Recent Trends in the Incidence of Clear Cell Adenocarcinoma and Survival Outcomes: A SEER Analysis

Abstract Objective. To investigate recent trends in the epidemiological and prognostic factors of clear cell adenocarcinoma (CCA) which is considered a relatively rare tumor with a glycogen-rich phenotype. Methods. Patients with CCA from years 2000 to 2016 were identified from the Surveillance, Epidemiological, and End Results (SEER) database. Relevant population data were used to analyze the rates age-adjusted incidence, age-standardized 3-year and 5-year relative survivals, and overall survival (OS). Results. Of the 104,206 CCA patients identified. The age-adjusted incidence of CCA increased 2.7-fold from the year 2000 (3.3/100,000) to 2016 (8.8/100,000). This increase occurred across all ages, races, stages, and grades. Of all these subgroups, the increase was largest in the grade IV group. The age-standardized 3-year and 5-year relative survivals increased during this study period, rising by 9.1% and 9.5% from 2000 to 2011, respectively. Among all the stages and grades, the relative survival increase was greatest in the grade IV group. According to multivariate analysis of all CCA patients, predictors of OS were: age, gender, year of diagnosis, marital status, race, grade, stage, and primary tumor site (P < 0.001). The OS of all CCA patients during the period 2008 to 2016 was significantly higher than that from 2000 to 2007 (hazard ratio [HR], 0.87; 95% CI: 0.85–0.89; P < 0.001). Conclusions. The incidence of CCA and survival of these patients improved over time. In particular, the highest increases were reported for grade IV CCA, which may be due to an earlier diagnosis and improved treatment.

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Ovarian cancer in Manitoba: trends in incidence and survival, 1992–2011

Current Oncology ◽

10.3747/co.24.3312 ◽

2017 ◽

Vol 24 (2) ◽

pp. 78 ◽

Cited By ~ 1

Author(s):

P. Lambert ◽

K. Galloway ◽

A. Altman ◽

M.W. Nachtigal ◽

D. Turner

Keyword(s):

Ovarian Cancer ◽

Survival Rates ◽

Stage Iv ◽

Relative Survival ◽

Random Fluctuation ◽

Poor Survival ◽

Limited Power ◽

Recent Trends ◽

Trends Over Time ◽

Over Time

Background Because the International Cancer Benchmarking Partnership, in a study of diagnosis years between 1995 and 2007, showed lower-than-expected survival for Manitoba’s ovarian cancer patients, we undertook an analysis to describe the features of ovarian cancer diagnosed in Manitoba during a 20-year period. We also determined the most recent trends in survival to see if the previous results were sustained.Methods In this retrospective cohort study, ovarian cancer cases diagnosed during 1992–2011 were extracted from the Manitoba Cancer Registry. The incidence of ovarian cancer was calculated for the overall group and for age, morphology, residence, treatment, and stage. Trends over time, with a particular focus on changes that might correlate with poor survival, were analyzed. The 1- and 3-year relative survival rates were also calculated.Results The incidence of ovarian cancer did not vary over time (p = 0.640), even when stratified by age or morphology groups. Use of adjuvant chemotherapy decreased (p = 0.005) and use of neoadjuvant chemotherapy increased over time (p = 0.002). Diagnoses of stage iv cancers declined over time (p < 0.020). Trends in incidence did not coincide with previously observed decreases in relative survival.Conclusions A decline in diagnoses of stage iv ovarian cancer could be responsible for a recent increase in relative survival. However, sample size might have limited power in some analyses, and the previously reported decrease in relative survival might have been due to a random fluctuation in the data. Future efforts will focus on continued monitoring of the patterns of ovarian cancer presentation and outcomes in Manitoba.

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Clear Cell Adenocarcinoma of the Urinary Bladder Is a Glycogen-Rich Tumor with Poorer Prognosis

Journal of Clinical Medicine ◽

10.3390/jcm9010138 ◽

2020 ◽

Vol 9 (1) ◽

pp. 138 ◽

Cited By ~ 2

Author(s):

Zhengqiu Zhou ◽

Connor J. Kinslow ◽

Peng Wang ◽

Bin Huang ◽

Simon K. Cheng ◽

...

Keyword(s):

Urinary Bladder ◽

Clear Cell ◽

Tumor Staging ◽

Urinary Bladder Cancer ◽

Clear Cell Adenocarcinoma ◽

Urinary Bladder Carcinoma ◽

Beam Radiation ◽

Incidence And Mortality ◽

Patient Prognosis ◽

Adjusted Incidence

Clear cell adenocarcinoma (CCA) is a rare variant of urinary bladder carcinoma with a glycogen-rich phenotype and unknown prognosis. Using the National Cancer Institute’s surveillance, epidemiology, and end results (SEER) program database, we documented recent trends in incidence, mortality, demographical characteristics, and survival on this rare subtype of urinary bladder cancer. The overall age-adjusted incidence and mortality of CCA was 0.087 (95% confidence interval (CI): 0.069–0.107) and 0.064 (95% CI: 0.049–0.081) respectively per million population. In comparison to non-CCAs, CCAs were more commonly associated with younger age (<60 years old, p = 0.005), female (p < 0.001), black ethnicity (p = 0.001), grade III (p < 0.001), and higher AJCC 6th staging (p < 0.001). In addition, CCA patients more frequently received complete cystectomy (p < 0.001) and beam radiation (p < 0.001) than non-CCA patients. Our study showed a poorer prognosis of CCAs compared to all other carcinomas of the urinary bladder (p < 0.001), accounted for by higher tumor staging of CCA cases. This study adds to the growing evidence that glycogen-rich cancers may have unique characteristics affecting tumor aggressiveness and patient prognosis. Additional mechanistic studies are needed to assess whether it’s the excess glycogen that contributes to the higher stage at diagnosis.

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