Characteristics and nomogram for primary lung lepidic adenocarcinoma

Abstract Background: Lepidic adenocarcinoma (LPA) is an infrequent subtype of invasive pulmonary adenocarcinoma (ADC). However, the clinicopathological features and prognostic factors of LPA have not been elucidated.Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database of 4087 LPA patients were retrospectively analyzed and compared with non-LPA pulmonary ADC to explore the clinicopathological and prognosis features of LPA. Univariate and multivariate Cox proportional hazard models were performed to identify independent survival predictors for further nomogram development. The nomograms were validated by using the concordance index, receiver operating characteristic curves, and calibration plots, as well as decision curve analysis, in both the training and validation cohorts.Results: Compared with non-LPA pulmonary ADC patients, those with LPA exhibited unique clinicopathological features, including more elderly and female patients, smaller tumor size, less pleural invasion, and lower histological grade and stage. Multivariate analyses showed that age, sex, marital status, primary tumor size, pleural invasion, histological grade, stage, primary tumor surgery, and chemotherapy were independently associated with overall survival (OS) and cancer-specific survival (CSS) in patients with LPA, while race was the only independent prognostic factor for OS, not for CSS. The nomograms showed good accuracy compared with the actual observed results and demonstrated improved prognostic capacity compared with TNM stage.Conclusions: Patients with LPA are more likely to be older and female. Smaller tumor size, lower histological grade and stage are the clinicopathological features of LPA, which may indicate a good prognosis. The constructed nomograms accurately predict the long-term survival of LPA patients.

Download Full-text

Characteristics and Nomogram for Primary Lung Lepidic Adenocarcinoma

10.21203/rs.3.rs-1202617/v1 ◽

2021 ◽

Author(s):

Hui Tang ◽

Yingyi Wang ◽

Chunmei Bai

Keyword(s):

Tumor Size ◽

Primary Tumor ◽

Histological Grade ◽

Good Prognosis ◽

Clinicopathological Features ◽

Cancer Specific Survival ◽

Term Survival ◽

Receiver Operating Characteristic Curves ◽

Pleural Invasion ◽

Cox Proportional Hazard Models

Download Full-text

The characteristics and nomogram for primary lung lepidic adenocarcinoma

10.21203/rs.3.rs-246772/v1 ◽

2021 ◽

Author(s):

Hui Tang ◽

Yingyi Wang ◽

Chunmei Bai

Keyword(s):

Marital Status ◽

Tumor Size ◽

Primary Tumor ◽

Histological Grade ◽

Clinicopathological Features ◽

Tnm Stage ◽

Term Survival ◽

Long Term Survival ◽

Pleural Invasion

Abstract Background Lepidic adenocarcinoma (LPA) is an infrequent subtype of invasive pulmonary adenocarcinoma (ADC). However, the clinicopathological features and prognostic factors of LPA have not been elucidated. We undertook a retrospective population-based analysis to examine the clinicopathological features of LPA, and construct nomograms predicting long-term survival of LPA patients. Methods Data from the Surveillance, Epidemiology, and End Results (SEER) database of 4087 LPA patients diagnosed between 2005 and 2014 were retrospectively analyzed and compared with non-LPA pulmonary ADC to explore the clinicopathological and prognosis features of LPA. All patients included in our study were histologically confirmed. Those with multiple primary tumors in their lifetime, unknown survival data, unknown tumor-node-metastasis (TNM) stage, and unknown information including age, race, and marital status were excluded. Univariate and multivariate Cox proportional hazard models were performed to identify independent survival predictors for further nomogram development. The nomograms were internally and externally validated for concordance index and calibration plots as well as decision curve analysis. Results Compared with non-LPA pulmonary ADC patients, those with LPA exhibited unique clinicopathological features, including more elderly and female patients, smaller tumor size, lesser pleural invasion, lower histological grade and stage. Multivariate analyses showed that age, sex, marital status, primary tumor size, pleural invasion, histological grade, stage, primary tumor surgery, and chemotherapy were independently associated with overall survival (OS) and cancer-specific survival (CSS) in patients with LPA, while race was the only independent prognostic factor for OS, not for CSS. The nomograms showed good accuracy comparing with actual observed results and demonstrated improved prognostic capacity than TNM stage. Conclusions Patients with LPA are more common in older age and female. The smaller tumor size, lower histological grade and stage are the clinicopathological features of LPA which may indicate a good prognosis. The constructed nomograms accurately predict the long-term survival of LPA patients.

Download Full-text

Actual Long-Term Survival After Resection of Stage III Soft Tissue Sarcoma

10.21203/rs.3.rs-72207/v1 ◽

2020 ◽

Author(s):

Do Weon Lee ◽

Han-Soo Kim ◽

Ilkyu Han

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Tumor Size ◽

Poor Prognosis ◽

Histological Grade ◽

Stage Iii ◽

Term Survival ◽

Long Term Survival ◽

Long Term Survivors

Abstract Background: Actuarial survival based on the Kaplan–Meier method can overestimate actual long-term survival, especially among those with factors of poor prognosis. Patients with American Joint Committee on Cancer stage III soft tissue sarcoma (STS) represent a subset with a high risk of STS-specific mortality. Therefore, we aimed to characterize the clinicopathological characteristics associated with actual long-term survival in patients with stage III STS.Methods: We retrospectively reviewed 116 patients who underwent surgical resection for stage III STS with curative intent between March 2000 and December 2013. Long-term survivors (n = 61), defined as those who survived beyond 5 years, were compared with short-term survivors (n = 36), who died of STS within 5 years.Results: Multivariate logistic regression analyses showed that a tumor size <10 cm [odds ratio (OR) 3.95, p = 0.047], histological grade of 2 (OR 8.12, p = 0.004), and American Society of Anesthesiologists (ASA) score of 1 (OR 11.25, p = 0.001) were independently associated with actual 5-year survival. However, 66% of the long-term survivors exhibited factors of poor prognosis: 36% had a tumor size >10 cm and 48% had a histological grade of 3. Leiomyosarcoma (3 of 10) was negatively associated with actual long-term survival.Conclusions: Actual 5-year survival after resection of stage III STS was associated with tumor size, histological grade, and ASA score. However, majority of the actual 5-year survivors exhibit factors of poor prognosis, suggesting that resection should be offered for a chance of long-term survival in these patients.

Download Full-text

Actual long-term survival after resection of stage III soft tissue sarcoma

BMC Cancer ◽

10.1186/s12885-020-07730-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Do Weon Lee ◽

Han-Soo Kim ◽

Ilkyu Han

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Tumor Size ◽

Poor Prognosis ◽

Histological Grade ◽

Stage Iii ◽

Term Survival ◽

Long Term Survival ◽

Long Term Survivors

Abstract Background Actuarial survival based on the Kaplan–Meier method can overestimate actual long-term survival, especially among those with factors of poor prognosis. Patients with American Joint Committee on Cancer stage III soft tissue sarcoma (STS) represent a subset with a high risk of STS-specific mortality. Therefore, we aimed to characterize the clinicopathological characteristics associated with actual long-term survival in patients with stage III STS. Methods We retrospectively reviewed 116 patients who underwent surgical resection for stage III STS with curative intent between March 2000 and December 2013. Long-term survivors (n = 61), defined as those who survived beyond 5 years, were compared with short-term survivors (n = 36), who died of STS within 5 years. Results Multivariate logistic regression analyses showed that a tumor size < 10 cm [odds ratio (OR) 3.95, p = 0.047], histological grade of 2 (OR 8.12, p = 0.004), and American Society of Anesthesiologists (ASA) score of 1 (OR 11.25, p = 0.001) were independently associated with actual 5-year survival. However, 66% of the long-term survivors exhibited factors of poor prognosis: 36% had a tumor size > 10 cm and 48% had a histological grade of 3. Leiomyosarcoma (3 of 10) was negatively associated with actual long-term survival. Conclusions Actual 5-year survival after resection of stage III STS was associated with tumor size, histological grade, and ASA score. However, majority of the actual 5-year survivors exhibit factors of poor prognosis, suggesting that aggressive treatment should be offered for a chance of long-term survival in these patients.

Download Full-text

Development and external validation of a nomogram for predicting the effect of tumor size on survival of patients with perihilar cholangiocarcinoma

10.21203/rs.3.rs-20223/v2 ◽

2020 ◽

Author(s):

Yaodong Zhang ◽

Zhengshan Wu ◽

Xing Wang ◽

Changxian Li ◽

Jiang Chang ◽

...

Keyword(s):

Surgical Resection ◽

Tumor Size ◽

Cox Regression ◽

Predictive Accuracy ◽

External Validation ◽

Perihilar Cholangiocarcinoma ◽

Optimal Cutoff ◽

Cancer Specific Survival ◽

Term Survival ◽

Cutoff Value

Abstract Background: The effect of tumor size on account of the long-term survival results in perihilar cholangiocarcinoma (PCCA) patients has remained a controversial debate. It is urgent necessary to identify the optimal cutoff value of tumor size in PCCA and integrate tumor size with other prognostic factors into a nomogram to improve the predictive accuracy of the prognosis of patients with PCCA. Methods: 363 PCCA patients underwent surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year cancer-specific survival (CSS) based on the independent risk factors chosen by Kaplan-Meier methods and multivariable cox regression models. The precision of the nomogram for predicting survival was validated internally and externally. Results: PCCA patients underwent surgical resection were classified into 1-19 mm, 20-33 mm and ³34 mm subgroup based on the optimal cutoff for tumor size in terms of CSS. And we noticed that more larger tumor size group had worse tumor grade, advanced T stage, more positive regional lymph nodes and more frequency vascular invasion. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7 th Tumor-Node-Metastasis (TNM) stage systems. Conclusions: The results demonstrated that the larger the tumor size was, the worse the survival would be. The proposed nomogram, which outperforms the conventional TNM staging system, showed consistently reliability and clinically practicality for predicting the prognosis of PCCA patients.

Download Full-text

Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

10.21203/rs.3.rs-34558/v1 ◽

2020 ◽

Author(s):

Hanlong Zhu ◽

Si Zhao ◽

Kun Ji ◽

Wei Wu ◽

Jian Zhou ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Tumor Size ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Treatment Modalities ◽

Cancer Specific Survival ◽

Term Survival ◽

Population Based Study

Abstract Background: With the rapid advances in endoscopic technology, endoscopic therapy (ET) is increasingly applied to the treatment of small (≤20 mm) colorectal neuroendocrine tumors (NETs). However, long-term data comparing ET and surgery for management of T1N0M0 colorectal NETs are lacking. The purpose of this work was to compare overall survival (OS) and cancer-specific survival (CSS) of such patients with ET or surgery.Methods: Patients with T1N0M0 colorectal NETs were identified within the Surveillance Epidemiology and End Results (SEER) database (2004-2016). Demographics, tumor characteristics, therapeutic methods, and survival were compared. Propensity score matching (PSM) was used 1:3 and among this cohort, Cox proportional hazards regression models were performed to evaluate correlation between treatment and outcomes.Results: Of 4487 patients with T1N0M0 colorectal NETs, 1125 were identified in the matched cohort, among whom 819 (72.8%) underwent ET and 306 (27.2%) underwent surgery. There was no difference in the 5-year and 10-year OS and CSS rates between the 2 treatment modalities. Likewise, analyses stratified by tumor size and site showed that patients did not benefit more from surgery compared with ET. Moreover, multivariate analyses found no significant differences in OS [Hazard Ratio (HR) = 0.857, 95% Confidence Interval (CI): 0.513–1.431, P = 0.555] and CSS (HR = 0.925, 95% CI: 0.282–3.040, P = 0.898) between the 2 groups. Similar results were observed when comparisons were limited to patients with different tumor size and site.Conclusions: In this population-based study, patients treated endoscopically had comparable long-term survival compared with those treated surgically, which demonstrates ET as an alternative to surgery in T1N0M0 colorectal NETs.

Download Full-text

Breast-Conserving Therapy Has Better Prognosis for Tumors in the Central and Nipple Portion of Breast Cancer Compared with Mastectomy: A SEER Data-Based Study

Frontiers in Oncology ◽

10.3389/fonc.2021.642571 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jing Wang ◽

Xiaoyu Wang ◽

Zhenyu Zhong ◽

Xue Li ◽

Jiazheng Sun ◽

...

Keyword(s):

Breast Cancer ◽

Molecular Subtype ◽

Histological Grade ◽

Treatment Strategies ◽

Breast Conserving Therapy ◽

Breast Cancer Patients ◽

Cancer Specific Survival ◽

Kaplan Meier ◽

Seer Data ◽

Cox Proportional Hazard Models

Background and ObjectivesCurrently, the location of primary tumor was an independent prognostic factor of breast cancer. Tumors in the central and nipple portion (TCNP) had poor prognosis compared to other peripheral quadrants. The breast-conserving therapy (BCT) is becoming increasingly common worldwide in breast cancer operations. However, whether the availability of BCT was performed for TCNP remained a matter of debate. We sought to investigate whether BCT was suitable for TCNP with respect to survival outcomes, compared with mastectomy therapy.MethodsUtilizing the Surveillance, Epidemiology, and End Results (SEER) database, we obtained TCNP breast cancer patients diagnosed during the period of 2010–2015. One-to-one (1:1) propensity score matching (PSM) was applied to construct a matched sample consisting of pairs of BCT and mastectomy groups. Univariate and multivariate Cox proportional hazard models were applied to estimate the factors associated with breast cancer-specific survival (BCSS) and overall survival (OS). Survival analysis was performed with the Kaplan–Meier method.ResultsIn the overall cohort, a total of 9,900 patients were enrolled. We found that patients with BCT showed significantly better BCSS (log-rank, p < 0.001) and OS (log-rank, p < 0.001) than the mastectomy group before PSM. The same finding was also shown in 5,820 patients after PSM. Additionally, none of the subgroups, including age, sex, race, histological grade, AJCC stage, and molecular subtype undergoing mastectomy therapy, had better BCSS than BCT.ConclusionsOur study was the first research to show that BCT exhibited superior prognosis in the cohort of TCNP from SEER databases than mastectomy therapy. This finding could provide a cue for treatment strategies for suitable TCNP patients, especially those with a strong willingness to conserve their breasts.

Download Full-text

Sex-Based Heterogeneity in the Clinicopathological Characteristics and Prognosis of Breast Cancer: A Population-Based Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.642450 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yiqun Han ◽

Jiayu Wang ◽

Zijing Wang ◽

Binghe Xu

Keyword(s):

Breast Cancer ◽

Cox Regression ◽

Ductal Carcinoma ◽

Molecular Subtype ◽

Histological Grade ◽

Population Based ◽

Clinicopathological Characteristics ◽

Clinicopathological Features ◽

Disease Stage ◽

Cancer Specific Survival

PurposeTo better understand the differences in clinicopathological features and prognosis between male breast cancer (MBC) and female breast cancer (FBC).Material and MethodsData on patients diagnosed with breast cancer from January 1, 2010, to December 31, 2016, were obtained from the Surveillance, Epidemiology, and End Results database. Selected patients were classified into MBC and FBC, of which population demographics and clinicopathological features at baseline were successively extracted for analysis. Comparative analysis was performed to explore the differences in baseline characteristics, followed by propensity-score matching to calibrate the objective distinctions for adjusted analysis. Survival analysis was carried out to investigate divergences presented in prognosis from the two cohorts, and risk factors for prognosis were successively identified using univariate and multivariate COX regression analyses.ResultsA total of 407341 individuals were eligible, including 3111 MBC (0.7%) and 404230 FBC (99.3%) patients. Comparatively, patients with MBC tended to be older at diagnosis, with a higher confirmation of ductal carcinoma, a higher histological grade, a higher TNM stage, a higher proportion of luminal-like subtype, a higher rate of lung metastasis, a lower incidence of liver involvement, and a lower rate of surgical, radiation, and chemotherapeutic delivery. The overall prognosis of MBC was significantly worse than that of FBC, with a decreasing divergence both in median overall survival (65.5 months vs. 72.7 months, P<0.0001) and median breast cancer-specific survival (75.4 months vs. 77.8 months, P<0.0001). However, these discrepancies were not consistent among patients from different subgroups stratified by molecular subtype, age at diagnosis, or disease stage.ConclusionIn this study, sex-based heterogeneity in clinicopathological characteristics and prognostic profiles was observed in the overall population of patients with breast cancer and was significantly variable among different subgroups. A male-specific design with reasonable endpoints for a clinical trial protocol will be warranted in the future.

Download Full-text

Prognostic Factors Associated With Survival in Patients With Diffuse Astrocytoma

Frontiers in Surgery ◽

10.3389/fsurg.2021.712350 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shuo Liu ◽

Xiaoqiang Liu ◽

Weiduan Zhuang

Keyword(s):

Tumor Size ◽

Primary Tumor ◽

Protective Factor ◽

Diffuse Astrocytoma ◽

Tumor Site ◽

Seer Database ◽

Cancer Specific Survival ◽

Primary Tumor Site ◽

Factors Associated ◽

Epidemiological Characteristics

Background: Diffuse astrocytoma (DA) is a rare disease with inadequately understood epidemiological characteristics and prognosis. Identification of the factors associated with the survival in DA patients is therefore necessary. In this study, we aim to investigate the clinicopathological characteristics of DA to delineate factors influencing the survival of DA.Methods: A population-based cohort study was conducted, utilizing prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database. Patients with histological diagnosis of DA in the SEER database from 1973 to 2017 were included.Results: A total of 799 participants with DA were included, consisting of 95.9% fibrillary astrocytoma and 4.1% protoplasmic variants. The average age of participants was 41.9 years, with 57.2% being male. The majority of the population was white (87.5%). More than half (53.9%) of the patients were married. DA arose mostly in the cerebrum (63.8%). Around 71.6% of the population had received surgical treatment. The overall 1-, 3-, 5-, and 10-year survival rate were 73.7, 55.2, 49.4, and 37.6%, respectively. Kaplan–Meier analysis showed that age at diagnosis, marital status, primary tumor site, tumor size, and surgery was possibly associated with cancer-specific survival (CSS) (p < 0.05). Multivariate Cox proportional hazard analysis indicated that surgery was a protective factor whereas older age, larger tumor size, and tumor in the brainstem were harmful factors for patients with DA. Moreover, a nomogram predicting 5- and 10-year survival probability for DA was developed.Conclusions: Age, primary tumor site, tumor size, and surgery were associated with the survival of patients with DA.

Download Full-text

An analysis of invasive micropapillary breast carcinoma based on hormone receptor and epidermal growth receptor 2 status

10.21203/rs.3.rs-75398/v1 ◽

2020 ◽

Author(s):

Yuting Sun

Keyword(s):

Breast Carcinoma ◽

Tumor Size ◽

Hormone Receptor ◽

Histological Grade ◽

Cox Proportional Hazards ◽

Cancer Specific Survival ◽

Exact Probability ◽

Her 2 ◽

Epidermal Growth ◽

To Receive

Abstract Background This research aimed to explore the role of combining hormone receptor (HR) with epidermal growth factor receptor 2 (Her-2) status of invasive micropapillary breast carcinoma (IMPC). Methods 1291 IMPC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute. The X2 test and Fisher’s exact probability test were used to evaluate differences between qualitative variables. Univariate and multivariate Cox proportional hazards regressions were performed to assess the independent prognostic factors on cancer-specific survival (CSS) and overall survival (OS). The nomogram models were made to predict 3-year survival rate of IMPC using R software. Results Among 1291 patients, HR+/Her-2- subtype accounted for 74.7%, while HR-/Her-2+, HR-/Her-2-, HR+/Her-2 + accounted for 4.7%, 4.0% and 15.6% respectively. The X2 test indicated compared to HR+/Her-2- subgroup, HR-/Her-2- or HR+/Her-2 + subtype IMPC had larger tumor size (T stage) and higher histological grade. Compared to HR+/Her-2- IMPC, HR-/Her-2- and HR+/Her-2 + subtypes were more likely to receive mastectomy than conserving surgery. Furthermore, HR+/Her-2- IMPC had more projections to receive chemotherapy and was less likely to receive radiotherapy compared with HR-/Her-2- subtype. Survival analysis suggested that HR-/Her-2- IMPC had the worst OS and CSS. Conclusion This population-based study provided evidence that HR-/Her-2- IMPC accounted the smallest part of four subtypes, but were more likely to have larger tumor size and more advanced histological grade. Furthermore, HR+/Her-2- IMPC had most unfavorable prognosis among four subtypes.

Download Full-text