Gynecologic Malignancies in Children and Adolescents: How Common is the Uncommon?

The aim of this study is to assess the projected incidence and prognostic indicators of gynecologic malignancies in the pediatric population. In this population-based retrospective cohort study, girls ≤18 years with ovarian, uterine, cervical, vaginal and vulvar malignancies diagnosed between 2000 and 2016 were identified from the Surveillance, Epidemiology and End Results (SEER)-18 registry. The Kaplan–Meier method was used to analyze overall survival (OS). The age-adjusted annual incidence of gynecologic malignancies was 6.7 per 1,000,000 females, with neoplasms of the ovary accounting for 87.5%, vagina 4.5%, cervix 3.9%, uterus 2.5% and vulva 1.6% of all gynecologic malignancies. Malignant germ-cell tumors represented the most common ovarian neoplasm, with an increased incidence in children from 5–18 years. Although certain subtypes were associated with advanced disease stages, the 10-year OS rate was 96.0%. Sarcomas accounted for the majority of vaginal, cervical, uterine and vulvar malignancies. The majority of vaginal neoplasms were observed in girls between 0–4 years, and the 10-year OS rate was 86.1%. Overall, gynecologic malignancies accounted for 4.2% of all malignancies in girls aged 0–18 years and the histologic subtypes and prognosis differed significantly from patients in older age groups.

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Application of the International Germ Cell Consensus Classification (IGCCC) to the Nova Scotia population of patients with germ cell tumors (GCT)

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14625 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14625-14625

Author(s):

E. Maydanski Murphy ◽

J. Douglas ◽

K. Thompson ◽

L. A. Wood

Keyword(s):

Nova Scotia ◽

Germ Cell ◽

Germ Cell Tumors ◽

Retrospective Chart Review ◽

Progression Free Survival ◽

Population Based ◽

Similar Distribution ◽

Kaplan Meier ◽

Visceral Metastases ◽

Consensus Classification

14625 Background: The IGCCC is the internationally accepted, clinically based, prognostic classification used to aid in the management of GCT. The goal of this study was to determine if the IGCCC is applicable to a population based cohort. Methods: A retrospective chart review of all patients diagnosed with GCT in NS between 1984–2004 was completed, and IGCCC classification (good, intermediate, poor) was assigned to each patient based on the site of the primary lesion, the presence or absence of non-pulmonary visceral metastases and pre-chemotherapy tumor marker values. Kaplan-Meier estimates of five year progression free survival (PFS) and overall survival (OS) were calculated for each IGCCC group, for both non-seminomatous GCT and seminomatous GCT. Results: The distribution, PFS and OS are shown below. Conclusions: The IGCCC seems applicable to a population-based cohort, with similar distribution of categories, as well as clear prognostic ability. This project was funded by a Norah Stephen Oncology Scholars Summer Studentship Grant from Cancer Care Nova Scotia. [Table: see text] [Table: see text]

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Curative treatments and survival benefit in elderly patients with hepatocellular carcinoma: A SEER population-based analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.355 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 355-355

Author(s):

Oxana V. Makarova-Rusher ◽

Susanna Varkey Ulahannan ◽

Austin G. Duffy ◽

Tim F. Greten ◽

Sean Altekruse

Keyword(s):

Hepatocellular Carcinoma ◽

Elderly Patients ◽

Age Groups ◽

Relative Survival ◽

Population Based ◽

Outcome Data ◽

Chi Square ◽

Diagnostic Codes ◽

Kaplan Meier ◽

Young Old

355 Background: Transplant, resection, and ablation are potentially curative treatments for hepatocellular carcinoma (HCC) with limited outcome data in young-old (65-74) and older (≥75) patients. Methods: We evaluated curative treatment and relative survival (RS) outcomes in patients with HCC in 3 age groups (<65 years, 65-74 years, and ≥75 years). Patients with HCC diagnostic codes (histology 8,170-8,175, morphology C22) were identified in the SEER 18 database from 2000 to 2011. Treatments included curative (transplant, resection, radiofrequency ablation (RFA), and other ablations) and palliative therapies. Primary outcome was 5 year RS. Statistical analysis was performed using Kaplan-Meier and Chi-Square tests. Results: We identified 29,654 cases. The mean age was 62 years with almost 40% of HCC cases in patients over 65 years old. Potentially curable, localized stage rates were similar in all age groups, 46%, 48% and 46%, respectively. As a result of less resection and rare transplant use, fewer cases underwent curative treatments in the group 75 years and older in comparison to all other age groups (15% vs. 27%, p = 0.001). Five-year RS in all 3 age groups (<65 years, 65-74 years, and ≥75 years) was better after resection relative to RFA (47% vs. 35% p<0.0001, 44% vs. 37%, p=0.0093, and 43% vs. 28% p=0.0002). The highest survival was seen after liver transplant. Interestingly, among transplanted patients with HCC, 13% were 65-75 years old. Five-year RS was similar in transplanted patients 65-75 vs. those under 65 (76% vs 74% p=0.65). Conclusions: The use of curative treatments for HCC significantly decreases with age, yet there are clear survival benefits in elderly patients receiving such. Even when considering transplant, the data shows that outcome is as good in elderly patients as in younger patients. The benefit of hepatic resection appears to be superior compared to RFA in all age groups, in our analysis. [Table: see text]

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Survival in a cohort of patients with lung cancer: the role of age and gender in prognosis

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562016000000298 ◽

2017 ◽

Vol 43 (6) ◽

pp. 431-436 ◽

Cited By ~ 3

Author(s):

Juliana Pereira Franceschini ◽

Sérgio Jamnik ◽

Ilka Lopes Santoro

Keyword(s):

Lung Cancer ◽

Age Distribution ◽

Age Groups ◽

Rank Test ◽

Age Group ◽

Tertiary Referral Hospital ◽

Kaplan Meier ◽

Stage Disease ◽

And Gender ◽

Disease Stages

ABSTRACT Objective: To determine the demographic and clinical characteristics of patients with non-small cell lung cancer (NSCLC), as well as their disease course, by age group and gender. Methods: This was a retrospective cohort study of patients diagnosed with NSCLC from 2000 to 2012 and followed until July 2015 in a tertiary referral hospital in the city of São Paulo, Brazil. Based on the 25th and 75th percentiles of the age distribution, patients were stratified into three age groups: < 55 years; ≥ 55 and < 72 years; and ≥ 72 years. Survival time was evaluated during the follow-up period of the study. Functions of overall and gender-specific survival stratified by age groups (event: all-cause mortality) were calculated using the Kaplan-Meier method. Differences among survival curves were assessed via the log-rank test. Results: We included 790 patients with the following age distribution: < 55 years, 165 patients; ≥ 55 and < 72 years, 423; and ≥ 72 years, 202. In the entire sample, there were 493 men (62.4%). Adenocarcinoma was the most common histological pattern in the < 72-year age groups; 575 patients (73%) presented with advanced disease (stages IIIB-IV). The median 5-year survival was 12 months (95% CI: 4-46 months), with no significant differences among the age groups studied. Conclusions: NSCLC remains more common in men, although we found an increase in the proportion of the disease in women in the < 55-year age group. Adenocarcinoma predominated in women. In men, squamous cell carcinoma predominated in the ≥ 72-year age group. Most patients presented with advanced-stage disease at diagnosis. There were no statistical differences in survival between genders or among age groups.

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Pediatric Primary Hepatic Tumors: Diagnostic Considerations

Diagnostics ◽

10.3390/diagnostics11020333 ◽

2021 ◽

Vol 11 (2) ◽

pp. 333

Author(s):

Bryony Lucas ◽

Sanjita Ravishankar ◽

Irina Pateva

Keyword(s):

Clinical Presentation ◽

Pediatric Population ◽

Age Groups ◽

Population Based ◽

Current Evidence ◽

Molecular Diagnostic ◽

Hepatic Tumors ◽

Common Site ◽

The Third ◽

Abdominal Tumors

The liver is the third most common site of abdominal tumors in children. This review article aims to summarize current evidence surrounding identification and diagnosis of primary hepatic tumors in the pediatric population based upon clinical presentation, epidemiology, and risk factors as well as classical imaging, histopathological, and molecular diagnostic findings. Readers will be able to recognize the features and distinguish between benign and malignant hepatic tumors within different age groups.

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Determining the accuracy of the Canadian Hospitals Injury Reporting and Prevention Program for the representation of the rates of mild traumatic brain injuries in Quebec

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.39.11.01 ◽

2019 ◽

Vol 39 (11) ◽

pp. 291-297

Author(s):

Glenn Keays ◽

Debbie Friedman ◽

Isabelle Gagnon ◽

Marianne Beaudin

Keyword(s):

Prevention Program ◽

Brain Injuries ◽

Pediatric Population ◽

Age Groups ◽

The United States ◽

Traumatic Brain Injuries ◽

Population Based ◽

Number Of Children ◽

Mild Traumatic Brain Injuries ◽

Injury Reporting

Introduction The recent rise in mild traumatic brain injuries (mTBI) in the pediatric population has been documented by many studies in Canada and the United States. The objective of our study was to compare mTBI rates from the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP) in Montréal with population-based rates (Quebec mTBI rates). Methods We calculated CHIRPP’s mTBI rates via two methods: (1) using all CHIRPP injuries as the denominator; and (2) using the number of children aged 0 to 17 years living within 5 km of either of two CHIRPP centres in Montréal as the denominator. We plotted CHIRPP’s mTBI rates against the provincial rates and compared them according to sex and age. Results Whether using all CHIRPP injuries or the number of children aged 0 to 17 years living within 5 km of either CHIRPP centre in Montreal as the denominator, CHIRPP paralleled the fluctuations seen in Quebec’s rates between 2003 and 2016. When stratifying by sex and age, CHIRPP was better at estimating the population-based rates for the youngest (0 to 4 years) and the oldest (13 to 17 years) age groups. Conclusion CHIRPP in Montréal proved a valid tool for estimating the variations in rates of mTBI in the population. This suggests that CHIRPP could also be used to estimate population-based rates of other types of injuries.

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Computed tomography–generated anthropometric measurements of orbital relationships in normal infants and children

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.2.peds15475 ◽

2016 ◽

Vol 18 (2) ◽

pp. 201-206 ◽

Cited By ~ 7

Author(s):

Garrett M. Pool ◽

Ryne A. Didier ◽

Dianna Bardo ◽

Nathan R. Selden ◽

Anna A. Kuang

Keyword(s):

Soft Tissue ◽

Horizontal Plane ◽

Pediatric Population ◽

Age Groups ◽

Population Based ◽

Age Group ◽

Craniofacial Anomalies ◽

Craniofacial Abnormalities ◽

The Mean ◽

Frankfort Horizontal Plane

OBJECTIVE The aim of this study was to develop soft-tissue and bony anthropometric orbital measurements in a normal pediatric population based upon CT scans. METHODS This was a retrospective stratified study of children with ages ranging from birth to 36 months. Head CT images for 204 children were available and obtained with 0.625–1-mm slice widths. Soft-tissue and bone windows were reviewed. Images were oriented in the Frankfort horizontal plane, and the intercanthal (IC), bony interorbital (IO), and bony lateral orbital (LO) distances were measured. Age group stratifications were 0–3, > 3–6, > 6–9, > 9–12, > 12–18, > 18–24, > 24–30, and > 30–36 months. Patients with known syndromes or craniofacial abnormalities were excluded. Statistical analysis included the mean, SD, SEM, 95% CI, and an evaluation of IO:LO ratio. RESULTS There was an average of 25.5 patients in each age group (range 25–27 patients). All soft-tissue and bony measurements consistently showed rapid increase from 0–6 months of age, which tapered after age > 12 months. The mean IC, bony IO, and bony LO distances started at 22.22 ± 1.13 mm, 14.16 ± 0.74 mm, and 65.56 ± 1.76 mm, and at 12 months were 27.74 ± 1.01 mm, 16.21 ± 0.75 mm, and 77.98 ± 1.57 mm, respectively. The bony LO position was equivalent to the lateral canthal position and measurements. The IC distance was approximately one-third the lateral canthal distance for all age groups. CONCLUSIONS This study established and reported normal anthropometric orbital measurements in a pediatric population using fine-cut craniofacial CT. These measurements are essential when evaluating children with craniofacial anomalies.

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Benefit of chemotherapy (ctx) in elderly patients (pts) with advanced pancreatic adenocarcinoma (PC): A population-based analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.310 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 310-310 ◽

Cited By ~ 1

Author(s):

MinYuen Teo ◽

Sandra Deady ◽

Linda Sharp ◽

Raymond S. McDermott

Keyword(s):

Age Groups ◽

Radical Resection ◽

The Elderly ◽

Population Based ◽

Entire Group ◽

Kaplan Meier ◽

Hazard Ratios ◽

P 75 ◽

Receive Treatment ◽

To Receive

310 Background: Benefit of ctx in elderly PC is unclear as they are under-represented in trials and most reports are retrospective series from academic centres. This population based study sought to examine the role of ctx in the elderly PC. Methods: Pts with diagnosis of PC between 1998 and 2010 inclusive who did not receive radical resection were identified from National Cancer Registry of Ireland database. Pts were divided into two age groups: ≥70 vs <70, and stratified based on metastatic status: M0 vs M1. Median overall survival (OS) was estimated with Kaplan-Meier method and hazard ratios (HR) with Cox regressional analysis. Results: A total of 4,509 pts were identified, of whom 2,875 (64%) were ≥70 yrs. For the entire group, 16% were staged M0, 42% were staged M1 and 42% didn't have documented staging (Mx). 16% received ctx, 5% chemoradiotherapy (crt) and 79% no cancer directed therapies. More pts ≥70 were Mx compared to <70 (48% vs 30%, p<.01); Mx pts were less likely to receive treatment than M0/M1 (88% vs 73% vs 73%, p<.01). Pts ≥70 were also less likely to receive any treatment (p<.01) (Table). Comparing the ≥70 and <70 groups, median OS (in months) for M0 who received ctx were 6.0 vs 7.3 (HR 1.28 [95% confidence interval 0.85-1.89], p=.24); received crt were 7.0 vs 9.7 (HR 0.95 [0.42-1.88] p=.89) and no treatment were 3.0 vs 3.5 (HR 1.03 [0.84-1.29] p=.75); median OS for M1 who received ctx were 2.4 vs 3.4 (HR 1.21 [0.97-1.49] p=.09), crt were 4.3 vs 6.0 (HR 1.69 [0.89-3.03] p = .11) and none were 1.2 vs 1.4 (HR 1.11 [1.00 – 1.24] p=.06). Regardless of age or M stage, cxt and crt conferred superior OS as compared to no treatment (Table). Conclusions: We observed a disparity in diagnostics and delivery of treatment to older pts with PC. Pts ≥70 who were treated benefited similarly to younger pts. Such therapeutic nihilism should be addressed in a systematic fashion. [Table: see text]

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Oropharyngeal Cancer Survival: A Population-Based Study of Patients Diagnosed between 1978 and 2002

ISRN Oncology ◽

10.5402/2012/207263 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Dyego Leandro Bezerra de Souza ◽

María Milagros Bernal ◽

Javier Jerez Roig ◽

Maria Paula Curado

Keyword(s):

Oropharyngeal Cancer ◽

Cancer Survival ◽

Survival Rates ◽

Age Groups ◽

Relative Survival ◽

Population Based ◽

First Year ◽

Population Based Study ◽

Kaplan Meier ◽

One Year

Objective. This paper aims at studying oropharyngeal cancer survival from the Population-Based Cancer Registry of Zaragoza, Spain, for the 1978–2002 period. Methods. The survival rates were calculated by the Kaplan-Meier method, and the automated calculation method of the Catalan Institute of Oncology was utilized to obtain the relative survival. Results. The oropharyngeal cancer survival rate was 61.3% in the first year and 33.9% in the fifth year. One-year relative survival was 62.2% (CI 95%: 57.4–67.4), and five-year relative survival was 36.6% (CI 95%: 31.8–42.1). Comparison of survival rates by sex revealed statistically significant differences (P value = 0.017) with better survival in women. There were no differences when comparing the three age groups and the three studied time periods 1978–1986, 1987–1994, and 1995–2002. Conclusions. The data suggests that there were no significant changes in oropharyngeal cancer survival in the province of Zaragoza throughout the years.

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Patterns of Improved Survival in Patients With Multiple Myeloma in the Twenty-First Century: A Population-Based Study

Journal of Clinical Oncology ◽

10.1200/jco.2009.25.4177 ◽

2010 ◽

Vol 28 (5) ◽

pp. 830-834 ◽

Cited By ~ 113

Author(s):

Ingemar Turesson ◽

Ramon Velez ◽

Sigurdur Y. Kristinsson ◽

Ola Landgren

Keyword(s):

Multiple Myeloma ◽

Age Groups ◽

Progression Free Survival ◽

Population Based ◽

Wilcoxon Test ◽

High Dose ◽

Treatment Information ◽

Kaplan Meier ◽

Survival Patterns ◽

High Dose Melphalan

Purpose Randomized multiple myeloma (MM) studies show improved response rates and better progression-free survival for newer therapies. However, a less pronounced effect has been found for overall survival (OS). Using population-based data including detailed treatment information for individual patients, we assessed survival patterns for all patients diagnosed with MM in Malmö, Sweden from 1950 to 2005. Patients and Methods We identified 773 patients with MM (48% males). On the basis of the age limit used for treatment with high-dose melphalan with autologous stem-cell support (HDM-ASCT; ≤ 65 years old) in Sweden, we constructed Kaplan-Meier curves and used the Breslow generalized Wilcoxon test to evaluate OS patterns (diagnosed in six calendar periods) for patients 65 years old or younger and patients older than 65 years. Results Including all age groups, patients diagnosed from 1960 to 1969 had a better survival than patients diagnosed from 1950 to 1959. In subsequent 10-year calendar periods, median OS increased from 24.3 to 56.3 months (P = .036) in patients ≤ 65 years old. In contrast, OS did not improve among patients older than age 65 years (21.2 to 26.7 months, P = .7). Conclusion With the establishment of HDM-ASCT as the standard therapy for younger patients with MM, OS has improved significantly for this age group in the general MM population. With novel therapies being commonly used at disease progression, presumably it becomes increasingly difficult to confirm survival differences between defined induction, consolidation, and maintenance therapies in the future. Consequently, in the era of novel MM therapies, population-based studies will serve as a necessary complement to randomized trials.

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Development of predictive prognostic nomogram for NECs of rectum on population-based exploration

Endocrine Connections ◽

10.1530/ec-18-0353 ◽

2018 ◽

Vol 7 (11) ◽

pp. 1178-1185 ◽

Cited By ~ 1

Author(s):

Yang Lv ◽

Ning Pu ◽

Wei-lin Mao ◽

Wen-qi Chen ◽

Huan-yu Wang ◽

...

Keyword(s):

Cox Regression ◽

Population Based ◽

Prognostic Indicators ◽

Rank Test ◽

Chi Square ◽

Related Factors ◽

Ki 67 ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Chi Square Test

Aim We aim to investigate the clinical characteristics of the rectal NECs and the prognosis-related factors and construct a nomogram for prognosis prediction. Methods The data of 41 patients and 1028 patients with rectal NEC were retrieved respectively from our institution and SEER database. OS or PFS was defined as the major study outcome. Variables were compared by chi-square test and t-test when appropriate. Kaplan–Meier analysis with log-rank test was used for survival analysis and the Cox regression analysis was applied. The nomogram integrating risk factors for predicting OS was constructed by R to achieve superior discriminatory ability. Predictive utility of the nomogram was determined by concordance index (C-index) and calibration curve. Results In the univariate and multivariate analyses, tumor differentiation, N stage, M stage and resection of primary site were identified as independent prognostic indicators. The linear regression relationship was found between the value of Ki-67 index and the duration of OS (P < 0.05). Furthermore, the independent prognostic factors were added to formulate prognostic nomogram. The constructed nomogram showed good performance according to the C-index. Conclusions Contrary to WHO classification guideline, we found that the rectal NEC diseases are heterogeneous and should be divided as different categories according to the pathological differentiation. Besides, the nomogram formulated in this study showed excellent discriminative capability to predict OS for those patients. More advanced predictive model for this disease is required to assist risk stratification via the formulated nomogram.

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