Proportion and Prognosis of Bone Metastases from Gastric Cancer in SEER database

Abstract Purpose The purpose of this study was to analyze the proportion and prognosis of bone metastases at diagnosis of gastric cancer using population-based data from SEER. Patients and methods Patients with gastric cancer and bone metastases (GCBM) at the time of diagnosis in advanced gastric cancer were identified using the Surveillance, Epidemiology and End Result (SEER) database of the National Cancer Institute. Multivariable logistic and Cox regression were performed to identify predictors of the presence of GCBM at diagnosis and factors associated with all-cause mortality and gastric cancer-specific mortality. Survival curves were obtained according to the Kaplan-Meier method and compared using the log-rank test. Results We identified 975 patients with gastric cancer and bone metastases at the time of diagnosis, representing 5.31% of the entire cohort and 13.35% of the subset with metastatic disease to any distant site. Among entire cohort, multivariable logistic regression identified five factors (lower age, diffused-type, adverse pathology grade, N1 staging and presence of more extraosseous metastases to liver, lung and brain.) as positive predictors of the presence of bone metastases at diagnosis. Median survival among the entire cohort with GCBM was 4.0 months (interquartile range: 1.0-8.0mo). Multivariable Cox model in SEER cohort confirmed two factors (non-cardia stomach and absence of chemotherapy) as negative predictors for overall survival. We also found poor survival in non-surgical patients using Fine and Gray’s competing risk regression model. Conclusion The findings of this study provided population-based estimates of the proportion and prognosis for GCBM at time of diagnosis. These findings provided guidance for screening and treatment of GCBM patients. Chemotherapy may make benefit for overall survival, but the role of surgery remained to be determined by further research.

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Does chemotherapy work in reversal of malignant obstruction due to gastric cancer?

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21676 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21676-e21676

Author(s):

Vanessa Montes Santos ◽

Renata Gondim Meira Velame Azevedo ◽

Rossana Veronica Mendoza Lopez ◽

Paulo Marcelo Hoff ◽

Jorge Sabbaga ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cox Regression ◽

Metastatic Gastric Cancer ◽

Rank Test ◽

Anticholinergic Drugs ◽

Significance Level ◽

Malignant Obstruction ◽

Kaplan Meier ◽

Clinical Measures

e21676 Background: Malignant obstruction (MO) is a common complication in patients with gastric cancer. Although palliative chemotherapy has already shown beneficial for overall survival in advanced cases, its value for MO reversal is still unknown. Methods: Inthis retrospective study we analyzed all consecutive patients with metastatic gastric cancer admitted with MO at the Instituto do Câncer do Estado de São Paulo (ICESP) from 2008 to 2016. The primary and secondary endpoints were overall survival and obstruction reversal rate respectively. Clinical measures other than chemotherapy and alimentary pause included the use of octreotide 0.1 mg, 3 times a day, steroids, antiemetics and anticholinergic drugs. Survival curves were calculated by Kaplan-Meier and log-rank test was used to compare them. The Cox regression model was used to evaluate risk factors for overall survival and the hazard ratio (HR) was calculated with its respective 95% confidence intervals. The analysis was performed in SPSS v.18 for Windows statistical software, and the significance level was 5%. Results: One hundred and eighteen(118)patients were included. Median overall survival was 11.2 months and survival time after the MO was 3.6 months for the whole group. Median time of use of octreotide was 3 days. Reversal of obstruction was seen in 16 of 36 patients (38.4%) in which chemotherapy was used and only in 22 of the 92 patients (24%) treated with exclusive clinical measures. In spite of these figures a significant better overall survival (p 0.002) was achieved in the group of patients that reached obstruction reversal without chemotherapy (13.6 months vs. 11.6 months for the clinical treatment group). Conclusions: This study suggests that chemotherapy even when reversing MO, has no impact in patients overall survival. These finding is particularly relevant for cost contingency in settings with limited resources. .

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Value of Radiotherapy in Primary Gastric Cancer and Establishment of a Prognostic Nomogram Model

10.21203/rs.3.rs-133308/v1 ◽

2020 ◽

Author(s):

Tongchao Jiang ◽

Nan Li ◽

Haishuang Sun ◽

Tongcui Jiang

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Cox Regression ◽

Tumor Grade ◽

Rank Test ◽

Seer Database ◽

Cancer Specific Survival ◽

Primary Tumor Site ◽

Entire Cohort

Abstract Background: This study aimed to compare the use of radiotherapy (RT) in gastric cancer (GC) patients from the SEER database and established a nomogram to assess cancer-specific survival (CSS).Methods: Patients from the SEER database between 2004 and 2013 were analyzed. Survival was analyzed by Kaplan-Meier curves and log-rank test. Prognostic factors in multivariate Cox analysis were screened to construct a nomogram. The performance the nomogram was validated via concordance index (C-index), calibration plots, and decision curve analyses (DCAs). Results: 9653 GC patients were analyzed totally. In the entire cohort, patients who received pre/postoperative RT had better survival than those who did not receive RT (P = 0.043 and < 0.001, respectively). Similar results were observed in lymph node-positive patients. However, no significant survival benefit was seen in lymph node-negative patients between postoperative RT group and no RT group (P = 0.057), but patients who received postoperative RT and those who did not receive RT experienced better survival than those who received preoperative RT (P < 0.001 and 0.001, respectively). Prognostic factors of GC analyzed by Cox regression model included age, race, tumor grade, tumor histology type, primary tumor site, T stage, lymph node metastasis ratio, RT status, and chemotherapy information independently (P < 0.001). The nomogram was established and showed excellent prediction performance, and its C-index of 0.725 were significantly higher than those of nomograms based AJCC system with C-index at 0.643. In addition, the calibration plots performed good consistency between the predicted and actual survival probabilities, and the DCAs indicated better clinical net benefits than the traditional AJCC system.Conclusions: RT can improve CSS in GC patients, especially those with positive lymph nodes. The construction and verification of a nomogram based on SEER database can effectively predict the survival outcomes of GC patients.

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Survival and prognostic factors analyses in malignant giant cell tumor of bone

10.21203/rs.2.12960/v2 ◽

2020 ◽

Author(s):

Jin Zhang ◽

Xin Wang ◽

Feng Lin ◽

Guijun Xu ◽

Haixiao Wu ◽

...

Keyword(s):

Cox Regression ◽

Large Population ◽

Univariate Analysis ◽

Survival Rates ◽

Population Based ◽

Rank Test ◽

Seer Database ◽

Kaplan Meier ◽

Giant Tumor ◽

Cox Proportional Hazard Regression

Abstract Background: The characteristics and survival in patients with malignant giant tumor cancer of bone (GCTB) have not been investigated thoroughly due to the limited population. We evaluated the issues based on a large cohort in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Methods: Patients who were diagnosed with malignant GCTB from 1975 to 2016 were extracted from the SEER database. The overall survival (OS) was calculated by Kaplan–Meier analysis and the inter-group difference was tested by log-rank test. Univariate and multivariate Cox proportional hazard regression were conducted to identify the independent survival factors. Results: A total of 325 patients with malignant GCTB were included. The overall 1-, 5-, and 10-year survival rates were 94.3% (95% CI: 91.7-96.8), 82.3% (95% CI: 77.9-86.6), and 80.1% (95% CI: 75.4-84.7), respectively. In the univariate analysis, age older than 34 years, grade IV, T2/3 stage, M1, distant and surgery of the primary site were independent factors for worse survival. Multivariate Cox regression showed the poor survival in patients with age older than 34 years (hazard ratio (HR) =3.65, 95% CI: 2.04-6.56, P <0.001), T2 stage (HR=4.85, 95% CI: 1.52-15.47, P =0.008), and distant tumor (HR=2.93, 95% CI: 1.24-6.88, P =0.014), and the extra-skeletal sites (HR=8.84, 95% CI: 2.89-27.07, P <0.001), respectively. Conclusions: This large population-based series described the clinical characteristics of the malignant GCTB. Age >34 years, T2, distant stage and extra-skeletal sites were associated with worse survival in the patients with malignant GCTB.

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Survival and Prognostic Factors Analyses in Malignant Giant Cell Tumor of Bone

10.21203/rs.3.rs-54236/v1 ◽

2020 ◽

Author(s):

Jin Zhang ◽

Xin Wang ◽

Feng Lin ◽

Guijun Xu ◽

Haixiao Wu ◽

...

Keyword(s):

Giant Cell ◽

Cox Regression ◽

Large Population ◽

Survival Rates ◽

Population Based ◽

Rank Test ◽

Seer Database ◽

Kaplan Meier ◽

Increased Risk ◽

Cox Proportional Hazard Regression

Abstract Background: The characteristics and survival of patients with malignant giant cell tumour of bone (GCTB) have not been investigated thoroughly due to the rarity of the disease. We evaluated these factors in a large cohort in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.Methods: Data from patients who were diagnosed with malignant GCTB from 1975 to 2016 were extracted from the SEER database. The overall survival was calculated by Kaplan–Meier analysis, and intergroup differences were tested by the log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were conducted to identify the independent survival factors.Results: A total of 325 patients with malignant GCTB were included. The overall 1-, 5-, and 10-year survival rates were 94.3% (95% CI: 91.7-96.8), 82.3% (95% CI: 77.9-86.6), and 80.1% (95% CI: 75.4-84.7), respectively. A potential non-linear J-shaped dose–response relationship between the age or diagnosis year and survival were found. Multivariate Cox regression showed poor survival in patients with age from 35 to 60 years (HR=9.99, 95% CI: 1.34-74.80, P=0.025), age older than 60 years (HR=62.03, 95% CI: 7.94-484.38, P<0.001), with stage T2 disease (HR=4.85, 95% CI: 1.52-15.47, P=0.008), with stage T3 disease (HR=6.09, 95% CI: 1.03-36.23, P=0.047), and with distant tumours (HR=2.76, 95% CI: 1.14-6.65, P=0.024), and extraskeletal sites (HR=3.33, 95% CI: 1.02-10.85, P=0.046).Conclusions: This large population-based series described the clinical characteristics of malignant GCTB. Patients with stage T2/3 disease, distant disease and extra-skeletal sites had more odds to be with worse survival. The elder age than 34 years had a gradually increased risk for survival.

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Survival Outcomes for Induction vs Adjuvant Chemotherapy in Squamous Cell Carcinoma of the Maxillary Sinus

Otolaryngology ◽

10.1177/0194599818804777 ◽

2018 ◽

Vol 160 (4) ◽

pp. 658-663 ◽

Cited By ~ 4

Author(s):

Phoebe Kuo ◽

Sina J. Torabi ◽

Dennis Kraus ◽

Benjamin L. Judson

Keyword(s):

Overall Survival ◽

Adjuvant Chemotherapy ◽

Maxillary Sinus ◽

Induction Chemotherapy ◽

Squamous Cell ◽

Cox Regression ◽

Rank Test ◽

Controlled Clinical Trial ◽

Log Rank Test ◽

Kaplan Meier

Objective In advanced maxillary sinus cancers treated with surgery and radiotherapy, poor local control rates and the potential for organ preservation have prompted interest in the use of systemic therapy. Our objective was to present outcomes for induction compared to adjuvant chemotherapy in the maxillary sinus. Study Design Secondary database analysis. Setting National Cancer Database (NCDB). Subjects and Methods In total, 218 cases of squamous cell maxillary sinus cancer treated with surgery, radiation, and chemotherapy between 2004 and 2012 were identified from the NCDB and stratified into induction chemotherapy and adjuvant chemotherapy cohorts. Univariate Kaplan-Meier analyses were compared by log-rank test, and multivariate Cox regression was performed to evaluate overall survival when adjusting for other prognostic factors. Propensity score matching was also used for further comparison. Results Twenty-three patients received induction chemotherapy (10.6%) and 195 adjuvant chemotherapy (89.4%). The log-rank test comparing induction to adjuvant chemotherapy was not significant ( P = .076). In multivariate Cox regression when adjusting for age, sex, race, comorbidity, grade, insurance, and T/N stage, there was a significant mortality hazard ratio of 2.305 for adjuvant relative to induction chemotherapy (confidence interval, 1.076-4.937; P = .032). Conclusion Induction chemotherapy was associated with improved overall survival in comparison to adjuvant chemotherapy in a relatively small cohort of patients (in whom treatment choice cannot be characterized), suggesting that this question warrants further investigation in a controlled clinical trial before any recommendations are made.

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Lymphopenia Is Associated with Gross Target Volumes and Fractions in Hepatocellular Carcinoma Patients Treated with External Beam Radiation Therapy and Also Indicates Worse Overall Survival

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/9691067 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Hai-Ge Zhang ◽

Ping Yang ◽

Tao Jiang ◽

Jian-Ying Zhang ◽

Xue-Juan Jin ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Cox Regression ◽

External Beam Radiation ◽

Rank Test ◽

Beam Radiation ◽

Kaplan Meier ◽

Target Volumes ◽

The Relationship

Purpose. To investigate whether lymphocyte nadir induced by radiation is associated with survival and explore its underlying risk factors in patients with hepatocellular carcinoma (HCC). Methods. Total lymphocyte counts were collected from 184 HCC patients treated by radiotherapy (RT) with complete follow-up. Associations between gross tumor volumes (GTVs) and radiation-associated parameters with lymphocyte nadir were evaluated by Pearson/Spearman correlation analysis and multiple linear regression. Kaplan–Meier analysis, log-rank test, as well as univariate and multivariate Cox regression were performed to assess the relationship between lymphocyte nadir and overall survival (OS). Results. GTVs and fractions were negatively related with lymphocyte nadir (p<0.001 and p=0.001, respectively). Lymphocyte nadir and Barcelona Clinic Liver Cancer (BCLC) stage were independent prognostic factors predicting OS of HCC patients (all p<0.001). Patients in the GTV ≤55.0 cc and fractions ≤16 groups were stratified by lymphocyte nadir, and the group with the higher lymphocyte counts (LCs) showed longer survival than the group with lower LCs (p<0.001 and p=0.006, respectively). Patient distribution significantly differed among the RT fraction groups according to BCLC stage (p<0.001). However, stratification of patients in the same BCLC stage by RT fractionation showed that the stereotactic body RT (SBRT) group achieved the best survival. Furthermore, there were significant differences in lymphocyte nadir among patients in the SBRT group. Conclusions. A lower lymphocyte nadir during RT was associated with worse survival among HCC patients. Smaller GTVs and fractions reduced the risk of lymphopenia.

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Consolidative Radioimmunotherapy after Chemoimmunotherapy in Patients with Histologic Transformation of Indolent Lymphoma

Blood ◽

10.1182/blood.v124.21.1746.1746 ◽

2014 ◽

Vol 124 (21) ◽

pp. 1746-1746

Author(s):

Patrick M. Reagan ◽

Jennifer L. Kelly ◽

Andrea Baran ◽

Paul M. Barr ◽

Carla Casulo ◽

...

Keyword(s):

Overall Survival ◽

Unmet Need ◽

Common Adverse Event ◽

Secondary Outcome ◽

Rank Test ◽

Cell Transplant ◽

Indolent Lymphoma ◽

Mortality And Morbidity ◽

Entire Cohort ◽

Kaplan Meier

Abstract Introduction:Histologic transformation (HT) has been well characterized in follicular lymphoma (FL), and has historically carried a poor prognosis with median overall survival (OS) of 1.2-1.8 years (yrs) in the pre-rituximab era (Montoto et al, 2007; Al-Tourah et al 2008). Despite improved outcomes in the rituximab era (Link et al, 2013), HT still represents a major source of mortality and morbidity in these patients (pts). While there is emerging evidence that autologous stem cell transplant (ASCT) confers a survival advantage compared to chemotherapy with rituximab alone (Ban-Hoefen et al, 2013; Villa et al, 2013), many of these patients have contraindications such as advanced age and frailty precluding ASCT as an option. We report a strategy of radioimmunotherapy (RIT) consolidation after chemoimmunotherapy to address this unmet need. Methods: Consecutive pts ≥ 18 yrs old, who received RIT as consolidation after chemoimmunotherapy for HT at the Wilmot Cancer Institute were identified who had been deemed ineligible for ASCT. Inclusion criteria were as follows: 1) clinical, composite or pathologic diagnosis of HT, and 2) receipt of RIT after response to rituximab and chemotherapy. HT was defined as biopsy confirmed diffuse large B cell or Burkitt-like lymphoma by the WHO classification ≥6 months following a biopsy establishing indolent lymphoma diagnosis (pathologic HT), or clinical evidence of transformation as defined in previous cohorts (Al-Tourah et al, 2008; Link et al, 2013) in the absence of biopsy confirmation (clinical HT). Composite diagnosis of HT was defined as concurrent indolent and large cell lymphoma. The primary endpoint was overall survival (OS). Progression free survival (PFS) was a secondary outcome. Kaplan-Meier survival estimation curves were generated using SAS (SAS Institute Inc., Cary, NC, USA), and p values were generated using the log rank test. Results: 21 consecutive pts who had a clinical, composite, or pathologic HT diagnosis were included in this analysis. All of these pts responded to rituximab and chemotherapy (CHOP like n=18, other n=3), and were treated with RIT for consolidation. The median age at the time of HT was 66 yrs (44-90). Nine pts received I-131 tositumomab and 12 received Y-90 ibritumomab tiuxetan. The median OS from HT was 6.9 yrs in the entire cohort with a median follow up of 3.5 yrs (Figure). There were no statistical differences in outcomes between the pathologic (n=11) and clinical/composite (n=10) HT pts (p=0.33). There was also no difference between those who received rituximab prior to HT (n=13), and those who did not (n=8; p=0.88). Twelve pts experienced grade 3-4 thrombocytopenia, which was the most common adverse event (AE). Nine deaths occurred. Disease-related death was the most common cause (n=4), followed by death unrelated to disease or treatment (n=3) and treatment-related death (n=2). Figure: Kaplan-Meier estimate of OS after HT in pts receiving RIT after chemoimmunotherapy (n=21) Figure:. Kaplan-Meier estimate of OS after HT in pts receiving RIT after chemoimmunotherapy (n=21) Conclusions: We report the use of RIT as consolidation of response to chemoimmunotherapy in pts with HT. This represents one of the largest series focused on pts with HT who were deemed unfit for ASCT. The RIT was well tolerated in this analysis with only 2 treatment related deaths, one of which was secondary to therapy related acute myeloid leukemia. Our observed median OS compares favorably to published reports of pts with HT who are younger and able to tolerate more aggressive therapeutic options. Consolidative RIT should be considered as a treatment approach in this vulnerable population of pts, and can serve as a platform for the incorporation of novel agents into prospective clinical trials. Disclosures Barr: Pharmacyclics: Research Funding.

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Marital Status Independently Predicts Survival in Patients with Small Cell Lung Cancer: A SEER Database Analysis

10.21203/rs.3.rs-832341/v1 ◽

2021 ◽

Author(s):

Pei Luo ◽

Yan Mao ◽

Liping Yang ◽

Chao Pan ◽

Jun Guo

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Marital Status ◽

Cell Lung Cancer ◽

Cox Regression ◽

Small Cell ◽

Rank Test ◽

Seer Database ◽

Small Cell Lung ◽

Kaplan Meier

Abstract Purpose This study will investigate the relationship between marital status and prognosis in small cell lung cancer patients. Methods Patients of SCLC was selected from the SEER database (1973-2013) and the patient sinformation. Kaplan-Meier analysis, log-rank test and Cox regression model were used for studying patientprognosis. Result 27069 SCLC patients eligible for inclusion were screened from the SEER database. Kaplan-meier test showed that the median OS values were 8, 7, 6 months in married, single and SDW patients, respectively. Conclusion This study shows that marital status is an independent prognostic factor for overall survival in SCLC patients. Married patients with small cell lung cancer have better prognosis than those who were divorced/separated, widowed and single.

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MicroRNA-124 alone might represent an indicator signifying cholangiocarcinoma prognosis

10.21203/rs.3.rs-33111/v1 ◽

2020 ◽

Author(s):

Ning Wang ◽

Yanni Li ◽

Yanfang Zheng ◽

Huoming Chen ◽

Xiaolong Wen ◽

...

Keyword(s):

Overall Survival ◽

Cox Regression ◽

Prognostic Biomarker ◽

Prognostic Indicator ◽

Rank Test ◽

Chi Square ◽

Log Rank Test ◽

Kaplan Meier ◽

Chi Square Test ◽

Polymerase Chain

Abstract Background: Previous studies have demonstrated that microRNAs (miRNAs) played a crucial role in various diseases, including cancers. The aim of the study was to evaluate the clinical significance of miR-124 in patients with cholangiocarcinoma (CCA).Methods: The expression pattern of miR-124 was detected in CCA tissues using quantitative reserve transcription polymerase chain reaction (qRT-PCR). The correlation of miR-124 expression with clinicopathological features and overall survival of patients were explored using chi-square test, Kaplan-Meier methods and Cox regression analyses.Results: The miR-124 expression level was strong down-regulated in CCA tissues compared with normal para-cancerous tissues (P<0.001). Moreover, aberrant miR-124 expression was significantly associated with differentiation (P=0.045) and lymph node metastasis (P=0.040). In addition, Kaplan-Meier method and log-rank test revealed that patients with low miR-124 expression has a poorer overall survival compared with those with high miR-124 expression (P=0.002). Furthermore, multivariate analysis confirmed that miR-124 expression (P=0.006; HR=2.006; 95%CI: 1.224-3.289) was an independent prognostic indicator in CCA.Conclusions: Collectively, our results defined miR-124 expression plays important roles in CCA patients. MiR-124 expression might used as a valuable prognostic biomarker for patients with CCA.

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Objective quantitation of EGFR protein levels using Quantitative Dot Blot (QDB) method for prognosis of gastric cancer patients

10.1101/2021.04.12.21255321 ◽

2021 ◽

Author(s):

Lei Xin ◽

Fangrong Tang ◽

Bo Song ◽

Maozhou Yang ◽

Jiandi Zhang

Keyword(s):

Gastric Cancer ◽

Lung Cancer ◽

Overall Survival ◽

Clinical Trials ◽

Cancer Patients ◽

Cox Regression ◽

Dot Blot ◽

Protein Levels ◽

Kaplan Meier ◽

Gastric Cancer Patients

Background: One causing factor underlying failures of several clinical trials of anti-EGFR therapies is the lack of effective method to select patients overexpressing EGFR protein. Quantitative Dot Blot method (QDB) is proposed here to measure EGFR protein levels objectively and quantitatively. Its feasibility was evaluated for prognosis of overall survival (OS) of gastric cancer patients. Methods: FFPE slices of 2X5 microM from gastric and Lung cancer specimens were used to extract total tissue lysates for QDB measurement. Absolutely quantitated EGFR protein levels were used for Kaplan-Meier Overall Survival (OS) analysis of gastric cancer patients. Results: EGFR protein levels ranged from 0 to 772 pmole/g for gastric cancer specimens (n=246), and from 0 to 2695 pmole/g for lung cancer patients (n=81). Poor correlation was observed between quantitated EGFR levels and IHC scores with r=0.018, p=0.786 from Spearman correlation analysis. EGFR was identified as an independent negative prognostic biomarker for gastric patients only through absolute quantitation, with HR at 2.29 (95%CI:1.23-4.26, p=0.0089) from multivariate cox regression OS analysis. A cutoff of 207.7 pmole/g was proposed to stratify gastric cancer patients, with 5-year survival probability at 37% for those whose EGFR levels were above the cutoff, and at 64% those below the cutoff based on Kaplan-Meier OS analysis. p=0.0057 from Log Rank test. Conclusion: A QDB-based assay was developed for both gastric and Lung cancer specimens to measure EGFR protein levels absolutely, quantitatively and objectively. This assay should facilitate clinical trials aiming to evaluate anti-EGFR therapies retrospectively and prospectively.

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