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Lian L, Lei H, Cheng S, Zheng R, Yao H, Chen J, Chen T. Survival benefit after radiotherapy for patients with malignant pleural mesothelioma: A propensity score-matched study. MedComm (Beijing) 2023; 4:e241. [PMID: 37009411 PMCID: PMC10060947 DOI: 10.1002/mco2.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 04/04/2023] Open
Affiliation(s)
- Liyou Lian
- Department of Oncologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Huijun Lei
- Department of Cancer PreventionZhejiang Cancer HospitalHangzhouChina
- Institute of Basic Medicine and Cancer (IBMC)Chinese Academy of SciencesHangzhouChina
| | - Shuwen Cheng
- Department of OncologyNanjing University of Medical SchoolNanjingChina
| | - Rujie Zheng
- Department of Oncologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Hongxia Yao
- Department of Oncologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jinfei Chen
- Department of Oncologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Tianhui Chen
- Department of Cancer PreventionZhejiang Cancer HospitalHangzhouChina
- Institute of Basic Medicine and Cancer (IBMC)Chinese Academy of SciencesHangzhouChina
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Zhang X, Chang L, Zhu Y, Mao Y, Zhang T, Zhang Q, Wang C. Establishment and validation of nomograms to predict survival probability of advanced malignant pleural mesothelioma based on the SEER database and a Chinese medical institution. Front Endocrinol (Lausanne) 2023; 14:1139222. [PMID: 37124752 PMCID: PMC10140559 DOI: 10.3389/fendo.2023.1139222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Objective The purpose of this study was to build nomograms for predicting the survival of individual advanced pleural mesothelioma (MPM) patients using the Surveillance, Epidemiology, and End Results (SEER) database. Methods The 1251 patients enrolled from the SEER database were randomized (in a 7:3 ratio) to a training cohort and an internal validation cohort. Eighty patients were enrolled from the Harbin Medical University Cancer Hospital as the external validation cohort. Nomograms were constructed from variables screened by univariate or multivariate Cox regression analyses and evaluated by consistency indices (C-index), calibration plots, and receiver operating characteristic (ROC) curves. Patients from the SEER database who received chemotherapy alone and chemoradiotherapy were statistically paired using propensity score matching of the two groups and performed subgroup analysis in the screened variables. Results The nomograms are well-structured and well-validated prognostic maps constructed from four variables: gender, histology, AJCC stage, and treatment. All individuals were allocated into high-risk versus low-risk groups based on the median risk score of the training cohort, with the high-risk group having worse OS and CSS in all three cohorts (P<0.05). The outcomes of the subgroup analysis indicated that the advanced MPM patients receiving chemotherapy with or without local radiotherapy do not affect OS or CSS. Conclusion The accurate nomograms to predict the survival of patients with advanced MPM were built and validated based on an analysis of the SEER database with an external validation cohort. The study suggests that the additional local radiotherapy to chemotherapy does not increase the survival benefit of patients.
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Affiliation(s)
- Xuemei Zhang
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lele Chang
- Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yingying Zhu
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuxin Mao
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Tao Zhang
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Qian Zhang
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Chunbo Wang
- Thoracic Radiotherapy, Harbin Medical University Cancer Hospital, Harbin, China
- *Correspondence: Chunbo Wang,
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Grosso F, Cerbone L, Pasello G. Pericardial Mesothelioma, a Disease for Brave Hearts. J Thorac Oncol 2022; 17:1333-1334. [DOI: 10.1016/j.jtho.2022.09.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022]
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Banks KC, Ossowski S, Hung YY, Hsu DS, Ashiku SK, Patel AR, Velotta JB, Suga JM. Comparison of Survival by Multimodal Treatment Regimen Among Malignant Pleural Mesothelioma Patients in an Integrated Health System. Clin Lung Cancer 2022; 23:694-701. [PMID: 36216742 DOI: 10.1016/j.cllc.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/17/2022] [Accepted: 09/09/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Optimal therapy for malignant pleural mesothelioma (MPM) remains unclear. We compared overall survival in patients with MPM after various multimodal treatment regimens including combinations of immunotherapy, chemotherapy, and surgery. PATIENTS AND METHODS We examined MPM patients treated within our integrated health system from January 1, 2009 to December 31, 2020. Patients were grouped based on treatment regimen: chemotherapy alone (CT), immunotherapy with or without chemotherapy (iCT), surgery with chemotherapy (sCT), and surgery with immunotherapy and chemotherapy (siCT). We analyzed baseline characteristics and overall patient survival among these groups and several subgroups. RESULTS One hundred seventy-nine patients were included. Among the study groups, there was no difference in age, sex, race/ethnicity, Charlson Comorbidity Index, or Eastern Cooperative Oncology Group performance status. Patients treated with CT (N = 109), iCT (N = 35), sCT (N = 26), and siCT (N = 9) had median (95% confidence interval) survivals of 11.7 (9.9-16.3), 18.2 (14.5-29.8), 20.7 (11.6-37.2), and 22.6 (19.7-37.8) months, respectively (P < .001). Median survival among patients with and without immunotherapy was 19.7 (17.4-29.8) and 12.3 (10.6-17.3) months, respectively (P = .023). Median survival among patients with and without surgery was 21.7 (17.6-34.8) and 13.6 (11.5-17.3) months, respectively (P = .007). Patients with biphasic/sarcomatoid subtypes who received immunotherapy experienced 76.2% (55.8%-100.0%) 12 month survival vs. 13.6% (4.8%-39.0%) among those who did not (P < .001). CONCLUSION MPM patients receiving surgery and immunotherapy as part of multimodal treatment regimens experienced the longest survival. Surgery and immunotherapy are each associated with survival. Further investigations are warranted to assess the benefit of immunotherapy within multimodal treatment regimens for MPM.
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Affiliation(s)
- Kian C Banks
- Department of Thoracic Surgery, Kaiser Oakland Medical Center, Oakland, CA; University of California, San Francisco - East Bay, Oakland, CA.
| | - Stephanie Ossowski
- Department of Hematology/Oncology, Kaiser San Francisco Medical Center, San Francisco, CA
| | - Yun-Yi Hung
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Diana S Hsu
- Department of Thoracic Surgery, Kaiser Oakland Medical Center, Oakland, CA; University of California, San Francisco - East Bay, Oakland, CA
| | - Simon K Ashiku
- Department of Thoracic Surgery, Kaiser Oakland Medical Center, Oakland, CA
| | - Ashish R Patel
- Department of Thoracic Surgery, Kaiser Oakland Medical Center, Oakland, CA
| | - Jeffrey B Velotta
- Department of Thoracic Surgery, Kaiser Oakland Medical Center, Oakland, CA
| | - J Marie Suga
- Department of Oncology, Kaiser Vallejo Medical Center, Vallejo, CA
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Kakamad FH, Ali RM, Mohammed DA, Salih AM, Hussein DA, Mustafa MQ, Mohammed SH, Hussein SI. Pericardial Dual Mesh Uptake on PET Scan Mimicking Residual Mesothelioma; A Case Report. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2022.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vayntraub A, Tayeb N, Squires B, Mehnert JM, Hassan Ii Q, Sebastian NT, Deryaniyagala R, Quinn TJ. The Association of Radiation Therapy and Chemotherapy on Overall Survival in Merkel Cell Carcinoma: A Population-Based Analysis. Cureus 2021; 13:e18276. [PMID: 34722054 PMCID: PMC8545516 DOI: 10.7759/cureus.18276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose/objective(s) Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous neoplasm traditionally managed with surgical resection followed by radiotherapy (RT). With the recent approval of checkpoint inhibitors, chemotherapy is less commonly utilized. We analyzed the impact of RT and chemotherapy on overall survival (OS) in patients with MCC using Surveillance, Epidemiology, and End Results (SEER), a population-level database. Materials and methods We performed retrospective analyses on SEER 18 Custom Data registries for MCC (ICD-0-3 8247). Data from 1980 to 2016 was queried for analysis, and an initial list of 9,792 patients was populated (ICD: C00, C07.9, C44, C80.9). Selection for cases with chemotherapy and RT status, single primary tumor, primary tumor location and surgery treatment type yielded 5,002 cases for analysis. Baseline characteristics were compared with Chi-square or Mann-Whitney U test. Univariate and multivariable analysis using Kaplan-Meier and Cox proportional hazards regression modeling were performed. Propensity-score matched analysis with inverse probability of treatment weighting (IPTW) was used to account for indication bias. Results Median follow-up time was 178 months (68 to 217 months). Independent prognostic factors positively correlated with increased OS, for both unadjusted Multivariate analysis and IPTW adjusted MVA were age, male sex, year of diagnosis, stage, RT status, and chemotherapy status. On adjusted MVA, use of chemotherapy was associated with worse OS (hazard ratio: 1.22 [95% CI 1.1-1.35], p<0.001), whereas RT was associated with improved OS (HR:0.9 [95% CI, 0.83-0.97], p=0.008). Conclusions The current study demonstrates that RT is associated with improved survival for patients with MCC. Chemotherapy was associated with worse OS. This supports the recent clinical shift towards immune checkpoints inhibitors as standard of care in the metastatic setting, and promising trials in the adjuvant and advanced settings.
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Affiliation(s)
| | - Nadine Tayeb
- Department of Radiation Oncology, Michigan State University College of Human Medicine, East Lansing, USA
| | - Bryan Squires
- Department of Radiation Oncology, Beaumont Health, Royal Oak, USA
| | - Janice M Mehnert
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, USA
| | - Quais Hassan Ii
- Medical Scientist Training Program, The Ohio State University College of Medicine, Columbus, USA
| | - Nikhil T Sebastian
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | | | - Thomas J Quinn
- Department of Radiation Oncology, Beaumont Health, Royal Oak, USA
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Parzen JS, Vayntraub A, Squires B, Almahariq MF, Thompson AB, Robertson JM, Kabolizadeh P, Quinn TJ. A population-based analysis of chemoradiation versus radiation alone in the definitive treatment of patients with stage I-II squamous cell carcinoma of the anus. J Gastrointest Oncol 2021; 12:831-844. [PMID: 34012670 DOI: 10.21037/jgo-20-530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The optimal management of patients with stage I-II squamous cell carcinoma (SCC) of the anus is controversial. The current study evaluates the efficacy of combined chemotherapy and radiation therapy (CRT) versus radiation therapy (RT) alone in the treatment of these patients using the Surveillance, Epidemiology, and End Results (SEER) registries. Methods SEER 18 Custom Data registries were queried for patients with stage I-II SCC of the anus. Univariate analysis (UVA) and multivariable analysis (MVA) using Kaplan-Meier and Cox proportional hazards regression modeling were performed. Propensity-score matched analysis with inverse probability of treatment weighting (IPTW) was used to account for indication bias. Results A total of 4,288 patients with stage I-II disease were identified, of whom 3,982 (93%) underwent CRT and 306 (7%) underwent RT. Median follow-up was 42 months. Approximately 30.8% had T1 disease and 69.2% had T2-T3 disease. The IPTW-adjusted 5-year overall survival (OS) was 76.7%, with no significant differences between the CRT and RT groups (77% vs. 73.5%, P=0.33). On multivariate IPTW-adjusted analysis, the lack of association between CRT use and OS was upheld (HR, 0.84, 95% CI, 0.65-1.08, P=0.2). On subgroup analyses, 5-year OS was 86% with CRT (n=1,216) and 84.2% with RT (n=103) (P=0.74) in stage I (T1N0) patients, while 5-year OS was 72.8% with CRT (n=2,766) and 66.4% with RT (n=203) (P=0.13) in stage II (T2-3N0) patients. CRT was associated with improved median OS in stage II patients (119 months vs. not reached, P=0.04). Conclusions The current study suggests that omission of concurrent chemotherapy is not associated with inferior OS in patients with stage I SCC of the anus. However, combined chemoradiation was superior to radiation alone in patients with stage II disease. Prospective evidence is needed to optimize clinical decision-making in this patient population.
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Affiliation(s)
- Jacob S Parzen
- Beaumont Health, Department of Radiation Oncology, Royal Oak, MI, USA
| | | | - Bryan Squires
- Beaumont Health, Department of Radiation Oncology, Royal Oak, MI, USA
| | | | - Andrew B Thompson
- Beaumont Health, Department of Radiation Oncology, Royal Oak, MI, USA
| | - John M Robertson
- Beaumont Health, Department of Radiation Oncology, Royal Oak, MI, USA
| | | | - Thomas J Quinn
- Beaumont Health, Department of Radiation Oncology, Royal Oak, MI, USA
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A Machine Learning-Based Investigation of Gender-Specific Prognosis of Lung Cancers. ACTA ACUST UNITED AC 2021; 57:medicina57020099. [PMID: 33499377 PMCID: PMC7911834 DOI: 10.3390/medicina57020099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 01/21/2023]
Abstract
Background and Objective: Primary lung cancer is a lethal and rapidly-developing cancer type and is one of the most leading causes of cancer deaths. Materials and Methods: Statistical methods such as Cox regression are usually used to detect the prognosis factors of a disease. This study investigated survival prediction using machine learning algorithms. The clinical data of 28,458 patients with primary lung cancers were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Results: This study indicated that the survival rate of women with primary lung cancer was often higher than that of men (p < 0.001). Seven popular machine learning algorithms were utilized to evaluate one-year, three-year, and five-year survival prediction The two classifiers extreme gradient boosting (XGB) and logistic regression (LR) achieved the best prediction accuracies. The importance variable of the trained XGB models suggested that surgical removal (feature “Surgery”) made the largest contribution to the one-year survival prediction models, while the metastatic status (feature “N” stage) of the regional lymph nodes was the most important contributor to three-year and five-year survival prediction. The female patients’ three-year prognosis model achieved a prediction accuracy of 0.8297 on the independent future samples, while the male model only achieved the accuracy 0.7329. Conclusions: This data suggested that male patients may have more complicated factors in lung cancer than females, and it is necessary to develop gender-specific diagnosis and prognosis models.
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Borrelli EP, McGladrigan CG. A Review of Pharmacologic Management in the Treatment of Mesothelioma. Curr Treat Options Oncol 2021; 22:14. [PMID: 33438079 DOI: 10.1007/s11864-020-00807-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 02/06/2023]
Abstract
OPINION STATEMENT Mesothelioma is a rare and severe form of cancer that is associated with asbestos exposure. Approximately 2500 Americans die annually from this condition with a median survival of 1 year. The latency period of this disease ranges anywhere from 20 to 70 years, with shorter latency periods associated with a higher exposure intensity to asbestos. Therefore, cases of mesothelioma are expected in the coming decades. This highlights the need for clinicians to understand the pharmacologic regimens available for treating this rare, yet serious malignancy. With multiple treatment regimens available in the treatment of this condition, clinicians should take an evidence-based approach and consider the totality of evidence and safety information while considering the best patient-centered approach for treatment. This article provides a review of current pharmacologic treatment options available for mesothelioma and goes into detail about the recommended medication regimens and dosages and the available evidence of efficacy, effectiveness, and/or safety and estimates the annual cost of treatment for these medications on the U.S. healthcare system per patient. A brief introduction is provided for several promising agents currently under investigation for mesothelioma as well.
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Affiliation(s)
- Eric P Borrelli
- University of Rhode Island College of Pharmacy, 7 Greenhouse Rd, Kingston, RI, 02881, USA.
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