Identifying Benefit Factors Associated With Primary Tumor Resection in Patients With Stage IV Gastric Cancer: a Propensity Score-matched Analysis

2021 ◽  
Author(s):  
Haihao Yan ◽  
Zheng Liu ◽  
Ye Jin
Keyword(s):  
Gastric Cancer ◽  
Primary Tumor ◽  
Histological Grade ◽  
Stage Iv ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Stage Iv Gastric Cancer ◽  
Factors Associated ◽  
T Stage ◽  
Surgery Group

Abstract Background: At present, the beneficial factors related to surgery at the primary tumor site in patients with stage IV gastric cancer (GC) are unclear. We developed a new selection process to determine the beneficial factors associated with primary tumor surgery.Methods: Patients with stage IV GC were screened from the Surveillance, Epidemiology, and End Results (SEER) database and were divided into surgery and non-surgery groups. The Kaplan-Meier method was used to estimate the survival curve before and after the propensity score-matched analysis (PSM). We believe that patients in the surgery group who have a longer median cancer-specific survival (CSS) time than those in the non-surgery group can benefit from surgery. Use Multivariate Logistic regression analysis to determine the benefit factors related to surgery.Results: A total of 7259 patients with stage IV GC were included, of which 29.95% (2174) underwent primary tumor surgery. After PSM, the median CSS of the surgery group and the non-surgery group was 12 months and 7 months, respectively (p < 0.001). Multivariate COX regression analysis showed that age, T stage, primary tumor site, histological classification, histological grade, and chemotherapy were independently correlated with CSS. We included the independent related factors affecting CSS in COX analysis in the multivariate Logistics regression model. The results showed that T stage, histological grade, and chemotherapy were related to surgical benefit.Conclusion: The surgery to the primary tumor site can prolong the survival time of patients with stage IV GC, and surgeons should screen patients before surgery. Our results show that patients with T stage T4b and histological grade GIII/GIV do not benefit from surgery, while patients receiving chemotherapy can benefit from surgery.

Treatment patterns and long-term clinical outcomes in Chinese patients with nonmetastatic gastric cancer: Results from the non-interventional EVIDENCE registry study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 307-307
Author(s):  
Jiafu Ji ◽  
Shukui Qin ◽  
Xin Wang ◽  
Weiping Zhou ◽  
Lin Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Outcomes ◽  
Adjuvant Treatment ◽  
Primary Tumor ◽  
Chinese Patients ◽  
Tumor Site ◽  
Registry Study ◽  
Primary Tumor Site ◽  
Free Survival

307 Background: Although gastric cancer (GC) is a leading cause of cancer-related death in China, important questions about optimal management remain unanswered. The EVIDENCE registry study evaluated data from patients with GC in China to assess the pattern of treatments and long-term clinical outcomes. Methods: Five cohorts of patients with different HER2 and metastatic (m) status were evaluated from April 2013 to June 2018 in this prospective, multicenter, non-interventional, real-world study. Data from patients with operable non-mGC are reported: Cohort III (HER2+) and Cohort V (HER2−). Outcome measures included overall survival (OS), event-free survival (EFS), and disease-free survival (DFS). Results: Cohorts III/V included 758 patients (Cohort III, 271; Cohort V, 487); 75.5% were male and the mean age was 58.8 years. The majority of Cohort III/V patients (538/758; 71.0%) received only adjuvant treatment, with 215/758 (28.4%) receiving S1+oxaliplatin. Neoadjuvant or adjuvant trastuzumab was administered to 43/758 patients (Cohort III, 42; Cohort V, 1). Radiation during neoadjuvant or adjuvant treatment was administered to 23/758 (3.0%) patients. The median duration of follow-up was 515 days, during which 72 (9.5%) patients died due to progressive disease. OS rates (95% CI) for Cohorts III and V were 94% (89–96) and 95% (92–97) at 1 year, and 76% (67–83) and 70% (64–75) at 3 years, respectively. Respective EFS rates were 82% (76–87) and 86% (83–89) at 1 year, and 62% (53–70) and 57% (51–63) at 3 years; and respective DFS rates were 88% (82–93) and 86% (81–89) at 1 year and 69% (58–78) and 62% (55–68) at 3 years. Multivariate analysis indicated that the primary tumor site (p = 0.004) and overall cancer stage (p < 0.001) were associated with DFS. Regarding the primary tumor site, there was a trend towards better DFS for antrum tumors (hazard ratio 0.59; 95% CI 0.32–1.07) when evaluated against gastroesophageal junction tumors. Conclusions: This longitudinal analysis of clinicopathologic characteristics and outcomes of Chinese patients with non-mGC will provide critical information that will help to inform disease management. Clinical trial information: NCT01839500.

Prognostic factors for stage IV gastric cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 23-23
Author(s):  
K. Chu ◽  
S. Chan
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Stage Iv ◽  
Tumor Stage ◽  
C Reactive Protein ◽  
Stage Iv Gastric Cancer ◽  
Factors Associated ◽  
Reactive Protein ◽  
Stage Iv Disease ◽  
Significant Factors

23 Background: In general, the most significant prognostic factor for gastric cancer is tumor stage. In a patient with stage IV gastric cancer, other prognostic factors would be helpful to guide appropriate therapy and to avoid unnecessary suffering as well as fruitless and expensive therapy. Methods: Data of all patients with gastric cancer managed at the Department of Surgery of The University of Hong Kong are entered prospectively into a computer database. Between January 1996 and December 2007, 1,109 patients who have not received prior treatment for their gastric cancer are included in the present study. Factors correlated with tumor stage as well as factors associated with survival are studied with univariate analysis. Significant factors are then subjected to multivariate analysis. In patients with stage IV disease, significant factors associated with survival are then studied with univariate and multivariate Cox regression analysis. Results: 1,109 patients with age of 66 ± 14 years were included. There was a male predominance (M:F = 705:404). 18.1%, 10.3%, 28.3%, and 43.2% have stage I, II, III, and IV diseases, respectively. Spearman's rank correlation analysis identified haemoglobin, lymphocyte/WCC ratio (LWR), platelet count, albumin, CEA, CA19-9, and C-reactive protein (CRP) to be significantly correlated with tumor stage. Multivariate analysis identified LWR, platelet count, albumin, CA 19-9 and CRP as independent factors associated with tumor stage. On the other hand, CA19-9, CRP, LWR and tumor stage were found to be independent prognostic factors associated with overall survival. Among the group of patients with stage IV disease, ECOG status (OR 1.265, 95% CI 1.025 – 1.562), CA 19-9 (OR 1.0, 95% CI 1.0 – 1.0), CRP (OR 1.050, 95% CI 1.021 – 1.081) as well as LWR (OR 0.076, 95% CI 0.011 – 0.552) were found to be independent prognostic factors for survival. Conclusions: Within the group of patients with stage IV gastric cancer, ECOG status, lymphocyte/ WCC ratio, serum CA19.9 and C-reactive protein level were found to be independent prognostic factors for survival. No significant financial relationships to disclose.

scholarly journals Primary Tumor Resection and Survival in Patients with Stage IV Gastric Cancer

2016 ◽  
Vol 16 (2) ◽  
pp. 78 ◽  
Author(s):  
Fatma Yalçin Müsri ◽  
Hasan Mutlu ◽  
Mustafa Karaağaç ◽  
Melek Karakurt Eryilmaz ◽  
Şeyda Gündüz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Gastric Cancer

scholarly journals Prognostic Factors Associated With Survival in Patients With Diffuse Astrocytoma

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 &lt; 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.

scholarly journals Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

2020 ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

scholarly journals Resection of primary tumor at diagnosis in stage IV-S neuroblastoma: does it affect the clinical course?

1996 ◽  
Vol 14 (5) ◽  
pp. 1537-1544 ◽  
Author(s):  
M Guglielmi ◽  
B De Bernardi ◽  
A Rizzo ◽  
S Federici ◽  
C Boglino ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Free Survival ◽  
Significant Difference ◽  
Favorable Influence ◽  
Previous Group

PURPOSE To determine whether resection of primary tumor has a favorable influence on outcome of infants (age 0 to 11 months) with stage IV-S neuroblastoma. PATIENTS AND METHODS Between March 1976 and December 1993, 97 infants with previously untreated neuroblastoma diagnosed in 21 Italian institutions were classified as having stage IV-S disease. Seventy percent were younger than 4 months. Adrenal was the primary tumor site in 64 of 85 patients with a recognizable primary tumor. Liver was the organ most often infiltrated by the tumor (82 patients), followed by bone marrow and skin. RESULTS The overall survival (OS) rate at 5 years in 80% and event-free survival (EFS) rate 68%. In 24 infants, the effect of resection of primary tumor could not be evaluated because of rapidly fatal disease progression (n = 8), absence of a primary tumor (n = 12), or partial resection (n = 4). Of 73 assessable patients, 26 underwent primary tumor resection at diagnosis: one died of surgical complications, one relapsed locally and died, and two others relapsed (one of these two locally) and survived, for a 5-year OS rate of 92% and EFS rate of 84%. Of the remaining 47 patients who did not undergo primary tumor resection at diagnosis 11 suffered unfavorable events, of whom five died, for an OS rate of 89% and EFS rate of 75% (no significant difference from previous group). Disease recurred at the primary tumor site in only one five who died, and in only one of six survivors of progression or relapse; in these patients, the primary tumor, located in the mediastinum, was successfully resected. CONCLUSION Infants who underwent resection of the primary tumor at diagnosis had no better outcome than those in whom the decision was made not to operate.

Clinical Impact of Primary Tumor Site in Stage IV Colorectal Cancer: A Statewide Cohort Study

2021 ◽  
Vol 41 (11) ◽  
pp. 5693-5702
Author(s):  
HIDETAKA KAWAMURA ◽  
MICHITAKA HONDA ◽  
KOICHI TAKIGUCHI ◽  
TAKAHIRO KAMIGA ◽  
KATSUMASA SAITO ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Primary Tumor ◽  
Stage Iv ◽  
Clinical Impact ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Stage Iv Colorectal Cancer

scholarly journals Risk Factors for Osteoradionecrosis of the Jaw in Patients With Head and Neck Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14%, and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

scholarly journals Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hikaru Kubota ◽  
Daisuke Miyawaki ◽  
Naritoshi Mukumoto ◽  
Takeaki Ishihara ◽  
Megumi Matsumura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Primary Tumor ◽  
Tooth Extraction ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Factors Associated

Abstract Background To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose–volume histogram (DVH) parameters. Methods We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range 3–145) months. The median time to ORNJ development was 27 (range 2–127) months. DVH analysis revealed that V30–V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 > 14% were identified as important factors. In multivariate analyses, V60 > 14% (p = 0.0065) and primary tumor site (p = 0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤ 14% and > 14%, respectively (p < 0.0001), and 9.3% and 1.4% in patients with oropharyngeal or oral cancer and other cancers, respectively (p < 0.0001). Conclusions V60 > 14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

Gender associations in head and neck squamous cell carcinoma (HNSCC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16010-e16010 ◽  
Author(s):  
Tien Hoang ◽  
Chong Zhang ◽  
Heather M Geye ◽  
Tod Speer ◽  
Menggang Yu ◽  
...  
Keyword(s):  
Head And Neck ◽  
Primary Tumor ◽  
Performance Status ◽  
Stage Iv ◽  
Outcome Data ◽  
Primary Objective ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Site Distribution ◽  
Drinking Habits

e16010 Background: The primary objective of this analysis was to examine the association of gender with various presentation and outcome parameters in HNSCC. Methods: We queried the head and neck cancer (HNC) database at the University of Wisconsinand examined selected clinical, treatment and outcome data for all patients (pts) treated consecutively during the 10-year period (1/01-12/10). Results: From a total of 1,108 HNC pts, we identified 965 with SCC histology, including 252 women (26.1%) and 713 men (73.9%). Women were slightly older at presentation (mean age 62 vs. 60, p = 0.03); 29.6% of women vs. 19.6% of men were 70 years or older. There were no differences in race distribution. Smoking and drinking habits were frequently reported in both sexes, although seen more frequently in men. 74.1% of women vs. 83.1% of men had smoked cigarettes (p=0.003), while 74.9% and 90.6% respectively had consumed alcohol (p<0.0001). 16.3% women never smoked or drank in comparison to 4.6% in men (p<0.0001). There was a difference in primary tumor site distribution between genders (p=0.0003). Oral cavity (41.3%) and larynx (23%) were the most common sites in women vs. oropharynx (31.1%) and larynx (24.8%) in men. There appeared to be no difference in tumor T stage. However, more men presented with N2/3 (51.7% vs. 39.9%, p=0.01) and stage IV (63.1% vs. 53.2%, p=0.04). For initial treatment, more men received multi-modality therapy (56.2% vs. 48.4%, p=0.009) while more women received surgery as sole therapy (37.3% vs. 27.1%). Overall, 72.7% of men vs. 62.3% of women received radiation (XRT); 36.5% and 26.2% respectively received concurrent chemoradiation. There were no differences in baseline performance status, total XRT dose (mean 65.8 Gy), fractionation (mean 33), XRT technique (3D conformal, linac-based IMRT or tomotherapy), or chemotherapy delivered. Recurrence free outcome was achieved equally in both genders at the primary tumor site (~80%), neck (~84%) and distant sites (~88%). Median survival was 89.5 months in women and 84.2 months in men (p=0.65). Conclusions: Although there were no differences in overall survival,our analysis suggests that some gender differences may exist in risk factors and clinical presentation for HNSCC pts. Further study is warranted.

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