scholarly journals Retrospective analysis of primary neuroendocrine tumors of the ovary: Management and outcomes

2021 ◽  
Author(s):  
li pang ◽  
zhiqiang guo
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumors ◽  
Early Stage ◽  
Treatment Strategies ◽  
Histological Type ◽  
Comprehensive Treatment ◽  
Cancer Specific Survival ◽  
Ajcc Stage ◽  
Low Incidence ◽  
Patient Prognosis

Abstract Background Due to the low incidence of ovarian neuroendocrine tumors (NETs), clinicians may be unaware of appropriate treatments for the disease and factors influencing patient prognosis, which may cause them to miss the window of opportunity for treatment. Moreover, there is currently no recognized first-line treatment strategy, and no studies have reported prognostic statistics derived from large samples. This retrospective study aimed to investigate the clinical behavior of ovarian NETs. Methods The Surveillance, Epidemiology, and End Results database was used to identify women diagnosed with ovarian NETs from 2004 to 2015. Overall survival (OS), cancer-specific survival (CSS), and independent prognostic factors for ovarian NETs were evaluated. The effects of different treatments on prognosis were also compared, as were OS and CSS rates for histological subtypes. Results The 5-year OS rates were 83.3%, 30.0%, 20.3%, and 9.8% for patients in stages I (n = 159), II (n = 23), III (n = 101), and IV (n = 148), respectively. The 5-year CSS rates were 85.6%, 41.7%, 21.2%, and 9.8% for patients in stages I–IV, respectively. Age, American Joint Committee on Cancer (AJCC) stage, lymph node metastasis, treatment, and histological type were related to poor OS and CSS. In the early stage, the 5-year OS and CSS rates were 97.03% and 96.90%, respectively. For patients in the advanced stage receiving comprehensive treatment (surgery + chemotherapy + radiotherapy), 5-year OS and CSS rates were 72.9% and 70.00%, respectively. When comparing low- and high-grade neuroendocrine carcinoma, the 5-year OS rates were 93.96% vs. 7.01%, 5-year CSS rates were 97.44% vs. 7.31%, 10-year OS rates were 93.56% vs. 2.34%, and 10-year CSS rates were 97.44% vs. 4.88%, respectively. Conclusion Age, AJCC stage, treatment, and histological type are independent prognostic factors of ovarian NETs. Prognosis is relatively good for early-stage cases treated with surgery alone, whereas more comprehensive treatment is required to improve prognosis for advanced cases. Future studies should focus on the development of individualized treatment strategies for prolonging survival time in patients with ovarian NETs.

Risk Factors, Prognosis and A New Nomogram for Predicting Cancer-Specific Survival Among Lung Cancer Patients with Brain Metastasis: A Retrospective Study Based on SEER

2021 ◽  
Author(s):  
Guihong Zhang ◽  
Yue Jiao Liu ◽  
Ming De Ji
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Prognostic Factors ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Primary Site ◽  
Histological Type ◽  
Extracranial Metastasis ◽  
Cancer Specific Survival ◽  
Lung Cancer Patients

Abstract Purpose: A comprehensive population-based study on risk and prognostic factors of lung cancer with brain metastasis is lacking. Methods: 95191 patients diagnosed with lung cancer between 2010 and 2017 were collected from the Surveillance, Epidemiology and End Results (SEER) database. Patients were stratified by different variables. Multivariable logistic and Cox regression were applied to analyze the risk and prognostic factors of brain metastasis among lung cancer patients, respectively. The Fine and Gray’s competing risk regression model was performed to obtain prognostic factors associated with cancer-specific mortality.Results: Among the 95191 patients diagnosed with lung cancer, 10765 patients have brain metastasis, with a metastatic incidence of 11.31%. The primary site of tumor, residence type, age, histological type, race and extracranial metastasis were all independent risk factors of brain metastasis. Compared with other histological types, small cell lung cancer displayed a highest incidence of brain metastasis (16.62%). The median overall survival (OS) among lung cancer patients with brain metastasis was only 6.05 months. The primary site of tumor, median household income, age, histological type, race, gender and extracranial metastasis were all associated with the prognosis of brain metastasis. Patients with squamous cell carcinoma had the worst prognosis, the median OS was only 3.68 months. And our established new nomogram showed a good discriminative ability on predicting the probability of cancer-specific survival among patients with brain metastasis, the C-index was 0.61.Conclusion: Our study provided a deeper insight into the risk factors and prognosis of brain metastasis among lung cancer patients.

Comparison of prognostic factors and survival outcome between gastrointestinal tract and cutaneous invasive malignant melanoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 618-618
Author(s):  
Chi Lin ◽  
Christopher K Brown ◽  
Charles Arthur Enke ◽  
Fausto R. Loberiza
Keyword(s):  
Prognostic Factors ◽  
Proportional Hazards ◽  
Early Stage ◽  
Female Gender ◽  
Cox Proportional Hazards ◽  
Lymph Node Status ◽  
Cancer Specific Survival ◽  
White Race ◽  
Factors Associated ◽  
Cox Analysis

618 Background: Gastrointestinal melanoma (GIM) is a rare disease. The objective of this study is to compare the overall survival (OS), cancer specific survival (CSS) and prognostic factors of GIM to those of skin melanoma (SKM) using the Surveillance, Epidemiology, and End Results (SEER) registry. Methods: Patients diagnosed with invasive GIM (406) and SKM (173,622) between 1973 and 2008 were identified from the SEER database. Factors analyzed included age (18-40/41-60/61-100), gender, race (White/nonwhite), marital status, stage (localized/regional/distant), year of diagnosis (1973-87/1988-97/1998-2008), and type of treatment (radiotherapy (RT)/surgery). OS and CSS were evaluated using the Kaplan-Meier method. Cox proportional hazards regression analysis examined what factors were prognostic of survival. Results: The median age was 69 and 57 for patients with GIM and SKM, respectively. The GIM group was older with more advanced-stage cancer than the SKM group. Surgery was performed on 85% and 95%, while RT was received by 18% and 2% of GIM and SKM patients, respectively. The GIM group had a median OS and CSS of 15 and 16 months, respectively, while the SKM group had a median OS of 283 months and did not reach a median CSS. Cox analysis showed that SKM had significantly lower risk of total and cancer-specific mortality compared to GIM (Hazard Ratio (HR) 0.40, p<0.0001) and (HR 0.34, p<0.0001). Factors associated with improved OS and CSS in SKM included: age ≤60, female gender, non-white race, early stage, being married, more recent diagnosis, undergoing surgery and not receiving RT. Factors associated with improved OS and CSS in GIM included: age ≤60, early stage, non-white race and undergoing surgery. Subgroup analysis on patients who underwent surgery showed that lymph node status was the only prognostic factor for GIM, while all of the previously identified prognostic factors except for race were associated with OS and CSS for SKM. Conclusions: Outcomes of patients with GIM are inferior to those with SKM. The melanomas in these two sites also have different prognostic factors. Future studies should explore the reasons behind these differences to improve treatment outcomes.

Prognostic factors of overall survival and cancer-specific survival in patients with resected early-stage rectal adenocarcinoma: a SEER-based study

2017 ◽  
Vol 65 (8) ◽  
pp. 1148-1154 ◽  
Author(s):  
Ko-Chao Lee ◽  
Kuan-Chih Chung ◽  
Hong-Hwa Chen ◽  
Chia-Cheng Liu ◽  
Chien-Chang Lu
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Early Stage ◽  
Multivariable Analysis ◽  
Rectal Adenocarcinoma ◽  
Signet Ring Cell ◽  
Postoperative Radiation Therapy ◽  
Cancer Specific Survival ◽  
Tumor Deposit ◽  
The Impact

The benefits of radiotherapy for colorectal cancer are well documented, but the impact of adjuvant radiotherapy on early-stage rectal adenocarcinoma remains unclear. This study aimed to identify predictors of overall survival (OS) and cancer-specific survival (CSS) in patients with stage II rectal adenocarcinoma treated with preoperative or postoperative radiation therapy. Patients with early-stage rectal adenocarcinoma in the postoperative state were identified using the Surveillance, Epidemiology, and End Results database. The primary endpoints were OS and overall CSS. Stage IIA patients without radiotherapy had significantly lower OS and CSS compared with those who received radiation before or after surgery. Stage IIB patients with radiotherapy before surgery had significantly higher OS and CSS compared with patients in the postoperative or no radiotherapy groups. Patients with signet ring cell carcinoma had the poorest OS among all the groups. Multivariable analysis showed that ethnicity (HR, 0.388, p=0.006) and radiation before surgery (HR, 0.614, p=0.006) were favorable prognostic factors for OS, while age (HR, 1.064, p<0.001), race (HR, 1.599, p=0.041), stage IIB (HR, 3.011, p=0.011), and more than one tumor deposit (TD) (HR, 2.300, p=0.001) were unfavorable prognostic factors for OS. Old age (HR, 1.047, p<0.00 L), stage IIB (HR, 8.619, p=0.005), circumferential resection margin between 0.1 mm and 10 mm (HR, 1.529, p=0.039), and more than one TD (HR, 2.688, p=0.001) were unfavorable prognostic factors for CSS. This population-based study identified predictors of OS and CSS in patients with early-stage resected rectal adenocarcinoma, which may help to guide future management of this patient population.

scholarly journals Prognostic Evaluation for Patients over 45 Years Old with Gallbladder Adenocarcinoma Resection: A SEER-Based Nomogram Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Pengfei Li ◽  
Lujun Song
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Staging System ◽  
Lymph Node Staging ◽  
Internal Validation ◽  
Gallbladder Adenocarcinoma ◽  
Low Incidence ◽  
Using Data ◽  
Patient Prognosis ◽  
Lymph Node Stage

Gallbladder adenocarcinoma is the main histopathological type of gallbladder cancer (GBC), so it is particularly important to understand its biological characteristics. Due to the low incidence of this type of cancer, there are few studies with large sample sizes. The log of positive lymph nodes (LODDS) has been evaluated by many scholars as a lymph node stage that may play a better role than the 8th edition of the American Joint Committee on Cancer (AJCC) lymph node staging system in many cancers. However, the effect of LODDS has not been proven in gallbladder adenocarcinoma. Our research aimed to identify independent prognostic factors that are closely related to overall survival (OS) in patients with gallbladder adenocarcinoma over 45 years of age using data from the Surveillance, Epidemiology and, End Results (SEER) database. All patients were randomly divided into a modeling cohort and an internal validation cohort. Seven independent prognostic factors associated with OS—age, marital status, grade, tumor size, AJCC 8th edition T stage and M stage, and LODDS—were used to build a nomogram to predict 1-, 3-, and 5-year survival. The C-index of our nomogram was 0.735 (95% CI, 0.716 to 0.754), and together with the calibration curve and ROC curve validation, the results confirmed the prediction effect of our nomogram. We believe that our nomogram will be an accurate and convenient method for patient prognosis assessment in the future.

scholarly journals Butterfly Glioblastoma - the Impact of Tumor Volumes and Treatment Strategies on Clinical Outcome

2021 ◽  
Author(s):  
Line Sagerup Bjorland ◽  
Kathinka Dæhli Kurz ◽  
Fluge Øystein Fluge ◽  
Bjørnar Gilje ◽  
Rupavathana Mahesparan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Multimodal Treatment ◽  
Median Overall Survival ◽  
Treatment Strategies ◽  
Cox Proportional Hazards ◽  
Comprehensive Treatment ◽  
Term Survival ◽  
Dismal Prognosis ◽  
The Impact

Abstract PurposeButterfly glioblastoma is a rare subgroup of glioblastoma with a bihemispheric tumor crossing the corpus callosum, and is associated with a dismal prognosis. Prognostic factors are previously sparsely described and optimal treatment approaches remain uncertain. We aimed to analyse prognostic factors in butterfly glioblastoma, and to evaluate treatment strategies and outcome in a real-world setting.MethodsWe conducted a retrospective population-based cohort study of patients diagnosed with butterfly glioblastoma in Western Norway between 01/01/2007 and 31/12/2014. Clinical data were extracted from electronic medical records. Molecular and MRI volumetric analyses were retrospectively performed. Survival analyses were performed using Kaplan-Meier method and Cox proportional hazards regression models.ResultsAmong 381 patients diagnosed with glioblastoma, 33 patients (8.7%) met the criteria for butterfly glioblastoma. Median overall survival was 5.5 months (95% CI 3.1-7.9) and three-year survival was 9.1%. Older age and mainly deep-seated tumour location were associated with poor outcome, with adjusted hazard ratio (HR) 1.06 (95% CI 1.03-1.10), p<0.001, and adjusted HR 4.58 (95% CI 1.15-18.20), p=0.03. Best supportive care was associated with poorer survival compared to multimodal treatment (adjusted HR 5.11 (95% CI 1.09-23.89), p=0.04).ConclusionOutcome from butterfly glioblastoma was dismal, with a median overall survival of less than six months. However, long-term survival was comparable to that observed in glioblastoma in general, and multimodal treatment was associated with longer survival. This suggests that patients with butterfly glioblastoma may benefit from a more comprehensive treatment approach despite the overall poor prognosis.

Overall and cancer-specific survival in patients with breast Paget disease: A population-based study

2021 ◽  
pp. 153537022110562
Author(s):  
Tingting Hu ◽  
Zhiyuan Chen ◽  
Meng Hou ◽  
Kezhi Lin
Keyword(s):  
Predictive Accuracy ◽  
Tumor Grade ◽  
Curve Analysis ◽  
Histological Type ◽  
Related Factors ◽  
Cancer Specific Survival ◽  
Decision Curve Analysis ◽  
Paget Disease ◽  
Ajcc Stage ◽  
Calibration Curves

Paget disease of the breast is an uncommon malignant tumor with an inferior outcome. Therefore, establishing nomograms to predict the survival outcomes of breast Paget disease patients is urgent. Clinicopathological and follow-up data of breast Paget disease patients diagnosed between 2010 and 2016 were retrieved through the Surveillance, Epidemiology, and End Result (SEER) database. The significant factors were screened out, and then those factors were utilized to build two valuable nomograms. The discriminative ability of nomograms was investigated using concordance-index (C-index), while the predictive accuracy and benefits were evaluated using calibration curves and decision curve analysis. Finally, a total of 417 breast Paget disease patients were enrolled. Tumor grade, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, and marital status were confirmed as independent overall survival (OS)-related factors; tumor grade, histological type, AJCC stage, and age were associated with independent cancer-specific survival (CSS)-related factors. The values of the C-index for OS nomogram acquired were 0.827 and 0.745 for training and validation cohorts, respectively. Meanwhile, the corresponding values of the C-index to CSS nomogram were 0.890 and 0.655, respectively. The calibration curves and decision curve analysis indicated that both nomograms had an excellent performance. Finally, the nomogram-based risk stratification system indicated that all breast Paget disease patients could be classified into low- and high-risk groups and showed distinct outcomes. In conclusion, two valuable nomograms incorporating various clinicopathological indicators were established for breast Paget disease patients. These prognostic nomograms provide accurate prognostic assessment for breast Paget disease patients and help clinicians select appropriate treatment strategies.

Lymphocyte-Predominant and Classical Hodgkin's Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group

2008 ◽  
Vol 26 (3) ◽  
pp. 434-439 ◽  
Author(s):  
Lucia Nogová ◽  
Thorsten Reineke ◽  
Corinne Brillant ◽  
Michal Sieniawski ◽  
Thomas Rüdiger ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Complete Remission ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Treatment Strategies ◽  
Hodgkin's Lymphoma ◽  
Tumor Control ◽  
Study Group ◽  
Advanced Stage ◽  
German Hodgkin Study Group

Purpose Lymphocyte-predominant Hodgkin's lymphoma (LPHL) is rare and differs in histologic and clinical presentation from classical Hodgkin's lymphoma (cHL). To shed more light on the prognosis and outcome of LPHL, we reviewed all LPHL patients registered in the German Hodgkin Study Group (GHSG) database, comparing patient characteristics and treatment outcome with cHL patients. Patients and Methods We analyzed retrospectively 8,298 HL patients treated within the GHSG trials HD4 to HD12, of whom 394 had LPHL and 7,904 had cHL. Results Complete remission and unconfirmed complete remission after first-line treatment was achieved in 91.6% v 85.9% of patients in early favorable stages, 85.7% v 83.3% of patients in early unfavorable stages, and 76.8% v 77.8% of patients in advanced stages of LPHL compared with cHL, respectively. Tumor control (freedom from treatment failure [FFTF]) for LPHL and cHL patients at a median observation of 50 months was 88% and 82% (P = .0093) and overall survival (OS) was 96% and 92%, respectively (P = .0166). In LPHL patients, negative prognostic factors were advanced stage (P = .0092), Hb less than 10.5 g/dL (P = .0171), and lymphopenia (P = .010) for FFTF. Age ≥ 45 years (P = .0125), advanced stage (P = .0153), and Hb less than 10.5 g/dL (P = .0014) were negative prognostic factors for OS. Conclusion The better prognosis of LPHL as compared with cHL might allow different treatment strategies, particularly for early-stage LPHL patients.

Comparison of the clinical outcomes and prognostic factors of dedifferentiated chondrosarcoma and chondroblastic osteosarcoma: a population-based analysis

2020 ◽  
Author(s):  
Yiying Bian ◽  
Ziliang Zeng ◽  
Hao Yao ◽  
Yutong Zou ◽  
Jian Tu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lung Metastasis ◽  
Univariate Analysis ◽  
Tumor Stage ◽  
Dedifferentiated Chondrosarcoma ◽  
Ajcc Stage ◽  
Surgical Methods ◽  
High Tumor Stage ◽  
Chondroblastic Osteosarcoma ◽  
Patient Prognosis

Abstract Background Dedifferentiated chondrosarcoma (DDC) and chondroblastic osteosarcoma (COS) have some common morphological characteristics by pathology and involve the same surgical methods and chemotherapy regimen. We explored the prognostic differences and factors of patients with DDC and COS with similar pathological features to analyze the prognostic factors and effect of chemotherapy on the prognosis of each type. Methods From the SEER database, we included 228 patients with DDC and 631 patients with COS who underwent surgery from 1975 to 2016. Patient age was stratified with X-tile, and prognosis was analyzed by the Kaplan-Meier method and Cox proportional hazard regression. Results The 3- and 5-year overall survival (OS) rates for DDC were 33.3% and 26.5%, respectively, and the 3- and 5-year OS rates for COS were 71.5% and 63.8%, respectively. Compared with COS, DDC had an older onset age, a higher proportion of white patients, an increased likelihood of occurrence in soft tissue, a higher pathological grade, a larger tumor volume, more patients with M1-stage, a higher AJCC stage and a lower chemotherapy utilization rate. Univariate analysis showed that age, M1 stage and high tumor stage were negatively correlated with DDC patient prognosis, with a worse prognosis for patients with lung metastasis. In the multivariate analysis, higher tumor stage was an independent factor for reducing OS in DDC. Univariate analysis showed that COS patients were older and male; had tumors located in the pelvis; had high T-, M-, and AJCC-stage tumors; and had lung metastasis. Moreover, no chemotherapy was negatively correlated with patient prognosis. Furthermore, age, male sex and high tumor stage were independent factors for reducing OS in COS. Conclusion The OS of DDC patients is worse than that of COS patients. Chemotherapy cannot benefit patients with DDC. For COS patients, further exploration of the survival benefits of chemotherapy is needed.

The prognostic importance of p53, bcl-2, and bax in early stage epithelial ovarian carcinoma treated with adjuvant chemotherapy

2002 ◽  
Vol 12 (3) ◽  
pp. 265-276 ◽  
Author(s):  
I Skirnisdóttir ◽  
T Seidal ◽  
E Gerdin ◽  
B Sorbe
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Tumor Grade ◽  
Figo Stage ◽  
Epithelial Ovarian Carcinoma ◽  
Cancer Specific Survival ◽  
Persistent Disease ◽  
Prognostic Importance

Abstract.Skirnisdóttir I, Seidal T, Gerdin E, Sorbe B. The prognostic importance of p53, bcl-2, and bax in early stage epithelial ovarian carcinoma treated with adjuvant chemotherapy.Epithelial ovarian cancer is one of the major causes of death among women. The increasing knowledge about molecular events involved in the early stages of ovarian tumorigenesis may provide the basis for management in the future. In a series of 109 patients with epithelial carcinomas in FIGO stages IA-IIC, a number of clinicopathologic prognostic factors (age, FIGO stage, histopathologic type, and tumor grade) were studied in relation to the biologic factors p53, bcl-2, and bax, which are important regulators of apoptosis. Immunohistochemical techniques were used. All the patients received adjuvant chemotherapy after the primary surgery. Univariate analysis showed that expression of p53 was significantly associated with tumor grade (P = 0.014), probability of persistent disease (P = 0.016), and cancer-specific survival rate (P = 0.007). Positive bcl-2 staining was associated with endometrioid tumor subtype (P = 0.029) and a favorable tumor grade distribution (P = 0.034), but not with the survival status. The combined p53-bcl-2 expression was related to histopathologic subtype (P = 0.032), tumor grade (P = 0.011), persistent disease (P = 0.014), and risk of dying due to the disease (P = 0.039). The bax status was not a prognostic factor, but the combined p53-bax expression showed an association with FIGO stage (P = 0.014), tumor grade (P = 0.034), persistent disease (P = 0.006), and risk of dying due to the disease (P = 0.039). The combined bcl-2-bax expression was related to histopathologic subtype (P = 0.045) and tumor grade (P = 0.022). In a multivariate Cox analysis, tumor grade (P = 0.014), and p53 status (P = 0.020) were independent and significant prognostic factors with regard to the cancer-specific survival rate.

scholarly journals Neuroendocrine Tumors in Pediatrics

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986271
Author(s):  
Zainab Azam Farooqui ◽  
Aman Chauhan
Keyword(s):  
Neuroendocrine Tumors ◽  
Early Stage ◽  
Peptide Receptor Radionuclide Therapy ◽  
The Body ◽  
Neuroendocrine Cells ◽  
Presenting Symptoms ◽  
Rare Tumors ◽  
Pediatric Age Group ◽  
Organ Systems ◽  
Low Incidence

Neuroendocrine cells are dispersed diffusely throughout many organ systems in the body and hence neuroendocrine tumors (NETs) can arise from almost anywhere in the body. NETs are considered rare tumors, and the current incidence is reported to be about 6 cases in 100 000 in adults and about 2.8 cases per million in the pediatric age group. Despite the indolent nature of these tumors, they have the potential for metastasis and significant morbidity. NETs can be asymptomatic at the time of diagnosis or can present with flushing, diarrhea, wheezing, weight loss, and fatigue among other symptoms. Due to the ambiguity of presenting symptoms, it is not uncommon for NETs to be diagnosed late in the disease course. Despite low incidence, the prevalence of the disease is high since patients live for many years and sometimes decades. Early detection of well-differentiated NETs has excellent outcomes with the majority of early-stage diseases being cured with surgical resection alone. There have been recent advancements in the management of metastatic progressive NETs with approval of peptide receptor radionuclide therapy, telotristat, and everolimus. Awareness of these rare tumors and its management is crucial for optimal management. This article will focus on pediatric NETs and current advances in its management.

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