Cancer-related outcomes in oncology patients admitted to physical rehabilitation facilities.

e18643 Background: Admission to a physical rehabilitation facility (RF) can improve mobility and quality of life metrics in cancer patients, however, limited data exist on how these admissions impact cancer-related outcomes. We hypothesized that admissions to a RF following hospitalization delays cancer-directed treatment and increases mortality compared to those who are discharged home. Methods: A retrospective chart review identified oncology patients who were being treated with either intravenous or subcutaneous cancer-directed therapy between 2010-2020 and admitted to either a RF or home following hospitalization. Exclusion criteria were patients not on active cancer-directed treatment or going to hospice. Comparisons of RF vs. home were made using a chi-square test or Fisher’s exact test for categorical outcomes. Median days to next chemotherapy for each group were assessed with Kaplan-Meier/Product-Limit Estimates with a corresponding 95% confidence interval. Results: Of 189 patients, 24 were admitted to a RF and 165 went home. The median age of the study population was 65.6 years, with more males (66.7%) admitted to a RF vs. discharged home (49.7%), and both groups having >50% advanced stage cancer; primarily GI malignancies (25.9%) (Table). There was a statistically significant increase in the percent of patients who experienced delays in the time to their next anticipated chemotherapy date in the RF group vs. home (70.8% vs. 30.3%, P<0.0001), as well as median days to next chemotherapy (38.5 vs. 22, P<0.007). 30-day readmission rates were higher in patients at a RF vs. home (50% vs 29%, P<0.04). There were no significant differences in mortality comparing RF vs. home at 3, 6, or 12 months from the index inpatient hospitalization. Conclusions: Hospitalized oncology patients who were admitted to a RF had significant delays in cancer-directed therapy. Despite the smaller sample size of patients in a RF, their 30-day readmission rates were higher, suggesting a need to carefully select patients who can afford delays in cancer treatment.[Table: see text]

Efficacy of CDK4/6i in the visceral crisis setting: Result from a real-world database.

1047 Background: The combination of the CDK4/6 inhibitors(CDK4/6i) and endocrine therapy has improved overall survival(OS) in patients(pts) with either endocrine sensitive or resistant disease who are not in visceral crisis. The goal of this retrospective analysis of a real world database was to look at the efficacy of CDK4/6i among pts with hormone receptor positive (HR+ve)/HER2-ve metastatic breast cancer(MBC) who present with visceral crisis at diagnosis. Methods: For this analysis, we utilized a federated network of de-identified health data representing approximately 64 million patient lives available through the TriNetX Platform. We identified 5966 pts who had HR+ve/HER2-ve MBC diagnosed between 2015 and 2020. OS was computed using the Kaplan Meier product limit method. Propensity score matching was performed on all comparisons of survival. Visceral crisis was defined as either liver metastases with liver dysfunction, lymphangitis with dyspnea or the presence of pancytopenia. Results: 906(15%) pts received CDK4/6i. OS any time after treatment among pts who did and did not receive CDK4/6i was significantly different (p=0.0002) favoring the group receiving CDK4/6i, with median OS at 59.6 months and 46.2 months and 2-year OS at 71.6% and 61.4% respectively. Among pts who received CDK4/6i versus another treatment as first line therapy, OS was significantly different(HR 0.7, 95%CI 0.57 – 0.86, p<0.0001), and median OS was 59.6 months and 41.5 months respectively. 336 pts with HR+ve mbc presented with visceral crisis at the time of diagnosis of whom 61(18%) received CDK4/6i therapy as first line therapy. Median OS among pts who did and did not have visceral crisis at diagnosis and received treatment was 8.1 months and 210 months respectively. OS any time after initial treatment was significantly different among pts with visceral crisis who did and did not receive CDK4/6i (p=0.01), with 2-year OS at 26.1% and 8.1% and median OS at 11 months and 6 months respectively Conclusions: The use of CDK4/6i in the presence of visceral crisis at diagnosis was associated with a 5 month improvement in OS compared to chemotherapy. Future clinical trials should explore the use of CDK4/6i in the setting of visceral crisis.

Prognostic Autophagy-Related Genes of Gastric Cancer Patients on Chemotherapy

Background Gastric cancer(GC) treated with fluorouracil and cisplatin can cause chemotherapy resistance, which is one of the most common postoperative clinical complications and leads to in poor prognosis. Methods The purpose of this study is to investigate the susceptibility of patients with GC after postoperative chemotherapy based on autophagy-related genes (ATGs). Under the background of TCGA database, for patients with GC undergoing and during chemotherapy,gene expression data was integrated and analyzed. Prognostic genes were screened based on univariate and various analysis regression models. Subjects were divided into two groups: high-risk group and low-risk group. Univariate and various analytical regression models were used to screen for prognostic genes. Median risk score was used for analysis. OS and DFS were evaluated by the product limit estimation method. Subject curve analysis is used to determine the accuracy of the forecast. We also have performed appropriate analysis and conducted some detailed assessments in our work. The differential expression of ATGs was mainly associated with chemotherapy resistance.Results After chemotherapy administration, we have screened 9 ATGs outcomes in the subjects and DFS and OS were precisely predicted by the model of GEO and TCGA databases.Conclusions 9 genes were established as prognostic markers to predict the relationship between ATGs and GC chemotherapy susceptibility, suggesting a better individualized treatment in clinical practice.

Incidence and Demographics of Nasopharyngeal Carcinoma in Cheung Chau Island of Hong Kong – A Distinct Geographical area with Minimal Residential Mobility and Restricted Public Healthcare Referral Network

Background: Nasopharyngeal carcinoma (NPC) is endemic in Hong Kong with a skewed geographical and ethnic distribution. We performed an epidemiological study of NPC in Cheung Chau Island, a fishing village with very minimal residential mobility, and compared its demographics and survival with the rest of Hong Kong.Methods: NPC data in Cheung Chau and non-Cheung Chau residents between 2006 and 2017 treated in our tertiary center were collected. The incidence, stage distribution and mortality of Cheung Chau NPC residents were compared with those of their counterparts in the whole Hong Kong obtained from the Hong Kong Cancer Registry. Propensity score matching (PSM) was performed between Cheung Chau and non-Cheung Chau cases in a 1:4 ratio. Overall Survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) were compared between these two cohorts by product limit estimation and log-rank tests.Results: Sixty-one patients residing in Cheung Chau were identified between 2006 and 2017. There was a significantly higher NPC incidence (P<0.001) but insignificant difference in mortality rate in Cheung Chau compared to the whole Hong Kong data. After PSM with 237 non-Cheung Chau patients, Cheung Chau cohort revealed a stronger NPC family history (P<0.001). However, there were no significant differences in OS (P=0.170), PFS (P=0.053), and CSS (P=0.160) between these two cohorts.Conclusion: Our results revealed that Cheung Chau had a higher NPC incidence but similar survival outcomes compared to the whole Hong Kong. Cheung Chau can provide an excellent model for further studies on NPC oncogenesis and screening.

Prognostic Autophagy-Related Genes of Gastric Cancer Patients on Chemotherapy

Background Chemotherapy resistance based on fluorouracil and cisplatin is one of the most encountered postoperative clinical problems in patients diagnosed with gastric cancer (GC), resulting in poor prognosis. Methods This study aimed to combine autophagy-related genes (ATGs) to investigate the susceptibility of victims with gastric malignancy to postoperative chemotherapy. Based on the TCGA database, gene expression data for GC patients undergoing and during chemotherapy were integrated and analyzed. Prognostic genes were screened based on univariate and various analysis regression models. Subjects were divided into high-risk and low-risk groups and analyzed by the median risk score approach. The product limit estimator method was used to evaluate the OS and DFS. The accuracy of the prediction was resolved by the subject curve analysis. In addition, proper analysis carrying out was done in our work for some detailed assessments. The differential expression of ATGs is mainly related to chemotherapy resistance. Results A total of 9 ATGs of chemotherapy administration outcomes in these suffers were screened. Based on GEO and TCGA databases, the model accurately predicted DFS and OS after chemotherapy administration. Conclusions This study established prognostic markers based on 9 genes, predicting that ATGs are related to chemotherapy susceptibility of GC patients, which can provide better individualized treatment regimens for clinical practice.

Estimation of Bivariate Survival Function from Random Censored Data with Poisson Sample Size

At the present time there are several approaches to estimation of survival functions of vectors of lifetimes. However, some of these estimators either are inconsistent or not fully defined in range of joint survival functions and therefore not applicable in practice. In this article, we consider three types of estimates of exponential-hazard, product-limit, and relative-risk power structures for the bivariate survival function, when replacing the number of summands in empirical estimates with a sequence of Poisson random variables. It is shown that these estimates are asymptotically equivalent. AMS 2000 subject classification: 62N01

Prognostic Autophagy-Related Genes of Gastric Cancer Patients on Chemotherapy

Background, Chemotherapy resistance based on the use of fluorouracil and cisplatin is one of the most encountered clinical problems resulting from post operation and gives rise to poor prognosis in patients diagnosed with gastric cancer (GC). Methods , this study aims to combine autophagy-related genes (ATGs) to provide an investigation of the susceptibility of victims with gastric malignancy to postoperative chemotherapy. Based on the TCGA database, gene expression data for GC patients undergoing and are using chemotherapy were integrated and analyzed. Prognostic genes were screened based on univariate and various analysis regression models. Subjects were divided into those with high and low-risk groups. This was analyzed by the utilization of the median risk score approach. The product limit estimator method had to be used to evaluate the OS and DFS. The accuracy of the prediction was resolved by the subject curve analysis. In addition, the carrying out of proper analysis was done in our work for some detailed assessments. The differential expression of ATGs is mainly related to chemotherapy resistance. Results, a total of 9 ATGs of chemotherapy administration outcomes in these suffers were screened. Based on GEO and TCGA databases, the model accurately predicted DFS and OS after chemotherapy administration. Conclusions, this study established prognostic markers based on 9 genes, which can predict ATGs related to chemotherapy susceptibility of GC patients, and provide better individualized treatment regimens for clinical practice.