scholarly journals Gender Disparities in Epidemiology, Treatment, and Outcome for Head and Neck Cancer in Germany: A Population-Based Long-Term Analysis from 1996 to 2016 of the Thuringian Cancer Registry

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3418
Author(s):  
Andreas Dittberner ◽  
Benedikt Friedl ◽  
Andrea Wittig ◽  
Jens Buentzel ◽  
Holger Kaftan ◽  
...  
Keyword(s):  
Neck Cancer ◽  
Multivariable Analysis ◽  
Stage Iv ◽  
Treatment Decision ◽  
Tumor Stage ◽  
Population Based ◽  
Gender Disparity ◽  
Hypopharyngeal Cancer ◽  
Federal State ◽  
Head Neck Cancer

This study determined with focus on gender disparity whether incidence based on age, tumor characteristics, patterns of care, and survival have changed in a population-based sample of 8288 German patients with head neck cancer (HNC) registered between 1996 and 2016 in Thuringia, a federal state in Germany. The average incidence was 26.13 ± 2.89 for men and 6.23 ± 1.11 per 100,000 population per year for women. The incidence peak for men was reached with 60–64 years (63.61 ± 9.37). Highest incidence in females was reached at ≥85 years (13.93 ± 5.87). Multimodal concepts increased over time (RR = 1.33, CI = 1.26 to 1.40). Median follow-up time was 29.10 months. Overall survival (OS) rate at 5 years was 48.5%. The multivariable analysis showed that male gender (Hazard ratio [HR] = 1.44; CI = 1.32 to 1.58), tumor subsite (worst hypopharyngeal cancer: HR = 1.32; CI = 1.19 to 1.47), and tumor stage (stage IV: HR = 3.40; CI = 3.01 to 3.85) but not the year of diagnosis (HR = 1.00; CI = 0.99 to 1.01) were independent risk factors for worse OS. Gender has an influence on incidence per age group and tumor subsite, and on treatment decision, especially in advanced stage and elderly HNC patients.

scholarly journals Prognosis for Cutaneous Melanoma by Clinical and Pathological Profile: A Population-Based Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Alessandra Buja ◽  
Andrea Bardin ◽  
Giovanni Damiani ◽  
Manuel Zorzi ◽  
Chiara De Toni ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Multivariable Analysis ◽  
Morphological Characteristics ◽  
Stage Iv ◽  
Tumor Infiltrating Lymphocytes ◽  
Tumor Stage ◽  
Population Based ◽  
Mitotic Count ◽  
Risk Of Death

IntroductionAmong white people, the incidence of cutaneous malignant melanoma (CMM) has been increasing steadily for several decades. Meanwhile, there has also been a significant improvement in 5-year survival among patients with melanoma. This population-based cohort study investigates the five-year melanoma-specific survival (MSS) for all melanoma cases recorded in 2015 in the Veneto Tumor Registry (North-Est Italian Region), taking both demographic and clinical-pathological variables into consideration.MethodsThe cumulative melanoma-specific survival probabilities were calculated with the Kaplan-Meier method, applying different sociodemographic and clinical-pathological variables. Cox’s proportional hazards model was fitted to the data to assess the association between independent variables and MSS, and also overall survival (OS), calculating the hazard ratios (HR) relative to a reference condition, and adjusting for sex, age, site of tumor, histotype, melanoma ulceration, mitotic count, tumor-infiltrating lymphocytes (TIL), and stage at diagnosis.ResultsCompared with stage I melanoma, the risk of death was increased for stage II (HR 3.31, 95% CI: 0.94-11.76, p=0.064), almost ten times higher for stage III (HR 10.51, 95% CI: 3.16-35.02, p<0.001), and more than a hundred times higher for stage IV (HR 117.17, 95% CI: 25.30-542.62, p<0.001). Among the other variables included in the model, the presence of mitoses and histological subtype emerged as independent risk factors for death.ConclusionsThe multivariable analysis disclosed that older age, tumor site, histotype, mitotic count, and tumor stage were independently associated with a higher risk of death. Data on survival by clinical and morphological characteristics could be useful in modelling, planning, and managing the most appropriate treatment and follow-up for patients with CMM.

scholarly journals Trends in Treatment of Head and Neck Cancer in Germany: A Diagnosis-Related-Groups-Based Nationwide Analysis, 2005–2018

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6060
Author(s):  
Isabel Hermanns ◽  
Rafat Ziadat ◽  
Peter Schlattmann ◽  
Orlando Guntinas-Lichius
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oropharyngeal Cancer ◽  
Diagnosis Related Groups ◽  
Treatment Strategies ◽  
Population Based ◽  
Gender Disparity ◽  
Hypopharyngeal Cancer ◽  
German Population

Advances in head and neck cancer (HNC) treatment might have changed treatment strategies. This study determined, with focus on gender disparity, whether treatment rates have changed for inpatients in Germany between 2005 and 2018. Nation-wide population-based diagnosis-related groups (DRG) data of virtually all HNC cases (1,226,856 procedures; 78% men) were evaluated. Poisson regression analyses were used to study changes of annual treatment rates per German population. For surgery, the highest increase was seen for women with cancer of the oral cavity (relative risk (RR) 1.14, 95% confidence interval (CI) 1.11–1.18, p < 0.0001) and the highest decrease for men with laryngeal cancer (RR 0.90, CI 0.87–0.93). In women with oropharyngeal cancer, the highest increase of radiotherapy rates was seen (RR 1.18, CI 1.10–1.27, p < 0.0001). A decrease was seen in men for hypopharyngeal cancer (RR 0.93, CI 0.87–0.98, p = 0.0093). The highest increase for chemotherapy/immunotherapy was seen for women with oropharyngeal cancer (RR 1.16, CI 1.08–1.24, p < 0.0001), and a decrease in men with hypopharyngeal cancer (RR 0.93, CI 0.88–0.97, p = 0.0014). Treatment patterns had changed for nearly all subsites and therapy types. There were relevant gender disparities, which cannot be explained by the DRG data.

Comparison of tumor characteristics and survival between esophageal and other gastroenteropancreatic neuroendocrine neoplasms.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15556-e15556
Author(s):  
Mehran Taherian ◽  
Shabnam Samankan ◽  
Adrienne Groman ◽  
Saikrishna S. Yendamuri ◽  
Amarpreet Bhalla
Keyword(s):  
Neoadjuvant Therapy ◽  
Tnm Classification ◽  
Multivariable Analysis ◽  
Stage Iv ◽  
Tumor Stage ◽  
Stage Iii ◽  
Resection Margins ◽  
Neuroendocrine Neoplasms ◽  
Limited Information ◽  
Pancreatic Net

e15556 Background: Neuroendocrine neoplasms (NEN) of esophagus are extremely rare. Limited information is available on survival of these tumors. The objective of this study was to define the clinicopathologic predictors of overall survival (OS) in esophageal NEN, and to compare them with the other gastroenteropancreatic NEN (GEP-NEN). Methods: Esophageal NEN were selected from the National Cancer Database (2004–2013). Multivariable analysis and Kaplan–Meier method were performed. The prognostic factors for GEP-NEN were derived from literature including WHO classification and AJCC TNM classification. Results: Of 802 selected patients with esophageal NEN, 97.5% were NEC and only 2.5% typical NET. The median age for NET was 58 vs. 66 for NEC (p = 0.007). NET more commonly presented in females (60%) compared to NEC wherein 68% patients were male. Most of the NEC were grade III/IV and > 4 cm, while most NET were grade I/II and < 4 cm. They most frequently metastasized to the liver. 10.7% of patients with esophageal NEN underwent esophagectomy while 86.5% had no surgery; 68.5% had adjuvant and 6.6% neoadjuvant therapy. Multivariable analysis showed that tumor > 4 cm (hazard ratio (HR) 1.45; P = 0.013), stage III and IV (HR 2.27; p = 0.030, and HR 4.02; P < 0.001, respectively) were associated with significantly worse OS, while esophagectomy (HR 0.30; P = 0.019) and neoadjuvant therapy (HR 0.35; p = 0.006) were predictors of better OS. The 5-year OS rate was 12% for all esophageal NEN (95% CI, 10-15): 89% for NET and 9% for NEC. Pancreatic NET are generally > 2 cm and NEC have an average size of 4 cm. The factors associated with worse prognosis in pancreatic NEN include positive surgical resection margins, lymph node metastases, advanced TNM stage, vascular invasion and distant metastasis. The 5-year OS for patients with pancreatic NET and NEC is 65% and 16%, respectively. NET of ileum are < 2 cm in 47% of cases, and the 5-year OS is about 60%. Tumor stage is the most important predictor of survival. The malignant potential is retained for ileal NET > 1 cm. Only Stage III vs. Stage IV has a better OS. The G3 NEC and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) have poor OS and variable median survival time reported up to 40 months. Conclusions: Using the largest dataset of esophageal NEN to date, the major independent predictors of OS include tumor size, stage, esophagectomy, and chemotherapy. The majority of esophageal NEN are NEC. Their OS is similar or slightly higher in comparison to ileal NEC but poor in comparison to similar tumors presenting in the pancreas.

scholarly journals The log odds of positive neck lymph nodes is a superior lymph node predictor for overall survival in head and neck cancer: a population-based analysis in Germany

2021 ◽  
Author(s):  
Mussab Kouka ◽  
Elisa Al-Ahmar ◽  
Jens Büntzel ◽  
Holger Kaftan ◽  
Daniel Böger ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Real Life ◽  
Stage Iv ◽  
Cancer Registries ◽  
Population Based ◽  
Log Odds

Abstract Background This population-based study investigated the influence of different lymph node (LN) classifications on overall survival (OS) in head and neck cancer (HNC). Methods 401 patients (median age: 57 years; 47% stage IV) of the Thuringian cancer registries with diagnosis of a primary HNC receiving a neck dissection (ND) in 2009 and 2010 were included. OS was assessed in relation to total number of LN removed, number of positive LN, LN ratio, and log odds of positive LN (LODDS). Results Mean number of LODDS was 0–0.96 ± 0.57. When limiting the multivariate analysis to TNM stage, only the UICC staging (stage IV: HR 9.218; 95% CI 2.721–31.224; p < 0.001) and LODDS >  – 1.0 (HR 2.120; 95% CI 1.129–3.982; p = 0.019) were independently associated with lower OS. Conclusion LODDS was an independent and superior predictor for OS in HNC in a population-based setting with representative real-life data.

Is Locally Advanced Head-Neck Cancer One More Candidate for Accelerated Hypofractionation?

2021 ◽  
Vol 41 (1) ◽  
pp. 467-475
Author(s):  
IOANNIS M. KOUKOURAKIS ◽  
ANNA ZYGOGIANNI ◽  
VASSILIOS KOULOULIAS ◽  
GEORGE KYRGIAS ◽  
MARIANTHI PANTELIADOU ◽  
...  
Keyword(s):  
Neck Cancer ◽  
Locally Advanced ◽  
Head Neck Cancer ◽  
Advanced Head ◽  
Head Neck

scholarly journals Presentation, Management, and Outcomes across the Rural-Urban Continuum for Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Kali Zhou ◽  
Trevor A Pickering ◽  
Christina S Gainey ◽  
Myles Cockburn ◽  
Mariana C Stern ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Rural Communities ◽  
Urban Areas ◽  
Tumor Stage ◽  
The United States ◽  
Population Based ◽  
Urban Residents ◽  
Place Of Residence ◽  
Incidence And Mortality ◽  
Receive Treatment

Abstract Background Hepatocellular carcinoma is one of few cancers with rising incidence and mortality in the United States. Little is known about disease presentation and outcomes across the rural-urban continuum. Methods Using the population-based SEER registry, we identified adults with incident hepatocellular carcinoma between 2000–2016. Urban, suburban and rural residence at time of cancer diagnosis were categorized by the Census Bureau’s percent of the population living in non-urban areas. We examined association between place of residence and overall survival. Secondary outcomes were late tumor stage and receipt of therapy. Results Of 83,368 cases, 75.8%, 20.4%, and 3.8% lived in urban, suburban, and rural communities, respectively. Median survival was 7 months (IQR 2–24). All stage and stage-specific survival differed by place of residence, except for distant stage. In adjusted models, rural and suburban residents had a respective 1.09-fold (95% CI = 1.04–1.14, p &lt; .001) and 1.08-fold (95% CI = 1.05–1.10, p &lt; .001) increased hazard of overall mortality as compared to urban residents. Furthermore, rural and suburban residents had 18% (OR = 1.18, 95% CI 1.10–1.27, p &lt; .001) and 5% (OR = 1.05, 95% CI = 1.02–1.09, p = .003) higher odds of diagnosis at late stage and were 12% (OR = 0.88, 95% CI = 0.80–0.94, p &lt; .001) and 8% (OR = 0.92, 95% CI = 0.88–0.95, p &lt; .001) less likely to receive treatment, respectively, compared to urban residents. Conclusions Residence in a suburban and rural community at time of diagnosis was independently associated with worse indicators across the cancer continuum for liver cancer. Further research is needed to elucidate the primary drivers of these rural-urban disparities.

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