Gastric Cancer Treatments and Survival Trends in the United States

Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease.

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Exploration of the Appropriate NT-Probnp Level for AL Amyloidosis Staging

Blood ◽

10.1182/blood-2021-151675 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 3777-3777

Author(s):

Hana Kim ◽

Darae Kim ◽

Jinoh Choi ◽

Eunseok Jeon ◽

Jung Eun Lee ◽

...

Keyword(s):

Overall Survival ◽

Mayo Clinic ◽

Medical Center ◽

Stage Iv ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Al Amyloidosis ◽

School Of Medicine ◽

Staging Systems

Abstract Exploration of the Appropriate NT-proBNP Level for AL Amyloidosis Staging Hana Kim, MD 1, Darae Kim, MD, PhD 2, Jin-Oh Choi, MD, PhD 2, Eun-Seok Jeon, MD, PhD 2, Jung Eun Lee, MD, PhD 3, Ju-Hong Min, MD, PhD 4, Joon Young Choi, MD, PhD 5, Jung-Sun Kim, MD, PhD 6, Seok Jin Kim, MD, PhD 1, Kihyun Kim, MD, PhD 1 1 Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 3 Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 4 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 5 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 6 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea The most important factor affecting prognosis of systemic light chain (AL) amyloidosis is severity of cardiac damage. For this reason, cardiac biomarkers are used in European 2015 and Mayo clinic 2012, two representative staging systems for AL amyloidosis. Since the NT-proBNP levels of the existing AL amyloidosis staging systems are different, we tried to find the appropriate NT-proBNP level in our 16-year AL amyloidosis patient cohort. Newly diagnoded AL amylodosis patients between August 2004 and July 2020 were included in this study (n=401). Patients who did not have laboratory results for staging had been exclude (n=86). Among them, 86 patients of stage III and 145 patients of stage IV patients (according to Mayo clinic 2012 stage) were analyzed (n=231). Of the 231 stage III, IV patients, 25, 82, 47, and 77 patients were classified as a group of NT-proBNP ≤1800, 1800 < NT-proBNP ≤5000, 5000< NT-proBNP ≤8000, and NT-proBNP >8000 (ng/L), respectively. The characteristics and overall survival of each group were investigated through statistical analysis. Age at diagnosis (p=0.016), ECOG (p=0.046), serum creatinine(p=0.001), and Estimated glomerular filtration rate (eGFR) (p=0.003) had statistically significant differences in the groups divided by the NT-proBNP criteria. With 54.4 months of median follow up, the overall survivals analyzed by Mayo clinic 2012 were stage I: not reached, stage II: 49.6 months, stage III: 46.8 months, and stage IV: 11.9months, respectively. As a result of European 2015 analysis, stage I: not reached, stage II: 65.9 months, stage IIIa: 41.4 months, stage IIIb: 4.3 months.) In our analysis according to NT-proBNP (ng/L) in stage III and IV patients, the overall survival of NT-proBNP ≤1800 group has not yet been reached. The median OS of group 1,800<NT-proBNP ≤5000, 5000< NT-proBNP ≤8000, and NT-proBNP >8000 were 54.8 months, 11.9 months, and 4.5 months, respectively (p <0.001). The Kaplan-Meier's curve for OS had a clear difference at NT-proBNP 5000 value. On the basis of NT-proBNP, the OS of less than 5000 group was 62 months, and the OS of 5000 or more group was 5.9 months. In analysis of factors affecting the OS, statistically significant results were age at diagnosis (p = 0.018), ECOG (p = 0.002), and NT-proBNP 5000 ng/L or higher (p < 0.001). The dFLC included in the Mayo clinic 2012 was found to have a statistically insignificant on the overall survival (p=0.584). Although disease stage is important in predicting the prognosis of AL amyloidosis, it was revealed that NT-proBNP is the most important factor in predicting survival prognosis. In this study we confirmed that AL amyloid patients with high NT-proBNP of >5000 ng/L may have particularly poor survival rate. When staging AL amyloidosis, it can be considered based on NT-proBNP 5000 ng/L level. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Results of a stage-based protocol for the treatment of retinoblastoma.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.5.1532 ◽

1996 ◽

Vol 14 (5) ◽

pp. 1532-1536 ◽

Cited By ~ 91

Author(s):

E Schvartzman ◽

G Chantada ◽

A Fandiño ◽

M T de Dávila ◽

E Raslawski ◽

...

Keyword(s):

Overall Survival ◽

Optic Nerve ◽

Stage Iv ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Disease Stage ◽

Hematogenous Metastasis ◽

Intrathecal Therapy ◽

Orbital Mass

PURPOSE To describe the treatment of retinoblastoma at a single institution using a prospective protocol based on histopathologic staging. PATIENTS AND METHODS We included 116 consecutive patients (101 eligible, 46 bilateral) from August 1987 to December 1993. Treatment was enucleation or conservative therapy for intraocular disease (stage I patients). Stage II patients (orbital or postlaminar invasion) received vincristine, cyclophosphamide, and doxorubicin for 57 weeks. Patients with orbital mass and extension beyond the cut end of the optic nerve also received orbital radiotherapy (45 Gy). The latter received intrathecal therapy. In those with CNS (stage III) or hematogenous metastasis (stage IV), cisplatin and etoposide were added along with cranial (in patients with a CNS mass and prophylactically in stage IV) or craniospinal (in patients with positive CSF) radiotherapy. RESULTS The median follow-up time was 39 months (range, 12 to 84). The overall survival rate was 0.84. Survival rates according to stage were as follows: stage I probability of overall survival [pOS] = 0.97) (alive/total), 59 of 60; stage II (pOS = 0.85) including patients with scattered episcleral cells, three of three; orbital mass, one of one; postlaminar invasion up to and beyond the cut end of optic nerve, 10 of 11 and 11 of 14, respectively; of stage III (pOS = 0), zero of six; and stage IV (pOS = 0.50), three of six. Only those patients with preauricular adenopathy as the only metastatic site survived in the latter group. Acute toxicity was mild. CONCLUSION Chemotherapy is not warranted to prevent systemic metastasis for intraocular disease. Patients with extraocular orbital disease and had a good outcome with this therapy. Patients with metastatic disease fared poorly, except for those with isolated malignant preauricular adenopathy.

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Contemporary utilization trends of systemic chemotherapy for upper tract urothelial carcinoma (UTUC).

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.441 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 441-441

Author(s):

Mohammed Haseebuddin ◽

Elizabeth Handorf ◽

Joshua Jones ◽

Alexander Kutikov ◽

Nikhil Waingankar ◽

...

Keyword(s):

Temporal Trends ◽

Logistic Models ◽

Stage Iv ◽

Stage Ii ◽

Stage Iii ◽

Rank Tests ◽

Chi Square ◽

Clinicopathologic Characteristics ◽

Kaplan Meier ◽

To Receive

441 Background: There is currently no consensus regarding the use of systemic therapy (ST) for surgically-treated patients with invasive UTUC. Using a large national cancer registry, our objective was to assess temporal trends in utilization of ST for stage II-IV UTUC undergoing definitive resection. Methods: The National Cancer Database (NCDB) was queried for all patients surgically treated (nephroureterectomy, segmental resection) for stage II-IV UTUC from 1998-2012. Temporal trends in receipt of ST [neoadjuvant (NAT), adjuvant (AT), or unknown timing (UKT)] were assessed using chi square analyses. After exclusion of patients receiving NAT or UKT, adjusting for patient and clinicopathologic characteristics, multivariable logistic models were used to examine the association between clinicopathologic characteristics and receipt of ST within 9 months of resection. Kaplan Meier analyses and stratified log-rank tests were performed comparing overall survival (OS) between patients receiving ST < 9 months and those who did not. Results: Of 7,629 patients identified over the study period, 24.1% of patients surgically treated for stage II-IV UTUC received any ST (NAT: 1.44%, AT: 19.11%, UKT: 3.51%). Utilization of any ST significantly increased from 1998-2012 (20.2% vs. 28.7%, p < 0.0001). Following adjustment, patients of increased age (61-70 years: OR 0.62 [CI 0.42-0.91], 71+ years: OR 0.26 [CI 0.17-0.38]) were less likely to receive ST, and patients with high grade (OR 2.46 [CI 1.95-3.09]), Stage III (OR 4.75 [CI 3.89-5.79]), and Stage IV (OR 9.37 [CI 7.49-11.74]) disease were more likely to be treated with ST. When restricted to stage III-IV disease, receipt of ST < 9 months was significantly associated with improved OS after adjustment for age, grade, and charlson index (p < 0.002). Conclusions: In hospitals reporting to the NCDB, while utilization has significantly increased from 1998-2012, less than one third of patients surgically treated for stage II-IV UTUC receive ST. In addition to unmeasured characteristics (decline of renal function following surgery), the lack of explicit guidelines and prospective evidence may contribute to limited use of systemic treatment.

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Survival benefit of gastric resection in the setting of metastatic gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.166 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 166-166

Author(s):

Trang Nguyen ◽

Brooke Vuong ◽

Mansen Wang ◽

Trevan D Fischer ◽

Melanie Goldfarb ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Survival Benefit ◽

Gastric Resection ◽

Stage Iv ◽

Metastatic Gastric Cancer ◽

The United States ◽

Primary Tumor Site ◽

Risk Of Death ◽

Co Morbidity

166 Background: Prognosis remains poor for metastatic gastric cancer. Gastrectomy in the setting of stage IV disease is typically reserved for palliation of symptoms such as bleeding or obstruction. The potential survival benefit of resection on survival is controversial. The objective of this study is to determine using the National Cancer Database (NCDB) whether there was an increase in overall survival in patients diagnosed with metastatic cancer who underwent a gastrectomy in addition to chemotherapy. Methods: The NCDB was queried between 2004-2014 for patients with metastatic gastric cancer (adenocarcinoma, mucinous adenocarcinoma, or signet ring carcinoma) who received chemotherapy. Kaplan-Meier analysis and multivariate Cox proportional hazards regression analysis was done using SAS software. Results: A total of 20,599 patients met inclusion criteria. A minority of these patients (2,508; 12.2%) underwent gastric resection in addition to chemotherapy. The median overall survival for those who underwent gastrectomy was 14.1 months compared to 8.6 months for chemotherapy alone (p < 0.0001). Other factors influencing survival included age, race, Charlson-Deyo co-morbidity index, year of diagnosis, primary tumor site, grade, and metastasis to multiple organs. Following multivariate analysis, patients who underwent gastrectomy and chemotherapy had a 36% lower risk of death compared to patients that had received chemotherapy alone (HR 0.64, 95% CI 0.48–0.80, P < 0.0001). Conclusions: In this population analysis, the addition of gastrectomy to chemotherapy was associated with improved overall survival for patients with stage IV gastric cancer and should be considered for patients that are surgical candidates. Patients who underwent gastrectomy had a 36% decreased risk of death compared to those who had chemotherapy alone. However, only a small proportion of patients in the United States received multimodality treatment.

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Bendamustine + Rituximab-Combinations and R-CHOP Achieve a Major Survival Improvement Of Patients With Follicular Lymphoma In Routine Care

Blood ◽

10.1182/blood.v122.21.5584.5584 ◽

2013 ◽

Vol 122 (21) ◽

pp. 5584-5584

Author(s):

Rudolf Weide ◽

Stefan Feiten ◽

Vera Friesenhahn ◽

Jochen Heymanns ◽

Kristina Kleboth ◽

...

Keyword(s):

Overall Survival ◽

Clinical Trials ◽

Follicular Lymphoma ◽

Stage Iv ◽

Relative Survival ◽

Routine Care ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Number Of Patients

Abstract Introduction Progress has been made in diagnosis and treatment of patients with follicular lymphoma who receive their treatment within prospective clinical trials. Due to necessary inclusion and exclusion criteria only a very limited number of patients are treated in studies. Therefore results from clinical trials can't be transferred into routine care. Little practice data are available how patients with follicular lymphoma are diagnosed and treated in routine care and whether improvements in survival are achieved. Methods A retrospective analysis of all patients with follicular lymphoma who were treated in an oncology group practice in Germany between 1995-2012. Relevant clinical data concerning diagnosis, treatment and survival were transferred from clinical files into a database and analyzed statistically using SPSS and SURVSOFT. Results 174 patients with a median age of 60 (27-87) were identified. 43.7% were male and 56.3% female. Stage distribution at initial diagnosis was as follows: Stage I 45 patients (25.9%), stage II 23 patients (13.2%), stage III 32 patients (18.4%), stage IV 62 patients (35.6%), in 12 patients (6.9%) initial stage could not be retrieved. 90.8% needed therapy with a median of 2 different therapies (1-12). Regimens most frequently applied were: Rituximab-containing (67.1%), Bendamustine-containig (41.8%), Bendamustine+Rituximab-combinations (39.9%) and R-CHOP (27.8%). 15 patients (9.5%) received radiotherapy only. 13.3% of patients were treated within a clinical trial. 5 and 10 year absolute overall survival was 88.9% and 73.9%. Relative survival after 5 and 10 years was 94.4% and 86.6%. Median overall survival according to stage was 28 years for stage I, median not reached for stage II, 21 years for stage III and 16 years for stage IV. Median relative survival was 17.4 years for stage IV and has not been reached for stages I-III. Conclusions Systemic treatment of patients with follicular lymphoma in routine care consisted mainly of Bendamustine+Rituximab-combinations and R-CHOP. Employment of the most active chemoimmunotherapies leads to a marked prolongation of survival compared to historical controls and registry data. Disclosures: No relevant conflicts of interest to declare.

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Effect of beta blocker on breast cancer progression in minority population.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e12564 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e12564-e12564

Author(s):

Rajshekhar Chakraborty ◽

Shiva Kumar Reddy Mukkamalla ◽

Natalia Calderon ◽

Linda Bulone

Keyword(s):

Breast Cancer ◽

Cancer Progression ◽

Beta Blocker ◽

Beta Blockers ◽

Stage Iv ◽

Breast Cancer Progression ◽

Stage I ◽

Stage Ii ◽

Minority Population ◽

Kaplan Meier

e12564 Background: Recent pharmaco-epidemiological studies have shown positive effects of beta blockers (BB) on breast cancer progression, recurrence, metastasis, and cancer specific mortality. To the best of our knowledge none of these studies specifically targeted the minority population. The purpose of our study was to determine the effect of beta blockers on the Progression Free Survival (PFS) of breast cancer patients belonging to the minority subgroup of US population. Methods: We retrospectively reviewed 142 consecutive cases of breast cancer in a city hospital in Queens County of New York City (Asians 36%, Blacks 42%, Hispanics 18% and Whites 4%) diagnosed between January 2007 and December 2009. Patients using beta blockers prior to diagnosis were compared to those who were not on any in terms of PFS after adjusting for the confounding effect of stage at presentation. Kaplan-Meier survival curves were used to look for any significant difference in the PFS between these two groups in minority population. Results: Patients on beta blockers (n=25) were compared to those who were not (n=111). The median follow-up time of this study was 54 months. The study population was stratified according to the stage of presentation (Stage I=32%, Stage II=36%, Stage III=22%, Stage IV=10%).Using Kaplan Meier survival analysis we found significant differences in PFS of patients in stages II and IV (Wilcoxon Test p<0.0001, Log-Rank Test p<0.0001). There was no progression of disease in stage I irrespective of beta blocker intake. In stage II, PFS at the end of study in patients on BB vs. not on BB was 91% vs. 87%. In stage IV the PFS was 100% vs. 10% in patients on BB vs. not on BB. However, in stage III the PFS was better in patients not on BB, which could be explained by the small number of patients on BB (50% vs. 77% in BB vs. no BB subgroup). Conclusions: In this study of breast cancer PFS in minority population, we found that beta blocker use was associated with improved PFS in stages II and IV. However, additional studies with larger sample size are required to substantiate this finding.

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Predictive factors of response to electrochemotherapy in canine oral malignant melanoma

10.1101/727164 ◽

2019 ◽

Author(s):

Matías Nicolás Tellado ◽

Felipe Horacio Maglietti ◽

Sebastián Diego Michinski ◽

Guillermo Ricardo Marshall ◽

Emanuela Signori

Keyword(s):

Overall Survival ◽

Malignant Melanoma ◽

Predictive Factors ◽

Objective Response ◽

Stage Iv ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Oral Melanoma ◽

Oral Malignant Melanoma

ABSTRACTElectrochemotherapy is a treatment modality which has been increasingly used in veterinary and human medicine for treating cutaneous and subcutaneous tumors. In this prospective work we evaluated the outcome of using electrochemotherapy as a first-line treatment for canine oral melanoma in different stages, with the aim of determining predictive factors of response to the treatment. Mucosal melanoma is the most common cause of oral cancer in dogs. Canine oral malignant melanoma is very similar to human oral melanoma in many aspects, being a very good translational model for studying response to this treatment. Sixty-seven canine patients were treated. Intravenous bleomycin was the preferred drug, and the standard operating procedures for electrochemotherapy were followed. The patients were followed-up for two years. According to WHO criteria, the objective response per stage was: stage I 100%, stage II 89.5%, stage III 57.7% and, stage IV 36.4%. The overall median survival was 7.5 months (2-30 months, mean 9.1 months). Median overall survival of patients in stage I was 16.5 months, in stage II was 9 months, in stage III 7.5 months, and in stage IV 4.5 months. The average number of electrochemotherapy sessions was 1.5 for every stage. The incidence of new metastases among treated patients was 28.4%. Patients in advanced stages, with bone involvement, and caudal location of the tumor had poorer response rates and shorter overall survival times. The treatment greatly improved the quality of life of the patients. Electrochemotherapy is an important technique in the oncological armamentarium against melanoma, and these results can be used to predict human response to this therapy in each stage.

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The Prognostic Impact of t(14;16) in Multiple Myeloma: A Multicenter Retrospective Study of 213 Patients. Is It Time to Revise the Revised ISS?

Blood ◽

10.1182/blood-2018-99-115971 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4452-4452

Author(s):

Artur Jurczyszyn ◽

Sarah Goldman-Mazur ◽

Jorge J. Castillo ◽

Anna Waszczuk-Gajda ◽

Norbert Grząśko ◽

...

Keyword(s):

Multiple Myeloma ◽

Overall Survival ◽

Research Funding ◽

Combined Therapy ◽

The United States ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Patient Treatment ◽

Prognostic Impact

Abstract Introduction One of the strongest predictors of outcome in multiple myeloma (MM) patients are the intrinsic genetic abnormalities in the malignant plasma cells. t(14;16)(q32;q23) deregulates the c-musculoaponeurotic fibrosarcoma (c-MAF) oncogene. Due to the relative rarity of t(14;16) [<5% of newly diagnosed MM], there are no large databases which provide the natural history of this abnormality (the largest reported by Palumbo et al, R-ISS for MM: An IMWG Report included 84 patients). Methods We retrospectively analyzed 213 patients with t(14;16) from 24 clinical centers in Germany, Italy, Spain, Israel, Poland, Romania, Czech Republic and the United States. Diagnosis and clinical responses were based on the International Myeloma Working Group criteria. The t(14;16) was detected by double color fluorescence in situ hybridization using bone marrow samples. Baseline characteristics at diagnosis, patient treatment and clinical outcomes were collected using unified forms. Overall survival (OS) was defined as the period between the date of diagnosis and the date of death or last observation. Progression-free survival (PFS) was defined as the period between the date of diagnosis and either the date of the first relapse, of the last observation or death of any causes. Cox proportional hazard regression analysis was applied to assess risk factors of death. Survival curves were plotted by the Kaplan-Meier method and compared using log-rank and Breslow-Gehan-Wilcoxon tests. Results We analyzed a total of 213 patients, mean age 62.1 years (range 32 to 90), including 91 (42.7%) males. Immunoglobulin isotype included IgG (n=98, 46.0%), IgA (n=60, 28.2%) and IgM (n=1, 0.5%), light chain only in 47 cases (22.1%). ISS stage at diagnosis included: stage III (n=78, 36.6%), stage II (n=81, 38.0%) and stage I (n=47, 22.1%); for R-ISS: stage III (n=79, 37.1%), stage II (n=71, 33.3%), stage I (n=10, 4.7%). For stage is unknown for the remaining patients. Hypercalcemia was present in 38 cases (17.8%), anemia (<10g/dl) in 109 (51.2%) and impaired renal function (creatinine clearance <40 mL per minute or serum creatinine >2 mg/dl) in 54 (25.4%) patients. In 104 (48.8%) cases osteolytic lesions were present. The t(14;16) was associated with other aberrations in 134 (62.9%), in 35 (16.4%) patients with del17p. First line treatment for MM with t(14;16) included PIs + chemotherapy in 72 patients (36%), PIs + IMIDs in 39 patients (20%) or chemotherapy + PIs + IMIDs in 25 patients (13%). Overall response rate was 67%. Median PFS was 31 months (CI 95% 28-40.3 months; Figure 1, panel A). Median OS was 88 months (CI 95% 49-177 months; Figure 1, panel B). 5-year OS from MM diagnosis was 55% (46-63%), whereas 10-year OS reached 44% (31-56%). Median OS for stage I was not reached, for stage II was 62 months (95%CI 38-177 months) and for stage III was 32 months (95% CI 18-88 months). Patients in ISS stage I had better OS than stage III patients (p<0.001; Figure 2, panel A). A total of 74 (34.7%) patients died. The causes of death included mostly disease progression in 28 cases (37.8%; 16 patients received ≥4 treatment lines) and infection in patients with progression in 21 cases (28.4%). Patients treated with combined therapy of IMIDs, PIs ± chemotherapy had better survival than patients treated with IMIDs or PIs alone or chemotherapy alone (p=0.044; Figure 3, panel A). Patients after auto-PBSCT (median OS not reached, n=62, 29.1%), especially tandem auto-PBSCT (median OS not reached, n=18, 8.5%) performed better OS than patients without transplant (median OS: 42.1 months [95%CI 27- 62 months], p<0.0001, Figure 3, panel B). Patients with additional del17p exhibited worse OS than patient with single t(14;16) mutation (median OS 42 vs 107 months, p=0.043; Figure 2, panel B). Conclusion This is the largest report of myeloma patients with t(14;16). Patients with t(14;16) and del17p had a worse prognosis than patients with t(14;16) alone. The use of auto-PBSCT, especially in the subgroup who received planned tandem auto-PBSCT, is associated with better survival. Combined therapy with PIs and IMIDs improved the overall survival in t(14;16) patients, which may suggests, that this high-risk prognostic feature might be partially overcome by the use of new-drug therapies. This study of 213 patients indicates that t(14;16) is not as severe adverse factor as compared to the original IMWG R-ISS analysis (n= 84), which suggests that the revised ISS may require updating. Disclosures Castillo: Genentech: Consultancy; Abbvie: Consultancy, Research Funding; Millennium: Research Funding; Pharmacyclics: Consultancy, Research Funding; Beigene: Consultancy, Research Funding; Janssen: Consultancy, Research Funding. Niesvizky:Celgene: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Takeda: Consultancy, Research Funding; Amgen Inc.: Consultancy, Research Funding. Rosinol Dachs:Janssen: Honoraria; Celgene: Honoraria; Amgen: Honoraria. Cohen:Janssen: Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria, Research Funding; Neopharm Israel: Consultancy, Honoraria; Medisson Israel: Consultancy, Honoraria, Research Funding. Hari:Spectrum: Consultancy, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Kite Pharma: Consultancy, Honoraria; Sanofi: Honoraria, Research Funding; Janssen: Honoraria; Amgen Inc.: Research Funding; Bristol-Myers Squibb: Consultancy, Research Funding; Takeda: Consultancy, Honoraria, Research Funding. Goldberg:COTA Inc.: Employment, Equity Ownership.

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Colon Cancer Sidedness, Presentation, and Survival at Different Stages

Journal of Oncology ◽

10.1155/2019/4315032 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Mark B. Ulanja ◽

Mohit Rishi ◽

Bryce D. Beutler ◽

Mokshya Sharma ◽

Darryll R. Patterson ◽

...

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Cohort Study ◽

Stage Iv ◽

Population Based ◽

Stage I ◽

Stage Ii ◽

Cox Proportional Hazard ◽

Using Data ◽

The Relationship

Background. Several prognostic factors have been used to guide therapy for colon cancer (CC). However, the relationship between CC laterality (sidedness) and prognosis remains under investigation. Objectives. To assess the effect of laterality on CC presentation and survival, using a Surveillance, Epidemiology, and End Results (SEER) population-based cohort. Methods. A retrospective cohort study using data from the SEER program (2007-2015). Results. Of the 163,980 patients with CC, 85,779 (52.3%) presented with right-sided CC (RCC) and 78,201 (47.7%) with left-sided CC (LCC). Stage distributions were as follows: stage I, 24.1%; stage II, 27.3%; stage III, 28.2%; and stage IV, 20.4%. In an adjusted modified Poisson regression approach for risk ratio (RR), patients with LCCs were more likely to be male (RR = 1.14; 95% CI 1.12-1.15, p<0.001). As compared to stage I, stage II cancers (RR = 0.88, 95% CI 0.87-0.90, p<0.001) were less likely to be LCC. Stage IV CC was slightly less likely to be left-sided (RR = 0.98, 95% CI 0.98, 0.96-1.00, p = 0.028). The median overall survival (OS) for RCC was 87 months. The median OS for LCC was not established, as more than half of the patients diagnosed with LCC were still living at the time of the analysis. In adjusted Cox proportional Hazard model, individuals with stage I, III, and IV LCCs had superior OS as compared to those with matched-stage RCC (adjusted HR = 0.87; 95% CI 0.85-0.88, p<0.001). However, OS was worse among those with stage II disease who presented with LCC (adjusted Hazard ratio [aHR] = 1.06; 95% CI 1.02-1.11, p = 0.004). CC-specific survival (CSS) was superior for LCC versus RCC for stages III and IV but worse for II. Conclusions. In this population-cohort study, LCC is associated with superior OS and CSS survival. The overall survival advantage was attributed to stage I, III, and IV disease. Individuals presenting with stage II disease exhibit superior survival if the CC is right-sided.

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Survival of non-small cell lung cancer (NSCLC) patients with and without diabetes mellitus (DM): Findings from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6602 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6602-6602

Author(s):

Taher Abu Hejleh ◽

Elizabeth A. Chrischilles ◽

Jane F Pendergast ◽

Aaron T Porter ◽

Robert B Wallace ◽

...

Keyword(s):

Overall Survival ◽

Smoking Status ◽

Stage Iv ◽

The United States ◽

Rank Test ◽

Kaplan Meier ◽

Increased Risk ◽

Cox Proportional Hazard Models ◽

Care Outcomes ◽

Nsclc Patients

6602 Background: DM increases all-cause mortality in the general population. It is also associated with more complications from chemotherapy, increased risk of radiation pneumonitis and worse surgical-wound healing. In this study, we explored the effect of DM on NSCLC overall survival. Methods: This study utilized the surveys and abstracted medical record resources of NSCLC patients studied by CanCORS, an inception cohort of newly diagnosed lung and colon cancer patients from the United States. Patients with NSCLC stage I-IV were included. The log-rank test was used to compare the survival curves of patients with and without DM. Cox proportional hazard models were used to adjust for other variables in the survival model. Results: Of the 2243 NSCLC patients, 359 (16%) had DM. Survival for patients diagnosed with DM was significantly worse than patients without DM [hazard ratio (HR) 1.28; 95% confidence interval (CI) 1.13-1.45]. The median overall survival for patients with and without DM was 561 and 833 days, respectively. DM was also associated with poorer survival (HR 1.20; 95% CI 1.05, 1.36) after adjusting for age, smoking status, stage, treatment (radiation, chemotherapy), brain metastasis, severity of respiratory symptoms at diagnosis, and comorbidities. While a significant interaction between stage and DM was not detectable after adjusting for the above, the estimated Kaplan-Meier plots present more prominent differences in stages I-III, with virtually overlapping plots in stage IV. Conclusions: DM was associated with worse survival in NSCLC patients. Although this finding can be utilized when counseling diabetic NSCLC patients, it is unknown if improving DM care will result in a better survival. The effect of DM on survival in the various stages of NSCLC needs further study.

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