scholarly journals Sites of Distant Metastases and Cancer-Specific Survival in Intraductal Papillary Mucinous Neoplasm With Associated Invasive Carcinoma: A Study of 1,178 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoyi Huang ◽  
Siting You ◽  
Guiling Ding ◽  
Xingchen Liu ◽  
Jin Wang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Invasive Carcinoma ◽  
Cox Regression ◽  
Distant Metastases ◽  
Cancer Specific Survival ◽  
Mucinous Neoplasm ◽  
Isolated Lung ◽  
Multiple Metastases ◽  
The Impact ◽  
Isolated Liver

BackgroundTo explore the impact of distant metastases on cancer-specific survival in patients with intraductal papillary mucinous neoplasm (IPMN) with associated invasive carcinoma and identify the risk factor of distant metastases in IPMN with associated invasive carcinoma.MethodsPatients with IPMN with associated invasive carcinoma between 2010 and 2015 were retrospectively selected from the Surveillance, Epidemiology, and End Results (SEER) database. The survival analyses were assessed by Kaplan-Meier analyses and log-rank test. The impact of distant metastases was evaluated by Cox regression model and the risk factors of distant metastases were identified by logistic regression analyses, respectively.ResultsThe median cancer-specific survival time of patients with no metastases, isolated liver, isolated lung, and multiple site metastases were 19 months, 4 months, 7 months, and 3 months, respectively. In patients with isolated liver metastases, multivariate analysis after adjustment indicated that chemotherapy (Hazard Ratio [HR]=0.351, 95% confidence interval [CI]=0.256-0.481, P<0.001) was a protective prognostic factor for cancer-specific survival (CSS) in patients with isolated liver metastases. In isolated lung metastases subgroup, old age (HR=1.715, 95% CI=1.037-2.838, P=0.036) and chemotherapy (HR=0.242, 95% CI=0.134-0.435, P<0.001) were related to CSS in multivariable Cox regression analysis(P<0.05). Tumor located in the pancreatic body/tail (HR=2.239, 95% CI=1.140-4.400, P=0.019) and chemotherapy (HR=0.191, 95% CI=0.108-0.340, P<0.001) were independent prognostic factors for CSS in patients with multiple metastases. Finally, a nomogram was constructed for cancer-specific survival and the predicted C-index was 0.780 (95% CI=0.762-0.798).ConclusionThe liver is the most common site of distant metastases in IPMN with associated invasive carcinoma. Tumor located in the pancreatic body/tail and chemotherapy are independent prognostic factors for CSS in patients with multiple metastases. Further, tumor located in body/tail is identified as a risk factor of distant metastases.

scholarly journals Prognostic Analysis of Different Metastatic Patterns in Invasive Intraductal Papillary Mucinous Neoplasm: A Surveillance, Epidemiology, and End Results Database Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Chen Zhou ◽  
Zhiqiang Liu ◽  
Yingke Zhou ◽  
Dianyun Ren ◽  
Kun Liu ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Mucinous Neoplasm ◽  
Isolated Lung ◽  
Multiple Metastases ◽  
Metastatic Patterns ◽  
Isolated Liver ◽  
End Results

Objective. To evaluate the impacts of different metastatic patterns on the prognosis of patients with invasive intraductal papillary mucinous neoplasm (IPMN). Materials and Methods. All patients who were diagnosed with invasive IPMN in the Surveillance, Epidemiology, and End Results SEER database (2010–2015) were included in this study. They were grouped according to different metastatic patterns. Kaplan–Meier analysis and log-rank test were used for the comparison of their survival rates. The hazard ratio (HR) with 95% confidence interval (CI) was analyzed using the Cox proportional-hazards model. Results. A total of 2264 cases were included in this study. The most common metastatic site was the liver. The patients with the nonorgan metastasis demonstrated the best survival outcomes, while those with multiple metastases showed the worst survival outcomes. As compared to the patients with isolated liver metastasis, those with isolated lung and other organ metastases showed better overall survival rates and tumor-specific survival rates. The patients with liver, lung, multiple, and other organ metastases or of age >60 years were the independent predictors of poor prognosis. Conclusions. The patients with isolated lung and other organ metastases demonstrated better survival outcomes as compared to those with isolated liver metastasis. The patients with nonorgan metastasis demonstrated the best survival outcomes, while those with multiple metastases showed the worst survival outcomes. Further studies are needed to determine a highly selected subset of patients, who might benefit from surgery or chemotherapy.

scholarly journals The Effect of Marital Status on Survival of Patients with Gastrointestinal Stromal Tumors: A SEER Database Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Wei Song ◽  
Chuan Tian
Keyword(s):  
Prognostic Factor ◽  
Marital Status ◽  
Gastrointestinal Stromal Tumors ◽  
Cox Regression ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Stromal Tumors ◽  
Kaplan Meier ◽  
Risk Of Cancer ◽  
The Impact

Background. Marital status has been reported to be a prognostic factor in multiple malignancies. However, its prognostic value on gastrointestinal stromal tumors (GISTs) have not yet been determined. The objective of the present analysis was to assess the effects of marital status on survival in patients with GISTs. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze 6195 patients who were diagnosed with GISTs from 2001 to 2014. We also use Kaplan-Meier analysis and Cox regression to analyze the impact of marital status on cancer-specific survival (CSS). Results. Patients in the married group had more frequency in white people, more high/moderate grade tumors, and were more likely to receive surgery. Widowed patients had a higher proportion of women, a greater proportion of older patients (>60 years), and more common site of the stomach. Multivariate analysis demonstrated that marital status was an independent prognostic factor for GISTs (P<0.001). Married patients had better CSS than unmarried patients (P<0.001). Subgroup analysis suggested that widowed patients had the lowest CSS compared with all other patients. Conclusions. Marital status is a prognostic factor for survival in patients with GISTs, and widowed patients are at greater risk of cancer-specific mortality.

Abstract P207: Incidence of Hypertension in Colombia Similar to That Observed Decades Ago in Developed Countries: An Observation From the Chicamocha Cohort Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Juan C Villar ◽  
Luz X Martínez ◽  
Yeny Z Castellanos ◽  
Skarlet M Vásquez ◽  
Víctor M Herrera
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Incidence Rate ◽  
Latin American ◽  
Cox Regression ◽  
Population Attributable Fraction ◽  
Developed Countries ◽  
Cox Regression Analysis ◽  
Incident Cases ◽  
The Impact

Background: Overweight is a modifiable risk factor for high blood pressure (BP). Despite the increasing prevalence of both conditions in the Latin American population, there are no estimates of either the incidence of hypertension or the impact of overweight on it that inform the design and evaluation of individual and community-based preventive interventions in the region. Methods: We conducted a prospective cohort study in a sample of normotensive, blood donors from Bucaramanga, Colombia, who were free of transfusion-transmitted infectious and cardiovascular diseases at baseline. Participants were re-evaluated after a median follow-up of 12 years to determine the incidence of hypertension defined as: 1) Self-reported diagnosis with evidence of pharmacological treatment; 2) Systolic BP >140 mmHg or diastolic BP >90 mmHg (average of two measures in seated position); or 3) Current systolic/diastolic BP >120/80 mmHg with evidence of increments >10/5 mmHg from baseline. We estimated crude incidence rates of hypertension and age- and sex-adjusted hazard ratios (HRs) for baseline overweight (body mass index ≥25 kg/m2) using Cox regression analysis. The population attributable fraction (PAF) for overweight was also assessed. Results: We followed 594 participants (baseline mean age = 38.0 years; 64% male; adherence rate = 78%) at risk of hypertension among which we observed 164 incident cases: Cumulative incidence of 27.6%; incidence rate of 23.4 cases per 1,000 person-years. Incidence rate was similar in men and women (23.4 vs. 23.2 per 1,000 person-years; p>0.05) and tended to increase with age (17.4, 21.2, and 27.8 per 1,000 person-years among participants <30, 30-39, and ≥40 years old, respectively; p>0.05). Participants with overweight at baseline had twice the risk of developing hypertension than participants with normal weight (adjusted-HR = 2.00, 95%CI: 1.11, 3.61). The estimated PAF was 25.7%, considering a national prevalence of overweight equal to 34.6%. Conclusion: The incidence of hypertension in our study is similar to that reported two decades ago in cohorts from developed countries, which is consisting with the ongoing epidemiological transition in Latin America. We also confirmed the role of overweight as a risk factor for hypertension, accounting for about 1 out 4 incident cases. This finding highlights the importance of addressing overweight in our population.

Suggestion of new nomogram including inflammatory marker for predicting invasive carcinoma in intraductal papillary mucinous neoplasm of the pancreas.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 204-204
Author(s):  
In Woong Han
Keyword(s):  
Risk Factors ◽  
Factor Analysis ◽  
Risk Factor ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Inflammatory Markers ◽  
Invasive Carcinoma ◽  
Main Duct ◽  
Solid Portion ◽  
Mucinous Neoplasm ◽  
Invasive Ipmn

204 Background: Previous studies have analyzed that inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI), associated with the presence of invasive carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). This study aimed to evaluate the correlation between the inflammatory markers and the invasive carcinoma in IPMN and propose a nomogram including inflammatory markers for predicting invasive IPMN. Methods: From 1995 to 2016, total 468 patients who underwent surgical resection at four institutions for histologically confirmed IPMN and the data were reviewed retrospectively. The patients with history of pancreatitis, other malignancies and without CA19-9 data or lymphocyte counts were excluded, the study cohort consisted of 365 patients. Variables with P < 0.05 in risk factor analysis were included in the nomogram. Results: Of 365 patients, 98 (26.8%) patients had invasive IPMN. In univariate analysis, high body mass index (BMI) ( P = 0.037), pre-operative bilirubin level ( P = 0.001), CA19-9 ( P < 0.001), NLR ( P = 0.019), PLR ( P = 0.002), ALI ( P = 0.001), main duct type (P < 0.001), the presence of solid portion ( P < 0.001) and tumor size (P = 0.086) were identified as risk factors for invasive IPMN. In multivariate analysis, pre-operative bilirubin level (P = 0.003), CA19-9 (P = 0.002), main duct type (P = 0.034) and the presence of solid portion (P < 0.001) were independent predictive markers for invasive IPMN. The nomogram was developed including all factors of risk factor analysis. Conclusions: The inflammatory markers were the risk factors for the presence of IPMN-associated invasive carcinoma. This nomogram may be useful in identifying patients with IPMN at risk of malignancy and for selecting which patients should undergo surgery. Further validation studies are needed to assess the predictive ability of nomogram including inflammatory markers.

scholarly journals Altered Lipid Profile is a Risk Factor for the Progression Andrecurrenceof COVID-19: From Two Retrospective Cohorts

2020 ◽  
Author(s):  
Hui Jin ◽  
Junji He ◽  
Chuan Dong ◽  
Luhong Cao ◽  
Xing Qi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Lipid Profile ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Hospital Death ◽  
Lipid Lowering Therapy ◽  
Clinical Endpoints ◽  
Increased Risk ◽  
The Impact ◽  
The Relationship

Abstract Background The COVID-19 pandemic has spread worldwide. However, the impact of lipid profile and lipid-lowering treatment on clinical endpoints in COVID-19 have not previously been investigated. Methods In this retrospective, multicenter cohort study, we consecutively enrolled 430 adult COVID-19 patients from two Chinese hospitals (one each in Chengdu and Wuhan) admitted during February 2020 and followed-up until April 30. Demographic, metabolic profile, laboratory, treatment and clinical endpoint data including in-hospital death and recurrence of COVID-19, were collected. Results In Chengdu patients, univariable and multivariable Cox regression showed that the low-density lipoprotein cholesterol (LDL-C) dyslipidemia on admission was associated with the recurrence of COVID-19 during the follow-up period. In Wuhan cohort, the patients with triglycerides hyperlipemia had an increased risk of in-hospital death. However, in both cohorts, statin therapy during COVID-19 course did not affect these clinical endpoints. Compared to the Chengdu cohort, the Wuhan patients tended to have more severe COVID-19 but, unexpectedly, had lower levels of serum lipid. It is of interesting to notice that the relationship between the observed biomarkers of inflammation and lipid do not match the relationship between the organ function measures and this lipid. Conclusions The baseline dyslipidemia should be considered as a risk factor for poor prognosis and recurrence of COVID-19. The lipid level may be altered during COVID-19 course, since lipidology may be distinctly affected by both inflammation and organic damage for SARS-CoV-2. Further investigation is needed on the role of use of lipid-lowering therapy among patients with COVID-19 infections.

Investigating the association of cytoplasmic and nuclear HIF-2 expression with cancer specific survival (CSS) in clear cell renal cell carcinoma.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 387-387
Author(s):  
Nils Kroeger ◽  
David B. Seligson ◽  
Sabina Signoretti ◽  
Hong Yu ◽  
Frederic D. Birkhaeuser ◽  
...  
Keyword(s):  
Cox Regression ◽  
Distant Metastases ◽  
Continuous Variable ◽  
Rank Test ◽  
Initiation Complex ◽  
Cell Renal Cell Carcinoma ◽  
Cancer Specific Survival ◽  
Fuhrman Grade ◽  
Translational Initiation ◽  
Recursive Partition

387 Background: Studies support the prognostic importance of HIF-2α for ccRCC. Interestingly, a recent study has implicated HIF-2α as part of a protein translational initiation complex, a cytoplasmic function that goes far beyond its role as a nuclear transcription factor. We hypothesized that both the absolute expression as well as the subcellular localization of HIF-2α would predict clinicopathological features and CSS in ccRCC. Methods: A tissue microarray (TMA) study was conducted on 308 ccRCC patients. Survival differences were investigated with the log rank test and associations with CSS with uni- and multivariate Cox regression analyses. Recursive partition tree analysis was used to identify relevant cutoff values. Results: The median follow-up was 2.29 years (IQR 11.82). The mean percentage of positive cells was 22.45±18.00 and 0.12 ± 0.29 for HIF-2α nuclear (N) and cytoplasmic (C), respectively. High HIF-2α N (cutoff>32%) expression was associated with smaller tumor sizes (p = 0.002) and less advanced Fuhrman grades (p = 0.044). To the contrary, tumors with high HIF-2α C (>0%) more often had lymph node (p = 0.004), distant metastases (p = 0.021), and higher Fuhrman grades (p<0.0001). Univariate analyses showed an association of high HIF-2α N (p = 0.035) with better CSS. This was not found when HIF-2α N was used as a continuous variable (p = 0.067). In contrast, HIF-2α C demonstrated an association with CSS when examined as both a continuous (p < 0.0001) and as a dichotomized variable (p < 0.0001). After adjustment for TNM stage, ECOG PS, and Fuhrman grade, both continuous (p < 0.0001) and dichotomized (p < 0.0001) HIF-2α C variables remained significant predictors of CSS, while neither HIF-2α N variable was retained. The ratio of HIF-2α C/N was the strongest predictor of CSS in multivariate analysis (p = 0.001; HR 4.83 [95% CI: 1.99 – 11.76]). Conclusions: Our investigation suggests an important role for HIF-2α as a cytoplasmic protein translational initiation complex in ccRCC. This novel observation warrants further molecular and genetic studies examining biological pathways that are involved in the tumor promotive properties of HIF-2α in the cytoplasm.

Survival among colorectal cancer patients with a history of previous cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16146-e16146
Author(s):  
Sandi Pruitt ◽  
David E. Gerber ◽  
Hong Zhu ◽  
Daniel Heitjan ◽  
Bhumika Maddineni ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Population Based ◽  
Competing Risk ◽  
Cancer Specific Survival ◽  
Risk Of Death ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

e16146 Background: A growing number of patients with colorectal cancer (CRC) have survived a previous cancer. Although little is known about their prognosis, this population is frequently excluded from clinical trials. We examined the impact of previous cancer on overall and cancer-specific survival in a population-based cohort of patients diagnosed with incident CRC. Methods: We identified patients aged ≥66 years and diagnosed with CRC between 2005-2015 in linked SEER-Medicare data. For patients with and without previous cancer, we estimated overall survival using Cox regression and cause-specific survival using competing risk regression, separately by CRC stage, while adjusting for numerous covariates and competing risk of death from previous cancer, other causes, or the incident CRC. Results: Of 112,769 CRC patients diagnosed with incident CRC, 15,935 (14.1%) had a previous cancer – most commonly prostate (32.9%) or breast (19.4%) cancer, with many 7505 (47.1%) diagnosed ≤5 years of CRC. For all CRC stages except IV in which there was no significant difference in survival, patients with previous cancer had modestly worse overall survival (hazard ratios from fully adjusted models range from 1.11-1.28 across stages; see Table). This survival disadvantage was driven by deaths due to previous cancer and other causes. Notably, most patients with previous cancer had improved CRC-specific survival. Conclusions: CRC patients who have survived a previous cancer have generally worse overall survival but superior CRC-specific survival. This evidence should be considered concurrently with concerns about trial generalizability, low accrual, and heterogeneity of participants when determining exclusion criteria. [Table: see text]

scholarly journals Impact of gender on the survival of patients with glioblastoma

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Minjie Tian ◽  
Wenying Ma ◽  
Yueqiu Chen ◽  
Yue Yu ◽  
Donglin Zhu ◽  
...  
Keyword(s):  
Sex Hormones ◽  
Survival Data ◽  
Cox Regression ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Kaplan Meier ◽  
Male Patients ◽  
Stratified Analysis ◽  
The Impact

Background: Preclinical models have suggested a role for sex hormones in the development of glioblastoma multiforme (GBM). However, the impact of gender on the survival time of patients with GBM has not been fully understood. The objective of the present study was to clarify the association between gender and survival of patients with GBM by analyzing population-based data. Methods: We searched the Surveillance, Epidemiology, and End-Results database who were diagnosed with GBM between 2000 and 2008 and were treated with surgery. Five-year cancer specific survival data were obtained. Kaplan–Meier methods and multivariable Cox regression models were used to analyze long-term survival outcomes and risk factors. Results: A total of 6586 patients were identified; 61.5% were men and 38.5% were women. The 5-year cancer-specific survival (CSS) rates in the male and female groups were 6.8% and 8.3%, respectively (P=0.002 by univariate and P<0.001 by multivariate analysis). A stratified analysis showed that male patients always had the lowest CSS rate across localized cancer stage and different age subgroups. Conclusions: Gender has prognostic value for determining GBM risk. The role of sex hormones in the development of GBM warrants further investigation.

scholarly journals Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases

2009 ◽  
Vol 160 (4) ◽  
pp. 619-624 ◽  
Author(s):  
Frederik A Verburg ◽  
Uwe Mäder ◽  
Markus Luster ◽  
Christoph Reiners
Keyword(s):  
Thyroid Carcinoma ◽  
Cox Regression ◽  
Tumour Size ◽  
Retrospective Chart Review ◽  
Distant Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Disease Stage ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Extrathyroidal Invasion

ObjectivePapillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) show considerable differences in disease stage at initial presentation. The aim of this study was to investigate whether there are differences in tumour-specific survival if initial staging is accounted for.DesignRetrospective chart review study.PatientsThe study sample comprised 875 PTC and 350 FTC patients (856 females, 369 males, mean age 47.8 years) treated in our hospital from 1978 to 2002. All patients received total thyroidectomy with subsequent I-131 ablation except for those patients with an isolated papillary microcarcinoma.MethodsKaplan–Meier analyses and Cox-regression analyses were performed to assess the influence of histology on thyroid cancer-specific survival.ResultsFTC patients were on average older, more likely to be male, presented with a larger tumour and more frequently had multifocal carcinoma and distant metastases than PTC patients, whereas they presented less frequently with extrathyroidal invasion or lymph node metastases. Twenty-year tumour-specific survival in PTC was 90.6% and in FTC 73.7% (P<0.001). In multivariate analysis the presence of distant metastases (P<0.001), age (P<0.001), tumour size (P=0.001) and the presence of extrathyroidal invasion (P=0.007), but not histology (P=0.26), were independent determinant variables for tumour-specific survival.ConclusionThere is no difference in tumour-specific survival between PTC and FTC when accounting for the presence of metastases, age, tumour size and the presence of extrathyroidal invasion.

scholarly journals Intravesical Bacillus Calmette–Guérin Treatment for T1 High-Grade Non-Muscle Invasive Bladder Cancer with Divergent Differentiation or Variant Morphologies

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2615
Author(s):  
Makito Miyake ◽  
Nobutaka Nishimura ◽  
Kota Iida ◽  
Tomomi Fujii ◽  
Ryoma Nishikawa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cox Regression ◽  
World Health ◽  
High Grade ◽  
Bacillus Calmette Guerin ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Divergent Differentiation ◽  
Intravesical Bcg ◽  
The Impact

The 2016 World Health Organization classification newly described infiltrating urothelial carcinoma (UC) with divergent differentiation (DD) or variant morphologies (VMs). Data comparing oncological outcomes after bladder-preservation therapy using intravesical Bacillus Calmette–Guérin (BCG) treatment among T1 bladder pure UC (pUC), UC with DD (UC-DD), and UC with VMs (UC-VM) are limited. We evaluated 1490 patients with T1 high-grade bladder UC who received intravesical BCG during 2000–2019. They were classified into three groups: 93.6% with pUC, 4.4% with UC-DD, and 2.0% with UC-VM. Recurrence-free, progression-free, and cancer-specific survival following intravesical BCG were compared among the groups using multivariate Cox regression analysis, also used to estimate inverse probability of treatment weighting-adjusted hazard ratio and 95% confidence interval for the outcomes. Glandular differentiation and micropapillary variant were the most common forms in the UC-DD and UC-VM groups, respectively. Of 1490 patients, 31% and 13% experienced recurrence and progression, respectively, and 5.0% died of bladder cancer. Survival analyses revealed the impact of concomitant VMs was significant for cancer-specific survival, but not recurrence-free and progression-free survival compared with that of pUC. Our analysis clearly demonstrated that concomitant VMs were associated with aggressive behavior in contrast to concomitant DD in patients treated with intravesical BCG.

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