A single-institution and commercial laboratory database analysis of BRIP1-associated cancer risks.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1538-1538
Author(s):  
Kristen Danielle Whitaker ◽  
Ryan Bernhisel ◽  
John Kidd ◽  
Elisha Hughes ◽  
Eric Thomas Rosenthal ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Fold Increase ◽  
Cancer Center ◽  
Multivariable Logistic Regression Analysis ◽  
Commercial Laboratory ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Increased Risk ◽  
Myriad Genetics ◽  
Multigene Panel

1538 Background: BRIP1/ FANCJ participates in DNA replication and repair via interactions with BRCA1 and possibly MLH1. Previous studies have reported that pathogenic variants (PV) in BRIP1 are associated with an ~2-fold increase in risk for ovarian cancer (OC) and triple-negative breast cancer (TNBC). Although multigene panel testing for hereditary cancer (CA) has identified BRIP1 PV and uncertain variants (VUS) in patients with diverse CAs including breast (BC), colorectal (CRC) and melanoma (Mel), association with these CA types has not been established. Methods: We examined BRIP1 risks in two independent populations: Fox Chase Cancer Center (FCCC) and Myriad Genetics (MGL). At FCCC, pedigrees of BRIP1 PV ( N= 10) and VUS families ( N= 47) were reviewed. The MGL population included patients referred for testing by multigene panel (9/2013-12/2019) ( N= 586,740). Multivariable logistic regression analysis estimated BRIP1 CA risks as odds ratios (ORs) and 95% confidence intervals (CIs). Models were adjusted for age, sex, ancestry, personal CA history (PHX), and family CA history. Results: In the FCCC cohort, BRIP1 PV carriers ( N= 12) reported PHX of early-onset ( < 50) BC, CRC, and bladder CA. BRIP1 VUS were also identified among several patients with striking PHX and negative panel testing: BC < 40 ( N= 3), bilateral BC ( N= 4), TNBC ( N= 2), CRC < 40 ( N= 3), and a patient with 3 CAs < 40 (CRC, BC, and Mel). All FCCC families with a BRIP1 PV and select VUS families ( N= 6) are seen in the Table. In the MGL population, 0.3% (1,678/586,740) carried a BRIP1 PV. Logistic regression analyses found that female BRIP1 PV carriers have significantly increased risk for OC (OR 2.40, 95% CI 1.93-2.98) and TNBC (OR 1.93, 95% CI 1.52-2.46). Data were insufficient for testing risk of bladder or prostate CA. Findings did not support associations of BRIP1 with CRC, melanoma, endometrial, pancreatic or gastric CA. Conclusions: BRIP1 PV and VUS may be identified in patients with diverse CA histories. These results confirm studies showing that BRIP1 PV are associated with an ~2-fold increased risk of OC and TNBC, but do not support increased risks of CRC, melanoma or endometrial CA in BRIP1 PV carriers. [Table: see text]

scholarly journals Prevalence of Germline Pathogenic Variants in Cancer Predisposing Genes in Czech and Belgian Pancreatic Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4430
Author(s):  
Greet Wieme ◽  
Jan Kral ◽  
Toon Rosseel ◽  
Petra Zemankova ◽  
Bram Parton ◽  
...  
Keyword(s):  
Ductal Adenocarcinoma ◽  
Multiple Primary Cancers ◽  
Cancer History ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Increased Risk ◽  
Predisposition Genes ◽  
Family Cancer History ◽  
Multigene Panel Testing ◽  
Multigene Panel

(1) Background: The proportion and spectrum of germline pathogenic variants (PV) associated with an increased risk for pancreatic ductal adenocarcinoma (PDAC) varies among populations. (2) Methods: We analyzed 72 Belgian and 226 Czech PDAC patients by multigene panel testing. The prevalence of pathogenic variants (PV) in relation to personal/family cancer history were evaluated. PDAC risks were calculated using both gnomAD-NFE and population-matched controls. (3) Results: In 35/298 (11.7%) patients a PV in an established PDAC-predisposition gene was found. BRCA1/2 PV conferred a high risk in both populations, ATM and Lynch genes only in the Belgian subgroup. PV in other known PDAC-predisposition genes were rarer. Interestingly, a high frequency of CHEK2 PV was observed in both patient populations. PV in PDAC-predisposition genes were more frequent in patients with (i) multiple primary cancers (12/38; 32%), (ii) relatives with PDAC (15/56; 27%), (iii) relatives with breast/ovarian/colorectal cancer or melanoma (15/86; 17%) but more rare in sporadic PDAC (5/149; 3.4%). PV in homologous recombination genes were associated with improved overall survival (HR = 0.51; 95% CI 0.34–0.77). (4) Conclusions: Our analysis emphasizes the value of multigene panel testing in PDAC patients, especially in individuals with a positive family cancer history, and underlines the importance of population-matched controls for risk assessment.

Uptake of oophorectomy in women with findings on multigene panel testing: Results from the Prospective Registry of Multiplex Testing (PROMPT).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1508-1508 ◽  
Author(s):  
Susan M. Domchek ◽  
Jamie Brower ◽  
Heather Symecko ◽  
Vanessa Marcell ◽  
Michael Francis Walsh ◽  
...  
Keyword(s):  
Cancer Susceptibility ◽  
Personal History ◽  
Variant Of Uncertain Significance ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Increased Risk ◽  
History Of ◽  
Multigene Panel Testing ◽  
Multiplex Testing ◽  
Multigene Panel

1508 Background: With the expansion of multigene panel testing for cancer susceptibility, increasing numbers of patients are identified with pathogenic/likely pathogenic variants (P/LP V) in genes which do not have a clearly actionable increased risk of ovarian cancer (OC) (lifetime risk of OC >5%). However, there is concern that patients and/or providers may ascribe OC risk to such genetic findings with the potential for unnecessary oophorectomy (ooph). Methods: The Prospective Registry of Multiplex Testing (PROMPT) is an online registry for individuals with a genetic alteration detected on multiplex panel testing for cancer susceptibility. Participants self-enroll and complete baseline and annual follow-up questionnaires. PROMPT has enrolled 7388 participants (6936; 93.9% women) since September 2014. Results: 1566 women in the PROMPT registry reported ooph, the indications for which were reported as either cancer treatment (n=481, 30.7%) or benign disease (n=432, 27.6%). An additional 186 (12.8%) reported PV in genes associated with lifetime OC risk >5% ( BRCA1, BRCA2, RAD51C, RAD51D, BRIP, or Lynch syndrome genes). The remaining 467 did not have guideline based indications for ooph due to OC risk and are described further here. 92 (19.7%) had a variant of uncertain significance (VUS) in genes associated with OC, 241 (51.6%) had a personal history of breast cancer (BC) and no VUS in OC genes, and 119 (25.5%) had no personal history of BC and no VUS in OC genes. The majority of women had no family history (FH) of OC in first or second degree relatives (Table). Most ooph occurred prior to age 50. Of the 405 women with CHEK2 P/LP, 11.4% reported ooph (59% under age 50 when age known), as did 13.2% (of 228) with CHEK2 VUS, 8.8% (of 261) with ATM P/LP (66.7% under age 50), and 8.3% (of 387) with ATM VUS. In addition, of the 184 women with PALB2 P/LP, 14.1% reported ooph (35.3% under age 50) as did 11.6% (of 198) with PALB2 VUS. Of those who reported provider discussions, 47.2% stated “my provider recommended this” (including >60% in the OC gene VUS group) and an additional 25.2% stated “my provider presented this as an option, but not a requirement”. In those with no FH of OC, 45.8% stated that their provider recommended ooph. Conclusions: 10-15% of women with PV/VUS in genes not associated with a high risk of OC reported ooph without a clear indication. [Table: see text]

scholarly journals Rare Germline Pathogenic Variants Identified by Multigene Panel Testing and the Risk of Aggressive Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1495
Author(s):  
Tú Nguyen-Dumont ◽  
James G. Dowty ◽  
Robert J. MacInnis ◽  
Jason A. Steen ◽  
Moeen Riaz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Prediction ◽  
Prediction Models ◽  
Risk Prediction Models ◽  
Aggressive Prostate Cancer ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Increased Risk ◽  
Predisposition Genes ◽  
Rare Genetic Variants

While gene panel sequencing is becoming widely used for cancer risk prediction, its clinical utility with respect to predicting aggressive prostate cancer (PrCa) is limited by our current understanding of the genetic risk factors associated with predisposition to this potentially lethal disease phenotype. This study included 837 men diagnosed with aggressive PrCa and 7261 controls (unaffected men and men who did not meet criteria for aggressive PrCa). Rare germline pathogenic variants (including likely pathogenic variants) were identified by targeted sequencing of 26 known or putative cancer predisposition genes. We found that 85 (10%) men with aggressive PrCa and 265 (4%) controls carried a pathogenic variant (p < 0.0001). Aggressive PrCa odds ratios (ORs) were estimated using unconditional logistic regression. Increased risk of aggressive PrCa (OR (95% confidence interval)) was identified for pathogenic variants in BRCA2 (5.8 (2.7–12.4)), BRCA1 (5.5 (1.8–16.6)), and ATM (3.8 (1.6–9.1)). Our study provides further evidence that rare germline pathogenic variants in these genes are associated with increased risk of this aggressive, clinically relevant subset of PrCa. These rare genetic variants could be incorporated into risk prediction models to improve their precision to identify men at highest risk of aggressive prostate cancer and be used to identify men with newly diagnosed prostate cancer who require urgent treatment.

scholarly journals Extended gene panel testing in lobular breast cancer

2021 ◽  
Author(s):  
Elke M. van Veen ◽  
D. Gareth Evans ◽  
Elaine F. Harkness ◽  
Helen J. Byers ◽  
Jamie M. Ellingford ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Testing ◽  
Detection Rate ◽  
Gene Panel ◽  
Lobular Breast Cancer ◽  
Germline Variants ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Gene Panel Testing ◽  
Increased Risk

AbstractPurpose: Lobular breast cancer (LBC) accounts for ~ 15% of breast cancer. Here, we studied the frequency of pathogenic germline variants (PGVs) in an extended panel of genes in women affected with LBC. Methods: 302 women with LBC and 1567 without breast cancer were tested for BRCA1/2 PGVs. A subset of 134 LBC affected women who tested negative for BRCA1/2 PGVs underwent extended screening, including: ATM, CDH1, CHEK2, NBN, PALB2, PTEN, RAD50, RAD51D, and TP53.Results: 35 PGVs were identified in the group with LBC, of which 22 were in BRCA1/2. Ten actionable PGVs were identified in additional genes (ATM(4), CDH1(1), CHEK2(1), PALB2(2) and TP53(2)). Overall, PGVs in three genes conferred a significant increased risk for LBC. Odds ratios (ORs) were: BRCA1: OR = 13.17 (95%CI 2.83–66.38; P = 0.0017), BRCA2: OR = 10.33 (95%CI 4.58–23.95; P < 0.0001); and ATM: OR = 8.01 (95%CI 2.52–29.92; P = 0.0053). We did not detect an increased risk of LBC for PALB2, CDH1 or CHEK2. Conclusion: The overall PGV detection rate was 11.59%, with similar rates of BRCA1/2 (7.28%) PGVs as for other actionable PGVs (7.46%), indicating a benefit for extended panel genetic testing in LBC. We also report a previously unrecognised association of pathogenic variants in ATM with LBC.

scholarly journals Multigene Panel Testing Increases the Number of Loci Associated with Gastric Cancer Predisposition

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1340 ◽  
Author(s):  
Gianluca Tedaldi ◽  
Francesca Pirini ◽  
Michela Tebaldi ◽  
Valentina Zampiga ◽  
Ilaria Cangini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gastric Cancer ◽  
Susceptibility Genes ◽  
Cancer Predisposition ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Cancer Susceptibility Genes ◽  
Number Of Patients ◽  
Multigene Panel Testing ◽  
Multigene Panel

The main gene involved in gastric cancer (GC) predisposition is CDH1, the pathogenic variants of which are associated with diffuse-type gastric cancer (DGC) and lobular breast cancer (LBC). CDH1 only explains a fraction (10–50%) of patients suspected of DGC/LBC genetic predisposition. To identify novel susceptibility genes, thus improving the management of families at risk, we performed a multigene panel testing on selected patients. We searched for germline pathogenic variants in 94 cancer-related genes in 96 GC or LBC Italian patients with early-onset and/or family history of GC. We found CDH1 pathogenic variants in 10.4% of patients. In 11.5% of cases, we identified loss-of-function variants in BRCA1, BRCA2, PALB2, and ATM breast/ovarian cancer susceptibility genes, as well as in MSH2, PMS2, BMPR1A, PRF1, and BLM genes. In 78.1% of patients, we did not find any variants with clear-cut clinical significance; however, 37.3% of these cases harbored rare missense variants predicted to be damaging by bioinformatics tools. Multigene panel testing decreased the number of patients that would have otherwise remained genetically unexplained. Besides CDH1, our results demonstrated that GC pathogenic variants are distributed across a number of susceptibility genes and reinforced the emerging link between gastric and breast cancer predisposition.

Is rising BMI associated with an increased rate of clinically relevant pancreatic fistula after distal pancreatectomy for pancreatic adenocarcinoma?

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 360-360
Author(s):  
Evan Scott Glazer ◽  
Yixuan Zhou ◽  
Justin Drake ◽  
Jeremiah Lee Deneve ◽  
Stephen W Behrman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Logistic Regression Analysis ◽  
Older Age ◽  
Ductal Adenocarcinoma ◽  
Multivariable Logistic Regression Analysis ◽  
Term Survival ◽  
Increased Risk

360 Background: Clinically relevant pancreatic fistula (CR-POPF), following distal pancreatectomy (DP) remains a clinical challenge. Prior studies investigating the relationship between body mass index (BMI) and CR-POPF have yielded conflicting results. We examined this relationship utilizing our institutional database and hypothesized that BMI is associated with CR-POPF in patients having DP for pancreatic ductal adenocarcinoma (PDAC). Methods: Patients who underwent DP for PDAC at a single institution from 2007 to 2018 were retrospectively reviewed. A CR-POPF was defined as ISGPS grade B or C fistula. Uni- and multi-variable logistic regression analysis to assess factors associated with CR-POPF following DP was performed, controlling for factors such as gland texture, operative drain placement, gender, and smoking status. Results: 78 patients met the inclusion criteria. 51% were female, 51% were Caucasian, and the average age was 59 ± 15 years. The median BMI was 26 (interquartile range 24 to 29). Overall, 19% (n = 15) of patients had a CR-POPF. With a mean follow up 2.8 ± 2.5 years, the presence of a CR-POPF was not associated with long-term survival (P = 0.17). On univariable logistic regression, older age was associated with a decreased risk of CR-POPF (OR = 0.95, P = 0.015) while increasing BMI was associated with an increased risk of CR-POPF (OR = 1.1, P = 0.044). After controlling for multiple factors on multivariable logistic regression analysis, BMI (OR = 1.12, P = 0.035) was the only factor associated with development of a CR-POPF while older age (OR = 0.94, P < 0.001) was slightly protective of CR-POPF development. Conclusions: For patients undergoing DP for PDAC, increasing BMI is associated with an increased risk of CR-POPF, independent of other factors. These findings should be considered during preoperative counseling. Although there is no specific cut-off for the association between BMI and CR-POPF, efforts to diminish the risk of CR-POPF should be focused on patients with higher BMI based on this data.

scholarly journals Applicability of logistic regression with sum-to-zero constraint parameterization in risk assessment for parotid malignancy

2019 ◽  
Author(s):  
Shari Messinger Cayetano ◽  
Kaming Lo ◽  
Christopher Fundakowski ◽  
Zoukaa Sargi
Keyword(s):  
Logistic Regression ◽  
Odds Ratio ◽  
Fine Needle Aspiration Biopsy ◽  
Clinical Presentation ◽  
Fold Increase ◽  
Needle Aspiration ◽  
Reference Cell ◽  
Model Parameterization ◽  
Increased Risk ◽  
Risk Of Disease

Abstract Background Investigative interest is often to determine how results from a diagnostic tool change the patient’s risk of disease with respect to the overall(naïve) risk at clinical presentation. Logistic regression is popular for data analysis for this type of investigation. However, standard approach, which uses reference cell coding, may not be informative in this setting. This is because this approach compares the risk between two distinct groups.Methods We considered weighted and unweighted approaches to model parameterization using deviation from means coding for assessing the risk of parotid malignancy, comparing patients with indeterminate fine-needle aspiration biopsy(FNAB) results with the general(naïve) risk among all presenting patients. Results from deviation from means coding and standard reference cell coding were compared.Results Unweighted coding estimates a two-fold increase in the odds of malignancy with an indeterminate FNAB result compared to the naïve odds at clinical presentation (Odds ratio(OR): 1.97 [95% Confidence Interval(CI): 1.34–2.90], P=0.0006). The weighted approach estimates increased risk (OR: 2.38 [95% CI: 1.45 – 3.89], P=0.0006), more accurately representing the naïve risk at presentation based on the direction of sample imbalance in the study. Using standard reference cell coding, an indeterminate result has a higher risk compared to a negative result, but this does not inform us about the risk with respect to that inherent at clinical presentation.Conclusions Depending on the investigative interest, it is important to adopt the appropriate coding methodology when logistic regression is applied. In addition, a weighted approach should be considered to account for sample imbalance.

scholarly journals Germline Pathogenic Variants in Cancer Predisposition Genes Among Women With Invasive Lobular Carcinoma of the Breast

2021 ◽  
Author(s):  
Siddhartha Yadav ◽  
Chunling Hu ◽  
Katherine L. Nathanson ◽  
Jeffrey N. Weitzel ◽  
David E. Goldgar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lobular Carcinoma ◽  
Population Based ◽  
Cancer Predisposition ◽  
Clinical Cohort ◽  
Breast Cancer Predisposition ◽  
Panel Testing ◽  
Pathogenic Variants ◽  
Predisposition Genes ◽  
Multigene Panel

PURPOSE To determine the contribution of germline pathogenic variants (PVs) in hereditary cancer testing panel genes to invasive lobular carcinoma (ILC) of the breast. MATERIALS AND METHODS The study included 2,999 women with ILC from a population-based cohort and 3,796 women with ILC undergoing clinical multigene panel testing (clinical cohort). Frequencies of germline PVs in breast cancer predisposition genes ( ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, and TP53) were compared between women with ILC and unaffected female controls and between women with ILC and infiltrating ductal carcinoma (IDC). RESULTS The frequency of PVs in breast cancer predisposition genes among women with ILC was 6.5% in the clinical cohort and 5.2% in the population-based cohort. In case-control analysis, CDH1 and BRCA2 PVs were associated with high risks of ILC (odds ratio [OR] > 4) and CHEK2, ATM, and PALB2 PVs were associated with moderate (OR = 2-4) risks. BRCA1 PVs and CHEK2 p.Ile157Thr were not associated with clinically relevant risks (OR < 2) of ILC. Compared with IDC, CDH1 PVs were > 10-fold enriched, whereas PVs in BRCA1 were substantially reduced in ILC. CONCLUSION The study establishes that PVs in ATM, BRCA2, CDH1, CHEK2, and PALB2 are associated with an increased risk of ILC, whereas BRCA1 PVs are not. The similar overall PV frequencies for ILC and IDC suggest that cancer histology should not influence the decision to proceed with genetic testing. Similar to IDC, multigene panel testing may be appropriate for women with ILC, but CDH1 should be specifically discussed because of low prevalence and gastric cancer risk.

scholarly journals 2211. Impact of Early Fiberoptic Bronchoscopy on Microbiological Diagnostic Rate and Clinical Outcomes of Pneumonia in Acute Leukemia Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S753-S754 ◽  
Author(s):  
Aki Sakurai ◽  
Justin E Bala-Hampton ◽  
Victor E Mulanovich ◽  
William G Wierda ◽  
Jorge E Cortes ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Acute Leukemia ◽  
Antibacterial Therapy ◽  
Univariate Analysis ◽  
Pneumonia Severity Index ◽  
Fiberoptic Bronchoscopy ◽  
Admission Rate ◽  
Cancer Center ◽  
Multivariable Logistic Regression Analysis ◽  
Significant Difference

Abstract Background Fiberoptic bronchoscopy with BAL (FOB) remains the cornerstone in the diagnosis of pneumonia in immunocompromised patients; however, there is no uniform agreement on the best timing for FOB, and its impact on microbiological diagnostic rate and clinical outcome has not been established. Methods Retrospective study (October 2017–December 2017, July 2018–January 2019) at MD Anderson Cancer Center. The medical records of adult patients with AML, MDS or ALL who developed pneumonia (CAP, HCAP, HAP excluding VAP) and underwent FOB were reviewed. By definition, patients who underwent FOB within 48 hours after the diagnosis of pneumonia were categorized as early FOB group. We compared demographic, clinical, microbiological data, and outcomes between two groups. Data were analyzed via χ 2, Fisher’s exact and Wilcoxon rank-sum test and logistic regression. Results Of 140 patients included, 33 patients (24%) had early FOB and 107 patients (76%) had late FOB. There was no significant difference between two groups in demographic features, radiological findings, ANC and pneumonia severity index. Microbiological diagnostic rate of FOB did not differ between early FOB and late FOB: identification of pathogenic microorganisms (33.3% vs. 36.5%, p = 0.837), bacteria (6.1% vs. 13.1%, P = 0.36), fungi (18.2% vs. 12.2%, P = 0.39) and respiratory virus (12.1% vs. 16.8%, P = 0.6), respectively (Figures 1 and 2). On univariate analysis, the duration of intravenous antibacterial therapy was shorter in early FOB, with a median duration of 8.5 days (IQR 6.5–12) in early FOB and 11 days (IQR 8–18) in late FOB (P = 0.0047) (Figure 3). Multivariable logistic regression analysis showed that late FOB (OR 3.26, 95% CI 1.41 to 7.53, P = 0.0057) and negative bacterial culture on FOB (OR 3.06, 95% CI 1.01 to 9.22, P = 0.048) were significantly associated with longer duration of intravenous antibacterial therapy (≥10 days). There was no significant difference in ICU admission, 30-day and 60-day mortality and re-admission rate. Conclusion Early FOB was associated with shorter duration of intravenous antibacterial therapy for pneumonia in acute leukemia patients, which has an important impact on both optimization of antimicrobial therapy for patients and improvement of antimicrobial stewardship. Disclosures All authors: No reported disclosures.

Predicting hospital readmissions in the oncology population.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 177-177
Author(s):  
Sarah Thirlwell ◽  
Kristine A. Donovan ◽  
Mary Turney ◽  
C. Edward Emnett ◽  
Amber Lamoreaux ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Predictive Value ◽  
Emergency Department Visits ◽  
Cancer Center ◽  
Medical Setting ◽  
Cutoff Score ◽  
Operating Characteristics ◽  
Important Indicator ◽  
Increased Risk ◽  
Receiver Operating

177 Background: The 30-day readmission rate is established as an important indicator of quality of care. The LACE index is commonly used in the general medical setting to predict readmission but its ability to predict readmission with sensitivity and specificity in the oncology population has not yet been examined. At our cancer center, palliative care (PC) consultation is associated with an increased risk for readmission but it is not an element in the LACE index. Methods: We sought to characterize the operating characteristics of the LACE Index using receiver operating characteristics analyses to predict unplanned readmissions to our cancer center over a 6-week period beginning March 2016. Data was gathered from chart review to calculate a total LACE score for each unplanned admission. Logistic regression was used to examine the individual components of the LACE index and whether a PC consult improved the performance of the index. Results: A total of 329 patients with unplanned admissions were included. Fifty-nine (17.9%) were readmitted within 30 days of discharge. There was no difference between the median LACE scores of those readmitted compared to those who were not (Md = 10.0; p = .93). Receiver operating characteristic (ROC) curve analyses of LACE scores yielded an area under the curve estimate relative to 30-day readmissions of .45 indicative of poor overall accuracy. ROC analyses also showed that the previously established LACE cutoff score of 10 had sensitivity of .54 and specificity of .57 relative to readmissions. The positive predictive value was .81 and the negative predictive value was .18. In logistic regression analysis, only direct referral center/emergency department visits were an independent predictor of readmission, with a c-statistics of .64 for readmission. The inclusion of a PC consult did not improve the performance of the index. Conclusions: The LACE Index performed poorly in predicting 30-day readmission in the oncology setting; the inclusion of whether a PC consult took place did not improve the index’s utility. Further research is required to create a new tool or enhance existing indices to predict readmission in the oncology population.

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