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

2020 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

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.

2019 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

Abstract Background The characteristics and survival in patients with malignant giant tumor cancer of bone (GCTB) were not 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. Multivariate Cox regression showed the poor survival in patients with age older than 34 years (hazard ratio (HR) =3.68, 95% CI: 2.06-6.57, P<0.001), T2 stage (HR=4.96, 95% CI: 1.57-15.63, P=0.006), distant tumor (HR=3.02, 95% CI: 1.32-6.92, P=0.009), 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, T2, distant tumor and extra-skeletal sites were determinant survival factors of the patients with malignant GCTB.


2020 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

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.


2020 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

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 (OS) 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. Multivariate Cox regression showed poor survival in patients with age from 35 to 60 years (hazard ratio (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 age >34 years, stage T2/3 disease, distant disease and extra-skeletal sites had more odds to be with worse survival.


2020 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

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 (OS) 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 (hazard ratio (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 T2/3disease, 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.


2019 ◽  
Author(s):  
zepang sun ◽  
Hao Chen ◽  
Zhen Han ◽  
Jiang Yu ◽  
Weicai Huang ◽  
...  

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.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3593-3593
Author(s):  
Jackson Chu ◽  
Ozge Goktepe ◽  
Winson Y. Cheung

3593 Background: Early data suggest that synchronous and metachronous CRC portend a worse prognosis when compared to solitary CRC. Our aims were to 1) characterize the clinical features and treatment patterns of synchronous and metachronous CRC and 2) compare their survival outcomes with those of solitary CRC. Methods: All patients diagnosed with non-metastatic CRC between 1999 and 2008 and referred to any 1 of 5 regional cancer centers in British Columbia, Canada were reviewed. Synchronous and metachronous CRC were defined as multiple (2 or more) distinct tumors that were diagnosed within and beyond 6 months of the date of index CRC diagnosis, respectively, during the study period. Patients with liver metastases at initial diagnosis were excluded. Kaplan-Meier and Cox regression analyses were used to estimate survival among the different CRC groups. Results: A total of 6360 patients were identified: 6147 (96%) solitary, 178 (3%) synchronous and 35 (1%) metachronous tumors; median age was 68 years (IQR 59-76); 57% were men; and 75% were ECOG 0/1 at the time of index cancer diagnosis. Baseline demographic characteristics were comparable across patients (all p>0.05). Compared with solitary CRC, synchronous and metachronous CRC more commonly affected the colon rather than the rectum (84 vs 85 vs 59%, respectively, p<0.001), but presenting symptoms, treatment approaches, and use of chemotherapy, radiation and surgery were similar among the different tumor groups (all p>0.05). In terms of survival, no differences were observed in 3-year relapse free survival (66 vs 66 vs 56%, p=0.20), 5-year cancer specific survival (69 vs 69 vs 53%, p=0.34) and 5-year overall survival (62 vs 59 vs 49%, p=0.74) for solitary, synchronous and metachronous CRC, respectively. These findings persisted after controlling for known prognostic factors, such as age and ECOG. Conclusions: In this large population-based cohort, there were no differences in survival outcomes among solitary, synchronous and metachronous CRC. Patients who present with multiple tumors in the colon or the rectum should be managed similarly to those who present with an isolated tumor.


2021 ◽  
Author(s):  
Pei Luo ◽  
Yan Mao ◽  
Liping Yang ◽  
Chao Pan ◽  
Jun Guo

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.


Author(s):  
Nishant Sahni ◽  
Umesh Sharma ◽  
Rashi Arora

Background: Rising NT-proBNP are associated with reduced survival patients with HFrEF. However, it remains to be conclusively and formally demonstrated that the temporal trend in NT-proBNP level carries prognostic significance in HFpEF. Objective: To determine whether there is an association between rising NT-proBNP levels and 6-month survival in patients with HFpEF and HFrEF. Methods: We examined a cohort of 5203 patients to 5 hospitals in a regional health care system — who had at least one admission to the hospital with diagnoses of heart failure over a 3-year period. Kaplan-Meier survival curves were constructed for patients with downtrending (>25% net decrease), stable or uptrending (>25% net increase) NT-proBNP levels in HF, HFpEF and HFrEF patients. The log-rank test was used to test for differences in 6-month survival amongst the groups. Multivariate extended Cox regression models were constructed for 6-month survival with NT-proBNP as a time-varying covariate. Age, albumin, sex, race, serum creatinine, systolic and diastolic blood pressures and Charlson comorbidity scores at baseline were used as covariates in the model. Separate analyses were done for HFpEF and HFrEF patients. Results: HFpEF and HFrEF patients with up-trending levels had significantly lower 6-month survival rates than patients with downtrending or stable NT-proBNP levels. A doubling of the NT-proBNP level in patients was significantly associated with reduced 6-month survival in patients with in both subgroups of HF, HFpEF and HFrEF (HFpEF-HR: 1.53(1.49-2.57), HFrEF HR: 1.45(1.43-1.48) after adjusting for covariates.


2019 ◽  
Vol 26 (13) ◽  
pp. 4222-4228 ◽  
Author(s):  
Nadine L. de Boer ◽  
Job P. van Kooten ◽  
Ronald A. M. Damhuis ◽  
Joachim G. J. V. Aerts ◽  
Cornelis Verhoef ◽  
...  

Abstract Background Malignant peritoneal mesothelioma (MPM) is a rare and aggressive disease. Recently, focus has shifted toward a more aggressive and multimodal treatment approach. This study aimed to assess the patterns of care and survival for MPM patients in the Netherlands on a nationwide basis. Methods The records of patients with a diagnosis of MPM from 1993 to 2016 were retrieved from the Dutch Cancer Registry. Data regarding diagnosis, staging, treatment, and survival were extracted. Cox regression analyses and Kaplan–Meier survival curves were used to study overall survival. Results Between 1993 and 2016, MPM was diagnosed for 566 patients. Overall, the prognosis was very poor (24% 1-year survival). The most common morphologic subtype was the epithelioid subtype (88%), followed by the biphasic (8%) and sarcomatoid (4%) subtypes. Surgical treatment has become more common in recent years, which most likely has resulted in improved survival rates. In this study, improved survival was independently associated with hyperthermic intraperitoneal chemotherapy (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.21–0.55) and surgery with adjuvant systemic chemotherapy (HR, 0.33; 95% CI, 0.23–0.48). Nonetheless, most patients (67%) do not receive any form of anti-cancer treatment. Conclusion This study indicated that MPM still is a rare and fatal disease. The survival rates in the Netherlands have improved slightly in the past decade, most likely due to more aggressive treatment approaches and increased use of surgery. However, most patients still do not receive cancer-directed treatment. To improve MPM management, and ultimately survival, care should be centralized in expert medical centers.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xu Sun ◽  
Yijun Wu ◽  
Jing Shen ◽  
Chang Han ◽  
Kai Kang ◽  
...  

Background and ObjectivesThis study aims to conduct an updated systematic analysis of patients with pulmonary large cell neuroendocrine carcinoma (PLCNC) in recent decades, concerning incidence and mortality trends, demographics, treatments, survival and death causes.MethodsPatients who were diagnosed with PLCNC at the Peking Union Medical College Hospital (PUMCH) between 2000 to 2020 were retrospectively analyzed. The population-based Surveillance, Epidemiology, and End Results (SEER) database were also retrieved. Frequencies and average annual age-adjusted rates (AAR) of PLCNC patients were calculated and analyzed by Joint-point regression. Univariate and multivariate Cox regression were used for identifying prognostic factors. Predictive nomograms for overall survival (OS) and cancer-specific survival (CSS) were developed and then validated by calculating C-index values and drawing calibration curves. Survival curves were plotted using the Kaplan-Meier method and compared by log-rank test. Causes of death were also analyzed by time latency.ResultsA total of 56 PLCNC patients of the PUMCH cohort were included. Additionally, the PLCNC patients in the SEER database were also identified from different subsets. The AAR from 2001 to 2017 were 3.21 (95%CI: 3.12-3.30) per million. Its incidence and mortality rates in PLCNC patients increased at first but seemed to decline in recent years. Besides TNM stage and treatments, older age and male gender were independently associated with poorer survival, while marital status only affected CSS other than OS. The nomograms for OS and CSS presented great predictive ability and calibration performance. Surgery gave significantly more survival benefits to PLCNC patients, and chemotherapy might add survival benefits to stage II-IV. However, radiation therapy seemed to only improve stage III patients’ survival.ConclusionsThis study supported some previous studies in terms of incidence, survival, and treatment options. The mortality rates seemed to decline recently, after an earlier increase. Among PLCNC patients, most of the deaths occurred within the first five years, while other non-PLCNC diseases increased after that. Thus, careful management and follow-up of other comorbidities are of equal importance. Our study may partly solve the dilemma caused by PLCNC’s rarity and inspire more insights in future researches.


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