scholarly journals Comprehensive lymphadenectomy and survival prediction in uterine serous cancer patients after surgery: a population-based analysis

2020 ◽  
Author(s):  
Hui Li ◽  
Xiaofei Xie ◽  
Yunyun Liu ◽  
Xiaoxin Huang ◽  
Haoliang Lin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Cox Regression ◽  
Staging System ◽  
Population Based ◽  
Pelvic Lymphadenectomy ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Gynecology And Obstetrics ◽  
Objective Evidence

Abstract Objective Evidence on uterine serous cancer (USC) prognosis has been limited and inconclusive. We aim to explore the survival benefits of comprehensive lymphadenectomy in USC patients after surgery and develop a prognostic nomogram to predict survival. Materials and Methods USC patients who had undergone hysterectomy between 2010 and 2015 were identified from Surveillance, Epidemiology and End Results (SEER) database. The relationship between the extent of lymphadenectomy and survival, including overall survival (OS) and cancer-specific survival (CSS), was estimated with Kaplan-Meier (K-M) analysis. Univariate and multivariate Cox regression analyses were utilized to determine the independent prognostic factors. A nomogram was then developed, calibrated and internally validated. Results A total of 2853 patients were identified. K-M survival analysis revealed that patients with ≥12 pelvic lymph nodes (PLNs) removed had significantly better OS and CSS than those without (both P <0.001). However, patients with ≥6 para-aortic lymph nodes removed was not associated with similar survival benefits than patients without ( P >0.1). Multivariate analyses for OS and CSS revealed that age, T stage, N stage, tumor size, adjuvant therapy and ≥12 PLNs removed were independent prognostic factors (all P<0.05) and were subsequently incorporated into the nomogram. The Harrell’s C-index of the nomogram was significantly higher than that of the International Federation of Gynecology and Obstetrics staging system (OS: 0.739 vs 0.671, P <0.001; CSS: 0.752 vs 0.695, P <0.001). Furthermore, the nomogram was well calibrated with satisfactory consistency. Conclusions Comprehensive pelvic lymphadenectomy should be recommended to USC patients for its survival benefits. And a nomogram has been developed to predict the survivals of USC patients after surgery.

scholarly journals Adenosquamous Carcinoma of the Cervix: A Population-Based Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Pengfei Cui ◽  
Xiaofeng Cong ◽  
Chen Chen ◽  
Lei Yang ◽  
Ziling Liu
Keyword(s):  
Prognostic Factors ◽  
Calibration Curve ◽  
Cox Regression ◽  
Adenosquamous Carcinoma ◽  
Staging System ◽  
Predictive Performance ◽  
Tumor Grade ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Discrimination Ability

BackgroundDue to the rarity of adenosquamous carcinoma of the cervix (ASCC), studies on the incidence, prognostic factors, and treatment outcomes of ASCC remain scarce. Therefore, we performed a retrospective population-based study to systematically investigate the characteristics of ASCC patients.MethodsPatients with a histopathologically confirmed diagnosis of ASCC were enrolled from the Surveillance, Epidemiology, and End Results database between 1975 and 2016. Univariate and multivariate Cox regression analyses were performed to identify the potential predictors of cancer-specific survival (CSS) in patients with ASCC. Selected variables were integrated to establish a predictive nomogram and the predictive performance of the nomogram was estimated using Harrell’s concordance index (C-index), calibration curve, and decision curve analysis (DCA).ResultsA total of 1142 ASCC patients were identified and included in this study and were further randomized into the training and validation cohorts in a 7:3 ratio. The age-adjusted incidence of ASCC declined from 0.19 to 0.09 cases per 100,000 person-years between 2000 and 2017, with an annual percentage change of -4.05% (P&lt;0.05). We identified age, tumor grade, FIGO stage, tumor size, and surgical procedure as independent predictors for CSS in ASCC patients and constructed a nomogram to predict the 3- and 5-year CSS using these prognostic factors. The calibration curve indicated an outstanding consistency between the nomogram prediction and actual observation in both the training and testing cohorts. The C-index was 0.7916 (95% CI: 0.7990-0.8042) and 0.8148 (95% CI: 0.7954-0.8342) for the training and testing cohorts, respectively, indicating an excellent discrimination ability of the nomogram. The DCA showed that the nomogram exhibited more clinical benefits than the FIGO staging system.ConclusionsWe established and validated an accurate predictive nomogram for ASCC patients based on several clinical characteristics. This model might serve as a useful tool for clinicians to estimate the prognosis of ASCC patients.

scholarly journals A Novel Nomogram for Predicting Cancer-Specific Survival in Patients With Spinal Chordoma: A Population-Based Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110365
Author(s):  
Zhangheng Huang ◽  
Zhiyi Fan ◽  
Chengliang Zhao ◽  
He Sun
Keyword(s):  
Prognostic Factors ◽  
Area Under The Curve ◽  
Risk Groups ◽  
Population Based ◽  
Disease Stage ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Spinal Chordoma ◽  
Prediction Of Prognosis ◽  
High Degree

Background: Chordoma is a rare malignant bone tumor, and the survival prediction for patients with chordoma is difficult. The objective of this study was to construct and validate a nomogram for predicting cancer-specific survival (CSS) in patients with spinal chordoma. Methods: A total of 316 patients with spinal chordoma were identified from the SEER database between 1998 and 2015. The independent prognostic factors for patients with spinal chordoma were determined by univariate and multivariate Cox analyses. The prognostic nomogram was established for patients with spinal chordoma based on independent prognostic factors. Furthermore, we performed internal and external validations for this nomogram. Results: Primary site, disease stage, histological type, surgery, and age were identified as independent prognostic factors for patients with spinal chordoma. A nomogram for predicting CSS in patients with spinal chordoma was constructed based on the above 5 variables. In the training cohort, the area under the curve for predicting 1-, 3-, and 5-year CSS were 0.821, 0.856, and 0.920, respectively. The corresponding area under the curve in the validation cohort were 0.728, 0.804, and 0.839, respectively. The calibration curves of the nomogram showed a high degree of agreement between the predicted and the actual results, and the decision curve analysis further demonstrated the satisfactory clinical utility of the nomogram. Conclusions: The prognostic nomogram provides a considerably more accurate prediction of prognosis for patients with spinal chordoma. Clinicians can use it to categorize patients into different risk groups and make personalized treatment methods.

scholarly journals Conditional Survival After Surgical Resection of Appendiceal Tumors: a Population-based Study

2021 ◽  
Author(s):  
Shutao Zhao ◽  
Chang Lu ◽  
Junan Li ◽  
Chao Zhang ◽  
Xudong Wang
Keyword(s):  
Prognostic Factors ◽  
Cox Regression ◽  
Population Based ◽  
Conditional Survival ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Factors Affecting ◽  
Probability Of Survival ◽  
N Stage

Abstract Background: This study aimed to evaluate the conditional survival (CS) of appendiceal tumors (ATs) after surgery.Methods: A total of 3,031 patients with ATs who underwent surgery were included in the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2016. A multivariate Cox regression model was used to analyze the prognostic factors affecting overall survival (OS) and cancer-specific survival (CSS). CS was used to calculate the probability of survival for another 3 years after the patient had survived x years. The formulas were COS3 = OS (x + 3) /OS (x), and CCS3 = CSS (x + 3)/CSS (x).Results: The 1-year, 3-year, and 5-year OSs for all patients were 95.6%, 83.3%, and 73.9%, respectively, while the 1-year, 3-year, and 5-year CSSs were 97.0%, 87.1%, and 79.9%, respectively. Age, grade, histology, N stage, carcinoembryonic antigen (CEA), and radiation were independent prognostic factors for OS and CSS. For patients that survived for 1 year, 3 years, and 5 years, their COS3s were 81.7%, 83.9%, and 87.0%, respectively. The CCS3s were 85.5%, 88.3%, and 92.0% respectively. In patients with poor clinicopathological factors, COS3 and CCS3 increased significantly, and the survival gap between OS and COS3, CSS and CCS3 was more obvious.Conclusions: CS for appendiceal tumors were dynamic and increased over time, especially in patients with poor prognosis.

scholarly journals Development and Validation of Prognostic Nomogram for Primary Peritoneal Serous Carcinoma Compared With FIGO Staging System: A Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Ming Chen ◽  
Zhenzhen Wen ◽  
Zhengwei Qi ◽  
Min Gao
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cox Regression ◽  
Staging System ◽  
Serous Carcinoma ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Figo Staging ◽  
Gynecology And Obstetrics

BackgroundPrimary peritoneal serous carcinoma (PPSC) is a rare tumor that lacks a prognostic prediction model. Our study aims to develop a nomogram to predict overall survival (OS) of PPSC patients.MethodsPatients confirmed to have PPSC between 2004 and 2012 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. LASSO and multivariate Cox regression analyses were used to screen for meaningful independent prognostic factors to construct a nomogram model for 3-, 5-, and 10-year OS among patients with PPSC. The nomogram compared the discrimination, calibration, and net benefits with the International Federation of Gynecology and Obstetrics (FIGO) staging system of PPSC patients.ResultsEight variables were selected to establish the nomogram for PPSC. The established nomogram performed significantly better than the FIGO staging system (p &lt; 0.05). The 3-, 5-, and 10-year OS of PPSC was 0.498, 0.306, and 0.152, respectively. Patients of old age, widowed marital status, grade high, FIGO IIIB, IIIC, or IV, lymph node metastasis, no lymphadenectomy, no surgery, and no chemotherapy got higher score which corresponds with higher risk and lower OS. In the multivariate Cox regression analysis, age, histological grade, FIGO staging, lymph node metastasis, and lymphadenectomy (four or more) were identified as independent prognostic factors for PPSC.ConclusionsPPSC patients have distinct characteristics with respect to their presentation and survival outcomes. A prognostic nomogram constructed by various clinical indicators can provide better and more accurate predictions for patients with PPSC.

scholarly journals An Easy-to-use Clinical Nomogram for Predicting the Prognosis of Patients with Hepatocellular Carcinoma Concomitantly Suffer from Severe Fibrosis or Cirrhosis: A Population-based Analysis.

2020 ◽  
Author(s):  
Wang Hanyue ◽  
Ruan Shiye ◽  
Zou Yiping ◽  
Jin Liang ◽  
Jin Haosheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Staging System ◽  
Population Based ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Prediction Of Survival ◽  
Ishak Fibrosis Score ◽  
Severe Fibrosis

Abstract Background Patients with hepatocellular carcinoma (HCC) concomitantly suffer from liver cirrhosis may have worse prognosis. Based on Surveillance, Epidemiology, and End Results (SEER) database, we evaluated the overall survival (OS) and cancer-specific survival (CSS) of these patients. Methods A total of 2,369 patients were selected from the SEER database. They were classified into F0 (n=691) and F1 (n=1,678) groups by different Ishak fibrosis score. Propensity score matching (PSM) and Kaplan-Meier method were performed to evaluate the OS and CSS. The F1 group were randomized into training sub-set (n = 1,176, 70%) and validation sub-set (n = 502, 30%) for further construction and validation of nomogram . Results After matched, there were statistically significant worse outcome for F1 group patients compared with F0 group (n=587, OS: P<0.001, CSS: P<0.001). Six independent predictors for both OS and CSS were identified to construct the nomograms by COX regression analyses. The nomogram performed well concerning its ability of discrimination and calibration and its net benefits compared with the conventional staging system. Conclusions Patients with HCC concomitantly suffer from severe fibrosis or cirrhosis has a significant worse survival compared with none or moderate fibrosis patients. The validated nomograms provided useful prediction of survival.

scholarly journals Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhao Ding ◽  
Deshun Yu ◽  
Hefeng Li ◽  
Yueming Ding
Keyword(s):  
Marital Status ◽  
Cancer Patients ◽  
Laryngeal Cancer ◽  
Cox Regression ◽  
Group Analysis ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Prognostic Effect ◽  
The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

scholarly journals Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxin Ding ◽  
Runyi Jiang ◽  
Yuhong Chen ◽  
Jing Jing ◽  
Xiaoshuang Yang ◽  
...  
Keyword(s):  
Head And Neck ◽  
Health Management ◽  
External Validation ◽  
Area Under The Curve ◽  
Population Based ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Cox Models ◽  
Lentigo Maligna Melanoma ◽  
Clinical Tools

Abstract Background Previous studies reported cutaneous melanoma in head and neck (HNM) differed from those in other regions (body melanoma, BM). Individualized tools to predict the survival of patients with HNM or BM remain insufficient. We aimed at comparing the characteristics of HNM and BM, developing and validating nomograms for predicting the survival of patients with HNM or BM. Methods The information of patients with HNM or BM from 2004 to 2015 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The HNM group and BM group were randomly divided into training and validation cohorts. We used the Kaplan-Meier method and multivariate Cox models to identify independent prognostic factors. Nomograms were developed via the rms and dynnom packages, and were measured by the concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and calibration plots. Results Of 70,605 patients acquired, 21% had HNM and 79% had BM. The HNM group contained more older patients, male sex and lentigo maligna melanoma, and more frequently had thicker tumors and metastases than the BM group. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 88.1 ± 0.3% and 74.4 ± 0.4% in the HNM group and 92.5 ± 0.1% and 85.8 ± 0.2% in the BM group, respectively. Eight variables (age, sex, histology, thickness, ulceration, stage, metastases, and surgery) were identified to construct nomograms of CSS and OS for patients with HNM or BM. Additionally, four dynamic nomograms were available on web. The internal and external validation of each nomogram showed high C-index values (0.785–0.896) and AUC values (0.81–0.925), and the calibration plots showed great consistency. Conclusions The characteristics of HNM and BM are heterogeneous. We constructed and validated four nomograms for predicting the 3-, 5- and 10-year CSS and OS probabilities of patients with HNM or BM. These nomograms can serve as practical clinical tools for survival prediction and individual health management.

Demographic, Clinical, and Prognostic Factors of Ovarian Clear Cell Adenocarcinomas According to Endometriosis Status

2017 ◽  
Vol 27 (9) ◽  
pp. 1804-1812 ◽  
Author(s):  
Tine H. Schnack ◽  
Estrid Høgdall ◽  
Lotte Nedergaard Thomsen ◽  
Claus Høgdall
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Clear Cell ◽  
Statistical Tests ◽  
Gynecological Cancer ◽  
Population Based ◽  
Clear Cell Adenocarcinoma ◽  
Ovarian Endometriosis ◽  
Increased Risk

ObjectivesWomen with endometriosis carry an increased risk for ovarian clear cell adenocarcinomas (CCCs). Clear cell adenocarcinoma may develop from endometriosis lesions. Few studies have compared clinical and prognostic factors and overall survival in patients diagnosed as having CCC according to endometriosis status.MethodsPopulation-based prospectively collected data on CCC with coexisting pelvic (including ovarian; n = 80) and ovarian (n = 46) endometriosis or without endometriosis (n = 95) were obtained through the Danish Gynecological Cancer Database. χ2 Test, independent-samples t test, logistic regression, Kaplan-Meier test, and Cox regression were used. Statistical tests were 2 sided. P values less than 0.05 were considered statistically significant.ResultsPatients with CCC and pelvic or ovarian endometriosis were significantly younger than CCC patients without endometriosis, and a higher proportion of them were nulliparous (28% and 31% vs 17% (P = 0.07 and P = 0.09). Accordingly, a significantly higher proportion of women without endometriosis had given birth to more than 1 child. Interestingly, a significantly higher proportion of patients with ovarian endometriosis had pure CCCs (97.8% vs 82.1%; P = 0.001) as compared with patients without endometriosis. Overall survival was poorer among CCC patients with concomitant ovarian endometriosis (hazard ratio, 2.56 [95% confidence interval, 1.29–5.02], in the multivariate analysis.ConclusionsAge at CCC diagnosis and parity as well as histology differ between CCC patients with and without concomitant endometriosis. Furthermore, CCC patients with concomitant ovarian endometriosis have a poorer prognosis compared with endometriosis-negative CCC patients. These differences warrant further research to determine whether CCCs with and without concomitant endometriosis develop through distinct pathogenic pathways.

scholarly journals Impact of pre-existing cardiovascular disease on treatment patterns and survival outcomes in patients with lung cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Atul Batra ◽  
Dropen Sheka ◽  
Shiying Kong ◽  
Winson Y. Cheung
Keyword(s):  
Lung Cancer ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Population Based ◽  
Treatment Patterns ◽  
Competing Risk ◽  
Survival Outcomes ◽  
Multistate Model ◽  
Cancer Specific Survival ◽  
Increased Risk

Abstract Background Baseline cardiovascular disease (CVD) can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing CVD prior to their diagnosis of lung cancer. Methods We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015 in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between CVD and treatment patterns, and its impact on overall (OS) and cancer-specific survival (CSS), respectively. A competing risk multistate model was developed to determine the excess mortality risk of patients with pre-existing CVD. Results A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70 years. One-third had at least one CVD, with the most common being congestive heart failure in 15% of patients. Pre-existing CVD was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.48–0.58; P < .0001), radiotherapy (OR, 0.76; 95% CI, 0.7–0.82; P < .0001), and surgery (OR, 0.56; 95% CI, 0.44–0.7; P < .0001). Adjusting for measured confounders, the presence of pre-existing CVD predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1–1.2; P < .0001) and CSS (HR, 1.1; 95% CI, 1.1–1.1; P < .0001). However, in the competing risk multistate model that adjusted for baseline characteristics, prior CVD was associated with increased risk of non-cancer related death (HR, 1.48; 95% CI, 1.33–1.64; P < 0.0001) but not cancer related death (HR, 0.98; 95% CI, 0.94–1.03; P = 0.460). Conclusions Patients with lung cancer and pre-existing CVD are less likely to receive any modality of cancer treatment and are at a higher risk of non-cancer related deaths. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management of lung cancer.

scholarly journals Incidence and Prognostic Factors of Primary Thyroid Lymphoma and Construction of Prognostic Models for Post-chemotherapy and Postoperative Patients: A Population-based Study

2020 ◽  
Author(s):  
Nan Xiang ◽  
Fangyuan Dong ◽  
Xuebing Zhan ◽  
Shuhan Wang ◽  
Junjie Wang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prediction Models ◽  
Cox Regression ◽  
Prognostic Models ◽  
Steady Increase ◽  
Thyroid Lymphoma ◽  
Annual Percent Change ◽  
Cancer Specific Survival ◽  
Good Reliability ◽  
Primary Thyroid Lymphoma

Abstract Background: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, there are few large sample studies on PTL and no standardized treatment regimen has been established due to the rarity. Objective: The aims of this study were to explore the incidence and prognostic factors of PTL and construct visual prognostic prediction models for post-chemotherapy and postoperative patients.Methods: The incidence of PTL in 1975-2017 was extracted from the US Surveillance, Epidemiology, and End Results (SEER) database, then assessed using joinpoint regression software. A total of 1,616 eligible PTL patients diagnosed in 1998-2016 were brought into prognostic analysis. Multivariate Cox regression analyses were carried out to reveal independent prognostic elements for overall survival (OS) and cancer-specific survival (CSS).Results: PTL incidence showed a relatively steady increase in 1975-1994, which annual percent change (APC) was 4.0%, and steady decreasing in 1994-2017(APC -2.4%). Age, marital status, lymphoma Ann Arbor stage, histological subtypes, surgery, chemotherapy, and radiation were significantly correlated to OS and CSS. The combination of radiotherapy with chemotherapy or surgery was beneficial to the prognosis of patients. Nomograms were constructed to predict OS and CSS in post-chemotherapy and postoperative PTL patients separately, and were verified to have good reliability.Conclusions: The incidence of PTL increased and subsequently decreased. We revealed the prognostic implications and constructed reliable nomograms for post-chemotherapy and postoperative PTL patients.

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