Cancer Registries
See also: Registry and Registrar Associations
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ThailandRecent Research Publications
Megwalu UC, Ma Y
Racial Disparities in Oropharyngeal Cancer Stage at Diagnosis.
Anticancer Res. 2017; 37(2):835-839 [PubMed] Related Publications
Racial Disparities in Oropharyngeal Cancer Stage at Diagnosis.
Anticancer Res. 2017; 37(2):835-839 [PubMed] Related Publications
AIM: To evaluate the impact of race on disease stage at diagnosis in patients with oropharyngeal cancer.
PATIENTS AND METHODS: The cohort included 18,791 adult patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012, from the Surveillance, Epidemiology, and End Results 18 Database.
RESULTS: After adjusting for age, sex, marital status, tumor site, and year of diagnosis, black race was associated with increased risk of presenting with Stage III or IV disease (OR 1.24, p=0.016), T3 or T4 tumors (OR 2.16, <0.001), distant metastasis (OR 2, p<0.001), and unresectable tumors (OR 1.65, p<0.001). Race was not associated with risk of presenting with nodal metastasis diagnosis (OR 0.93, p=0.241).
CONCLUSION: Black race is associated with increased risk of advanced disease presentation in oropharyngeal cancer.
PATIENTS AND METHODS: The cohort included 18,791 adult patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012, from the Surveillance, Epidemiology, and End Results 18 Database.
RESULTS: After adjusting for age, sex, marital status, tumor site, and year of diagnosis, black race was associated with increased risk of presenting with Stage III or IV disease (OR 1.24, p=0.016), T3 or T4 tumors (OR 2.16, <0.001), distant metastasis (OR 2, p<0.001), and unresectable tumors (OR 1.65, p<0.001). Race was not associated with risk of presenting with nodal metastasis diagnosis (OR 0.93, p=0.241).
CONCLUSION: Black race is associated with increased risk of advanced disease presentation in oropharyngeal cancer.
Related: 
Oropharyngeal Cancer USA
Oropharyngeal Cancer USA
Prouet P, Giri S, Wiedower E, et al.
Addition of Rituximab to Chemotherapy Reduced the Rate of Surgery for Gastric-DLBCL Without Increasing Early Mortality.
Anticancer Res. 2017; 37(2):813-817 [PubMed] Related Publications
Addition of Rituximab to Chemotherapy Reduced the Rate of Surgery for Gastric-DLBCL Without Increasing Early Mortality.
Anticancer Res. 2017; 37(2):813-817 [PubMed] Related Publications
BACKGROUND: We evaluated surgical trends for gastric diffuse large B-cell lymphoma (gDLBCL) before and after the approval of rituximab and whether an association of early mortality existed in patients treated after approval of rituximab.
PATIENTS AND METHODS: We utilized the Surveillance Epidemiology and End Results (SEER) 18 database to extract data on patients with gDLBCL diagnosed between 1983-2012. Primary site-specific cancer-directed surgery using SEER site-specific surgical codes and annual trends were analyzed. Patients were analyzed before and after 2006, the year rituximab gained U.S. Food and Drug Administration approval.
RESULTS: Joinpoint trend analysis showed the sharpest decline in surgical rates between 2000-2010. Adjusted surgical rates computed using poisson regression declined from 54.4% in 1983 to 6.9% in 2012, with an annual percentage change of -8.9% (95% confidence interval=-9.7% to -8.3%; p-value <0.01). No significant mortality increase at 30 and 60 days was found.
CONCLUSION: While rituximab appears to have significantly changed how surgery is utilized for patients with gDLBCL, early mortality was unchanged.
PATIENTS AND METHODS: We utilized the Surveillance Epidemiology and End Results (SEER) 18 database to extract data on patients with gDLBCL diagnosed between 1983-2012. Primary site-specific cancer-directed surgery using SEER site-specific surgical codes and annual trends were analyzed. Patients were analyzed before and after 2006, the year rituximab gained U.S. Food and Drug Administration approval.
RESULTS: Joinpoint trend analysis showed the sharpest decline in surgical rates between 2000-2010. Adjusted surgical rates computed using poisson regression declined from 54.4% in 1983 to 6.9% in 2012, with an annual percentage change of -8.9% (95% confidence interval=-9.7% to -8.3%; p-value <0.01). No significant mortality increase at 30 and 60 days was found.
CONCLUSION: While rituximab appears to have significantly changed how surgery is utilized for patients with gDLBCL, early mortality was unchanged.
Wu HC, Southey MC, Hibshoosh H, et al.
DNA Methylation in Breast Tumor from High-risk Women in the Breast Cancer Family Registry.
Anticancer Res. 2017; 37(2):659-664 [PubMed] Related Publications
DNA Methylation in Breast Tumor from High-risk Women in the Breast Cancer Family Registry.
Anticancer Res. 2017; 37(2):659-664 [PubMed] Related Publications
To examine DNA methylation profiles in breast tumors of women with a strong breast cancer family history, we measured methylation by bisulfite sequencing in 40 genes in 40 breast tumor tissues from women in the Breast Cancer Family Registry. We selected candidate genes from analysis of the Cancer Genome Atlas project (TCGA) breast data. Compared to TCGA breast cancer, BCFR cases are younger and more likely to be ER-negative. Overall, we found that many of the methylation differences between BCFR tumor and normal adjacent tissues were smaller than that in TCGA samples. We found only 32% of tested genes were hypermethylated in BCFR; the largest difference was 36.1% for SEPW1, and the smallest difference was 10% for RYR2. These data suggest the importance of examining breast cancer cases including familial cases enriched with early-onset cancers to identify methylation markers that can be examined in blood as biomarkers for early detection.
Related: Breast Cancer
Breast Cancer
Nayar P, Chandak A, Gupta N, et al.
Postoperative mortality following multi-modality therapy for pancreatic cancer: Analysis of the SEER-Medicare data.
J Surg Oncol. 2017; 115(2):158-163 [PubMed] Related Publications
Postoperative mortality following multi-modality therapy for pancreatic cancer: Analysis of the SEER-Medicare data.
J Surg Oncol. 2017; 115(2):158-163 [PubMed] Related Publications
BACKGROUND AND OBJECTIVES: The objective of this study was to examine post-operative mortality for elderly pancreatic cancer patients treated with multi-modality therapy.
METHODS: Surveillance Epidemiology and End Results (SEER) Medicare linked data were used to examine differences in mortality between patients who underwent pancreatectomy alone and those who had early (within 12 weeks) and late (after 12 weeks) adjuvant therapy (chemotherapy and/or radiotherapy).
RESULTS: Among 4,105 patients who underwent pancreatectomy between 1991 and 2008, 1-year mortality (Odds Ratio [OR] = 0.71; P-value = 0.000; 95% Confidence Interval [CI]: 0.60-0.85) and 6-month mortality (OR = 0.44; P-value = 0.000; 95%CI: 0.35-0.53) following pancreatectomy were significantly lower in the group that underwent pancreatectomy with early adjuvant therapy. Late adjuvant therapy group also had lower 1 year (OR = 0.51; P-value = 0.000; 95%CI: 0.43-0.61) and 6 months (OR = 0.14; P-value = 0.000; 95%CI: 0.10-0.17) mortality, compared to surgery alone.
CONCLUSIONS: Post-operative outcomes were better for patients treated with surgery with adjuvant therapy, with the late adjuvant therapy group having the best outcomes (lowest odds of 6 month and 1-year mortality following surgery). J. Surg. Oncol. 2017;115:158-163. © 2017 Wiley Periodicals, Inc.
METHODS: Surveillance Epidemiology and End Results (SEER) Medicare linked data were used to examine differences in mortality between patients who underwent pancreatectomy alone and those who had early (within 12 weeks) and late (after 12 weeks) adjuvant therapy (chemotherapy and/or radiotherapy).
RESULTS: Among 4,105 patients who underwent pancreatectomy between 1991 and 2008, 1-year mortality (Odds Ratio [OR] = 0.71; P-value = 0.000; 95% Confidence Interval [CI]: 0.60-0.85) and 6-month mortality (OR = 0.44; P-value = 0.000; 95%CI: 0.35-0.53) following pancreatectomy were significantly lower in the group that underwent pancreatectomy with early adjuvant therapy. Late adjuvant therapy group also had lower 1 year (OR = 0.51; P-value = 0.000; 95%CI: 0.43-0.61) and 6 months (OR = 0.14; P-value = 0.000; 95%CI: 0.10-0.17) mortality, compared to surgery alone.
CONCLUSIONS: Post-operative outcomes were better for patients treated with surgery with adjuvant therapy, with the late adjuvant therapy group having the best outcomes (lowest odds of 6 month and 1-year mortality following surgery). J. Surg. Oncol. 2017;115:158-163. © 2017 Wiley Periodicals, Inc.
Henley SJ, Singh SD, King J, et al.
Invasive Cancer Incidence and Survival - United States, 2013.
MMWR Morb Mortal Wkly Rep. 2017; 66(3):69-75 [PubMed] Related Publications
Invasive Cancer Incidence and Survival - United States, 2013.
MMWR Morb Mortal Wkly Rep. 2017; 66(3):69-75 [PubMed] Related Publications
Although cancer represents many heterogeneous diseases, some cancer types share common risk factors. For example, conclusive evidence links cancer at multiple sites with tobacco use, alcohol use, human papillomavirus (HPV) infection, excess body weight, and physical inactivity (1,2). To monitor changes in cancer incidence and assess progress toward achieving Healthy People 2020 objectives,* CDC analyzed data from the U.S. Cancer Statistics (USCS) data set for 2013, the most recent year for which incidence and survival data are available. In 2013, a total of 1,559,130 invasive cancers were reported to cancer registries in the United States (excluding Nevada), for an annual age-adjusted incidence rate of 439 cases per 100,000 persons. Cancer incidence rates were higher among males (479) than females (413), highest among blacks (444), and ranged by state from 364 (New Mexico) to 512 (Kentucky) per 100,000 persons (359 in Puerto Rico). The proportion of persons with cancer who survived ≥5 years after diagnosis was 67%. This proportion was the same for males and females (67%), but lower among blacks (62%) than among whites (67%). Cancer surveillance data are key to cancer epidemiologic and clinical outcomes research, program planning and monitoring, resource allocation, and state and federal appropriations accountability.
Related: Cancer Prevention and Risk Reduction USA
Cancer Prevention and Risk Reduction USA
Announcement: 25th Anniversary of National Program of Cancer Registries, 1992-2017.
MMWR Morb Mortal Wkly Rep. 2017; 66(3):92 [PubMed] Related Publications
This year marks the 25th anniversary of the Cancer Registries Amendment Act (Public Law 102-515), which established the National Program of Cancer Registries (NPCR) administered by CDC (1). NPCR collects high quality data on cancer occurrence (including the type, extent, and location of the cancer), type of initial treatment, and outcomes. NPCR supports cancer registries in 45 states, the District of Columbia, Puerto Rico, and U.S. Pacific Island jurisdictions, covering 96% of all cancers diagnosed in the United States.
Related: Cancer Prevention and Risk Reduction USA
Cancer Prevention and Risk Reduction USA
Wang H, Zhang C, Kong L, et al.
Better survival in PMRT of female breast cancer patients with >5 negative lymph nodes: A population-based study.
Medicine (Baltimore). 2017; 96(4):e5998 [PubMed] Free Access to Full Article Related Publications
Better survival in PMRT of female breast cancer patients with >5 negative lymph nodes: A population-based study.
Medicine (Baltimore). 2017; 96(4):e5998 [PubMed] Free Access to Full Article Related Publications
Many studies have confirmed the role of postmastectomy radiotherapy (PMRT) for breast cancer patients with at least 4 lymph nodes invasion in the postoperative therapy. Recently, the number of negative lymph nodes (NLNs) has been increasingly paid attention to and recognized as a prognostic indicator in different kinds of caners. Therefore, it is very necessary to study the association between the number of NLNs and the prognosis of PMRT in breast cancer patients. In our study, we used Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 16,686 breast cancer patients to explore their correlation. The ROC curve and the log-rank χ test were applied to determine the appropriate cutoff point of the number of NLNs and 5 was selected as the cutoff point. Furthermore, the cutoff point 5 was validated as an independent prognostic factor affecting cancer-specific survival (CSS) and overall survival (OS) in breast cancer patients, as confirmed by both univariate and multivariate analysis (P < 0.001). In addition, subgroup analysis showed that the number of NLNs >5 can be a prognostic indicator in patients with PMRT according to different clinical variables (all, P < 0.001). Importantly, our results showed that PMRT obviously improved CSS and OS in patients regardless of the number of NLNs (P < 0.001). In conclusion, our study showed the number of NLNs is an independent prognostic factor for breast cancer patients with PMRT, and those who have higher number of NLNs have an increased CSS and OS.
Related: Breast Cancer USA
Breast Cancer USA
Waseem D, Tushar P
Intrahepatic, perihilar and distal cholangiocarcinoma: Management and outcomes.
Ann Hepatol. 2017 Jan-Feb 2017; 16(1):133-139 [PubMed] Related Publications
Intrahepatic, perihilar and distal cholangiocarcinoma: Management and outcomes.
Ann Hepatol. 2017 Jan-Feb 2017; 16(1):133-139 [PubMed] Related Publications
Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsistent use of nomenclature for these cancers has obscured a true knowledge of the epidemiology, natural history and response to therapy of these cancers. Our aims were to define demographic characteristics, management and outcomes of these three distinct cancer types.
MATERIALS AND METHODS: A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis.
RESULTS: 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma.
CONCLUSION: Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.
MATERIALS AND METHODS: A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis.
RESULTS: 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma.
CONCLUSION: Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.
Megwalu UC
Observation versus thyroidectomy for papillary thyroid microcarcinoma in the elderly.
J Laryngol Otol. 2017; 131(2):173-176 [PubMed] Related Publications
Observation versus thyroidectomy for papillary thyroid microcarcinoma in the elderly.
J Laryngol Otol. 2017; 131(2):173-176 [PubMed] Related Publications
OBJECTIVE: To compare the effectiveness of non-surgical versus surgical therapy in elderly patients with papillary thyroid microcarcinoma.
METHODS: The study cohort included 2323 elderly patients (aged 65 years and over) diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
RESULTS: The five-year overall survival rate was 23 per cent for non-surgical patients compared with 91 per cent for surgical patients (p < 0.0001). Unadjusted analysis revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.06; p < 0.0001). Propensity score analysis also revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.11; p < 0.0001).
CONCLUSION: Thyroidectomy appears to provide a survival benefit for elderly patients with papillary thyroid microcarcinoma. High-quality prospective studies are needed to better evaluate the comparative effectiveness of immediate thyroidectomy versus observation for elderly patients with papillary thyroid microcarcinoma.
METHODS: The study cohort included 2323 elderly patients (aged 65 years and over) diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
RESULTS: The five-year overall survival rate was 23 per cent for non-surgical patients compared with 91 per cent for surgical patients (p < 0.0001). Unadjusted analysis revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.06; p < 0.0001). Propensity score analysis also revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.11; p < 0.0001).
CONCLUSION: Thyroidectomy appears to provide a survival benefit for elderly patients with papillary thyroid microcarcinoma. High-quality prospective studies are needed to better evaluate the comparative effectiveness of immediate thyroidectomy versus observation for elderly patients with papillary thyroid microcarcinoma.
Related: Thyroid Cancer
Thyroid Cancer
Bai L, Wang F, Li ZZ, et al.
Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer: Results of a registry-based cohort analysis.
Medicine (Baltimore). 2016; 95(51):e4531 [PubMed] Free Access to Full Article Related Publications
Chemotherapy plus bevacizumab versus chemotherapy plus cetuximab as first-line treatment for patients with metastatic colorectal cancer: Results of a registry-based cohort analysis.
Medicine (Baltimore). 2016; 95(51):e4531 [PubMed] Free Access to Full Article Related Publications
The present observational cohort study was designed to elucidate the efficacy and safety profile of bevacizumab or cetuximab with chemotherapy as the first-line treatment in Chinese patients with metastatic colorectal cancer (mCRC). Clinical data were collected from a single-center registry study where mCRC patients received first-line fluoropyrimidine-based chemotherapy combined with either bevacizumab (188 patients with KRAS wild-type or mutated tumors) or cetuximab (101 patients with KRAS wild-type tumors) between January 2009 and December 2013. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for estimating the prognostic and predictive values of clinicopathological characteristics. No statistically significant difference was observed between the bevacizumab and cetuximab groups in terms of median progression-free survival (PFS) (10.6 vs 8.7 months, P = 0.317), median overall survival (OS) (27.7 vs 28.3 months, P = 0.525), or overall response rate (43.1% vs 53.5%, P = 0.108). For the subset of patients with peritoneal dissemination, bevacizumab-based triplet appears to be superior to cetuximab-based triplet as measured by PFS (9.6 vs 6.1 months) and OS (26.3 vs 12.7 months), but not for patients without peritoneal dissemination (PFS, 10.6 vs 9.1 months; OS, 27.9 vs 30.7 months) (all unadjusted and adjusted interaction P < 0.05). Our study suggests that bevacizumab- or cetuximab-based regimens have similar effectiveness as first-line treatment of mCRC in Chinese population. Patients with peritoneal dissemination were likely to gain more benefit from bevacizumab than cetuximab treatment. Future prospective studies are required to further confirm these results.
Megwalu UC, Saini AT
Racial disparities in papillary thyroid microcarcinoma survival.
J Laryngol Otol. 2017; 131(1):83-87 [PubMed] Related Publications
Racial disparities in papillary thyroid microcarcinoma survival.
J Laryngol Otol. 2017; 131(1):83-87 [PubMed] Related Publications
OBJECTIVE: To evaluate the impact of race on survival in patients with papillary thyroid microcarcinoma.
METHODS: The study cohort included 17 668 patients diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
RESULTS: Black patients had lower overall survival than other racial groups (p < 0.001). Black patients had significantly worse overall survival (hazard ratio = 2.59) after adjusting for sex, marital status, age, year of diagnosis, multifocal disease and type of surgery. A subset analysis of Black patients revealed no significant difference in overall survival for total thyroidectomy versus lobectomy (p = 0.15).
CONCLUSION: Black race is a negative prognostic factor in thyroid cancer, which cannot be explained by advanced disease stage. Further research on mechanisms by which race affects survival is needed to reveal areas of opportunity for interventions aimed at reducing health disparities in cancer care.
METHODS: The study cohort included 17 668 patients diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
RESULTS: Black patients had lower overall survival than other racial groups (p < 0.001). Black patients had significantly worse overall survival (hazard ratio = 2.59) after adjusting for sex, marital status, age, year of diagnosis, multifocal disease and type of surgery. A subset analysis of Black patients revealed no significant difference in overall survival for total thyroidectomy versus lobectomy (p = 0.15).
CONCLUSION: Black race is a negative prognostic factor in thyroid cancer, which cannot be explained by advanced disease stage. Further research on mechanisms by which race affects survival is needed to reveal areas of opportunity for interventions aimed at reducing health disparities in cancer care.
Related: Thyroid Cancer USA
Thyroid Cancer USA
Bakhsheshian J, Jin DL, Chang KE, et al.
Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database.
Neurosurg Focus. 2016; 41(6):E8 [PubMed] Related Publications
Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database.
Neurosurg Focus. 2016; 41(6):E8 [PubMed] Related Publications
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma. Patient-level factors, including age, race, comorbidities, and insurance type, as well as hospital factors were collected. Outcomes analyzed included mortality rate, endocrine and nonendocrine complications, hospital charges, and length of stay. A multivariate model controlling for variables analyzed was constructed to examine significant independent risk factors. RESULTS Between 2000 and 2011, 1961 pediatric patients were identified who underwent a transcranial (71.2%) or a transsphenoidal (28.8%) craniotomy for resection of a craniopharyngioma. A major predilection for age was observed with the selection of a transcranial (23.4% in < 7-year-olds, 28.1% in 7- to 12-year-olds, and 19.7% in 13- to 18-year-olds) versus transphenoidal (2.9% in < 7-year-olds, 7.4% in 7- to 12-year-olds, and 18.4% in 13- to 18-year-olds) approach. No significant outcomes were associated with a particular surgical approach, except that 7- to 12-year-old patients had a higher risk of nonendocrine complications (relative risk [RR] 2.42, 95% CI 1.04-5.65, p = 0.04) with the transsphenoidal approach when compared with 13- to 18-year-old patients. The overall inpatient mortality rate was 0.5% and the most common postoperative complication was diabetes insipidus (64.2%). There were no independent factors associated with inpatient mortality rates and no significant differences in outcomes among groups based on sex and race. The average length of stay was 11.8 days, and the mean hospital charge was $116,5 22. Hospitals with medium and large bed capacity were protective against nonendocrine complications (RR 0.53, 95% CI 0.3-0.93, p = 0.03 [medium]; RR 0.45, 95% CI 0.25-0.8, p < 0.01 [large]) and total complications (RR 0.73, 95% CI 0.55-0.97, p = 0.03 [medium]; RR 0.68, 95% CI 0.51-0.9, p < 0.01 [large]) when compared with hospitals with small bed capacity (< 200 beds). Patients admitted to rural hospitals had an increased risk for nonendocrine complications (RR 2.56, 95% CI 1.11-5.9, p = 0.03). The presence of one or more medical comorbidities increased the risk of higher total complications (RR 1.38, 95% CI 1.14-1.68), p < 0.01 [1 comorbidity]; RR 2.37, 95% CI 1.98-2.84, p < 0.01 [≥ 2 comorbidities]) and higher total hospital charges (RR 2.9, 95% CI 1.08-7.81, p = 0.04 [1 comorbidity]; RR 9.1, 95% CI 3.74-22.12, p < 0.01 [≥ 2 comorbidities]). CONCLUSIONS This analysis identified patient age, comorbidities, insurance type, hospital bed capacity, and rural or nonteaching hospital status as independent risk factors for postoperative complications and/or increased hospital charges in pediatric patients with craniopharyngioma. Transsphenoidal surgery in younger patients with craniopharyngioma was a risk factor for nonendocrine complications.
Chiou WY, Chen CA, Lee MS, et al.
Pelvic inflammatory disease increases the risk of a second primary malignancy in patients with cervical cancer treated by surgery alone.
Medicine (Baltimore). 2016; 95(47):e5409 [PubMed] Free Access to Full Article Related Publications
Pelvic inflammatory disease increases the risk of a second primary malignancy in patients with cervical cancer treated by surgery alone.
Medicine (Baltimore). 2016; 95(47):e5409 [PubMed] Free Access to Full Article Related Publications
As the number of long-term cervical cancer survivors continues to increase because of improvements in treatment, concerns about second primary malignancy have grown. The high-risk area of second primary cancers in cervical cancer survivors is the pelvis. Pelvic inflammatory disease (PID) could be a useful marker for gynecological cancers. Thus, we designed a large-scale, nationwide, controlled cohort study to investigate whether PID or other risk factors increased the risk of second primary cancers in patients with cervical cancer treated by surgery alone.Between 2000 and 2010, a total of 24,444 cervical cancer patients were identified using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan. Patients who received definite surgery were selected. To exclude the effect on second primary malignancy by treatment modalities, all cervical patients who ever having received adjuvant or definite radiotherapy or chemotherapy for primary cervical cancer were excluded. Finally, 3860 cervical cancer patients treated by surgery alone without adjuvant treatments were analyzed.Cox proportional hazards model was used for multivariate analysis and the Kaplan-Meier method was used to assess the cumulative risks. Regarding the incidence of second primary cancers, the standardized incidence ratio (SIR) was used.The median follow-up time was 56.6 months. The 6-year cumulative risk of second primary cancers is 0.16% and 0.12% for PID and without PID, respectively. After adjustment for confounders, age of less than 50 years, the presence of diabetes mellitus, and PID were significantly positivity associated with the risk of second primary cancers. The hazard ratios (HRs) of age less than 50 years, diabetes mellitus, and PID were 1.38 (95% CI = 1.11-2.04), 1.40 (95% CI = 1.06-1.85), and 1.35 (95% CI = 1.00-1.81), respectively. A higher incidence of second primary cancers was observed in the genitals, bladder, and colon.In conclusion, the incidence of second primary cancers was higher in the genitals, bladder, and colon in patients with cervical cancer treated with surgery alone. The patients with PID had a higher risk of second primary cancers.
Related: Cervical Cancer
Cervical Cancer
Fu J, Wu L, Jiang M, et al.
Signet ring cell carcinoma of resectable metastatic colorectal cancer has rare surgical value.
J Surg Oncol. 2016; 114(8):1004-1008 [PubMed] Related Publications
Signet ring cell carcinoma of resectable metastatic colorectal cancer has rare surgical value.
J Surg Oncol. 2016; 114(8):1004-1008 [PubMed] Related Publications
BACKGROUND AND OBJECTIVES: Signet ring cell carcinoma (SRCC) is a uniquely separated subgroup in metastatic colorectal cancer (mCRC). The aims are to investigate the value of resection in patients with resectable metastatic signet ring cell colorectal cancer.
METHODS: Patients with mCRC who underwent resection in Surveillance, Epidemiology, and End Results database during 1998-2010 were retrospectively analyzed. Kaplan-Meier and COX models were used to analyze the differences in the survival. Logistic regression models were used to evaluate the relationship between SRCC and other clinicopathological factors.
RESULTS: Among the 3,568 patients, 94 (2.63%) patients had SRCC. The median survival time of patients with SRCC and non-SRCC were 17 and 29 months, respectively (P < 0.001). Multivariate analysis indicated that SRCC was an independent prognostic factor for poor overall survival. Logistic regression model based on variables identified by univariate analysis indicated that younger age (≤50 years old) (P = 0.005), female (P < 0.001), location in colon (P = 0.012), and N positive status (P = 0.003) were independent variables correlated with the SRCC subgroup. SRCC had a dramatically higher invalid surgical outcome rate than non-SRCC (P = 0.001).
CONCLUSION: SRCC patients might benefit little from the resection of primary and metastatic lesions with a high rate of undergoing invalid operations. J. Surg. Oncol. 2016;114:1004-1008. © 2016 Wiley Periodicals, Inc.
METHODS: Patients with mCRC who underwent resection in Surveillance, Epidemiology, and End Results database during 1998-2010 were retrospectively analyzed. Kaplan-Meier and COX models were used to analyze the differences in the survival. Logistic regression models were used to evaluate the relationship between SRCC and other clinicopathological factors.
RESULTS: Among the 3,568 patients, 94 (2.63%) patients had SRCC. The median survival time of patients with SRCC and non-SRCC were 17 and 29 months, respectively (P < 0.001). Multivariate analysis indicated that SRCC was an independent prognostic factor for poor overall survival. Logistic regression model based on variables identified by univariate analysis indicated that younger age (≤50 years old) (P = 0.005), female (P < 0.001), location in colon (P = 0.012), and N positive status (P = 0.003) were independent variables correlated with the SRCC subgroup. SRCC had a dramatically higher invalid surgical outcome rate than non-SRCC (P = 0.001).
CONCLUSION: SRCC patients might benefit little from the resection of primary and metastatic lesions with a high rate of undergoing invalid operations. J. Surg. Oncol. 2016;114:1004-1008. © 2016 Wiley Periodicals, Inc.
Related: Colorectal (Bowel) Cancer
Colorectal (Bowel) Cancer
Sperling CD, Verdoodt F, Friis S, et al.
Statin use and risk of endometrial cancer: a nationwide registry-based case-control study.
Acta Obstet Gynecol Scand. 2017; 96(2):144-149 [PubMed] Related Publications
Statin use and risk of endometrial cancer: a nationwide registry-based case-control study.
Acta Obstet Gynecol Scand. 2017; 96(2):144-149 [PubMed] Related Publications
INTRODUCTION: Laboratory and epidemiological evidence have suggested that statin use may protect against the development of certain cancers, including endometrial cancer. In a nationwide registry-based case-control study, we examined the association between statin use and risk of endometrial cancer.
MATERIAL AND METHODS: Cases were female residents of Denmark with a primary diagnosis of endometrial cancer during 2000-2009. For each case, we selected 15 female population controls matched on date of birth (±one month) using risk-set sampling. Ever use of statin was defined as two or more prescriptions on separate dates. Conditional logistic regressions were used to estimate age-matched (by design) and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CI) for endometrial cancer associated with statin use. The multivariable-adjusted models included parity, hormone replacement therapy (HRT), obesity, diabetes, chronic obstructive pulmonary disease and education. We evaluated whether the association between statin use and endometrial cancer varied with duration and intensity of statin use, type of endometrial cancer or patient characteristics.
RESULTS: The study population comprised 5382 endometrial cancer cases and 72 127 population controls. We observed no association between ever use of statins and endometrial cancer risk (OR 1.03, 95% CI 0.94-1.14). In addition, endometrial cancer risk did not vary substantially with duration or intensity of statin use. Stratification by type of endometrial cancer also yielded neutral ORs.
CONCLUSIONS: In our nationwide case-control study, we found no association between statin use and risk of endometrial cancer.
MATERIAL AND METHODS: Cases were female residents of Denmark with a primary diagnosis of endometrial cancer during 2000-2009. For each case, we selected 15 female population controls matched on date of birth (±one month) using risk-set sampling. Ever use of statin was defined as two or more prescriptions on separate dates. Conditional logistic regressions were used to estimate age-matched (by design) and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CI) for endometrial cancer associated with statin use. The multivariable-adjusted models included parity, hormone replacement therapy (HRT), obesity, diabetes, chronic obstructive pulmonary disease and education. We evaluated whether the association between statin use and endometrial cancer varied with duration and intensity of statin use, type of endometrial cancer or patient characteristics.
RESULTS: The study population comprised 5382 endometrial cancer cases and 72 127 population controls. We observed no association between ever use of statins and endometrial cancer risk (OR 1.03, 95% CI 0.94-1.14). In addition, endometrial cancer risk did not vary substantially with duration or intensity of statin use. Stratification by type of endometrial cancer also yielded neutral ORs.
CONCLUSIONS: In our nationwide case-control study, we found no association between statin use and risk of endometrial cancer.
Plato N, Martinsen JI, Sparén P, et al.
Occupation and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban.
Epidemiol Health. 2016; 38:e2016039 [PubMed] Free Access to Full Article Related Publications
Occupation and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban.
Epidemiol Health. 2016; 38:e2016039 [PubMed] Free Access to Full Article Related Publications
OBJECTIVES: We updated the Swedish component of the Nordic Occupational Cancer (NOCCA) Study through 2009 in order to investigate the incidence of mesothelioma of the peritoneum and pleura in both genders, and explored occupational exposures that may be associated with mesothelioma.
METHODS: The Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort were linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009, and then further linked to the Swedish NOCCA job-exposure matrix, which includes 25 carcinogenic substances and the corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardized incidence ratios (SIRs) for mesothelioma of the peritoneum and pleura by gender, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously.
RESULTS: A total of 3,716 incident mesotheliomas were recorded (21.1% in women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as clear differences between the genders. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers (SIR, 4.99; 95% confidence interval, 4.20 to 5.90). Among women, increased risks were observed in sewing workers, canning workers, packers, cleaners, and postal workers. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma.
CONCLUSIONS: Asbestos exposure was associated with mesothelioma incidence in our study. The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort. Among women, the occupations of canning workers and cleaners showed increased risks of mesothelioma of the pleura without evidence of asbestos exposure.
METHODS: The Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort were linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009, and then further linked to the Swedish NOCCA job-exposure matrix, which includes 25 carcinogenic substances and the corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardized incidence ratios (SIRs) for mesothelioma of the peritoneum and pleura by gender, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously.
RESULTS: A total of 3,716 incident mesotheliomas were recorded (21.1% in women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as clear differences between the genders. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers (SIR, 4.99; 95% confidence interval, 4.20 to 5.90). Among women, increased risks were observed in sewing workers, canning workers, packers, cleaners, and postal workers. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma.
CONCLUSIONS: Asbestos exposure was associated with mesothelioma incidence in our study. The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort. Among women, the occupations of canning workers and cleaners showed increased risks of mesothelioma of the pleura without evidence of asbestos exposure.
Related: Mesothelioma
Mesothelioma
Hammer A, Kahlert J, Rositch A, et al.
The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark: a population-based cohort study.
Acta Obstet Gynecol Scand. 2017; 96(2):150-157 [PubMed] Related Publications
The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark: a population-based cohort study.
Acta Obstet Gynecol Scand. 2017; 96(2):150-157 [PubMed] Related Publications
INTRODUCTION: Hysterectomy is a common gynecological procedure; however, the incidence of total and subtotal hysterectomy varies across countries, by age, and over time. As only women with an intact cervix are at risk of cervical cancer, failing to remove hysterectomized women from the denominator may underestimate the cervical cancer incidence. We aimed to describe the temporal and age-dependent patterns of cervical cancer incidence in Denmark before and after correction for hysterectomy.
MATERIAL AND METHODS: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000-11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator.
RESULTS: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95% CI 17.3-18.3). After correction for hysterectomy, the rate increased by 8.4% to 19.3/100 000 person-years (95% CI 18.8-19.9). The highest uncorrected incidence was seen in women aged 35-39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75-79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence.
CONCLUSIONS: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35-39 years to age 75-79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60-65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.
MATERIAL AND METHODS: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000-11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator.
RESULTS: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95% CI 17.3-18.3). After correction for hysterectomy, the rate increased by 8.4% to 19.3/100 000 person-years (95% CI 18.8-19.9). The highest uncorrected incidence was seen in women aged 35-39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75-79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence.
CONCLUSIONS: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35-39 years to age 75-79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60-65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.
Related: Cervical Cancer
Cervical Cancer
Yamasaki S, Hirakawa A, Aoki J, et al.
Role of reduced-intensity conditioning allogeneic hematopoietic cell transplantation in older patients with de novo acute myeloid leukemia.
Ann Hematol. 2017; 96(2):289-297 [PubMed] Related Publications
Role of reduced-intensity conditioning allogeneic hematopoietic cell transplantation in older patients with de novo acute myeloid leukemia.
Ann Hematol. 2017; 96(2):289-297 [PubMed] Related Publications
Reduced-intensity conditioning (RIC) regimens extend the therapeutic use of allogeneic hematopoietic cell transplantation (HCT) to older patients. The survival trend in 2325 patients aged >50 years presenting with de novo acute myeloid leukemia (AML) who underwent first reduced-intensity HCT (RIC-HCT) was assessed by retrospectively analyzing outcomes between 2000 and 2013. The annual number of RIC-HCTs in Japan was higher in the 2008-2013 period (n = 205/year [1229/6 years]) than in the 2000-2007 period (n = 137/year [1096/8 years]). Overall and disease-free survival were higher in the 2008-2013 period (P < 0.001) because of the improvement in transplant-related mortality (TRM). Survival regarding RIC-HCT for AML has improved over time, with an increased number of RIC-HCTs in patients with a Karnofsky performance status (KPS) ≥80. However, TRM remains high and the relapse rate has not improved over time. Multivariate analyses showed that a KPS ≥80 and complete remission at HCT were associated with less TRM and relapse, and better survival regardless of age ≥65 years. Accurate timing and prospective identification of patients at risk of TRM may aid the development of risk-adapted strategies for RIC-HCT in AML patients regardless of age.
Related: Acute Myeloid Leukemia (AML)
Acute Myeloid Leukemia (AML)
Tchelebi L, Guirguis A, Ashamalla H
Rectal melanoma: epidemiology, prognosis, and role of adjuvant radiation therapy.
J Cancer Res Clin Oncol. 2016; 142(12):2569-2575 [PubMed] Related Publications
Rectal melanoma: epidemiology, prognosis, and role of adjuvant radiation therapy.
J Cancer Res Clin Oncol. 2016; 142(12):2569-2575 [PubMed] Related Publications
PURPOSE: Rectal melanoma (RM) is a lethal malignancy which is not well understood. While cases are rising, data concerning effective management are limited. The present paper sought to elucidate the epidemiology and prognosis of RM, while also analyzing the role of adjuvant radiation therapy (RT).
METHODS: We used the surveillance, epidemiology, and end results program to find all cases of RM diagnosed between 2004 and 2011. Patients 18 or older with non-metastatic disease who had undergone surgery were included. Data regarding the age, race, sex, marital status, stage, and radiation sequence with surgery were extracted from the database and analyzed. Disease-free (DFS) and overall survival (OS) was studied for the group overall and between subgroups.
RESULTS: Median age at diagnosis was 69 years. RM is significantly more common in whites compared to nonwhites and occurs equally in males and females. Most patients are diagnosed at an early stage. Prognosis is poor with a median DFS of 27 months and median OS of 22 months. There were no differences in outcomes based on age, sex, marital status, or stage; however, OS was improved in nonwhites as compared to whites (P = 0.04). RT did not improve DFS (27 vs 28 months for surgery vs surgery and radiation, P = 0.82) or OS (19 vs 22 months for surgery vs surgery and radiation P=0.80) regardless of stage.
CONCLUSIONS: RM is an aggressive disease primarily affecting older, white patients. RT does not improve survival, regardless of stage. Optimal management of this lethal disease remains to be elucidated.
METHODS: We used the surveillance, epidemiology, and end results program to find all cases of RM diagnosed between 2004 and 2011. Patients 18 or older with non-metastatic disease who had undergone surgery were included. Data regarding the age, race, sex, marital status, stage, and radiation sequence with surgery were extracted from the database and analyzed. Disease-free (DFS) and overall survival (OS) was studied for the group overall and between subgroups.
RESULTS: Median age at diagnosis was 69 years. RM is significantly more common in whites compared to nonwhites and occurs equally in males and females. Most patients are diagnosed at an early stage. Prognosis is poor with a median DFS of 27 months and median OS of 22 months. There were no differences in outcomes based on age, sex, marital status, or stage; however, OS was improved in nonwhites as compared to whites (P = 0.04). RT did not improve DFS (27 vs 28 months for surgery vs surgery and radiation, P = 0.82) or OS (19 vs 22 months for surgery vs surgery and radiation P=0.80) regardless of stage.
CONCLUSIONS: RM is an aggressive disease primarily affecting older, white patients. RT does not improve survival, regardless of stage. Optimal management of this lethal disease remains to be elucidated.
Related: Melanoma
Melanoma
Ilahi NE, Anwar S, Noreen M, et al.
Detection of human papillomavirus-16 DNA in archived clinical samples of breast and lung cancer patients from North Pakistan.
J Cancer Res Clin Oncol. 2016; 142(12):2497-2502 [PubMed] Related Publications
Detection of human papillomavirus-16 DNA in archived clinical samples of breast and lung cancer patients from North Pakistan.
J Cancer Res Clin Oncol. 2016; 142(12):2497-2502 [PubMed] Related Publications
PURPOSE: Over the past few decades, human papillomavirus (HPV) has been recorded as a key player in the development of various genital cancers, most notably cervical cancer. It has also been associated with some non-genital cancers. A subset of oropharyngeal cancers are known to be caused by HPV. Its aetiological involvement has been suggested for breast and lung cancer as well. However, reports regarding the HPV DNA detection vary widely from different parts of the world. Due to scarcity of local data in this regard, the current study aimed at retrospective detection of HPV presence in the archival samples of breast and lung cancer patients from north part of the country.
METHODS: A total of 55 formalin-fixed paraffin-embedded tissue sections of invasive ductal carcinoma of breast (n = 46) and lung (n = 9) were collected for this study. Genotyping for HPV16 and 18 was carried out through PCR.
RESULTS: HPV16 DNA was found in both breast and lung carcinoma samples with the prevalence rate of 17 and 11 %, respectively. An interesting association was found between ER/PR (Oestrogen/Progesterone receptor) and HER2/Neu (Human epidermal growth factor receptor-2) positivity with HPV occurrence in breast tumours.
CONCLUSION: Current study shows the presence of HPV16 DNA in archived clinical biopsy sections from breast and lung cancers (17, 11 %), respectively. A positive correlation of HPV16 presence was found with ER/PR and HER2-positive breast cancers. These initial findings warrant further investigation in order to determine HPV prevalence and aetiological role in local cancers, especially in ER/PR/HER2-positive breast cancers on a larger scale.
METHODS: A total of 55 formalin-fixed paraffin-embedded tissue sections of invasive ductal carcinoma of breast (n = 46) and lung (n = 9) were collected for this study. Genotyping for HPV16 and 18 was carried out through PCR.
RESULTS: HPV16 DNA was found in both breast and lung carcinoma samples with the prevalence rate of 17 and 11 %, respectively. An interesting association was found between ER/PR (Oestrogen/Progesterone receptor) and HER2/Neu (Human epidermal growth factor receptor-2) positivity with HPV occurrence in breast tumours.
CONCLUSION: Current study shows the presence of HPV16 DNA in archived clinical biopsy sections from breast and lung cancers (17, 11 %), respectively. A positive correlation of HPV16 presence was found with ER/PR and HER2-positive breast cancers. These initial findings warrant further investigation in order to determine HPV prevalence and aetiological role in local cancers, especially in ER/PR/HER2-positive breast cancers on a larger scale.
Related: Breast Cancer Lung Cancer
Breast Cancer Lung Cancer
Baldin E, Testoni S, de Pasqua S, et al.
Incidence of neuroepithelial primary brain tumors among adult population of Emilia-Romagna Region, Italy.
Neurol Sci. 2017; 38(2):255-262 [PubMed] Related Publications
Incidence of neuroepithelial primary brain tumors among adult population of Emilia-Romagna Region, Italy.
Neurol Sci. 2017; 38(2):255-262 [PubMed] Related Publications
Incidence of neuroepithelial Primary Brain Tumors (nPBT) varies, ranging from 7.3 to 11.6 cases/100,000/year across Europe. We present incidence and survival of nPBT in the Emilia-Romagna region (ER), Italy. This study is the largest in Southern Europe. Specialists in neurosurgery, neurology, neuroradiology, oncology, radiotherapy, genetics, and pathology of ER notified all suspected nPBT adult cases residing in ER (4,337,966 inhabitants) observed during 2009. Furthermore, through ICD-9 discharge codes, we identified and reviewed all possible cases. Neuroepithelial PBT diagnosis was based on histological or radiological findings. We included 400 incident nPBT cases, of which 102 (25%) were retrospectively identified. These latter were significantly older. The standardized incidence was 10.5/100,000/year (95% CI 9.4-11.5), higher for men. It was 9.2/100,000/year (95% CI 8.3-10.2) for astrocytic tumors, 0.6/100,000/year (95% CI 0.4-0.9) for oligodendroglial tumors, and 7.1 (95% CI 6.3-8.0) for glioblastoma (GBM). Among GBM patients, median survival was 249 days if prospectively identified vs. 132 days when identified through ICD-9 codes (p < 0.0001). The incidence of nPBT in the ER region is among the highest in the literature. Older patients were more likely to escape an active surveillance system. This should be considered when comparing incidence rates across studies, giving the increasing number of elderly people in the general population.
Austin MT, Hamilton E, Zebda D, et al.
Health disparities and impact on outcomes in children with primary central nervous system solid tumors.
J Neurosurg Pediatr. 2016; 18(5):585-593 [PubMed] Related Publications
Health disparities and impact on outcomes in children with primary central nervous system solid tumors.
J Neurosurg Pediatr. 2016; 18(5):585-593 [PubMed] Related Publications
OBJECTIVE Health disparities in access to care, early detection, and survival exist among adult patients with cancer. However, there have been few reports assessing how health disparities impact pediatric patients with malignancies. The objective in this study was to examine the impact of racial/ethnic and social factors on disease presentation and outcome for children with primary CNS solid tumors. METHODS The authors examined all children (age ≤ 18 years) in whom CNS solid tumors were diagnosed and who were enrolled in the Texas Cancer Registry between 1995 and 2009 (n = 2421). Geocoded information was used to calculate the driving distance between a patient's home and the nearest pediatric cancer treatment center. Socioeconomic status (SES) was determined using the Agency for Healthcare Research and Quality formula and 2007-2011 US Census block group data. Logistic regression was used to determine factors associated with advanced-stage disease. Survival probability and hazard ratios were calculated using life table methods and Cox regression. RESULTS Children with advanced-stage CNS solid tumors were more likely to be < 1 year old, Hispanic, and in the lowest SES quartile (all p < 0.05). The adjusted odds ratios of presenting with advanced-stage disease were higher in children < 1 year old compared with children > 10 years old (OR 1.71, 95% CI 1.06-2.75), and in Hispanic patients compared with non-Hispanic white patients (OR 1.56, 95% CI 1.19-2.04). Distance to treatment and SES did not impact disease stage at presentation in the adjusted analysis. Furthermore, 1- and 5-year survival probability were worst in children 1-10 years old, Hispanic patients, non-Hispanic black patients, and those in the lowest SES quartile (p < 0.05). In the adjusted survival model, only advanced disease and malignant behavior were predictive of mortality. CONCLUSIONS Racial/ethnic disparities are associated with advanced-stage disease presentation for children with CNS solid tumors. Disease stage at presentation and tumor behavior are the most important predictors of survival.
Related: Brain and Spinal Cord Tumours
Brain and Spinal Cord Tumours
Phanphaisarn A, Patumanond J, Settakorn J, et al.
Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand.
Asian Pac J Cancer Prev. 2016; 17(9):4335-4340 [PubMed] Related Publications
Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand.
Asian Pac J Cancer Prev. 2016; 17(9):4335-4340 [PubMed] Related Publications
BACKGROUND: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal- related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs.
MATERIALS AND METHODS: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis.
RESULTS: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain.
CONCLUSIONS: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.
MATERIALS AND METHODS: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis.
RESULTS: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain.
CONCLUSIONS: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.
Related: Thailand
Thailand
Sunkara V, Hebert JR
The Colorectal Cancer Mortality-to-Incidence Ratio as a Potential Cancer Surveillance Measure in Asia.
Asian Pac J Cancer Prev. 2016; 17(9):4323-4326 [PubMed] Related Publications
The Colorectal Cancer Mortality-to-Incidence Ratio as a Potential Cancer Surveillance Measure in Asia.
Asian Pac J Cancer Prev. 2016; 17(9):4323-4326 [PubMed] Related Publications
BACKGROUND: The cancer mortality-to-incidence ratio (MIR) has been established as an important measure of health disparities in local and global circumstances. Past work has corroborated a linkage between the colorectal cancer MIR and the World Health Organization (WHO) Health System ranking. The literature further documents many Asian countries having incomplete cancer registries and a lack of comprehensive colorectal cancer screening guidelines.
MATERIALS AND METHODS: The colorectal cancer MIR values for 23 Asian countries were calculated from data obtained from the 2012 GLOBOCAN database. The 2000 World Health Organization (WHO) Health System rankings were used as a proxy for health system infrastructure and responsiveness. A regression equation was calculated with the MIR as the dependent variable and the WHO Health System ranking as the independent variable. Predicted MIR values were next calculated based on the regression results. Actual MIR values that exceeded 0.20 from the predicted MIR were removed as 'divergent'points. The regression equation was then re-plotted. Goodness-of-fit for both regressions was assessed by the R-squared test.
RESULTS: Asian countries have a relatively wide colorectal cancer MIR range, from a minimum of 0.24 to a maximum of 0.86. For the full dataset, the adjusted R-squared value for this regression was 0.53. The equation was then used to calculate a predicted MIR, whereby two data points were identified as 'divergent' and removed. The adjusted R-squared for the edited dataset increased to 0.66.
CONCLUSIONS: Asian countries have a marked range in their colorectal cancer MIR values and there is a strong correlationwith the WHO Health System ranking. These results corroborate the contribution of the MIR as a potentially robust tool in monitoring changes in colorectal cancer care for Asian nations.
MATERIALS AND METHODS: The colorectal cancer MIR values for 23 Asian countries were calculated from data obtained from the 2012 GLOBOCAN database. The 2000 World Health Organization (WHO) Health System rankings were used as a proxy for health system infrastructure and responsiveness. A regression equation was calculated with the MIR as the dependent variable and the WHO Health System ranking as the independent variable. Predicted MIR values were next calculated based on the regression results. Actual MIR values that exceeded 0.20 from the predicted MIR were removed as 'divergent'points. The regression equation was then re-plotted. Goodness-of-fit for both regressions was assessed by the R-squared test.
RESULTS: Asian countries have a relatively wide colorectal cancer MIR range, from a minimum of 0.24 to a maximum of 0.86. For the full dataset, the adjusted R-squared value for this regression was 0.53. The equation was then used to calculate a predicted MIR, whereby two data points were identified as 'divergent' and removed. The adjusted R-squared for the edited dataset increased to 0.66.
CONCLUSIONS: Asian countries have a marked range in their colorectal cancer MIR values and there is a strong correlationwith the WHO Health System ranking. These results corroborate the contribution of the MIR as a potentially robust tool in monitoring changes in colorectal cancer care for Asian nations.
Padrik P, Valter A, Valter E, et al.
Trends in incidence and survival of cutaneous malignant melanoma in Estonia: a population-based study.
Acta Oncol. 2017; 56(1):52-58 [PubMed] Related Publications
Trends in incidence and survival of cutaneous malignant melanoma in Estonia: a population-based study.
Acta Oncol. 2017; 56(1):52-58 [PubMed] Related Publications
BACKGROUND: Previous studies have shown an increase in the incidence of cutaneous melanoma (CM) in Estonia, but also poor survival in international comparisons, with a significant survival gap between the sexes. The aim of this study was to analyze the time trends in CM incidence and relative survival by age, TNM stage and anatomical subsite among men and women in Estonia.
MATERIALS AND METHODS: Data from the Estonian Cancer Registry were used to calculate age-standardized (World) and age-specific incidence of CM in 1995-2013, and five-year relative survival ratios (RSR) for cases diagnosed in 1995-2012 and followed through in 2014. Period hybrid analysis was used to calculate the most recent survival estimates for 2010-2014.
RESULTS: Between 1995 and 2013, the age-standardized incidence of CM increased significantly in Estonia among both sexes, at a rate of around 4% per year. Among women, the proportion of trunk melanomas increased from 26% in 1995-1999 to 39% in 2010-2012 and became the most common site. The proportion of stage I cases and T1 tumors increased considerably. Women had more favorable stage distribution and thinner tumors than men. The age-adjusted five-year RSR increased significantly, from 64% in 1995-1999 to 81% in 2010-2014. The latest age-adjusted RSRs were 76% among men and 84% among women. Survival gains were the largest in patients below 50 years, those with head and neck or trunk melanomas, and stage III cancer.
CONCLUSIONS: The proportion of stage I and T1 cases is lower in Estonia compared with the Scandinavian data and is likely a major contributor to the persisting overall survival deficit in Estonia. The apparent deficit in stage II survival also warrants further investigation. A public health program is necessary in Estonia to raise awareness of CM and to significantly increase early stage diagnosis.
MATERIALS AND METHODS: Data from the Estonian Cancer Registry were used to calculate age-standardized (World) and age-specific incidence of CM in 1995-2013, and five-year relative survival ratios (RSR) for cases diagnosed in 1995-2012 and followed through in 2014. Period hybrid analysis was used to calculate the most recent survival estimates for 2010-2014.
RESULTS: Between 1995 and 2013, the age-standardized incidence of CM increased significantly in Estonia among both sexes, at a rate of around 4% per year. Among women, the proportion of trunk melanomas increased from 26% in 1995-1999 to 39% in 2010-2012 and became the most common site. The proportion of stage I cases and T1 tumors increased considerably. Women had more favorable stage distribution and thinner tumors than men. The age-adjusted five-year RSR increased significantly, from 64% in 1995-1999 to 81% in 2010-2014. The latest age-adjusted RSRs were 76% among men and 84% among women. Survival gains were the largest in patients below 50 years, those with head and neck or trunk melanomas, and stage III cancer.
CONCLUSIONS: The proportion of stage I and T1 cases is lower in Estonia compared with the Scandinavian data and is likely a major contributor to the persisting overall survival deficit in Estonia. The apparent deficit in stage II survival also warrants further investigation. A public health program is necessary in Estonia to raise awareness of CM and to significantly increase early stage diagnosis.
Related: Melanoma
Melanoma
Huang B, Ni M, Chen C, et al.
LODDS is superior to lymph node ratio for the prognosis of node-positive rectal cancer patients treated with preoperative radiotherapy.
Tumori. 2017; 103(1):87-92 [PubMed] Related Publications
LODDS is superior to lymph node ratio for the prognosis of node-positive rectal cancer patients treated with preoperative radiotherapy.
Tumori. 2017; 103(1):87-92 [PubMed] Related Publications
PURPOSE: Yielding pathologic-lymph node ratio (yp-LNR) was considered to be a better staging system than yp-N stage in rectal cancer patients treated with preoperative radiotherapy (pre-RT). We aimed to compare the predictive ability of yielding pathologic log odds of positive lymph nodes (yp-LODDS) with that of yp-LNR for cancer-specific survival (CSS) in stage III rectal cancer patients treated with pre-RT.
METHODS: We analyzed stage III rectal cancer patients treated with pre-RT in the Surveillance, Epidemiology and End Results (SEER) database. Patients were classified into 4 groups, yp-LNR1 to 4, based on the LNR cutoff points 0.25, 0.50, and 0.75. Subjects were categorized into 5 groups, yp-LODDS1 to yp-LODDS5, based on the LODDS cutoff points -1, 0, 1, and 2. Univariate and multivariate Cox proportional hazards models were performed to analyze the risk factors for survival outcome.
RESULTS: A total of 4,612 patients were included from the SEER database. Patients in the yp-LNR4 group could be further divided into yp-LODDS4 and yp-LODDS5 groups with 5-year CSS of 47.6% and 31.5%, respectively (p<0.001). In the multivariate analysis without yp-LODDS, yp-LNR was an independent prognostic factor (hazard ratio [HR] 2.006, 95% confidence interval [CI] 1.619-2.484, p<0.001). However, after adjusting for yp-LODDS, yp-LNR was no longer associated with CSS (p = 0.393), and yp-LODDS was identified as an independent prognostic factor (HR 1.274, 95% CI 1.069-1.520, p = 0.007).
CONCLUSIONS: The prognostic value of yp-LNR can be confounded by yp-LODDS. In stage III rectal cancer patients treated with pre-RT, yp-LODDS has superior discrimination power over yp-LNR and can more accurately evaluate CSS.
METHODS: We analyzed stage III rectal cancer patients treated with pre-RT in the Surveillance, Epidemiology and End Results (SEER) database. Patients were classified into 4 groups, yp-LNR1 to 4, based on the LNR cutoff points 0.25, 0.50, and 0.75. Subjects were categorized into 5 groups, yp-LODDS1 to yp-LODDS5, based on the LODDS cutoff points -1, 0, 1, and 2. Univariate and multivariate Cox proportional hazards models were performed to analyze the risk factors for survival outcome.
RESULTS: A total of 4,612 patients were included from the SEER database. Patients in the yp-LNR4 group could be further divided into yp-LODDS4 and yp-LODDS5 groups with 5-year CSS of 47.6% and 31.5%, respectively (p<0.001). In the multivariate analysis without yp-LODDS, yp-LNR was an independent prognostic factor (hazard ratio [HR] 2.006, 95% confidence interval [CI] 1.619-2.484, p<0.001). However, after adjusting for yp-LODDS, yp-LNR was no longer associated with CSS (p = 0.393), and yp-LODDS was identified as an independent prognostic factor (HR 1.274, 95% CI 1.069-1.520, p = 0.007).
CONCLUSIONS: The prognostic value of yp-LNR can be confounded by yp-LODDS. In stage III rectal cancer patients treated with pre-RT, yp-LODDS has superior discrimination power over yp-LNR and can more accurately evaluate CSS.
Trama A, Marcos-Gragera R, Sánchez Pérez MJ, et al.
Data quality in rare cancers registration: the report of the RARECARE data quality study.
Tumori. 2017; 103(1):22-32 [PubMed] Related Publications
Data quality in rare cancers registration: the report of the RARECARE data quality study.
Tumori. 2017; 103(1):22-32 [PubMed] Related Publications
PURPOSE: Rare cancers represent 22% of all tumors in Europe; however, the quality of the data of rare cancers may not be as good as the quality of data for common cancer. The project surveillance of rare cancers in Europe (RARECARE) had, among others, the objective of assessing rare cancer data quality in population-based cancer registries (CRs). Eight rare cancers were considered: mesothelioma, liver angiosarcoma, sarcomas, tumors of oral cavity, CNS tumors, germ cell tumors, leukemia, and malignant digestive endocrine tumors.
METHODS: We selected data on 18,000 diagnoses and revised, on the basis of the pathologic and clinical reports (but not on pathologic specimens), unspecified morphology and topography codes originally attributed by CR officers and checked the quality of follow-up of long-term survivors of poor prognosis cancers.
RESULTS: A total of 38 CRs contributed from 13 European countries. The majority of unspecified morphology and topography cases were confirmed as unspecified. The few unspecified cases that, after the review, changed to a more specific diagnosis increased the incidence of the common cancer histotypes. For example, 11% of the oral cavity epithelial cancers were reclassified from unspecified to more specific diagnoses: 8% were reclassified as squamous cell carcinoma (commoner) and only 1% as adenocarcinoma (rarer). The revision confirmed the majority of long-term survivors revealing a relative high proportion of mesothelioma long-term survivors. The majority of appendix carcinoids changed behavior from malignant to borderline lesions.
CONCLUSIONS: Our study suggests that the problem of poorly specified morphology and topography cases is mainly one of difficulty in reaching a precise diagnosis. The awareness of the importance of data quality for rare cancers should increase among registrars, pathologists, and clinicians.
METHODS: We selected data on 18,000 diagnoses and revised, on the basis of the pathologic and clinical reports (but not on pathologic specimens), unspecified morphology and topography codes originally attributed by CR officers and checked the quality of follow-up of long-term survivors of poor prognosis cancers.
RESULTS: A total of 38 CRs contributed from 13 European countries. The majority of unspecified morphology and topography cases were confirmed as unspecified. The few unspecified cases that, after the review, changed to a more specific diagnosis increased the incidence of the common cancer histotypes. For example, 11% of the oral cavity epithelial cancers were reclassified from unspecified to more specific diagnoses: 8% were reclassified as squamous cell carcinoma (commoner) and only 1% as adenocarcinoma (rarer). The revision confirmed the majority of long-term survivors revealing a relative high proportion of mesothelioma long-term survivors. The majority of appendix carcinoids changed behavior from malignant to borderline lesions.
CONCLUSIONS: Our study suggests that the problem of poorly specified morphology and topography cases is mainly one of difficulty in reaching a precise diagnosis. The awareness of the importance of data quality for rare cancers should increase among registrars, pathologists, and clinicians.
Related: Cancer Prevention and Risk Reduction
Cancer Prevention and Risk Reduction
Clèries R, Buxó M, Yasui Y, et al.
Estimating long-term crude probability of death among young breast cancer patients: a Bayesian approach.
Tumori. 2016; 102(6):555-561 [PubMed] Related Publications
Estimating long-term crude probability of death among young breast cancer patients: a Bayesian approach.
Tumori. 2016; 102(6):555-561 [PubMed] Related Publications
AIMS AND BACKGROUND: Bayesian survival analysis was applied to assess the long-term survival and probability of death due to breast cancer (BC) in Girona, the Spanish region with the highest BC incidence.
METHODS: A Bayesian autoregressive model was implemented to compare survival indicators between the periods 1985-1994 and 1995-2004. We assessed the long-term excess hazard of death, relative survival (RS), and crude probability of death due to BC (PBC) up to 20 years after BC diagnosis, reporting the 95% credible intervals (CI) of these indicators.
RESULTS: Patients diagnosed from 1995 onwards showed lower 20-year excess hazards of death than those diagnosed earlier (RS during 1985-1994: local stage: 76.6%; regional stage: 44.9%; RS during 1995-2004: local stage: 85.2%; regional stage: 57.0%). The PBC after 20 years of BC diagnosis for patients diagnosed in 1995 and after might reach 14.4% (95% CI: 8.9%-21.2%) in local stage and 41.0% (95% CI: 36.1%-47.1%) in regional stage.
CONCLUSIONS: The method presented could be useful when dealing with population-based survival data from a small region. Better survival prospects were found in patients diagnosed after 1994, although we detected a non-decreasing long-term excess hazard of death, suggesting that these patients have higher mortality than the general population even 10 years after the diagnosis of BC.
METHODS: A Bayesian autoregressive model was implemented to compare survival indicators between the periods 1985-1994 and 1995-2004. We assessed the long-term excess hazard of death, relative survival (RS), and crude probability of death due to BC (PBC) up to 20 years after BC diagnosis, reporting the 95% credible intervals (CI) of these indicators.
RESULTS: Patients diagnosed from 1995 onwards showed lower 20-year excess hazards of death than those diagnosed earlier (RS during 1985-1994: local stage: 76.6%; regional stage: 44.9%; RS during 1995-2004: local stage: 85.2%; regional stage: 57.0%). The PBC after 20 years of BC diagnosis for patients diagnosed in 1995 and after might reach 14.4% (95% CI: 8.9%-21.2%) in local stage and 41.0% (95% CI: 36.1%-47.1%) in regional stage.
CONCLUSIONS: The method presented could be useful when dealing with population-based survival data from a small region. Better survival prospects were found in patients diagnosed after 1994, although we detected a non-decreasing long-term excess hazard of death, suggesting that these patients have higher mortality than the general population even 10 years after the diagnosis of BC.
Related: Breast Cancer
Breast Cancer
Zhou R, Zhang J, Sun H, et al.
Comparison of three lymph node classifications for survival prediction in distant metastatic gastric cancer.
Int J Surg. 2016; 35:165-171 [PubMed] Related Publications
Comparison of three lymph node classifications for survival prediction in distant metastatic gastric cancer.
Int J Surg. 2016; 35:165-171 [PubMed] Related Publications
BACKGROUND: The optimal lymph node (LN) classification system for prognostic assessment in distant metastatic gastric cancer (DMGC) patients who undergo LN dissection remains unclear. Therefore, we compared the prognostic performance of positive LN (PLN), LN ratio (LNR), and log odds of positive LNs (LODDS) in DMGC patients.
METHODS: A total of 1999 DMGC patients who underwent lymphadenectomy recorded in the Surveillance Epidemiology and End Results database from 2004 to 2012 were reviewed.
RESULTS: Univariate analyses showed that the PLN, LNR and LODDS systems were all significantly correlated with cancer-specific survival (CSS). However, only the LODDS classification remained an independent prognostic factor through the multivariate analysis. Furthermore, this classification could efficiently discriminate survival outcomes in patients within the same positive PLN category, as well as in patients with no positive node involvement. Both the LODDS and LNR classifications had better discriminatory ability, monotonicity, and homogeneity of prognostic stratification, as well as more accurate 1 or 2-year CSS prediction, than the PLN classification. The performances of the LNR and LODDS classifications were similar. Additionally, we found that inclusion of PORT carried a survival benefit across all LODDS intervals except the "LODDS ≤ -1.0" subgroup.
CONCLUSION: Our findings indicate that the LODDS classification is the most optimal system for prognostic assessment in DMGC patients. Incorporating LODDS into the staging system of DMGC patients will enable clinicians to more accurately predict prognosis and guide regional therapy regimen decisions in DMGC patients.
METHODS: A total of 1999 DMGC patients who underwent lymphadenectomy recorded in the Surveillance Epidemiology and End Results database from 2004 to 2012 were reviewed.
RESULTS: Univariate analyses showed that the PLN, LNR and LODDS systems were all significantly correlated with cancer-specific survival (CSS). However, only the LODDS classification remained an independent prognostic factor through the multivariate analysis. Furthermore, this classification could efficiently discriminate survival outcomes in patients within the same positive PLN category, as well as in patients with no positive node involvement. Both the LODDS and LNR classifications had better discriminatory ability, monotonicity, and homogeneity of prognostic stratification, as well as more accurate 1 or 2-year CSS prediction, than the PLN classification. The performances of the LNR and LODDS classifications were similar. Additionally, we found that inclusion of PORT carried a survival benefit across all LODDS intervals except the "LODDS ≤ -1.0" subgroup.
CONCLUSION: Our findings indicate that the LODDS classification is the most optimal system for prognostic assessment in DMGC patients. Incorporating LODDS into the staging system of DMGC patients will enable clinicians to more accurately predict prognosis and guide regional therapy regimen decisions in DMGC patients.
Related: USA
USA
Doulamis IP, Mylonas KS, Kalfountzos CE, et al.
Pancreatic mucinous cystadenocarcinoma: Epidemiology and outcomes.
Int J Surg. 2016; 35:76-82 [PubMed] Related Publications
Pancreatic mucinous cystadenocarcinoma: Epidemiology and outcomes.
Int J Surg. 2016; 35:76-82 [PubMed] Related Publications
BACKGROUND: Pancreatic mucinous cystadenocarcinoma is a rare malignancy. Our aim was to investigate the demographic, pathological characteristics, treatment modalities and survival of patients with mucinous cystadenocarcinoma via the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database analysis.
MATERIALS AND METHODS: This was a retrospective study of SEER database's records on patients with mucinous cystadenocarcinoma diagnosed from 1988 to 2012. Primary outcome measures were clinico-pathological characteristics, observed and disease-specific survival.
RESULTS: A total of 507 patients were identified. Median age at diagnosis was 67 years and most patients were female (68.4%). The tumors were mainly low grade (82.9%, grade I-II) and frequently localized (42.8%) in the body/tail of the pancreas (45.6%). According to Kaplan-Meier curves observed survival was 111 months (95%CI: 82.5, 139.5) vs 14 months (95% CI: 10.9, 17.1) vs 4 months (95%CI: 2.9, 5.1) for patients with localized, regional and distant disease, respectively. One-year disease-specific survival for patients with localized disease was 90.1%, vs. 56.7% for those with regional and 18.7% with distant tumor spread.
CONCLUSIONS: Mucinous cystadenocarcinomas tend to be low grade tumors, localized to the pancreatic body/tail. Surgery as the primary therapeutic intervention and tumor stage are independent predictors of disease-specific survival.
MATERIALS AND METHODS: This was a retrospective study of SEER database's records on patients with mucinous cystadenocarcinoma diagnosed from 1988 to 2012. Primary outcome measures were clinico-pathological characteristics, observed and disease-specific survival.
RESULTS: A total of 507 patients were identified. Median age at diagnosis was 67 years and most patients were female (68.4%). The tumors were mainly low grade (82.9%, grade I-II) and frequently localized (42.8%) in the body/tail of the pancreas (45.6%). According to Kaplan-Meier curves observed survival was 111 months (95%CI: 82.5, 139.5) vs 14 months (95% CI: 10.9, 17.1) vs 4 months (95%CI: 2.9, 5.1) for patients with localized, regional and distant disease, respectively. One-year disease-specific survival for patients with localized disease was 90.1%, vs. 56.7% for those with regional and 18.7% with distant tumor spread.
CONCLUSIONS: Mucinous cystadenocarcinomas tend to be low grade tumors, localized to the pancreatic body/tail. Surgery as the primary therapeutic intervention and tumor stage are independent predictors of disease-specific survival.
