Human papillomavirus, radiation dose and survival of patients with anal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15071-e15071
Author(s):  
Rafi Kabarriti ◽  
Patrik Brodin ◽  
Nitin Ohri ◽  
Rahul Narang ◽  
Renee Huang ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cancer Patients ◽  
Anal Cancer ◽  
Advanced Disease ◽  
Early Stage ◽  
Locally Advanced ◽  
Early Stage Disease ◽  
Locally Advanced Disease ◽  
Stage Disease ◽  
Hpv Status

e15071 Background: To determine if anal cancer patients with HPV positive disease have different overall survival (OS) compared to those with HPV negative disease, and to elucidate differences in the association between radiation dose and OS. Methods: We utilized the National Cancer Database (NCDB) registry to identify a cohort of non-metastatic anal cancer patients treated with curative intent between 2008 – 2015. Propensity score matching was used to account for potential selection bias between patients with HPV positive and negative disease. Multivariable Cox regression was used to determine the association between HPV status and OS. Kaplan-Meier methods were used to compare actuarial survival estimates. Results: We identified 5,927 patients with tumor HPV status for this analysis, 3,523 (59.4%) had HPV positive disease and 2,404 (40.6%) had HPV negative disease. Propensity-matched analysis demonstrated that patients with HPV positive locally advanced (T3-4 or node positive) anal cancer had better OS (HR=0.81 (95%CI: 0.68-0.96), p=0.018). For patients with early stage disease (T1-2 and node negative) there was no difference in OS (HR=1.11 (95%CI:0.86-1.43), p=0.43). In the unmatched cohort, there was an increase in 3-year OS for patients with HPV positive tumors or early stage disease up to 45-49.9 Gy (p<0.001), whereas for patients with HPV negative and locally advanced disease there was an increase in survival from 46% at 30-44.9 Gy, to 64% at 45-49.9 Gy (p=0.093) and further to 71% at 50-54.9 Gy (p=0.005). Conclusions: We found HPV to be a significant prognostic marker in anal tumors, especially for locally advanced disease. We further found that higher radiation dose up to 50-55 Gy was associated with better OS, mainly for locally advanced disease in HPV negative patients. Multivariable Cox proportional hazards regression for OS. [Table: see text]

scholarly journals Clinical outcomes and impact of prognostic factors following adjuvant radiotherapy in oral tongue cancer patients

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Sidharth Pant ◽  
Punita Lal ◽  
Shagun Misra ◽  
Piyush Gupta ◽  
K. J. Maria Das ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cancer Patients ◽  
Advanced Disease ◽  
Tongue Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Oral Tongue ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Oral Tongue Cancer

Abstract Background The purpose of the study was to evaluate survival outcomes in post-operative oral tongue cancer patients undergoing adjuvant radiotherapy (RT) at a tertiary cancer care center and to critically review the impact of various clinical-pathological factors on recurrence and survival. Demographic factors, stage of all the histology proven oral tongue cancer, and treatment details were documented. Overall survival (OS) and recurrence-free survival (RFS) were analyzed along with the potential prognostic factors affecting outcome. Results One hundred forty-four post-operative oral tongue cancer patients referred to our department for adjuvant treatment were evaluated. Median age at presentation was 45 years. Forty-seven patients had pathological early stage disease (stages I and II) and 95 had locally advanced (stages III and IV) disease while post-op details were not present in 2 patients. At a median follow-up of 87 months (60–124) of alive patients, the median RFS for entire cohort was 62 months while median OS was 74 months respectively. Age, perineural invasion (PNI), and grade of the tumor emerged as independent prognostic factors for OS and RFS. Among patients with early stage disease, depth of invasion (DOI), age, and PNI were found as independent prognostic factors for RFS and OS. In locally advanced disease, higher grade, age, and PNI independently impacted the respective survival end points. Conclusions Age (> 45 years), higher grade, and presence of PNI showed inferior survival outcomes across the sub-groups (early versus locally advanced disease). This may warrant adjuvant treatment intensification. DOI > 10 mm was particularly found to worsen survival in early node negative SCC oral tongue patients.

scholarly journals Time, Distance and Economics Influencing Cancer Care: Experience From a Regional Cancer Center in India

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 76s-76s
Author(s):  
N. Ballari ◽  
R. Miriyala ◽  
T. Jindia ◽  
S. Gedela ◽  
L. Annam ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Early Stage ◽  
Private Insurance ◽  
Locally Advanced ◽  
Cancer Center ◽  
Advanced Stage ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Time Distance

Background: There is a geographical, socioeconomical and logistic diversity among the cancer patients who reach a regional cancer center. In a developing economy like that of India's, only a minority of patients have medical insurance. So in our setup a cancer patient is met with time, distance and financial challenges. These intangible factors theoretically are expected to influence the ultimate outcome of cancer treatment. Aim: To evaluate the prevailing demographic and economic variables of cancer patients visiting our RCC and to look for any correlation among each other. Methods: The demographic details of cancer patients registered at our RCC between August 2017- September 2017 were retrieved retrospectively. Distance traveled to get to the RCC and get a diagnosis of cancer, time taken for diagnosis and initiation of treatment, and the source of finances for treatment were collected. A correlation among these factors was attempted to be identified. Statistical correlation was identified using Student t-test. Results: Among 591 patients who were analyzed, the median age of patient was 55 years old. The median time taken for the patient to reach the RCC from permanent residence after the beginning of cancer related complaints was 3.19 months. The median distance traveled for the same was 131 km. The source of income was private employment for 223 patients and government employment for 164 patients and self-employment for 200 patients. Only 164 patients had some kind of structured health scheme to manage their health care expenses. Among these, 96 patients had private insurance/reimbursement and 64 patients had government reimbursement. 384 (64%) of patients presented with advanced and locally advanced stage disease while 114 (19%) patients presented to us with early stage disease. However a correlation between delay in presentation to the RCC, distance traveled to reach the RCC, source of income and advanced stage of disease couldn't not be established. Conclusion: Majority of patients visiting our RCC is from far off places and most of these patients pay for the cancer treatment themselves without any support from government or private insurances. All these factors may be responsible for late or advanced stage presentation of cancer patients.

scholarly journals Clinical and Epidemiological Profile of Breast Cancer in Mexico: Results of the Seguro Popular

2017 ◽  
Vol 3 (6) ◽  
pp. 757-764 ◽  
Author(s):  
Nancy Reynoso-Noverón ◽  
Cynthia Villarreal-Garza ◽  
Enrique Soto-Perez-de-Celis ◽  
Claudia Arce-Salinas ◽  
Juan Matus-Santos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Protection ◽  
Advanced Disease ◽  
Early Stage ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Cancer Center ◽  
Seguro Popular ◽  
Early Stage Disease ◽  
Locally Advanced Disease

Purpose One half of the Mexican population lacks comprehensive health care coverage. In 2003, a reform to the General Health Law was approved that led to the creation of the System of Social Protection in Health and made universal health coverage mandatory. The main innovation of this reform was Seguro Popular, which provided coverage for breast cancer. Here we report the outcomes of women with breast cancer treated at a cancer center in Mexico under Seguro Popular. Materials and Methods This was a retrospective cohort study that included all patients with breast cancer treated in the Instituto Nacional de Cancerología in Mexico City between January 2007 and December 2013 with Seguro Popular coverage. Demographic and clinical information were collected and survival outcomes were analyzed. Results A total of 4,300 women with breast cancer were included in this analysis. Most patients had locally advanced disease at diagnosis (53%, n = 2,293), and 13% (n = 558) presented with stage IV disease. Neoadjuvant chemotherapy was administered to 1,834 patients (52%), with a pathologic complete response in 25.1% (n = 460). Median follow-up was 40.5 months. Five-year survival for the entire cohort was 82% (95% CI, 81% to 84%). Five-year survival was 97% for early-stage disease (95% CI, 95% to 98%), 82% for locally advanced disease (95% CI, 80% to 84%), and 36% for metastatic disease (95% CI, 30% to 42%). Conclusion This represents the first description of a cohort of patients with breast cancer treated in Mexico under Seguro Popular. Seguro Popular has allowed our institution, and other Mexican centers, to establish efficient standardized mechanisms to treat patients with breast cancer.

Plasma hTERT mRNA discriminates between clinically localized and locally advanced disease and is a predictor of recurrence in prostate cancer patients

2012 ◽  
Vol 12 (sup1) ◽  
pp. S69-S77 ◽  
Author(s):  
José A March-Villalba ◽  
José M Martínez-Jabaloyas ◽  
María J Herrero ◽  
José Santamaría ◽  
Salvador F Aliño ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Htert Mrna ◽  
Locally Advanced Disease

scholarly journals Institutional experience of the multimodality treatment of cancer tongue

2017 ◽  
Vol 4 (6) ◽  
pp. 1896
Author(s):  
Mrinal Shankar ◽  
Manisa Pattanayak ◽  
Vipul Nautiyal ◽  
Sunil Saini
Keyword(s):  
Early Stage ◽  
Locally Advanced ◽  
Early Recurrence ◽  
Prognostic Indicators ◽  
Medical Sciences ◽  
Early Stage Disease ◽  
Aggressive Approach ◽  
Stage Disease ◽  
Definitive Surgery ◽  
Multimodality Approach

Background: Cancer (Ca) tongue incidence has shown a rising trend in India in the last couple of years. Increasing use of tobacco being the main risk factor. Guidelines available for management of this disease include it broadly under oral cavity cancers. However, the biological behaviour of this disease is warrant of more aggressive approach to treatment. In early stage disease, treatment is mainly with single modality, surgery being the most preferred. Locally advanced disease treated with multimodality approach with surgery and adjuvant RT/chemoRT. Adverse histopathological factors are important prognostic indicators for early recurrence. Even if the mainstay of treatment in metastatic disease is palliation, multimodality approach is preferred. The aim of the study is to study clinical profile of Ca tongue ant to study outcome of multimodality management of SCC tongue and identification of treatment failure.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India over a period of 12 months on patients attending Surgical Oncology OPD. Written informed consent and ethical committee clearance was obtained in all 64 cases included, and study type is observational.Results: This is an observational study conducted at Himalayan Institute of Medical Sciences, Dehradun over a period of 12 months. 64 patients diagnosed with SCC tongue were included. Treatment protocols were prescribed by the multidisciplinary tumour board, and patients were followed up to 6 months after completion of the planned treatment. 68.75% patients were below 55 years of age. 87.5% were chronic tobacco chewers. 79.68% had lesion in the anterior tongue. 84.37% received treatment with curative intent (of these 16.66% patients showed early recurrence). 71.86% patients underwent definitive surgery (of these 78.26% remained disease free after 6 months of completion of treatment). Radiotherapy was used in both adjuvant and primary setting. Nodal recurrence was the commonest pattern of recurrence in patients who had underwent definitive surgery. Co-relation with adverse histopathological prognostic indicators also establish early recurrence.Conclusions: Ca tongue was found to be commoner in individuals between 36-55 years. Tobacco users were seen to be at high risk. Surgery was the preferred modality of treatment in early stage disease. Regional lymph node metastasis is the commonest site of early treatment failure. Adverse histopathological factors were important indicators of prognosis and need consideration in planning adjuvant treatment.

scholarly journals PV-0536 On the impact of HPV status and radiation dose on survival in a large cohort of anal cancer patients

2019 ◽  
Vol 133 ◽  
pp. S282-S283
Author(s):  
R. Kabarriti ◽  
P. Brodin ◽  
R. Narang ◽  
R. Huang ◽  
J. Chuy ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cancer Patients ◽  
Anal Cancer ◽  
Large Cohort ◽  
Hpv Status ◽  
The Impact

scholarly journals The role of perioperative radiotherapy in gastric cancer

2012 ◽  
Vol 6 (2) ◽  
pp. 23 ◽  
Author(s):  
Thales Paulo Batista ◽  
Lucas Marque De Mendonça ◽  
Ana Luiza Fassizoli-Fonte
Keyword(s):  
Gastric Cancer ◽  
Therapeutic Strategy ◽  
Multimodal Therapy ◽  
Early Stage ◽  
Locally Advanced ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Locally Advanced Tumors ◽  
Related Mortality

Gastric cancer is one of the most common neoplasms and a main cause of cancer-related mortality worldwide. Surgery remains the mainstay for cure and is considered for all patients with potentially curable disease. However, despite the fact that surgery alone usually leads to favorable outcomes in early stage disease, late diagnosis usually means a poor prognosis. In these settings, multimodal therapy has become the established treatment for locally advanced tumors, while the high risk of locoregional relapse has favored the inclusion of radiotherapy in the comprehensive therapeutic strategy. We provide a critical, non-systematic review of gastric cancer and discuss the role of perioperative radiation therapy in its treatment.

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