 Background: It has been hypothesized that very low PSAs in men with high-grade prostate cancer could reflect dedifferentiation and a poorer prognosis, but clinical evidence to support this is limited. We sought to determine whether a very low-presenting PSA was associated with greater prostate cancer-specific mortality (PCSM) among men with Gleason score (GS) 8-10 disease. Methods: The Surveillance, Epidemiology and End Results Program was used to identify a national cohort of 328,904 men diagnosed with cT1-4N0M0 prostate cancer between 2004 and 2010. Multivariable Fine-Gray competing-risks regression analysis was used to determine PCSM as a function of PSA level (<2.5 ng/mL, 2.6-4 ng/mL, 4.1-10 ng/mL, 10.1-20 ng/mL, 20.1-40 ng/mL, or >40ng/mL) and GS (8-10 vs. <=7). Results: Median follow-up was 38 months. Among men with GS 8-10 disease, using PSA 4.1-10 as the reference group, the Adjusted HR (AHR) for PCSM for men with PSA level <2.5 was 1.86 (95% CI 1.51-2.29; P<0.001), PSA 2.6-4 was1.44 (1.17-1.78; P<0.001), PSA 10.1-20 was 1.58 (1.39-1.78; P<0.001), PSA 20.1-40 was 2.04 (1.78-2.33; P<0.001), and PSA>40 was 3.19 (2.83-3.59; P<0.001), suggesting a U-shaped distribution. There was a significant interaction between PSA level and GS (Pinteraction<0.001) such that PSA <2.5 only significantly predicted for poorer PCSM among patients with high grade GS 8-10 disease. Conclusions: Among patients with high grade GS 8-10 disease, patients with PSA <2.5 and 2.6-4 appear to have a higher risk for cancer-specific death compared to patients with a 10.1-20 PSA level, supporting the notion that low PSA in GS 8-10 disease may be a sign of underlying aggressive and extremely poorly differentiated or anaplastic low PSA-producing tumors. Patients with low PSA GS 8-10 disease should be considered for clinical trials studying the use of chemotherapy and other novel agents in very-high risk prostate cancers.

Physical Activity and Survival After Colorectal Cancer Diagnosis

2006 ◽  
Vol 24 (22) ◽  
pp. 3527-3534 ◽  
Author(s):  
Jeffrey A. Meyerhardt ◽  
Edward L. Giovannucci ◽  
Michelle D. Holmes ◽  
Andrew T. Chan ◽  
Jennifer A. Chan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Cancer Survival ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Recreational Physical Activity ◽  
Activity Assessment ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Overall Mortality

Purpose Physically active individuals have a lower risk of developing colorectal cancer but the influence of exercise on cancer survival is unknown. Patients and Methods By a prospective, observational study of 573 women with stage I to III colorectal cancer, we studied colorectal cancer–specific and overall mortality according to predefined physical activity categories before and after diagnosis and by change in activity after diagnosis. To minimize bias by occult recurrences, we excluded women who died within 6 months of their postdiagnosis physical activity assessment. Results Increasing levels of exercise after diagnosis of nonmetastatic colorectal cancer reduced cancer-specific mortality (P for trend = .008) and overall mortality (P for trend = .003). Compared with women who engaged in less than 3 metabolic equivalent task [MET] -hours per week of physical activity, those engaging in at least 18 MET-hours per week had an adjusted hazard ratio for colorectal cancer–specific mortality of 0.39 (95% CI, 0.18 to 0.82) and an adjusted hazard ratio for overall mortality of 0.43 (95% CI, 0.25 to 0.74). These results remained unchanged even after excluding women who died within 12 and 24 months of activity assessment. Prediagnosis physical activity was not predictive of mortality. Women who increased their activity (when comparing prediagnosis to postdiagnosis values) had a hazard ratio of 0.48 (95% CI, 0.24 to 0.97) for colorectal cancer deaths and a hazard ratio of 0.51 (95% CI, 0.30 to 0.85) for any-cause death, compared with those with no change in activity. Conclusion Recreational physical activity after the diagnosis of stages I to III colorectal cancer may reduce the risk of colorectal cancer–specific and overall mortality.

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