scholarly journals Incidence and Demographics of Nasopharyngeal Carcinoma in Cheung Chau Island of Hong Kong – A Distinct Geographical area with Minimal Residential Mobility and Restricted Public Healthcare Referral Network

2021 ◽  
Author(s):  
Sik-Kwan Chan ◽  
Sze-Chun Chau ◽  
Sum-Yin Chan ◽  
Chi-Chung Tong ◽  
Ka-On Lam ◽  
...  
Keyword(s):  
Hong Kong ◽  
Nasopharyngeal Carcinoma ◽  
Residential Mobility ◽  
Geographical Area ◽  
Progression Free Survival ◽  
Public Healthcare ◽  
Cancer Specific Survival ◽  
Tertiary Center ◽  
Product Limit ◽  
Similar Survival

Abstract Background: Nasopharyngeal carcinoma (NPC) is endemic in Hong Kong with a skewed geographical and ethnic distribution. We performed an epidemiological study of NPC in Cheung Chau Island, a fishing village with very minimal residential mobility, and compared its demographics and survival with the rest of Hong Kong.Methods: NPC data in Cheung Chau and non-Cheung Chau residents between 2006 and 2017 treated in our tertiary center were collected. The incidence, stage distribution and mortality of Cheung Chau NPC residents were compared with those of their counterparts in the whole Hong Kong obtained from the Hong Kong Cancer Registry. Propensity score matching (PSM) was performed between Cheung Chau and non-Cheung Chau cases in a 1:4 ratio. Overall Survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) were compared between these two cohorts by product limit estimation and log-rank tests.Results: Sixty-one patients residing in Cheung Chau were identified between 2006 and 2017. There was a significantly higher NPC incidence (P<0.001) but insignificant difference in mortality rate in Cheung Chau compared to the whole Hong Kong data. After PSM with 237 non-Cheung Chau patients, Cheung Chau cohort revealed a stronger NPC family history (P<0.001). However, there were no significant differences in OS (P=0.170), PFS (P=0.053), and CSS (P=0.160) between these two cohorts.Conclusion: Our results revealed that Cheung Chau had a higher NPC incidence but similar survival outcomes compared to the whole Hong Kong. Cheung Chau can provide an excellent model for further studies on NPC oncogenesis and screening.

scholarly journals Incidence and Demographics of Nasopharyngeal Carcinoma in Cheung Chau Island of Hong Kong—A Distinct Geographical Area With Minimal Residential Mobility and Restricted Public Healthcare Referral Network

2021 ◽  
Vol 28 ◽  
pp. 107327482110471
Author(s):  
Sik-Kwan Chan ◽  
Sze-Chun Chau ◽  
Sum-Yin Chan ◽  
Chi-Chung Tong ◽  
Ka-On Lam ◽  
...  
Keyword(s):  
Hong Kong ◽  
Nasopharyngeal Carcinoma ◽  
Residential Mobility ◽  
Geographical Area ◽  
Progression Free Survival ◽  
Public Healthcare ◽  
Cancer Specific Survival ◽  
Tertiary Center ◽  
Similar Survival ◽  
Underlying Mechanisms

Background Nasopharyngeal carcinoma (NPC) is endemic in Hong Kong with a skewed geographical and ethnic distribution. We performed an epidemiological study of NPC in Cheung Chau Island, a fishing village with very minimal residential mobility, and compared its demographics and survival with the rest of Hong Kong. Methods NPC data in Cheung Chau and non–Cheung Chau residents between 2006 and 2017 treated in our tertiary center were collected. The incidence, stage distribution, and mortality of Cheung Chau NPC residents were compared with those of their counterparts in the whole Hong Kong obtained from the Hong Kong Cancer Registry. Propensity score matching (PSM) was performed between Cheung Chau and non–Cheung Chau cases in a 1:4 ratio. Overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) were compared between these two cohorts by product limit estimation and log-rank tests. Results Sixty-one patients residing in Cheung Chau were identified between 2006 and 2017. There was a significantly higher NPC incidence ( P < .001) but an insignificant difference in the mortality rate in Cheung Chau compared to the whole Hong Kong data. After PSM with 237 non–Cheung Chau patients, the Cheung Chau cohort revealed a stronger NPC family history ( P < .001). However, there were no significant differences in OS ( P = .170), PFS ( P = .053), and CSS ( P = .160) between these two cohorts. Conclusion Our results revealed that Cheung Chau had a higher NPC incidence but similar survival outcomes compared to the whole of Hong Kong. Further prospective studies are warranted to verify this finding and to explore the possible underlying mechanisms.

scholarly journals Oncologic Outcomes of Surgery in T3 Prostate Cancer: Experience of a Single Tertiary Center

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
D. Milonas ◽  
G. Smailyte ◽  
M. Jievaltas
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Oncologic Outcomes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Risk Of Death ◽  
Tertiary Center

Aim. The aim of this study is to present the oncologic outcomes and to determine the prognostic factors of overall survival (OS), cancer-specific survival (CSS), disease-progression-free survival (DPFS), and biochemical-progression-free survival (BPFS) after surgery for pT3 prostate cancer (PCa).Methods. Between 2002 and 2007, a pT3 stage after radical prostatectomy was detected in 182 patients at our institution. The Kaplan-Meier analysis was used to calculate OS, CSS, DPFS, and BPFS. Cox regression was used to identify predictive factors of survival.Results. pT3a was detected in 126 (69%) and pT3b in 56 (31%) of cases. Five-year OS, CSS, DPFS, and BPFS rates were 90.7%, 94%, 91.8%, and 48.4%, respectively. Survival was significantly different when comparing pT3a to pT3b groups. The 5-year OS, CSS, DPFS, and BPFS were 96% versus 72%, 98% versus 77%, 97.3% versus 79.3%, and 60% versus 24.2%, respectively. Specimen Gleason score was the most significant predictor of OS, CSS, DPFS, and BPFS. The risk of death increased up to 3-fold when a Gleason score 8–10 was present at the final pathology.Conclusions. Radical prostatectomy may offer very good CSS, OS, DPFS, and BPFS rates in pT3a PCa. However, outcomes in patients with pT3b or specimen Gleason ≥8 were significantly worse, suggesting the need for multimodality treatment in those cases.

scholarly journals Comprehensive single-cell sequencing reveals the stromal dynamics and tumor-specific characteristics in the microenvironment of nasopharyngeal carcinoma

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Lanqi Gong ◽  
Dora Lai-Wan Kwong ◽  
Wei Dai ◽  
Pingan Wu ◽  
Shanshan Li ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Single Cell ◽  
Rna Sequencing ◽  
Progression Free Survival ◽  
Developmental Trajectory ◽  
Free Survival ◽  
Genetic Profiling ◽  
Single Cell Rna Sequencing ◽  
Infiltrating Cells ◽  
Patient Prognosis

AbstractThe tumor microenvironment (TME) of nasopharyngeal carcinoma (NPC) harbors a heterogeneous and dynamic stromal population. A comprehensive understanding of this tumor-specific ecosystem is necessary to enhance cancer diagnosis, therapeutics, and prognosis. However, recent advances based on bulk RNA sequencing remain insufficient to construct an in-depth landscape of infiltrating stromal cells in NPC. Here we apply single-cell RNA sequencing to 66,627 cells from 14 patients, integrated with clonotype identification on T and B cells. We identify and characterize five major stromal clusters and 36 distinct subpopulations based on genetic profiling. By comparing with the infiltrating cells in the non-malignant microenvironment, we report highly representative features in the TME, including phenotypic abundance, genetic alternations, immune dynamics, clonal expansion, developmental trajectory, and molecular interactions that profoundly influence patient prognosis and therapeutic outcome. The key findings are further independently validated in two single-cell RNA sequencing cohorts and two bulk RNA-sequencing cohorts. In the present study, we reveal the correlation between NPC-specific characteristics and progression-free survival. Together, these data facilitate the understanding of the stromal landscape and immune dynamics in NPC patients and provides deeper insights into the development of prognostic biomarkers and therapeutic targets in the TME.

scholarly journals NRG1 Genetic Variant Influences the Efficacy of Androgen-Deprivation Therapy in Men with Prostate Cancer

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Shu-Pin Huang ◽  
Yei-Tsung Chen ◽  
Lih-Chyang Chen ◽  
Cheng-Hsueh Lee ◽  
Chao-Yuan Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Deprivation Therapy ◽  
Tyrosine Kinases ◽  
Multiple Testing ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Androgen Deprivation ◽  
Nucleotide Polymorphisms ◽  
Multiple Testing Correction ◽  
Cancer Specific Survival

Neuregulins (NRGs) activate receptor tyrosine kinases of the ErbB family, and play essential roles in the proliferation, survival, and differentiation of normal and malignant tissue cells. We hypothesized that genetic variants of NRG signalling pathway genes may influence treatment outcomes in prostate cancer. To test this hypothesis, we performed a comprehensive analysis to evaluate the associations of 459 single-nucleotide polymorphisms in 19 NRG pathway genes with cancer-specific survival (CSS), overall survival (OS), and progression-free survival (PFS) in 630 patients with prostate cancer receiving androgen-deprivation therapy (ADT). After multivariate Cox regression and multiple testing correction, we found that NRG1 rs144160282 C > T is significantly associated with worsening CSS, OS, and PFS during ADT. Further analysis showed that low expression of NRG1 is closely related to prostate cancer, as indicated by a high Gleason score, an advanced stage, and a shorter PFS rate. Meta-analysis of 16 gene expression datasets of 1,081 prostate cancer samples and 294 adjacent normal samples indicate lower NRG1 expression in the former compared with the latter (p < 0.001). These results suggest that NRG1 rs144160282 might be a prognostic predictor of the efficacy of ADT. Further studies are required to confirm the significance of NRG1 as a biomarker and therapeutic target for prostate cancer.

scholarly journals Clinicopathological review of epithelial ovarian tumors in young females and reproductive and survival outcome: Ten years expierence from a tertiary center

2016 ◽  
Author(s):  
Kusum Lata ◽  
Nutan Agarwal ◽  
Neerja Bhatla ◽  
Alka Kriplani
Keyword(s):  
Age Groups ◽  
Young Patients ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Survival Outcome ◽  
Ovarian Tumors ◽  
Tertiary Referral Hospital ◽  
Young Females ◽  
Presenting Symptoms ◽  
Tertiary Center

Objective: To find out the prevalence of epithelial ovarian tumors in young females and correlation with reproductive and survival outcome. Design: Retrospective study. Setting: Tertiary referral hospital. Methods: A retrospective analysis of females from 9-35 year of age group treated for ovarian tumors between January 2003 to July 2013 was performed. Variables studied included age, presenting symptoms, imaging, tumor markers, surgical findings, type of surgery, histopathology reports and follow-up. Main Outcome Measures: Histopathological variant, FIGO stage, reproductive and survival outcome. Results: A total of 155 patients were found to have ovarian tumors. Mean age at time of diagnosis was 24.9 ± 1.8 years (range 9-35). Clinical presentation in majority of the cases was abdominal pain in 68 (43.8%), ascites in 13 (8.3%) mass in abdomen in 25 (16%), followed by irregular menstrual cycles in 15 (9.6%), infertility in 18 (11.6%) 12 (7.7%) were found to be incidental on ultrasound examination while 4 women were found to have virilising symptoms. There were 76 (49.1%) cases of epithelial ovarian tumors, 6 (0.03%) of borderline tumors and 30 (19.3%) were of malignant ovarian tumors while 40 (25.8%) were benign. Stage IA (N = 80), Stage I 8 (n = 2), Stage III (N = 6) and Stage IV (N = 12). Females were further subdivided into three age groups 9-15 years, 15-25 years and 25 to 35 years for determining outcome of epitheliail tumors. Reproductive and survival outcome were studied in each stage. Conclusions: Limited data exists about the histological type distribution, surgical treatment and overall survival of epithelial ovarian tumors in women aged below 35 years. Young patients have higher overall progression-free survival and a better clinical outcome than older patients. Any women presenting with pain and nonspecific symptoms should be investigated and evaluated properly.

Chemoradiotherapy is an Alternative Choice for Patients with Primary Mediastinal Seminoma

2021 ◽  
Author(s):  
Yirui Zhai ◽  
Bo Chen ◽  
Xiaoli Feng ◽  
Kan Liu ◽  
Shulian Wang ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Progression Free Survival ◽  
Poor Performance ◽  
Rank Test ◽  
Clinicopathologic Characteristics ◽  
Cancer Specific Survival ◽  
Adjacent Structures ◽  
Significant Difference ◽  
Mediastinal Seminoma ◽  
Alternative Choice

Abstract Background: The low incidence of primary mediastinal seminomas has precluded the development of clinical trials on mediastinal seminomas. We investigated the clinicopathologic characteristics, prognosis of patients with primary mediastinal seminomas as well as the efficiency of nonsurgical treatments compared with treatments containing surgery.Methods: We retrospectively collected data on the clinicopathologic characteristics, treatments, toxicities, and survival of 27 patients from a single center between 2000 and 2018. Patients were divided into two groups according to whether they received operation. Survivals were assessed using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test.Results: The median age was 28 (13-63) years. The most common symptoms were chest pain (29.6%), cough (25.9%), and dyspnea (22.2%). There were 13 and 14 patients in surgery and non-surgery group. Patients in the non-surgical group were more likely to be with poor performance scores (100% vs.76.9%) and disease invaded to adjacent structures(100% vs.76.9%) especially great vessels(100% vs.46.2%).The median follow-up period was 32.23 (2.7-198.2) months. There was no significant difference of overall survival (5-year 100% vs 100%), cancer-specific survival (5-year 100% vs.100%), local regional survival (5-year 91.7% vs.90.0%, p=0.948) , distant metastasis survival (5-year 100.0% vs. 90.9%, p=0.340) and progression-free survival (82.5% vs.90.0%, p=0.245) between patients with and without surgery. Conclusions: Primary mediastinal seminoma was with favorable prognosis, even though frequently invasion into adjacent structures brings difficulties to surgery administration. Chemoradiotherapy is an alternative treatment with both efficacy and safety.

scholarly journals Exploration of a Novel Prognostic Risk Signature and Its Effect on the Immune Response in Nasopharyngeal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Shuang Zhao ◽  
Xin Dong ◽  
Xiaoguang Ni ◽  
Lin Li ◽  
Xin Lu ◽  
...  
Keyword(s):  
Immune Response ◽  
Nasopharyngeal Carcinoma ◽  
Risk Group ◽  
Progression Free Survival ◽  
Gene Signature ◽  
Metastatic Carcinoma ◽  
High Risk Group ◽  
Molecular Characteristics ◽  
Novel Gene ◽  
Kaplan Meier

Nasopharyngeal carcinoma (NPC) is a highly invasive and metastatic carcinoma with different molecular characteristics and clinical outcomes. In this work, we aimed to establish a novel gene signature that could predict the prognosis of NPC patients. A total of 13 significant genes between the recurrence/metastasis (RM) group and the no recurrence/metastasis (no-RM) group were identified by machine learning from RNA-Seq data including 60 NPC tumor biopsies. Based on these genes, a 4-mRNA signature (considering U2AF1L5, TMEM265, GLB1L and MLF1) was identified. Receiver operating characteristic (ROC) and Kaplan-Meier (K-M) analyses indicated that this signature had good prognostic value for NPC. The overall survival (OS) and progression-free survival (PFS) of the patients in the high-risk group were significantly shorter than those of the patients in the low-risk group (p = 0.00126 and p = 0.000059, respectively). The area under the ROC curve (AUC) values of the 4-mRNA signature were higher than those of T stage and N stage for OS (0.893 vs 0.619 and 0.582, respectively) and PFS (0.86 vs 0.538 and 0.622, respectively). Furthermore, the 4-mRNA signature was closely associated with cell proliferation and the immune response. The expression of GLB1L and TMEM265 was associated with the level of tumor-infiltrating immune cells (r &gt; 0.4, p &lt; 0.05). We have validated the model through measuring the expression levels of the 4-mRNA signature by qRT-PCR, in an independent cohort of NPC patients. Here, we report a novel gene signature that can serve as a new tool for predicting the prognosis of NPC patients.

scholarly journals Early intra-treatment diffusion weighted magnetic resonance imaging in patients with recurrent nasopharyngeal carcinoma treated with nivolumab

2020 ◽  
Vol 6 (3) ◽  
pp. 568
Author(s):  
Tiffany Y. So ◽  
Qi-Yong Ai ◽  
Brigette B.Y. Ma ◽  
Ann D. King
Keyword(s):  
Magnetic Resonance Imaging ◽  
Overall Survival ◽  
Magnetic Resonance ◽  
Nasopharyngeal Carcinoma ◽  
Progression Free Survival ◽  
Tumour Volume ◽  
Resonance Imaging ◽  
Free Survival ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging

<p class="abstract">Immune check point inhibitors have demonstrated promising efficacy in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) in phase I and phase II trials. Early identification of treatment response is important in these patients. This report aimed to document the early intratreatment diffusion weighted magnetic resonance imaging (DW-MRI) findings in NPC patients following treatment with the programmed cell death-1 inhibitor, nivolumab. Two consecutive patients with histologically confirmed recurrent undifferentiated NPC treated with nivolumab were prospectively recruited. Nivolumab was administered at a dosage of 3 mg/kg intravenously every 2 weeks. Patients underwent magnetic resonance imaging examinations at baseline, and at 3 and 5 weeks after commencement of treatment. Intratreatment changes in tumour volume and apparent diffusion coefficient (ADC<sub>mean</sub>)were calculated. The endpoints were objective response by response evaluation criteria in solid tumors and survival. In patient 1, an intratreatment ADC increase at 5 weeks corresponded with anatomical tumour volume reduction and a better long-term survival outcome (progression free survival 1.3 years, overall survival 2.9 years). In patient 2, an intratreatment ADC decrease at 5 weeks corresponded to progressive disease and worse outcome (progression free survival 0.0 years, overall survival 0.9 years). Intratreatment ADC changes at 3 weeks were not associated with response outcome. These cases suggest that intratreatment changes in ADC at 5 weeks may potentially predict tumour response in patients treated with nivolumab. Dedicated studies are needed to clarify these findings and fully characterise patterns of treatment related ADC change.</p>

Q-TWiST analysis of tivozanib (T) versus sorafenib (S) in patients with advanced renal cell carcinoma (RCC) in the TIVO-3 study.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 298-298
Author(s):  
Michael Szarek ◽  
Michael N. Needle ◽  
Brian I. Rini ◽  
Sumanta K. Pal ◽  
David F. McDermott ◽  
...  
Keyword(s):  
Progression Free Survival ◽  
Phase Iii ◽  
P Value ◽  
Patient Centered ◽  
Health States ◽  
Significant Difference ◽  
Phase Iii Study ◽  
The Difference ◽  
Similar Survival ◽  
Mean Differences

298 Background: In the randomized phase III study TIVO-3, the VEGFR-TKI tivozanib (TIVO) increased progression-free survival with better tolerability but no difference in overall survival (OS) relative to sorafenib (SORA) as third- or fourth-line therapy in patients with metastatic RCC. These results provide motivation to apply quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) methods to quantify the net health benefits of TIVO, in the presence of similar survival, when compared to SORA. Methods: In application of Q-TWiST, patient-level OS was subdivided into three mutually exclusive states: time with toxicity (TOX), time without symptoms and toxicity (TWiST), and time after progression/relapse (REL). Mean Q-TWiST was calculated by applying utility coefficients of 0.5, 1.0, and 0.5 to the restricted mean (max 36 months follow-up) health states of TOX, TWiST, and REL, respectively; 95% CIs for the means and mean differences were estimated by bootstrap distributions. Relative Q-TWiST gain was defined as the mean absolute Q-TWiST difference divided by the SORA mean OS. Results: Mean TWiST was significantly longer for TIVO than for SORA (10.30 months v.5.35 months; Table). Mean REL time was significantly shorter for TIVO, with no difference in mean TOX time. Mean Q-TWiST was 15.04 and 12.78 months for TIVO and SORA, respectively, a statistically significant difference (p=0.0493). The relative gain for TIVO was 11.2%. Clinical trial information: NCT02627963 . Values in table are mean (95% CI) in months or p-value for difference in treatment group means. Conclusions: The difference in Q-TWiST in TIVO-3 was primarily driven by benefits of TIVO in TWiST, partially offset by superiority of SORA in REL time. As a third- or fourth-line treatment for RCC, TIVO significantly increased Q-TWiST relative to SORA, primarily through an increase in TWiST, which is generally considered to be the state with highest utility to patients. Consequently, Q-TWiST may be considered an alternative patient-centered measure of benefit of TIVO in these settings. [Table: see text]

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