Adenosquamous Carcinoma of the Cervix: A Population-Based Analysis

BackgroundDue to the rarity of adenosquamous carcinoma of the cervix (ASCC), studies on the incidence, prognostic factors, and treatment outcomes of ASCC remain scarce. Therefore, we performed a retrospective population-based study to systematically investigate the characteristics of ASCC patients.MethodsPatients with a histopathologically confirmed diagnosis of ASCC were enrolled from the Surveillance, Epidemiology, and End Results database between 1975 and 2016. Univariate and multivariate Cox regression analyses were performed to identify the potential predictors of cancer-specific survival (CSS) in patients with ASCC. Selected variables were integrated to establish a predictive nomogram and the predictive performance of the nomogram was estimated using Harrell’s concordance index (C-index), calibration curve, and decision curve analysis (DCA).ResultsA total of 1142 ASCC patients were identified and included in this study and were further randomized into the training and validation cohorts in a 7:3 ratio. The age-adjusted incidence of ASCC declined from 0.19 to 0.09 cases per 100,000 person-years between 2000 and 2017, with an annual percentage change of -4.05% (P<0.05). We identified age, tumor grade, FIGO stage, tumor size, and surgical procedure as independent predictors for CSS in ASCC patients and constructed a nomogram to predict the 3- and 5-year CSS using these prognostic factors. The calibration curve indicated an outstanding consistency between the nomogram prediction and actual observation in both the training and testing cohorts. The C-index was 0.7916 (95% CI: 0.7990-0.8042) and 0.8148 (95% CI: 0.7954-0.8342) for the training and testing cohorts, respectively, indicating an excellent discrimination ability of the nomogram. The DCA showed that the nomogram exhibited more clinical benefits than the FIGO staging system.ConclusionsWe established and validated an accurate predictive nomogram for ASCC patients based on several clinical characteristics. This model might serve as a useful tool for clinicians to estimate the prognosis of ASCC patients.

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Comprehensive lymphadenectomy and survival prediction in uterine serous cancer patients after surgery: a population-based analysis

10.21203/rs.2.24587/v1 ◽

2020 ◽

Author(s):

Hui Li ◽

Xiaofei Xie ◽

Yunyun Liu ◽

Xiaoxin Huang ◽

Haoliang Lin ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Nodes ◽

Cox Regression ◽

Staging System ◽

Population Based ◽

Pelvic Lymphadenectomy ◽

Survival Prediction ◽

Cancer Specific Survival ◽

Gynecology And Obstetrics ◽

Objective Evidence

Abstract Objective Evidence on uterine serous cancer (USC) prognosis has been limited and inconclusive. We aim to explore the survival benefits of comprehensive lymphadenectomy in USC patients after surgery and develop a prognostic nomogram to predict survival. Materials and Methods USC patients who had undergone hysterectomy between 2010 and 2015 were identified from Surveillance, Epidemiology and End Results (SEER) database. The relationship between the extent of lymphadenectomy and survival, including overall survival (OS) and cancer-specific survival (CSS), was estimated with Kaplan-Meier (K-M) analysis. Univariate and multivariate Cox regression analyses were utilized to determine the independent prognostic factors. A nomogram was then developed, calibrated and internally validated. Results A total of 2853 patients were identified. K-M survival analysis revealed that patients with ≥12 pelvic lymph nodes (PLNs) removed had significantly better OS and CSS than those without (both P <0.001). However, patients with ≥6 para-aortic lymph nodes removed was not associated with similar survival benefits than patients without ( P >0.1). Multivariate analyses for OS and CSS revealed that age, T stage, N stage, tumor size, adjuvant therapy and ≥12 PLNs removed were independent prognostic factors (all P<0.05) and were subsequently incorporated into the nomogram. The Harrell’s C-index of the nomogram was significantly higher than that of the International Federation of Gynecology and Obstetrics staging system (OS: 0.739 vs 0.671, P <0.001; CSS: 0.752 vs 0.695, P <0.001). Furthermore, the nomogram was well calibrated with satisfactory consistency. Conclusions Comprehensive pelvic lymphadenectomy should be recommended to USC patients for its survival benefits. And a nomogram has been developed to predict the survivals of USC patients after surgery.

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Survival predictors of metastatic angiosarcomas: a surveillance, epidemiology, and end results program population-based retrospective study

BMC Cancer ◽

10.1186/s12885-020-07300-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shihong Ren ◽

Yucheng Wang ◽

Zhan Wang ◽

Jinxiang Shao ◽

Zhaoming Ye

Keyword(s):

Tumor Size ◽

Cox Regression ◽

Radiation Treatment ◽

Tumor Grade ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Metastatic Sites ◽

Survival Predictors ◽

End Results

Abstract Background Angiosarcomas (AS) have poor prognosis and often metastasize to distant sites. The potential predictors of metastatic angiosarcomas (MAS) have not been extensively investigated. The main objective of this study was to identify survival predictors of MAS. Methods Surveillance, Epidemiology, and End Results (SEER) datasets were used to identify patients with MAS from 2010 to 2016. Risk predictors were determined with the aid of Kaplan-Meier and Cox regression model analyses. Results A total of 284 MAS patients met the study entry criteria. Among these, 121 patients (42.6%) were diagnosed with metastasis in bone, 26 in brain (9.2%), 86 in liver (30.3%) and 171 in lung (60.2%). Overall, 96 patients (33.8%) had two or more metastatic sites. The 1- and 3-year overall survival (OS) rates were 20.8 and 3.8% while 1- and 3-year cancer-specific survival (CSS) rates were 22.0 and 5.2%, respectively. Cox regression analysis revealed chemotherapy, radiation treatment (RT) and tumor size ≤10 cm as independent favorable predictors of OS. In terms of CSS, tumor grade IV, tumor size > 10 cm and absence of chemotherapy were independent adverse predictors. Surgery did not prolong survival outcomes (both OS and CSS) in the current cohort. Conclusion MAS is associated with extremely poor survival. Chemotherapy, RT, and tumor size are independent predictors of OS. Chemotherapy and tumor size are independent prognostic factors of CSS. Chemotherapy is therefore recommended as the preferred treatment option for MAS patients.

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Conditional Survival After Surgical Resection of Appendiceal Tumors: a Population-based Study

10.21203/rs.3.rs-403708/v1 ◽

2021 ◽

Author(s):

Shutao Zhao ◽

Chang Lu ◽

Junan Li ◽

Chao Zhang ◽

Xudong Wang

Keyword(s):

Prognostic Factors ◽

Cox Regression ◽

Population Based ◽

Conditional Survival ◽

Seer Database ◽

Cancer Specific Survival ◽

Population Based Study ◽

Factors Affecting ◽

Probability Of Survival ◽

N Stage

Abstract Background: This study aimed to evaluate the conditional survival (CS) of appendiceal tumors (ATs) after surgery.Methods: A total of 3,031 patients with ATs who underwent surgery were included in the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2016. A multivariate Cox regression model was used to analyze the prognostic factors affecting overall survival (OS) and cancer-specific survival (CSS). CS was used to calculate the probability of survival for another 3 years after the patient had survived x years. The formulas were COS3 = OS (x + 3) /OS (x), and CCS3 = CSS (x + 3)/CSS (x).Results: The 1-year, 3-year, and 5-year OSs for all patients were 95.6%, 83.3%, and 73.9%, respectively, while the 1-year, 3-year, and 5-year CSSs were 97.0%, 87.1%, and 79.9%, respectively. Age, grade, histology, N stage, carcinoembryonic antigen (CEA), and radiation were independent prognostic factors for OS and CSS. For patients that survived for 1 year, 3 years, and 5 years, their COS3s were 81.7%, 83.9%, and 87.0%, respectively. The CCS3s were 85.5%, 88.3%, and 92.0% respectively. In patients with poor clinicopathological factors, COS3 and CCS3 increased significantly, and the survival gap between OS and COS3, CSS and CCS3 was more obvious.Conclusions: CS for appendiceal tumors were dynamic and increased over time, especially in patients with poor prognosis.

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Analysis of clinical characteristics and prognosis with cervical adenosquamous carcinoma: a large population-based study

Future Oncology ◽

10.2217/fon-2020-1156 ◽

2021 ◽

Author(s):

Yanan Ma ◽

Aimei Zhao ◽

Jinjuan Zhang ◽

Sumei Wang ◽

Jiandong Zhang

Keyword(s):

Overall Survival ◽

Regression Models ◽

Clinical Characteristics ◽

Cox Regression ◽

Adenosquamous Carcinoma ◽

Large Population ◽

Population Based ◽

Cancer Specific Survival ◽

Population Based Study ◽

Good Consistency

Objective: The target of this work was to analyze the clinical characteristics and construct nomograms to predict prognosis in patients with cervical adenosquamous carcinoma (ASC). Methods: A total of 788 ASC patients were tracked in the Surveillance, Epidemiology and End Results database. We compared the clinical characteristics and prognostic factors of ASC. Cox regression models were established, and nomograms constructed and verified. Results: ASC patients have lower age levels and higher histological grades than patients with squamous cell carcinoma. Nomograms were constructed with good consistency and feasibility in clinical practice. The C-indices for overall survival and cancer-specific survival were 0.783 and 0.787, respectively. Conclusion: ASC patients have unique clinicopathological and prognostic characteristics. Nomograms were successfully constructed and verified.

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Incidence, Risk Factors and Prognosis of T4a Gastric Cancer: A Population-Based Study

Frontiers in Medicine ◽

10.3389/fmed.2021.767904 ◽

2022 ◽

Vol 8 ◽

Author(s):

Zhiya Hu ◽

Ziyi Zuo ◽

Han Miao ◽

Zhijie Ning ◽

Youyuan Deng

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Calibration Curve ◽

Tumor Size ◽

Area Under The Curve ◽

Risk Groups ◽

Lymph Node Involvement ◽

Population Based ◽

Signet Ring Cell ◽

Cancer Specific Survival

Background: T4a gastric cancer (GC) is a subtype of advanced GC (AGC), which urgently needs a comprehensive grade method for better treatment strategy choosing. The purpose of this study was to develop two nomograms for predicting the prognosis of patients with T4a GC.Methods: A total of 1,129 patients diagnosed as T4a GC between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Result (SEER) program database. Univariate and multivariate Cox analyses were performed to explore the independent predictors and to establish nomogram for overall survival (OS) of the patients, whereas competing risk analyses were performed to find the independent predictors and to establish nomogram for cancer-specific survival (CSS) of the patients. The area under the curve (AUC), calibration curve, decision curve analysis (DCA), and Kaplan–Meier analysis were performed to evaluate the nomograms.Results: Older age, larger tumor size, black race, signet ring cell carcinoma (SRCC), more lymph node involvement, the absence of surgery, the absence of radiotherapy, and the absence of chemotherapy were identified as independent prognostic factors for both OS and CSS. In the training cohort, the AUCs of the OS nomogram were 0.760, 0.743, and 0.723 for 1-, 3-, and 5-year OS, whereas the AUCs of the CSS nomogram were 0.724, 0.703, and 0.713 for 1-, 3-, and 5-year CSS, respectively. The calibration curve and DCA indicated that both nomograms can effectively predict OS and CSS, respectively. The abovementioned results were also confirmed in the validation cohort. Stratification of the patients into high- and low-risk groups highlighted the differences in prognosis between the two groups both in training and in validation cohorts.Conclusions: Age, tumor size, race, histologic type, N stage, surgery status, radiotherapy, and chemotherapy were confirmed as independent prognostic factors for both OS and CSS in patients with T4a GC. Two nomograms based on the abovementioned variables were constructed to provide more accurate individual survival predictions for them.

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Prognostic Indicators in Base of Tongue Adenocarcinoma: A Population-Based Analysis

Ear Nose & Throat Journal ◽

10.1177/0145561319881241 ◽

2019 ◽

pp. 014556131988124

Author(s):

Kristen Kraimer ◽

Ashwin Ganti ◽

Max A. Plitt ◽

Peter Revenaugh ◽

Kerstin Stenson ◽

...

Keyword(s):

Prognostic Factors ◽

Primary Outcome ◽

Cox Regression ◽

Tumor Grade ◽

Population Based ◽

Prognostic Indicators ◽

Inclusion Criteria ◽

Cox Regression Analysis ◽

Base Of Tongue ◽

Kaplan Meier

Introduction: The objectives of this investigation are to characterize the epidemiology of base of tongue adenocarcinoma utilizing a population-based database and to identify prognostic factors that may affect survival. Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database. Univariate Kaplan-Meier analysis and multivariate Cox-regression analysis were performed to evaluate the association of suspected prognostic factors with survival. Overall survival (OS) and disease-specific survival (DSS) were the primary outcome measures. Results: A total of 176 cases were eligible based on inclusion criteria. The 5-year OS and DSS were 49% and 66%, respectively. On multivariate analysis, surgical management was associated with improved OS and DSS (OS hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.20-0.58, P < .001; DSS HR: 0.20, 95% CI: 0.09-0.48, P < .001), while higher tumor grade was associated with worse OS and DSS (OS HR: 1.58, 95% CI: 1.14-2.19, P = .006; DSS HR: 1.68, 95% CI: 1.01-2.79, P = .045). Administration of chemotherapy or radiation did not have a significant association with OS or DSS. Conclusion: This investigation is the largest to date to analyze the base of tongue adenocarcinoma as its own entity. Surgery remains the mainstay of treatment, and lower tumor grade is associated with improved survival in these patients. Administration of radiation or chemotherapy was not associated with improved survival.

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An Easy-to-use Clinical Nomogram for Predicting the Prognosis of Patients with Hepatocellular Carcinoma Concomitantly Suffer from Severe Fibrosis or Cirrhosis: A Population-based Analysis.

10.21203/rs.2.24813/v1 ◽

2020 ◽

Author(s):

Wang Hanyue ◽

Ruan Shiye ◽

Zou Yiping ◽

Jin Liang ◽

Jin Haosheng ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cox Regression ◽

Staging System ◽

Population Based ◽

Seer Database ◽

Cancer Specific Survival ◽

Kaplan Meier ◽

Prediction Of Survival ◽

Ishak Fibrosis Score ◽

Severe Fibrosis

Abstract Background Patients with hepatocellular carcinoma (HCC) concomitantly suffer from liver cirrhosis may have worse prognosis. Based on Surveillance, Epidemiology, and End Results (SEER) database, we evaluated the overall survival (OS) and cancer-specific survival (CSS) of these patients. Methods A total of 2,369 patients were selected from the SEER database. They were classified into F0 (n=691) and F1 (n=1,678) groups by different Ishak fibrosis score. Propensity score matching (PSM) and Kaplan-Meier method were performed to evaluate the OS and CSS. The F1 group were randomized into training sub-set (n = 1,176, 70%) and validation sub-set (n = 502, 30%) for further construction and validation of nomogram . Results After matched, there were statistically significant worse outcome for F1 group patients compared with F0 group (n=587, OS: P<0.001, CSS: P<0.001). Six independent predictors for both OS and CSS were identified to construct the nomograms by COX regression analyses. The nomogram performed well concerning its ability of discrimination and calibration and its net benefits compared with the conventional staging system. Conclusions Patients with HCC concomitantly suffer from severe fibrosis or cirrhosis has a significant worse survival compared with none or moderate fibrosis patients. The validated nomograms provided useful prediction of survival.

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Value of Radiotherapy in Primary Gastric Cancer and Establishment of a Prognostic Nomogram Model

10.21203/rs.3.rs-133308/v1 ◽

2020 ◽

Author(s):

Tongchao Jiang ◽

Nan Li ◽

Haishuang Sun ◽

Tongcui Jiang

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Cox Regression ◽

Tumor Grade ◽

Rank Test ◽

Seer Database ◽

Cancer Specific Survival ◽

Primary Tumor Site ◽

Entire Cohort

Abstract Background: This study aimed to compare the use of radiotherapy (RT) in gastric cancer (GC) patients from the SEER database and established a nomogram to assess cancer-specific survival (CSS).Methods: Patients from the SEER database between 2004 and 2013 were analyzed. Survival was analyzed by Kaplan-Meier curves and log-rank test. Prognostic factors in multivariate Cox analysis were screened to construct a nomogram. The performance the nomogram was validated via concordance index (C-index), calibration plots, and decision curve analyses (DCAs). Results: 9653 GC patients were analyzed totally. In the entire cohort, patients who received pre/postoperative RT had better survival than those who did not receive RT (P = 0.043 and < 0.001, respectively). Similar results were observed in lymph node-positive patients. However, no significant survival benefit was seen in lymph node-negative patients between postoperative RT group and no RT group (P = 0.057), but patients who received postoperative RT and those who did not receive RT experienced better survival than those who received preoperative RT (P < 0.001 and 0.001, respectively). Prognostic factors of GC analyzed by Cox regression model included age, race, tumor grade, tumor histology type, primary tumor site, T stage, lymph node metastasis ratio, RT status, and chemotherapy information independently (P < 0.001). The nomogram was established and showed excellent prediction performance, and its C-index of 0.725 were significantly higher than those of nomograms based AJCC system with C-index at 0.643. In addition, the calibration plots performed good consistency between the predicted and actual survival probabilities, and the DCAs indicated better clinical net benefits than the traditional AJCC system.Conclusions: RT can improve CSS in GC patients, especially those with positive lymph nodes. The construction and verification of a nomogram based on SEER database can effectively predict the survival outcomes of GC patients.

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Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

Scientific Reports ◽

10.1038/s41598-020-80698-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhao Ding ◽

Deshun Yu ◽

Hefeng Li ◽

Yueming Ding

Keyword(s):

Marital Status ◽

Cancer Patients ◽

Laryngeal Cancer ◽

Cox Regression ◽

Group Analysis ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Prognostic Effect ◽

The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

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Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽

10.1186/s12885-021-07855-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dechuang Jiao ◽

Jingyang Zhang ◽

Jiujun Zhu ◽

Xuhui Guo ◽

Yue Yang ◽

...

Keyword(s):

Breast Cancer ◽

Cox Model ◽

Survival Rates ◽

Tumor Grade ◽

Population Based ◽

Rank Test ◽

Breast Cancers ◽

Significant Independent Predictor ◽

Cancer Specific Survival ◽

7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

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