The Impact of Primary Tumor Location on Long-Term Survival in Patients Undergoing Hepatic Resection for Metastatic Colon Cancer

455 Background: Metastatic colon cancer (mCC) patients often receive multiple lines of chemotherapy as treatment (TX) to improve survival or quality of life, yet the “real world” benefits and risks of multiple TX lines have not been fully examined. Methods: Elderly (65+) SEER-Medicare patients diagnosed with mCC in 2003-2007 were followed until death or 12/31/09 to examine the survival benefits for different chemotherapy lines. The median time between diagnosis date and the starting date of 2nd line was 352 days. Therefore, we restricted comparative analysis of 2nd and subsequent chemotherapy TX lines to patients who survived at least 1 year after mCC diagnosis date. We used Cox regression framework and adjusted for patients’ TX and censoring histories by using inverse probability weighting method. Separate analyses were conducted for short (2 years) and long-term (5 years) survival to examine different benefits of 2nd and subsequent chemotherapy lines. Results: Of 2,600 elderly Medicare mCC patients diagnosed between 2003-2007 and who survived at least 1 year, 2,530 were dead by the end of 2009. Significant factors associated with long-term survival were 1st line therapy(HR = 0.76; p < 0.01), 2nd line therapy (HR = 0.83; p < 0.01) , and subsequent chemotherapy line therapy(HR = 0.85; p = 0.04), as compared to no therapy, age groups 95+ (HR = 3.07; p < 0.01), 85-94 (HR = 1.33; p < 0.01), and 75-84 (HR = 1.10; p = 0.04) as compared to 65+-74, Asian vs. White (HR = 0.71; p < 0.01), and zip code level household median income (HR = 0.98; p = 0.01). For short-term survival, the benefits of 2nd and subsequent chemotherapy lines were maintained until month 29. Patients with poor performance status were less likely to proceed to 2nd line therapy. No statistically significant variables predicting receipt of subsequent chemotherapy lines were identified. Conclusions: Among elderly Medicare mCC patients who survived at least 1 year after diagnosis, 1st line therapy improved both short and long-term survival. 2nd and subsequent chemotherapy line therapy reduced short-term mortality (2 years); however, they didn’t add any additional long term survival benefit (5 years) as compared to 1st line therapy.

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Cardiac Recurrence in a Patient with Long-Term Survival from Metastatic Colon Cancer

Case Reports in Oncology ◽

10.1159/000338741 ◽

2012 ◽

Vol 5 (1) ◽

pp. 202-207

Author(s):

Annabelle Butler ◽

Eric A. Wiebke

Keyword(s):

Colon Cancer ◽

Metastatic Colon Cancer ◽

Term Survival ◽

Long Term Survival

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Pathologic factors are more important than tumor location in long-term survival in colon cancer

International Journal of Colorectal Disease ◽

10.1007/s00384-018-3027-5 ◽

2018 ◽

Vol 33 (6) ◽

pp. 709-717 ◽

Cited By ~ 3

Author(s):

L. G. J. Leijssen ◽

A. M. Dinaux ◽

H. Kunitake ◽

L. G. Bordeianou ◽

D. L. Berger

Keyword(s):

Colon Cancer ◽

Tumor Location ◽

Term Survival ◽

Long Term Survival

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The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis

Journal of Personalized Medicine ◽

10.3390/jpm11121363 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1363

Author(s):

Wojciech Krajewski ◽

Łukasz Nowak ◽

Bartosz Małkiewicz ◽

Joanna Chorbińska ◽

Paweł Kiełb ◽

...

Keyword(s):

Systematic Review ◽

Urothelial Carcinoma ◽

Primary Tumor ◽

Meta Analysis ◽

Tumor Location ◽

Radical Nephroureterectomy ◽

Primary Tumor Location ◽

Oncological Outcomes ◽

The Impact

Background: Upper tract urothelial carcinoma (UTUC) accounts for up to 10% of all urothelial neoplasms. Currently, various tumor-related factors are proposed to be of importance in UTUC prognostic models; however, the association of the primary UTUC location with oncological outcomes remains controversial. Thus, we sought to perform a systematic review and meta-analysis of the latest available evidence and assess the impact of primary tumor location on long-term oncological outcomes in patients with UTUC undergoing radical nephroureterectomy. Materials and Methods: A computerized systematic literature search was conducted in October 2021 through the PubMed, Web of Science, Scopus, and Cochrane Library databases. The primary endpoint was cancer-specific survival (CSS), and the secondary endpoints were overall survival (OS) and disease-free survival (DFS). Effect measures for the analyzed outcomes were reported hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among the total number of 16,836 UTUC in 17 included studies, 10,537 (62.6%) were renal pelvic tumors (RPTs), and 6299 (37.4%) were ureteral tumors (UTs). Pooled results indicated that patients with UT had significantly worse CSS (HR: 1.37, p < 0.001), OS (HR: 1.26, p = 0.003, and DFS (HR: 1.51, p < 0.001) compared to patients with RPT. Based on performed subgroup analyses, we identified different definitions of primary tumor location and geographical region as potential sources of heterogeneity. Conclusions: Ureteral location of UTUC is associated with significantly worse long-term oncological outcomes. Our results support the need for close follow-up and the consideration of perioperative chemotherapy in patients with UTUC located in the ureter. However, further prospective studies are needed to draw final conclusions.

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Variation in center-level frailty burden and the impact of frailty on long-term survival in patients undergoing elective repair for abdominal aortic aneurysms

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.01.074 ◽

2020 ◽

Vol 71 (1) ◽

pp. 46-55.e4 ◽

Cited By ~ 9

Author(s):

Elizabeth L. George ◽

Rui Chen ◽

Amber W. Trickey ◽

Benjamin S. Brooke ◽

Larry Kraiss ◽

...

Keyword(s):

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Term Survival ◽

Long Term Survival ◽

Abdominal Aortic ◽

Elective Repair ◽

The Impact

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Long-Term Tacrolimus Blood Trough Level and Patient Survival in Adult Liver Transplantation

Journal of Personalized Medicine ◽

10.3390/jpm11020090 ◽

2021 ◽

Vol 11 (2) ◽

pp. 90

Author(s):

Chih-Yang Hsiao ◽

Ming-Chih Ho ◽

Cheng-Maw Ho ◽

Yao-Ming Wu ◽

Po-Huang Lee ◽

...

Keyword(s):

Patient Survival ◽

Trough Level ◽

Medical Center ◽

Term Survival ◽

Blood Concentrations ◽

Long Term Survival ◽

Tacrolimus Level ◽

Cox's Model ◽

The Impact

Tacrolimus is the most widely used immunosuppressant in liver transplant (LT) patients. However, the ideal long-term target level for these patients is unknown. This retrospective study aimed to investigate the impact of tacrolimus blood concentration five years after LT on long-term patient survival outcomes in adult LT recipients. Patients who underwent LT between January 2004 and July 2014 at a tertiary medical center were included in this study (n = 189). The mean tacrolimus blood concentrations of each patient during the fifth year after LT were recorded and the overall survival rate was determined. A multivariate analysis of factors associated with long-term survival was conducted using a Cox’s model. The median follow-up period was 9.63 years, and 144 patients (76.2%) underwent live donor LT. Sixteen patients died within 5 years of LT. In the Cox’s model, patients with a mean tacrolimus blood trough level of 4.6–10.2 ng/mL had significantly better long-term survival than those with a mean tacrolimus blood trough level outside this range (estimated hazard ratio = 4.76; 95% confidence interval: 1.34–16.9, p = 0.016). Therefore, a tacrolimus level no lower than 4.6 ng/mL would be recommended in adult LT patients.

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