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Sedeta E, Jemal A, Nisotel L, Sung H. Survival difference between secondary and de novo acute myeloid leukemia by age, antecedent cancer types, and chemotherapy receipt. Cancer 2024; 130:1952-1963. [PMID: 38244208 DOI: 10.1002/cncr.35214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/13/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND This study compared the survival of persons with secondary acute myeloid leukemia (sAML) to those with de novo AML (dnAML) by age at AML diagnosis, chemotherapy receipt, and cancer type preceding sAML diagnosis. METHODS Data from Surveillance, Epidemiology, and End Results 17 Registries were used, which included 47,704 individuals diagnosed with AML between 2001 and 2018. Multivariable Cox proportional hazards regression was used to compare AML-specific survival between sAML and dnAML. Trends in 5-year age-standardized relative survival were examined via the Joinpoint survival model. RESULTS Overall, individuals with sAML had an 8% higher risk of dying from AML (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.05-1.11) compared to those with dnAML. Disparities widened with younger age at diagnosis, particularly in those who received chemotherapy for AML (HR, 1.14; 95% CI, 1.10-1.19). In persons aged 20-64 years and who received chemotherapy, HRs were greatest for those with antecedent myelodysplastic syndrome (HR, 2.04; 95% CI, 1.83-2.28), ovarian cancer (HR, 1.91; 95% CI, 1.19-3.08), head and neck cancer (HR, 1.55; 95% CI, 1.02-2.36), leukemia (HR, 1.45; 95% CI, 1.12-1.89), and non-Hodgkin lymphoma (HR, 1.42; 95% CI, 1.20-1.69). Among those aged ≥65 years and who received chemotherapy, HRs were highest for those with antecedent cervical cancer (HR, 2.42; 95% CI, 1.15-5.10) and myelodysplastic syndrome (HR, 1.28; 95% CI, 1.19-1.38). The 5-year relative survival improved 0.3% per year for sAML slower than 0.86% per year for dnAML. Consequently, the survival gap widened from 7.2% (95% CI, 5.4%-9.0%) during the period 2001-2003 to 14.3% (95% CI, 12.8%-15.8%) during the period 2012-2014. CONCLUSIONS Significant survival disparities exist between sAML and dnAML on the basis of age at diagnosis, chemotherapy receipt, and antecedent cancer, which highlights opportunities to improve outcomes among those diagnosed with sAML.
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MESH Headings
- Humans
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/epidemiology
- Middle Aged
- Female
- Male
- Adult
- Aged
- SEER Program
- Young Adult
- Age Factors
- Neoplasms, Second Primary/mortality
- Neoplasms, Second Primary/epidemiology
- Aged, 80 and over
- Adolescent
- Proportional Hazards Models
- United States/epidemiology
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/epidemiology
- Neoplasms/mortality
- Neoplasms/drug therapy
- Neoplasms/epidemiology
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Affiliation(s)
- Ephrem Sedeta
- Brookdale University Hospital Medical Center, Brooklyn, New York, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Lauren Nisotel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Hyuna Sung
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Bian Z, Zhang R, Yuan S, Fan R, Wang L, Larsson SC, Theodoratou E, Zhu Y, Wu S, Ding Y, Li X. Healthy lifestyle and cancer survival: A multinational cohort study. Int J Cancer 2024; 154:1709-1718. [PMID: 38230569 DOI: 10.1002/ijc.34846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/18/2024]
Abstract
Lifestyle factors after a cancer diagnosis could influence the survival of cancer 60 survivors. To examine the independent and joint associations of healthy lifestyle factors with mortality outcomes among cancer survivors, four prospective cohorts (National Health and Nutrition Examination Survey [NHANES], National Health Interview Survey [NHIS], UK Biobank [UKB] and Kailuan study) across three countries. A healthy lifestyle score (HLS) was defined based on five common lifestyle factors (smoking, alcohol drinking, diet, physical activity and body mass index) that related to cancer survival. We used Cox proportional hazards regression to estimate the hazard ratios (HRs) for the associations of individual lifestyle factors and HLS with all-cause and cancer mortality among cancer survivors. During the follow-up period of 37,095 cancer survivors, 8927 all-cause mortality events were accrued in four cohorts and 4449 cancer death events were documented in the UK and US cohorts. Never smoking (adjusted HR = 0.77, 95% CI: 0.69-0.86), light alcohol consumption (adjusted HR = 0.86, 95% CI: 0.82-0.90), adequate physical activity (adjusted HR = 0.90, 95% CI: 0.85-0.94), a healthy diet (adjusted HR = 0.69, 95% CI: 0.61-0.78) and optimal BMI (adjusted HR = 0.89, 95% CI: 0.85-0.93) were significantly associated with a lower risk of all-cause mortality. In the joint analyses of HLS, the HR of all-cause and cancer mortality for cancer survivors with a favorable HLS (4 and 5 healthy lifestyle factors) were 0.55 (95% CI 0.42-0.64) and 0.57 (95% CI 0.44-0.72), respectively. This multicohort study of cancer survivors from the United States, the United Kingdom and China found that greater adherence to a healthy lifestyle might be beneficial in improving cancer prognosis.
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Affiliation(s)
- Zilong Bian
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Rongqi Zhang
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rong Fan
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yuan Ding
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
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Lammers SWM, Meegdes M, Vriens IJH, Voogd AC, de Munck L, van Nijnatten TJA, Keymeulen KBMI, Tjan-Heijnen VCG, Geurts SME. Treatment and survival of patients diagnosed with high-risk HR+/HER2- breast cancer in the Netherlands: a population-based retrospective cohort study. ESMO Open 2024; 9:103008. [PMID: 38677006 PMCID: PMC11067336 DOI: 10.1016/j.esmoop.2024.103008] [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: 12/01/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Several factors may increase the risk of recurrence of patients diagnosed with hormone receptor-positive human epidermal growth factor receptor 2-negative (HR+/HER2-) breast cancer (BC). We aim to determine the proportion of patients with high-risk HR+/HER2- BC within the total HR+/HER2- BC cohort and compare their systemic treatments and survival rates with those of patients with low- and intermediate-risk HR+/HER2- BC and triple-negative (TN) BC. PATIENTS AND METHODS Women diagnosed with nonmetastatic invasive HR+/HER2- BC and TNBC in the Netherlands between 2011 and 2019 were identified from the Netherlands Cancer Registry. Patients with HR+/HER2- BC were categorised according to risk profile, defined by nodal status, tumour size, and histological grade. High-risk HR+/HER2- BC was defined by either four or more positive lymph nodes or one to three positive lymph nodes with a tumour size of ≥5 cm or a histological grade 3 tumour. Overall survival (OS) and relative survival (RS) were calculated using the Kaplan-Meier and Pohar-Perme method. RESULTS In this study of 87 455 patients with HR+/HER2- BC, 44 078 (50%) patients were diagnosed with low risk, 28 452 (33%) with intermediate risk, and 11 285 (13%) with high-risk HR+/HER2- BC. In 3640 (4%) patients, the risk profile could not be defined. Endocrine therapy and chemotherapy were used in 38% and 7% of low-risk, 90% and 47% of intermediate-risk, and 94% and 73% of high-risk patients, respectively. The 10-year OS and RS rates were 84.1% [95% confidence interval (95% CI) 83.5% to 84.7%] and 98.7% (95% CI 97.3% to 99.4%) in low-risk, 75.1% (95% CI 74.2% to 76.0%) and 91.7% (95% CI 89.7% to 93.3%) in intermediate-risk, and 63.4% (95% CI 62.0% to 64.7%) and 72.3% (70.1% to 74.3%) in high-risk patients. The 10-year OS and RS rates of 12 689 patients with TNBC were 69.7% (95% CI 68.6% to 70.8%) and 79.1% (95% CI 77.0% to 80.9%), respectively. CONCLUSION The poor prognosis of patients with high-risk HR+/HER2- BC highlights the need for a better acknowledgement of this subgroup and supports ongoing clinical trials aimed at optimising systemic therapy.
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Affiliation(s)
- S W M Lammers
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht.
| | - M Meegdes
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - I J H Vriens
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - A C Voogd
- Department of Epidemiology, Maastricht University, Maastricht
| | - L de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht
| | - T J A van Nijnatten
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, GROW, Maastricht
| | - K B M I Keymeulen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - V C G Tjan-Heijnen
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht
| | - S M E Geurts
- Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht.
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Vincent G, Adachi JD, Schemitsch E, Tarride JE, Ho N, Wani RJ, Brown JP. Postfracture survival in a population-based study of adults aged ≥66 yr: a call to action at hospital discharge. JBMR Plus 2024; 8:ziae002. [PMID: 38596507 PMCID: PMC11001756 DOI: 10.1093/jbmrpl/ziae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/11/2023] [Accepted: 11/17/2023] [Indexed: 04/11/2024] Open
Abstract
Postfracture survival rates provide prognostic information but are rarely reported along with other mortality outcomes in adults aged ≥50 yr. The timing of survival change following a fracture also needs to be further elucidated. This population-based, matched-cohort, retrospective database study examined 98 474 patients (73% women) aged ≥66 yr with an index fracture occurring at an osteoporotic site (hip, clinical vertebral, proximal non-hip non-vertebral [pNHNV], and distal non-hip non-vertebral [dNHNV]) from 2011 to 2015, who were matched (1:1) to nonfracture individuals based on sex, age, and comorbidities. All-cause 1- and 5-yr overall survival and relative survival ratios (RSRs) were assessed, and time trends in survival changes were characterized starting immediately after a fracture. In both sexes, overall survival was markedly decreased over 6 yr of follow-up after hip, vertebral, and pNHNV fractures, and as expected, worse survival rates were observed in older patients and males. The lowest 5-yr RSRs were observed after hip fractures in males (66-85 yr, 51.9%-63.9%; ≥86 yr, 34.5%), followed by vertebral fractures in males (66-85 yr, 53.2%-69.4%; ≥86 yr, 35.5%), and hip fractures in females (66-85 yr, 69.8%-79.0%; ≥86 yr, 52.8%). Although RSRs did not decrease as markedly after dNHNV fractures in younger patients, relatively low 5-yr RSRs were observed in females (75.9%) and males (69.5%) aged ≥86 yr. The greatest reduction in survival occurred within the initial month after hip, vertebral, and pNHNV fractures, indicating a high relative impact of short-term factors, with survival-reduction effects persisting over time. Therefore, the most critical period for implementing interventions aimed at improving post-fracture prognosis appears to be immediately after a fracture; however, considering the immediate need for introducing such interventions, primary fracture prevention is also crucial to prevent the occurrence of the initial fracture in high-risk patients.
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Affiliation(s)
- Geneviève Vincent
- Medical Affairs Division, Amgen Canada Inc., Mississauga, ON L5N 0A4, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Emil Schemitsch
- Division of Orthopaedic Surgery, Western University, London, ON N6A 3K7, Canada
| | - Jean-Eric Tarride
- McMaster Chair in Health Technology Management, Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON L8S 4L8, Canada
- Center for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON L8S 4L8, Canada
- Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Nathan Ho
- Medical Affairs Division, Amgen Canada Inc., Mississauga, ON L5N 0A4, Canada
| | - Rajvi J Wani
- Research Division, Amgen Canada Inc., Mississauga, ON L5N 0A4, Canada
| | - Jacques P Brown
- CHU de Québec Research Centre and Laval University, 2705 Boulevard Laurier, TR-83, Québec, QC L5N 0A4, Canada
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Khalighi S, Reddy K, Midya A, Pandav KB, Madabhushi A, Abedalthagafi M. Artificial intelligence in neuro-oncology: advances and challenges in brain tumor diagnosis, prognosis, and precision treatment. NPJ Precis Oncol 2024; 8:80. [PMID: 38553633 PMCID: PMC10980741 DOI: 10.1038/s41698-024-00575-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
This review delves into the most recent advancements in applying artificial intelligence (AI) within neuro-oncology, specifically emphasizing work on gliomas, a class of brain tumors that represent a significant global health issue. AI has brought transformative innovations to brain tumor management, utilizing imaging, histopathological, and genomic tools for efficient detection, categorization, outcome prediction, and treatment planning. Assessing its influence across all facets of malignant brain tumor management- diagnosis, prognosis, and therapy- AI models outperform human evaluations in terms of accuracy and specificity. Their ability to discern molecular aspects from imaging may reduce reliance on invasive diagnostics and may accelerate the time to molecular diagnoses. The review covers AI techniques, from classical machine learning to deep learning, highlighting current applications and challenges. Promising directions for future research include multimodal data integration, generative AI, large medical language models, precise tumor delineation and characterization, and addressing racial and gender disparities. Adaptive personalized treatment strategies are also emphasized for optimizing clinical outcomes. Ethical, legal, and social implications are discussed, advocating for transparency and fairness in AI integration for neuro-oncology and providing a holistic understanding of its transformative impact on patient care.
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Affiliation(s)
- Sirvan Khalighi
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Kartik Reddy
- Department of Radiology, Emory University, Atlanta, GA, USA
| | - Abhishek Midya
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Krunal Balvantbhai Pandav
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Anant Madabhushi
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
- Atlanta Veterans Administration Medical Center, Atlanta, GA, USA.
| | - Malak Abedalthagafi
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
- The Cell and Molecular Biology Program, Winship Cancer Institute, Atlanta, GA, USA.
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Somasegar S, Reddy RA, Chow S, Dorigo O, Renz M, Karam A. Trends in ovarian, fallopian tube, and primary peritoneal cancer incidence, mortality, and survival: A 15-year population-based analysis. Gynecol Oncol 2024; 184:190-197. [PMID: 38330833 DOI: 10.1016/j.ygyno.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To characterize trends in ovarian, fallopian tube, and primary peritoneal cancer incidence and incidence-based mortality based on histology and site of origin. METHODS We obtained age-adjusted incidence and incidence-based mortality for patients with ovarian, fallopian tube, and primary peritoneal cancer from 2000 to 2019 from the US SEER 17 database. Joinpoint 4.9.1.0 was used to characterize log-linear time trends. RESULTS The incidence and incidence-based mortality of all cancers trended down during the study period. The incidence of epithelial cancers decreased from 2004 to 2019 (AAPC -1.2%, p < 0.001), including that of high-grade (2006-2019: APC -1.2%, p < 0.05) and low-grade (2003-2019: APC -2.4%, p < 0.05) epithelial cancers. There was no change in incidence or incidence-based mortality for ovarian stromal and germ cell cancers. CONCLUSION There has been a decrease in the incidence and incidence-based mortality of ovarian, fallopian tube, and primary peritoneal cancer, primarily due to reductions in advanced stage epithelial cancers originating in the ovary, fallopian tube, or peritoneum.
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Affiliation(s)
- Sahana Somasegar
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America.
| | - Ravali A Reddy
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America
| | - Stephanie Chow
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America
| | - Oliver Dorigo
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America
| | - Malte Renz
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America
| | - Amer Karam
- Stanford University School of Medicine, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Palo Alto, CA, United States of America
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Devasia TP, Howlader N, Dewar RA, Stevens JL, Mittu K, Mariotto AB. Increase in the Life Expectancy of Patients with Cancer in the United States. Cancer Epidemiol Biomarkers Prev 2024; 33:196-205. [PMID: 38015774 PMCID: PMC10872878 DOI: 10.1158/1055-9965.epi-23-1006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Cancer is becoming more of a chronic disease due to improvements in treatment and early detection for multiple cancer sites. To gain insight on increased life expectancy due to these improvements, we quantified trends in the loss in expectation of life (LEL) due to a cancer diagnosis for six cancer sites from 1975 through 2018. METHODS We focused on patients diagnosed with female breast cancer, chronic myeloid leukemia (CML), colon and rectum cancer, diffuse large B-cell lymphoma (DLBCL), lung cancer, or melanoma between 1975 and 2018 from nine Surveillance, Epidemiology, and End Results cancer registries. Life expectancies for patients with cancer ages 50+ were modeled using flexible parametric survival models. LEL was calculated as the difference between general population life expectancy and life expectancy for patients with cancer. RESULTS Over 2 million patients were diagnosed with one of the six cancers between 1975 and 2018. Large increases in life expectancy were observed between 1990 and 2010 for female breast, DLBCL, and CML. Patients with colon and rectum cancer and melanoma had more gradual improvements in life expectancy. Lung cancer LEL only began decreasing after 2005. Increases in life expectancy corresponded with decreases in LEL for patients with cancer. CONCLUSIONS The reported gains in life expectancy largely correspond to progress in the screening, management, and treatment of these six cancers since 1975. IMPACT LEL provides an important public health perspective on how improvements in treatment and early detection and their impacts on survival translate into changes in cancer patients' life expectancy.
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Affiliation(s)
- Theresa P Devasia
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Nadia Howlader
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Ron A Dewar
- Cancer Care Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Karen Mittu
- Information Management Services Inc., Calverton, MD, USA
| | - Angela B Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Jenul A, Stokmo HL, Schrunner S, Hjortland GO, Revheim ME, Tomic O. Novel ensemble feature selection techniques applied to high-grade gastroenteropancreatic neuroendocrine neoplasms for the prediction of survival. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 244:107934. [PMID: 38016391 DOI: 10.1016/j.cmpb.2023.107934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/05/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Determining the most informative features for predicting the overall survival of patients diagnosed with high-grade gastroenteropancreatic neuroendocrine neoplasms is crucial to improve individual treatment plans for patients, as well as the biological understanding of the disease. The main objective of this study is to evaluate the use of modern ensemble feature selection techniques for this purpose with respect to (a) quantitative performance measures such as predictive performance, (b) clinical interpretability, and (c) the effect of integrating prior expert knowledge. METHODS The Repeated Elastic Net Technique for Feature Selection (RENT) and the User-Guided Bayesian Framework for Feature Selection (UBayFS) are recently developed ensemble feature selectors investigated in this work. Both allow the user to identify informative features in datasets with low sample sizes and focus on model interpretability. While RENT is purely data-driven, UBayFS can integrate expert knowledge a priori in the feature selection process. In this work, we compare both feature selectors on a dataset comprising 63 patients and 110 features from multiple sources, including baseline patient characteristics, baseline blood values, tumor histology, imaging, and treatment information. RESULTS Our experiments involve data-driven and expert-driven setups, as well as combinations of both. In a five-fold cross-validated experiment without expert knowledge, our results demonstrate that both feature selectors allow accurate predictions: A reduction from 110 to approximately 20 features (around 82%) delivers near-optimal predictive performances with minor variations according to the choice of the feature selector, the predictive model, and the fold. Thereafter, we use findings from clinical literature as a source of expert knowledge. In addition, expert knowledge has a stabilizing effect on the feature set (an increase in stability of approximately 40%), while the impact on predictive performance is limited. CONCLUSIONS The features WHO Performance Status, Albumin, Platelets, Ki-67, Tumor Morphology, Total MTV, Total TLG, and SUVmax are the most stable and predictive features in our study. Overall, this study demonstrated the practical value of feature selection in medical applications not only to improve quantitative performance but also to deliver potentially new insights to experts.
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Affiliation(s)
- Anna Jenul
- Department of Data Science, Norwegian University of Life Sciences, Universitetstunet 3, 1433 Ås, Norway.
| | - Henning Langen Stokmo
- Department of Nuclear Medicine, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Stefan Schrunner
- Department of Data Science, Norwegian University of Life Sciences, Universitetstunet 3, 1433 Ås, Norway.
| | | | - Mona-Elisabeth Revheim
- Department of Nuclear Medicine, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, Oslo, Norway.
| | - Oliver Tomic
- Department of Data Science, Norwegian University of Life Sciences, Universitetstunet 3, 1433 Ås, Norway.
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Galvin A, Courtinard C, Bouteiller F, Gourgou S, Dalenc F, Jacot W, Arnedos M, Bailleux C, Dieras V, Petit T, Emile G, Dubray-Longeras P, Frenel JS, Bachelot T, Mailliez A, Brain E, Desmoulins I, Massard V, Patsouris A, Goncalves A, Grinda T, Delaloge S, Bellera C. First-line real-world treatment patterns and survival outcomes in women younger or older than 40 years with metastatic breast cancer in the real-life multicenter French ESME cohort. Eur J Cancer 2024; 196:113422. [PMID: 37977105 DOI: 10.1016/j.ejca.2023.113422] [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: 10/10/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
AIM To describe first-line treatment patterns, overall survival (OS) and real-world progression-free survival (rwPFS) in young women (<40) with metastatic breast cancer (mBC), as compared to women aged 40-69. MATERIALS AND METHODS Data on adult women diagnosed with mBC (2008-2017) were extracted from the ESME mBC database (NCT03275311) which includes consecutive patients starting first-line metastatic treatment in one of the 18 French Comprehensive cancer centers. We reported first-line therapeutic strategy and prognostic factors of OS and rwPFS for women aged < 40 and 40-69. RESULTS In total, 14,897 mBC women were included (1512 aged <40). HR+ /HER2- mBC was the most frequent subtype. First-line treatment differed between young patients and older ones for HR+ /HER2- and Triple Negative (TN) mBC. Median OS for women aged < 40 and 40-69, respectively, was 46.9 and 46.2 months for HR+ /HER2- mBC; 13.5 and 15.2 for TN mBC; and, 60.7 and 55.1 for HER2 + mBC. Median rwPFS under first line treatment was 11.6 and 11.9 months for HR+ /HER2- in women aged < 40 and 40-69, respectively; 5.5 and 5.9 for TN, and, 13.3 and 12.9 for HER2 + . Factors associated with shorter OS and rwPFS were similar for both women aged < 40 and 40-69 and included ≥ 3 metastatic sites, visceral metastases, and longer MFI, with time-varying effects observed for several prognostic factors. CONCLUSION Young women presented more frequently with TN and HER2 + subtypes and aggressive mBC than women aged 40-69 did. Prognostic factors of OS and rwPFS were quite similar between age groups and mBC subtypes.
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Affiliation(s)
- Angéline Galvin
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, 33000 Bordeaux, France.
| | - Coralie Courtinard
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, 33000 Bordeaux, France; Unicancer, Data and Partnership Department, 101 Rue de Tolbiac, 75654 Paris, France
| | - Fanny Bouteiller
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, 33000 Bordeaux, France
| | - Sophie Gourgou
- Biometrics unit, Institut du Cancer de Montpellier, 208 Rue des Apothicaires, 34298 Montpellier, France; University of Montpellier, 34000 Montpellier, France
| | - Florence Dalenc
- Department of Medical Oncology, Oncopole Claudius Regaud - IUCT, 1 Avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier, 208 Rue des Apothicaires, 34298 Montpellier, France
| | - Monica Arnedos
- Department of Medical Oncology, Institut Bergonié, 229 Cours de l'Argonne, 33000 Bordeaux, France
| | - Caroline Bailleux
- Department of Medical Oncology, Centre Antoine Lacassagne, 33 Avenue de Valambrose, 06189 Nice, France
| | - Véronique Dieras
- Department of Medical Oncology, Centre Eugène Marquis, Avenue de la Bataille Flandres-Dunkerque, 35000 Rennes, France
| | - Thierry Petit
- Department of Medical Oncology, Centre Paul Strauss, 3 Rue de la Porte de l'Hôpital, 67000 Strasbourg, France
| | - George Emile
- Department of Medical Oncology, Centre François Baclesse, 3 Avenue du Général Harris, 14000 Caen, France
| | - Pascale Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, 58 Rue Montalembert, 63011 Clermont Ferrand, France
| | - Jean-Sébastien Frenel
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Boulevard Jacques Monod, 44805 Nantes, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, 69008 Lyon, France
| | - Audrey Mailliez
- Medical Oncology Department, Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, 26 Rue d'Ulm, 75005 Paris, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges-François Leclerc, 21079 Dijon, France
| | - Vincent Massard
- Medical Oncology Department, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, 6 Avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - Anne Patsouris
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest - Paul Papin, 15 rue André Boquel, 49055 Angers, France
| | - Anthony Goncalves
- Department of Medical Oncology, Institut Paoli-Calmettes, 232 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Thomas Grinda
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Suzette Delaloge
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Carine Bellera
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, 33000 Bordeaux, France; Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, 33000 Bordeaux, France
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10
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Guerreiro T, Forjaz G, Antunes L, Bastos J, Mayer A, Aguiar P, Araújo A, Nunes C. Lung cancer survival and sex-specific patterns in Portugal: A population-based analysis. Pulmonology 2023; 29 Suppl 4:S70-S79. [PMID: 34642125 DOI: 10.1016/j.pulmoe.2021.09.001] [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: 05/08/2021] [Revised: 08/10/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION In Portugal, lung cancer (LC) is the first cause of cancer-related death and of death and disability combined. This study aims to analyze the overall survival (OS) and relative survival (RS) of patients diagnosed with LC in 2009-2011 by socio-demographic and tumor characteristics, and analyze sex-specific patterns. METHODS We estimated 5-year OS using the Kaplan-Meier method and 5-year net survival through the RS framework. Cox regression modeling was used to determine the hazard ratio (HR) of death associated with each independent variable. FINDINGS For the 11,523 cases analyzed, median 5-year OS was 264 days (95% confidence interval [CI]: 254.8-273.2), the cumulative OS was 13.6% and RS was 15.1%. Males had a lower median survival (237 days; 95% CI: 228.2-245.7) compared to females (416 days; 95% CI: 384.4-447.6) (p < 0.0001) and lower 5-year RS proportions (12.1% vs. 24.9%). RS progressively decreased with age (41.7% for age-group <40 to 7.2% for ≥80) and stage (66.6% for stage I to 2.4% for stage IV). As predictors of decreased survival, we identified male gender, increasing age >50, histologic types (squamous cell carcinoma, non-small cell lung cancer not otherwise specified, other unspecified and small cell lung cancer), and increasing stage. Compared to women, the risk of death in men was 37.7% higher (HR = 1.386; 95% CI: 1.295-1.484). CONCLUSIONS The differences between OS and RS were small, reflecting the high lethality of LC. Male gender and older age are factors related to poor prognosis. Histology also plays a role in survival prognosis and varies with gender, but the factor related to the worst survival is stage. Although the study reflects data from a decade ago, and major changes occurred in diagnosis, staging and treatment, particularly for advanced disease, as LC mortality is strongly correlated with late stage diagnosis, all efforts should be made to secure early diagnosis and improve survival prospects.
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Affiliation(s)
- T Guerreiro
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal.
| | - G Forjaz
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA; Azores Oncological Centre, Azores, Portugal
| | - L Antunes
- Cancer Epidemiology Group, IPO Porto Research (CI-IPOP), Portuguese Institute of Oncology Francisco Gentil, Porto, Portugal
| | - J Bastos
- Portuguese Institute of Oncology Francisco Gentil, Coimbra, Portugal
| | - A Mayer
- Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal
| | - P Aguiar
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
| | - A Araújo
- University Hospital Center of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
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Mariotto AB, Botta L, Bernasconi A, Zou Z, Gatta G, Capocaccia R. Prediction of Risk of Metastatic Recurrence for Female Breast Cancer Patients in the Presence of Competing Causes of Death. Cancer Epidemiol Biomarkers Prev 2023; 32:1683-1689. [PMID: 37707367 DOI: 10.1158/1055-9965.epi-23-0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND To estimate risk of recurrence for women diagnosed with nonmetastatic breast cancer considering the risks of other causes mortality. METHODS We extend a method based on the diagnosis-metastasis-death pathway to include risks of other causes mortality. We estimate three probabilities as cumulative incidence of: (i) being alive and recurrence-free, (ii) death for other causes before a recurrence, and (iii) recurrence. We apply the method to female breast cancer relative survival from the Surveillance, Epidemiology, and End Results Program registries (2000-2018) data. RESULTS The cumulative incidence of recurrence shows a higher increase with more advanced cancer stage and is less influenced by age at diagnosis. At 5 years from diagnosis, the cumulative incidence of recurrence is less than 3% for those diagnosed with stage I, 10% to 13% for those diagnosed with stage II, and 37% to 47% for those diagnosed with stage III breast cancer. The estimates of recurrence considering versus ignoring the risks of dying from other causes were generally consistent, except for older women with more advanced stage, and longer time since diagnosis. In these groups, the net probability of recurrence, excluding the risks of dying from other causes, were overestimated. CONCLUSIONS For patients with cancer who are older or long-term survivors, it is important to include the risks of other cause mortality as the crude cumulative incidence of recurrence is a more appropriate measure. IMPACT These estimates are important in clinical decision making, as higher competing mortality may preclude the benefits of aggressive treatments.
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Affiliation(s)
- Angela B Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Alice Bernasconi
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Zhaohui Zou
- Information Management Services Inc., Calverton, Maryland
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Riccardo Capocaccia
- Independent Researcher (formerly affilliated with Istituto Superiore di Sanita), Rome, Italy
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12
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Parry MG, Sujenthiran A, Nossiter J, Morris M, Berry B, Nathan A, Aggarwal A, Payne H, van der Meulen J, Clarke NW. Prostate cancer outcomes following whole-gland and focal high-intensity focused ultrasound. BJU Int 2023; 132:568-574. [PMID: 37422679 DOI: 10.1111/bju.16122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
OBJECTIVE To report the 5-year failure-free survival (FFS) following high-intensity focused ultrasound (HIFU). PATIENTS AND METHODS This observational cohort study used linked National Cancer Registry data, radiotherapy data, administrative hospital data and mortality records of 1381 men treated with HIFU for clinically localised prostate cancer in England. The primary outcome, FFS, was defined as freedom from local salvage treatment and cancer-specific mortality. Secondary outcomes were freedom from repeat HIFU, prostate cancer-specific survival (CSS) and overall survival (OS). Cox regression was used to determine whether baseline characteristics, including age, treatment year, T stage and International Society of Urological Pathology (ISUP) Grade Group were associated with FFS. RESULTS The median (interquartile range [IQR]) follow-up was 37 (20-62) months. The median (IQR) age was 65 (59-70) years and 81% had an ISUP Grade Group of 1-2. The FFS was 96.5% (95% confidence interval [CI] 95.4%-97.4%) at 1 year, 86.0% (95% CI 83.7%-87.9%) at 3 years and 77.5% (95% CI 74.4%-80.3%) at 5 years. The 5-year FFS for ISUP Grade Groups 1-5 was 82.9%, 76.6%, 72.2%, 52.3% and 30.8%, respectively (P < 0.001). Freedom from repeat HIFU was 79.1% (95% CI 75.7%-82.1%), CSS was 98.8% (95% CI 97.7%-99.4%) and OS was 95.9% (95% CI 94.2%-97.1%) at 5 years. CONCLUSION Four in five men were free from local salvage treatment at 5 years but treatment failure varied significantly according to ISUP Grade Group. Patients should be appropriately informed with respect to salvage radical treatment following HIFU.
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Affiliation(s)
- Matthew G Parry
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
| | - Arunan Sujenthiran
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
- Flatiron, London, UK
| | - Julie Nossiter
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
| | - Melanie Morris
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
| | - Brendan Berry
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
| | - Arjun Nathan
- The National Prostate Cancer Audit, Clinical Effectiveness Unit, Royal College of Surgeons of UK, London, UK
- University College London, London, UK
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Radiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Heather Payne
- Department of Oncology, University College London Hospitals, London, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Noel W Clarke
- Departments of Urology, The Christie and Salford Royal Hospitals, Manchester, UK
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13
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Zhu A, Rhodes S, Dong W, Rose J, Cullen J, Miller DB, Spratt DE, Ponsky L, Shoag D, Trapl E, Schumacher F, Penukonda S, Brant A, Strasser MO, Koroukian SM, Markt S, Shoag JE. Individual-level home values and cancer mortality in a statewide registry. JNCI Cancer Spectr 2023; 7:pkad076. [PMID: 37796836 PMCID: PMC10646779 DOI: 10.1093/jncics/pkad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Prior work assessing disparities in cancer outcomes has relied on regional socioeconomic metrics. These metrics average data across many individuals, resulting in a loss of granularity and confounding with other regional factors. METHODS Using patients' addresses at the time of diagnosis from the Ohio Cancer Incidence Surveillance System, we retrieved individual home price estimates from an online real estate marketplace. This individual-level estimate was compared with the Area Deprivation Index (ADI) at the census block group level. Multivariable Cox proportional hazards models were used to determine the relationship between home price estimates and all-cause and cancer-specific mortality. RESULTS A total of 667 277 patients in Ohio Cancer Incidence Surveillance System were linked to individual home prices across 16 cancers. Increasing home prices, adjusted for age, stage at diagnosis, and ADI, were associated with a decrease in the hazard of all-cause and cancer-specific mortality (hazard ratio [HR] = 0.92, 95% confidence interval [CI] = 0.92 to 0.93, and HR = 0.95, 95% CI = 0.94 to 0.95, respectively). Following a cancer diagnosis, individuals with home prices 2 standard deviations above the mean had an estimated 10-year survival probability (7.8%, 95% CI = 7.2% to 8.3%) higher than those with home prices 2 standard deviations below the mean. The association between home price and mortality was substantially more prominent for patients living in less deprived census block groups (Pinteraction < .001) than for those living in more deprived census block groups. CONCLUSION Higher individual home prices were associated with improved all-cause and cancer-specific mortality, even after accounting for regional measures of deprivation.
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Affiliation(s)
- Alec Zhu
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Stephen Rhodes
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Weichuan Dong
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Johnie Rose
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David B Miller
- Department of Social Work, Mandel School of Applied Social Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Daniel E Spratt
- Department of Radiation Oncology, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Lee Ponsky
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Daniel Shoag
- Department of Economics, Weatherhead School of Management, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Fredrick Schumacher
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Suhas Penukonda
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Aaron Brant
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Mary O Strasser
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Siran M Koroukian
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sarah Markt
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jonathan E Shoag
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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14
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Islam F, Nath N, Zehravi M, Khan J, Jashim SBT, Charde MS, Chakole RD, Kumar KP, Babu AK, Nainu F, Khan SL, Rab SO, Emran TB, Wilairatana P. Exploring the role of natural bioactive molecules in genitourinary cancers: how far has research progressed? NATURAL PRODUCTS AND BIOPROSPECTING 2023; 13:39. [PMID: 37843642 PMCID: PMC10579213 DOI: 10.1007/s13659-023-00400-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/17/2023] [Indexed: 10/17/2023]
Abstract
The primary approaches to treat cancerous diseases include drug treatment, surgical procedures, biotherapy, and radiation therapy. Chemotherapy has been the primary treatment for cancer for a long time, but its main drawback is that it kills cancerous cells along with healthy ones, leading to deadly adverse health effects. However, genitourinary cancer has become a concern in recent years as it is more common in middle-aged people. So, researchers are trying to find possible therapeutic options from natural small molecules due to the many drawbacks associated with chemotherapy and other radiation-based therapies. Plenty of research was conducted regarding genitourinary cancer to determine the promising role of natural small molecules. So, this review focused on natural small molecules along with their potential therapeutic targets in the case of genitourinary cancers such as prostate cancer, renal cancer, bladder cancer, testicular cancer, and so on. Also, this review states some ongoing or completed clinical evidence in this regard.
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Affiliation(s)
- Fahadul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh
| | - Nikhil Nath
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong, 4318, Bangladesh
| | - Mehrukh Zehravi
- Department of Clinical Pharmacy, College of Dentistry & Pharmacy, Buraydah Private Colleges, Buraydah, 51418, Kingdom of Saudi Arabia.
| | - Jishan Khan
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong, 4318, Bangladesh
| | - Sumiya Ben-Ta Jashim
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong, 4318, Bangladesh
| | - Manoj Shrawan Charde
- Government College of Pharmacy, Vidyanagar, Karad, Satara, 415124, Maharashtra, India
| | - Rita Dadarao Chakole
- Government College of Pharmacy, Vidyanagar, Karad, Satara, 415124, Maharashtra, India
| | - K Praveen Kumar
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Govt. of NCT of Delhi, Delhi Pharmaceutical Sciences and Research University (DPSRU), Mehrauli-Badarpur Road, PushpVihar, Sector 3, New Delhi, 110017, India
| | - A Kishore Babu
- Ratnadeep College of Pharmacy, Ratnapur, Jamkhed, Ahmednagar, 413206, Maharashtra, India
| | - Firzan Nainu
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Sharuk L Khan
- Department of Pharmaceutical Chemistry, N.B.S. Institute of Pharmacy, Ausa, 413520, Maharashtra, India
| | - Safia Obaidur Rab
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Talha Bin Emran
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh.
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School & Legorreta Cancer Center, Brown University, Providence, RI, 02912, USA.
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
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15
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Wilkinson AN, Ellison LF, Billette JM, Seely JM. Impact of Breast Cancer Screening on 10-Year Net Survival in Canadian Women Age 40-49 Years. J Clin Oncol 2023; 41:4669-4677. [PMID: 37540825 PMCID: PMC10564321 DOI: 10.1200/jco.23.00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 08/06/2023] Open
Abstract
PURPOSE In Canada, some provincial/territorial mammography screening programs include women age 40-49 years, whereas others do not. This study examines the impact of this dichotomy on the 10-year breast cancer (BC) net survival (NS) among women age 40-49 years and 50-59 years at diagnosis. METHODS Using the Canadian Cancer Registry data record linked to death information, we evaluated the cohort of Canadian women age 40-49 years and 50-59 years diagnosed with BC from 2002 to 2007. We compared 10-year NS estimates in the jurisdictions with organized screening programs that included women age 40-49 years, designated as screeners (Northwest Territories, British Columbia, Alberta, Nova Scotia, and Prince Edward Island), with comparator programs that did not (Yukon, Manitoba, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador). RESULTS BC was the primary cause of 10-year mortality in women age 40-49 years diagnosed with BC (90.7% of deaths). Among these women, the 10-year NS for screeners (84.8%; 95% CI, 83.8 to 85.8) was 1.9 percentage points (pp) higher than that for comparators (82.9%; 95% CI, 82.3 to 83.5; P = .001). The difference in favor of screeners was significant among women age 45-49 years (2.6 pp; P = .001) but not among women age 40-44 years (0.9 pp; P = .328). Similarly, the incidence-based BC mortality rate was significantly lower in screener jurisdictions among women age 40-49 years and 45-49 years, but not for 40-44 years. Provincial/territorial NS increased significantly with higher mammography screening participation (P = .003). The BC incidence rate was virtually identical in screener and comparator jurisdictions among women age 40-49 years (P = .976) but was significantly higher for comparators among women age 50-59 years (P < .001). CONCLUSION Screening programs that included women in their 40s were associated with a significantly higher BC 10-year NS in women age 40-49 years, but not an increased rate of BC diagnosis. These results may inform screening guidelines for women age 40-49 years.
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Affiliation(s)
| | - Larry F. Ellison
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean-Michel Billette
- Centre for Population Health Data at Statistics Canada, Government of Canada, Ottawa, Canada
| | - Jean M. Seely
- University of Ottawa, Department of Radiology, Ottawa Hospital Research Institute, Ottawa, Canada
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16
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Pendl‐Robinson E, Calkins KL, Simon SE, Barrett K, Poznyak D. The reliability and validity of lung cancer and melanoma clinical quality survival measures. Health Serv Res 2023; 58:1131-1140. [PMID: 37669902 PMCID: PMC10480076 DOI: 10.1111/1475-6773.14164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE To develop a risk adjustment approach and test reliability and validity for oncology survival measures. DATA SOURCES AND STUDY SETTING We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2010 to 2013, with mortality data through 2015. STUDY DESIGN We developed 2-year risk-standardized survival rates (RSSR) for melanoma, non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC). Patients were attributed to group practices based on the plurality of visits. We identified the risk-adjustment variables via bootstrap and calculated the RSSRs. Reliability was tested via three approaches: (1) signal-to-noise ratio (SNR) reliability, (2) split-half, and (3) test-retest using bootstrap. We tested known group validity by stage at diagnosis using Cohen's d. DATA COLLECTION/EXTRACTION METHODS We selected all patients enrolled in Medicare and linked to SEER during the measurement period with an incident first primary diagnosis of stage I-IV melanoma, NSCLC, or SCLC. We excluded patients with missing data on month and/or stage of diagnosis. PRINCIPAL FINDINGS Results are based on patients with melanoma (n = 4344); NSCLC (n = 16,080); and SCLC (n = 2807) diagnosed between 2012 and 2013. The median (interquartile range) for the RSSRs at the group practice-level were 0.89 (0.83-0.87) for melanoma, 0.37 (0.30-0.43) for NSCLC, and 0.19 (0.11-0.25) for SCLC. C-statistics for the models ranged from 0.725 to 0.825. The reliability varied by approach with median SNR 0.20, 0.25, and 0.13; median test-retest 0.59, 0.57, and 0.56; median split-half reliability 0.21, 0.29, and 0.29 for melanoma, NSCLC, and SCLC, respectively. Cohen's d for stage I-IIIa and IIIb+ was 1.27, 0.86, 0.60 for melanoma, NSCLC, and SCLC, respectively. CONCLUSIONS Our results suggest that these cancer survival measures demonstrated adequate test-retest reliability and expected findings for the known-group validity analysis. If data limitations and feasibility challenges can be addressed, implementation of these quality measures may provide a survival metric used for oncology quality improvement efforts.
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Banham D, Karnon J, Brown A, Roder D, Lynch J. The fraction of life years lost after diagnosis (FLYLAD): a person-centred measure of cancer burden. Popul Health Metr 2023; 21:14. [PMID: 37704992 PMCID: PMC10500871 DOI: 10.1186/s12963-023-00314-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cancer control initiatives are informed by quantifying the capacity to reduce cancer burden through effective interventions. Burden measures using health administrative data are a sustainable way to support monitoring and evaluating of outcomes among patients and populations. The Fraction of Life Years Lost After Diagnosis (FLYLAD) is one such burden measure. We use data on Aboriginal and non-Aboriginal South Australians from 1990 to 2010 to show how FLYLAD quantifies disparities in cancer burden: between populations; between sub-population cohorts where stage at diagnosis is available; and when follow-up is constrained to 24-months after diagnosis. METHOD FLYLADcancer is the fraction of years of life expectancy lost due to cancer (YLLcancer) to life expectancy years at risk at time of cancer diagnosis (LYAR) for each person. The Global Burden of Disease standard life table provides referent life expectancies. FLYLADcancer was estimated for the population of cancer cases diagnosed in South Australia from 1990 to 2010. Cancer stage at diagnosis was also available for cancers diagnosed in Aboriginal people and a cohort of non-Aboriginal people matched by sex, year of birth, primary cancer site and year of diagnosis. RESULTS Cancers diagnoses (N = 144,891) included 777 among Aboriginal people. Cancer burden described by FLYLADcancer was higher among Aboriginal than non-Aboriginal (0.55, 95% CIs 0.52-0.59 versus 0.39, 95% CIs 0.39-0.40). Diagnoses at younger ages among Aboriginal people, 7 year higher LYAR (31.0, 95% CIs 30.0-32.0 versus 24.1, 95% CIs 24.1-24.2) and higher premature cancer mortality (YLLcancer = 16.3, 95% CIs 15.1-17.5 versus YLLcancer = 8.2, 95% CIs 8.2-8.3) influenced this. Disparities in cancer burden between the matched Aboriginal and non-Aboriginal cohorts manifested 24-months after diagnosis with FLYLADcancer 0.44, 95% CIs 0.40-0.47 and 0.28, 95% CIs 0.25-0.31 respectively. CONCLUSION FLYLAD described disproportionately higher cancer burden among Aboriginal people in comparisons involving: all people diagnosed with cancer; the matched cohorts; and, within groups diagnosed with same staged disease. The extent of disparities were evident 24-months after diagnosis. This is evidence of Aboriginal peoples' substantial capacity to benefit from cancer control initiatives, particularly those leading to earlier detection and treatment of cancers. FLYLAD's use of readily available, person-level administrative records can help evaluate health care initiatives addressing this need.
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Affiliation(s)
- David Banham
- School of Public Health, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
- Wardliparingga Aboriginal Health Research, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Research, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
| | - David Roder
- School of Health Sciences, Cancer Research Institute, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia
| | - John Lynch
- School of Public Health, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
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Omotoso O, Teibo JO, Atiba FA, Oladimeji T, Paimo OK, Ataya FS, Batiha GES, Alexiou A. Addressing cancer care inequities in sub-Saharan Africa: current challenges and proposed solutions. Int J Equity Health 2023; 22:189. [PMID: 37697315 PMCID: PMC10496173 DOI: 10.1186/s12939-023-01962-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/13/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION Cancer is a significant public health challenge globally, with nearly 2000 lives lost daily in Africa alone. Without adequate measures, mortality rates are likely to increase. The major challenge for cancer care in Africa is equity and prioritization, as cancer is not receiving adequate attention from policy-makers and strategic stakeholders in the healthcare space. This neglect is affecting the three primary tiers of cancer care: prevention, diagnosis, and treatment/management. To promote cancer care equity, addressing issues of equity and prioritization is crucial to ensure that everyone has an equal chance at cancer prevention, early detection, and appropriate care and follow-up treatment. METHODOLOGY Using available literature, we provide an overview of the current state of cancer care in Africa and recommendations to close the gap. RESULTS We highlight several factors that contribute to cancer care inequity in Africa, including inadequate funding for cancer research, poor cancer education or awareness, inadequate screening or diagnostic facilities, lack of a well-organized and effective cancer registry system and access to care, shortage of specialized medical staff, high costs for screening, vaccination, and treatment, lack of technical capacity, poor vaccination response, and/or late presentation of patients for cancer screening. We also provide recommendations to address some of these obstacles to achieving cancer care equity. Our recommendations are divided into national-level initiatives and capacity-based initiatives, including cancer health promotion and awareness by healthcare professionals during every hospital visit, encouraging screening and vaccine uptake, ensuring operational regional and national cancer registries, improving healthcare budgeting for staff, equipment, and facilities, building expertise through specialty training, funding for cancer research, providing insurance coverage for cancer care, and implementing mobile health technology for telemedicine diagnosis. CONCLUSION Addressing challenges to cancer equity holistically would improve the likelihood of longer survival for cancer patients, lower the risk factors for groups that are already at risk, and ensure equitable access to cancer care on the continent. This study identifies the existing stance that African nations have on equity in cancer care, outlines the current constraints, and provides suggestions that could make the biggest difference in attaining equity in cancer care.
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Affiliation(s)
- Olabode Omotoso
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria
| | - John Oluwafemi Teibo
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria.
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Festus Adebayo Atiba
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Oluwatomiwa Kehinde Paimo
- Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Farid S Ataya
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, 11451, Riyadh, Saudi Arabia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, AlBeheira, 22511, Damanhour, Egypt
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, NSW, 2770, Hebersham, Australia
- AFNP Med, 1030, Wien, Austria
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Adrianzen-Herrera D, Sparks AD, Batra A, Zakai NA. Survival gains in myelodysplastic syndromes following a decade of the modern treatment paradigm. Leuk Lymphoma 2023; 64:1574-1578. [PMID: 37300451 DOI: 10.1080/10428194.2023.2220451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Diego Adrianzen-Herrera
- Department of Medicine, Division of Hematology and Oncology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Andrew D Sparks
- Biomedical Statistics Research Core, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Akshee Batra
- Department of Medicine, Division of Hematology and Oncology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Neil A Zakai
- Department of Medicine, Division of Hematology and Oncology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
- Department of Pathology and Laboratory Medicine, Oncology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
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Pham TD. Prediction of Five-Year Survival Rate for Rectal Cancer Using Markov Models of Convolutional Features of RhoB Expression on Tissue Microarray. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2023; 20:3195-3204. [PMID: 37155403 DOI: 10.1109/tcbb.2023.3274211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The ability to predict survival in cancer is clinically important because the finding can help patients and physicians make optimal treatment decisions. Artificial intelligence in the context of deep learning has been increasingly realized by the informatics-oriented medical community as a powerful machine-learning technology for cancer research, diagnosis, prediction, and treatment. This paper presents the combination of deep learning, data coding, and probabilistic modeling for predicting five-year survival in a cohort of patients with rectal cancer using images of RhoB expression on biopsies. Using about one-third of the patients' data for testing, the proposed approach achieved 90% prediction accuracy, which is much higher than the direct use of the best pretrained convolutional neural network (70%) and the best coupling of a pretrained model and support vector machines (70%).
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Huanca P, Guzmán-Pincheira C, Duran-Aguero S. Adherence to safe food-handling practices and dietary patterns in cancer survivors. Clin Nutr ESPEN 2023; 56:135-141. [PMID: 37344063 DOI: 10.1016/j.clnesp.2023.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/30/2023] [Accepted: 04/30/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND In Chile there is a high risk profile of developing cancer which is associated, among other factors, to eating behaviors and, in this line, it is essential for cancer survivors to have access to nutritional advice that includes aproppriate food safety practices. The objective of this study is to characterize the level of adherence of cancer survivors to safe food-handling practices and dietary patterns in a Chilean National Health Survey. METHODS Secondary analysis study, conducted using the National Health Survey 2016-2017 database. The association between adherence to dietary patterns and safe food-handling practices was conducted by means of a logistic regression analisys, considering a p value of <0.05 as statistically significant. RESULTS 2765 participants, females, 5.8% were cancer survivors who adhered twice more to the safe food-handling practice "wash your hands with soap and water before preparing food and before eating", and 1.5 times more to the practice "keep raw meat separate from other foods when preparing food or cooking". In both groups, it was observed a low adherence to achieve the recommendations on healthy weight, physical activity, fruits and vegetables consumption, and alcohol and sugar-sweetened beverages consumption of the WCRF/AICR. CONCLUSIONS Partial adherence to the safe food-handling recommendations and low adherence to the WCRF/AICR recommendations were observed among cancer survivors and subjects without cancer.
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Affiliation(s)
- Paula Huanca
- Escuela de Nutrición y Dietética. Facultad de Ciencias para el Cuidado de la Salud. Universidad San Sebastian, Chile; Clínica Santa María, Chile
| | - Carla Guzmán-Pincheira
- Escuela de Nutrición y Dietética. Facultad de Ciencias para el Cuidado de la Salud. Universidad San Sebastian, Chile
| | - Samuel Duran-Aguero
- Escuela de Nutrición y Dietética. Facultad de Ciencias para el Cuidado de la Salud. Universidad San Sebastian, Chile.
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Park BK, Seo JH, Han JH, Lee KJ, Son KJ, Choi JK. Trends in treatment patterns and survival outcomes in pancreatic cancer: A nationwide population-based study in Korea. Eur J Cancer 2023; 189:112932. [PMID: 37352643 DOI: 10.1016/j.ejca.2023.05.020] [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: 11/01/2022] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND The treatment of pancreatic cancer has evolved; however, real-world data on treatment trends remain scarce. This study investigated treatment patterns for pancreatic cancer and patient survival using a nationwide population-based study in Korea. METHODS Using the National Health Insurance database, data from 78,920 patients diagnosed with pancreatic cancer in Korea between 2006 and 2019 were extracted. Treatment patterns and survival by age group and year of diagnosis were examined. RESULTS Primary treatment was delivered as follows: 16,562 patients (21.0%) underwent surgery, 20,998 patients (26.6%) received chemotherapy, 1332 patients (1.7%) received chemoradiotherapy, and 40,040 patients (50.7%) received supportive care only. The proportion of patients undergoing surgery or chemotherapy increased gradually in all age groups over time. The commonly used anti-cancer drugs have changed from gemcitabine±erlotinib to gemcitabine+nab-paclitaxel and FOLFIRINOX. Survival improved mainly in patients who underwent surgery or chemotherapy. Median overall survival for all patients improved from 5.5 months in 2006-2008 to 9.8 months in 2018-2019, with greater improvement observed in younger age groups: 8.8-18.8 months, age ≤59 years, 6.8-14.6 months, age 60-69 years, 4.2-8.3 months, age 70-79 years and 2.4-3.4 months, age ≥80 years (all p < 0.0001). CONCLUSIONS An increase in the rates of surgery and chemotherapy for pancreatic cancer was observed. Survival rates for pancreatic cancer have generally improved over the past decade and are greater in patients undergoing surgery or chemotherapy and in younger age groups.
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Affiliation(s)
- Byung Kyu Park
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
| | - Jeong Hun Seo
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyong Joo Lee
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Kang Ju Son
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jung Kyu Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Korea
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Sung H, Nisotel L, Sedeta E, Islami F, Jemal A. Racial and Ethnic Disparities in Survival Among People With Second Primary Cancer in the US. JAMA Netw Open 2023; 6:e2327429. [PMID: 37540510 PMCID: PMC10403787 DOI: 10.1001/jamanetworkopen.2023.27429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/24/2023] [Indexed: 08/05/2023] Open
Abstract
Importance Comprehensive data for racial and ethnic disparities after second primary cancers (SPCs) are lacking despite the growing burden of SPCs. Objective To quantify racial and ethnic disparities in survival among persons with SPCs. Design, Setting, and Participants This population-based, retrospective cohort study used data from 18 Surveillance, Epidemiology, and End Results registries in the US for persons diagnosed with the most common SPCs at age 20 years or older from January 1, 2000, to December 31, 2013 (with follow-up through December 31, 2018). Data were analyzed between January and April 2023. Exposure Race and ethnicity (Hispanic, non-Hispanic Asian or Pacific Islander, non-Hispanic Black, and non-Hispanic White). Main Outcomes and Measures The main outcomes were 5-year relative survival and cause-specific survival. Cause-specific hazard ratios (HRs) were calculated for death from cancer or cardiovascular disease (CVD) in each racial and ethnic minority population compared with the White population overall and stratified by SPC type, with adjustment for sex, year and age at SPC diagnosis, and prior cancer type and stage (baseline model) and additionally for county attributes (household income, urbanicity), SPC characteristics (stage, subtype), and treatment. Results Among 230 370 persons with SPCs (58.4% male), 4.5% were Asian or Pacific Islander, 9.6% were Black, 6.4% were Hispanic, and 79.5% were White. A total of 109 757 cancer-related deaths (47.6%) and 18 283 CVD-related deaths (7.9%) occurred during a median follow-up of 54 months (IQR, 12-93 months). In baseline models, compared with the White population, the risk of cancer-related death overall was higher in the Black (HR, 1.21; 95% CI, 1.18-1.23) and Hispanic (HR, 1.10; 95% CI, 1.07-1.13) populations but lower in the Asian or Pacific Islander population (HR, 0.93; 95% CI, 0.90-0.96). When stratified by 13 SPC types, the risk of cancer-related death was higher for 10 SPCs in the Black population, with the highest HR for uterine cancer (HR, 1.87; 95% CI, 1.63-2.15), and for 7 SPCs in the Hispanic population, most notably for melanoma (HR, 1.46; 95% CI, 1.21-1.76). For CVD-related death, the overall HR was higher in the Black population (HR, 1.41; 95% CI, 1.34-1.49), with elevated risks evident for 11 SPCs, but lower in the Asian or Pacific Islander (HR, 0.75; 95% CI, 0.69-0.81) and Hispanic (HR, 0.90; 95% CI, 0.84-0.96) populations than in the White population. After further adjustments for county attributes and SPC characteristics and treatment, HRs were reduced for cancer-related death and for CVD-related death and associations in the same direction remained. Conclusions and Relevance In this cohort study of SPC survivors, the Black population had the highest risk of both death from cancer and death from CVD, and the Hispanic population had a higher risk of death from cancer than the White population. Attenuations in HRs after adjustment for potentially modifiable factors highlight opportunities to reduce survival disparities among persons with multiple primary cancers.
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Affiliation(s)
- Hyuna Sung
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Lauren Nisotel
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ephrem Sedeta
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York
| | - Farhad Islami
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
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24
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Chronological horse herd optimization-based gene selection with deep learning towards survival prediction using PAN-Cancer gene-expression data. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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25
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Toffolutti F, Guzzinati S, De Paoli A, Francisci S, De Angelis R, Crocetti E, Botta L, Rossi S, Mallone S, Zorzi M, Manneschi G, Bidoli E, Ravaioli A, Cuccaro F, Migliore E, Puppo A, Ferrante M, Gasparotti C, Gambino M, Carrozzi G, Stracci F, Michiara M, Cavallo R, Mazzucco W, Fusco M, Ballotari P, Sampietro G, Ferretti S, Mangone L, Rizzello RV, Mian M, Cascone G, Boschetti L, Galasso R, Piras D, Pesce MT, Bella F, Seghini P, Fanetti AC, Pinna P, Serraino D, Dal Maso L. Complete prevalence and indicators of cancer cure: enhanced methods and validation in Italian population-based cancer registries. Front Oncol 2023; 13:1168325. [PMID: 37346072 PMCID: PMC10280813 DOI: 10.3389/fonc.2023.1168325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives To describe the procedures to derive complete prevalence and several indicators of cancer cure from population-based cancer registries. Materials and methods Cancer registry data (47% of the Italian population) were used to calculate limited duration prevalence for 62 cancer types by sex and registry. The incidence and survival models, needed to calculate the completeness index (R) and complete prevalence, were evaluated by likelihood ratio tests and by visual comparison. A sensitivity analysis was conducted to explore the effect on the complete prevalence of using different R indexes. Mixture cure models were used to estimate net survival (NS); life expectancy of fatal (LEF) cases; cure fraction (CF); time to cure (TTC); cure prevalence, prevalent patients who were not at risk of dying as a result of cancer; and already cured patients, those living longer than TTC at a specific point in time. CF was also compared with long-term NS since, for patients diagnosed after a certain age, CF (representing asymptotical values of NS) is reached far beyond the patient's life expectancy. Results For the most frequent cancer types, the Weibull survival model stratified by sex and age showed a very good fit with observed survival. For men diagnosed with any cancer type at age 65-74 years, CF was 41%, while the NS was 49% until age 100 and 50% until age 90. In women, similar differences emerged for patients with any cancer type or with breast cancer. Among patients alive in 2018 with colorectal cancer at age 55-64 years, 48% were already cured (had reached their specific TTC), while the cure prevalence (lifelong probability to be cured from cancer) was 89%. Cure prevalence became 97.5% (2.5% will die because of their neoplasm) for patients alive >5 years after diagnosis. Conclusions This study represents an addition to the current knowledge on the topic providing a detailed description of available indicators of prevalence and cancer cure, highlighting the links among them, and illustrating their interpretation. Indicators may be relevant for patients and clinical practice; they are unambiguously defined, measurable, and reproducible in different countries where population-based cancer registries are active.
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Affiliation(s)
- Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | | | | | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Emanuele Crocetti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Sandra Mallone
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Manuel Zorzi
- Epidemiological Department, Azienda Zero, Padua, Italy
| | - Gianfranco Manneschi
- Tuscany Cancer Registry, Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Alessandra Ravaioli
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Forlì, Italy
| | - Francesco Cuccaro
- Registro Tumori Puglia - Sezione Azienda Sanitaria Locale (ASL) Barletta-Andria-Trani, Epidemiologia e Statistica, Barletta, Italy
| | - Enrica Migliore
- Piedmont Cancer Registry, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte and University of Turin, Turin, Italy
| | - Antonella Puppo
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Margherita Ferrante
- Registro tumori integrato di Catania-Messina-Enna, Igiene Ospedaliera, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Cinzia Gasparotti
- Struttura Semplice Epidemiologia, Agenzia di Tutela della Salute (ATS) Brescia, Brescia, Italy
| | - Maria Gambino
- Registro tumori ATS Insubria (Provincia di Como e Varese) Responsabile S.S. Epidemiologia Registri Specializzati e Reti di Patologia, Varese, Italy
| | - Giuliano Carrozzi
- Emilia-Romagna Cancer Registry, Modena Unit, Public Health Department, Local Health Authority, Modena, Italy
| | - Fabrizio Stracci
- Umbria Cancer Registry, Public Health Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Maria Michiara
- Emilia-Romagna Cancer Registry, Parma Unit, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Rossella Cavallo
- Cancer Registry Azienda Sanitaria Locale (ASL) Salerno- Dipartimento di Prevenzione, Salerno, Italy
| | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, Palermo, Italy
| | - Mario Fusco
- Registro Tumori ASL Napoli 3 Sud, Napoli, Italy
| | | | | | - Stefano Ferretti
- Emilia-Romagna Cancer Registry, Ferrara Unit, Local Health Authority, Ferrara, and University of Ferrara, Ferrara, Italy
| | - Lucia Mangone
- Emilia-Romagna Cancer Registry, Reggio Emilia Unit, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Michael Mian
- Innovation, Research and Teaching Service (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano-Bozen, Italy
| | - Giuseppe Cascone
- Azienda Sanitaria Provinciale (ASP) Ragusa - Dipartimento di Prevenzione -Registro Tumori, Ragusa, Italy
| | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | | | - Maria Teresa Pesce
- Monitoraggio rischio ambientale e Registro Tumori ASL Caserta, Caserta, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Siracusa, Italy
| | - Pietro Seghini
- Emilia-Romagna Cancer Registry, Piacenza Unit, Public Health Department, AUSL Piacenza, Piacenza, Italy
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Agenzia di Tutela della Salute della Montagna, Sondrio, Italy
| | - Pasquala Pinna
- Nuoro Cancer Registry, RT Nuoro, Servizio Igiene e Sanità Pubblica, ASL Nuoro, Nuoro, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
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Pohar Perme M, de Wreede LC, Manevski D. What is relative survival and what is its role in haematology? Best Pract Res Clin Haematol 2023; 36:101474. [PMID: 37353298 DOI: 10.1016/j.beha.2023.101474] [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: 01/17/2023] [Revised: 03/01/2023] [Accepted: 05/02/2023] [Indexed: 06/25/2023]
Abstract
In many haematological diseases, the survival probability is the key outcome. However, when the population of patients is rather old and the follow-up long, a significant proportion of deaths cannot be attributed to the studied disease. This lessens the importance of common survival analysis measures like overall survival and shows the need for other outcome measures requiring more complex methodology. When disease-specific information is of interest but the cause of death is not available in the data, relative survival methodology becomes crucial. The idea of relative survival is to merge the observed data set with the mortality data in the general population and thus allow for an indirect estimation of the burden of the disease. In this work, an overview of different measures that can be of interest in the field of haematology is given. We introduce the crude mortality that reports the probability of dying due to the disease of interest; the net survival that focuses on excess hazard alone and presents the key measure in comparing the disease burden of patients from populations with different general population mortality; and the relative survival ratio which gives a simple comparison of the patients' and the general population survival. We explain the properties of each measure, and some brief notes are given on estimation. Furthermore, we describe how association with covariates can be studied. All the methods and their estimators are illustrated on a sub-cohort of older patients who received a first allogeneic hematopoietic stem cell transplantation for myelodysplastic syndromes or secondary acute myeloid leukemia, to show how different methods can provide different insights into the data.
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Affiliation(s)
- Maja Pohar Perme
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - Liesbeth C de Wreede
- Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, the Netherlands; Clinical Trials Unit, DKMS, Augsburger Strasse 3, 01309, Dresden, Germany
| | - Damjan Manevski
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia
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27
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Taniguchi AN, Sutton SR, Nguyen SA, Kejner AE, Albergotti WG. The Lack of Standardized Outcomes for Surgical Salvage of HPV-Positive Recurrent Oropharyngeal Squamous Cell Carcinoma: A Systematic Scoping Review. Cancers (Basel) 2023; 15:2832. [PMID: 37345169 DOI: 10.3390/cancers15102832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Although HPV status is known to provide an improved prognosis in initial treatments of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), it is unclear how it affects patients who receive salvage surgery (SS), which has historically poor survival rates. The purpose of this study was to evaluate the role of SS for patients with locoregional recurrence (LRR) of HPV-positive OPSCC and its impact survival rates. We conducted a scoping review of literature through October 2022 and included 995 individuals. Survival endpoints, such as overall survival (OS), Kaplan-Meier curves, and median post-recurrence survival, were analyzed in addition to demographics. Of all studies, 18.8% (6/32) reported any survival data for SS patients, with the most prevalent reporting 2- and 5-year OS in two studies. Median post-recurrence survival was not reported for SS. These findings reveal the limited and unpredictable reporting of survival-specific data on SS for HPV-positive OPSCC. With limited survival assessment, it is difficult to assess the potential advantages and disadvantages of this therapy to guide clinical decision-making.
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Affiliation(s)
- April N Taniguchi
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Sarah R Sutton
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
- School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Alexandra E Kejner
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - William G Albergotti
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
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28
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Hemminki K, Försti A, Liska V, Kanerva A, Hemminki O, Hemminki A. Long-term survival trends in solid cancers in the Nordic countries marking timing of improvements. Int J Cancer 2023; 152:1837-1846. [PMID: 36571455 DOI: 10.1002/ijc.34416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/12/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
Survival studies are an important indicator of the success of cancer control. We analyzed the 5-year relative survival in 23 solid cancers in Denmark, Finland, Norway and Sweden over a 50-year period (1970-2019) at the NORDCAN database accessed from the International Agency for Research on Cancer website. We plotted survival curves in 5-year periods and showed 5-year periodic survival. The survival results were summarized in four groups: (1) cancers with historically good survival (>50% in 1970-1974) which include melanoma and breast, endometrial and thyroid cancers; (2) cancers which constantly improved survival at least 20% units over the 50 year period, including cancers of the stomach, colon, rectum, kidney, brain and ovary; (3) cancer with increase in survival >20% units with changes taking place in a narrow time window, including oral, oropharyngeal, testicular and prostate cancers; (4) the remaining cancers with <20% unit improvement in survival including lung, esophageal, liver, pancreatic, bladder, soft tissue, penile, cervical and vulvar cancers. For cancers in groups 1 and 2, the constant development implied multiple improvements in therapy, diagnosis and patient care. Cancers in group 3 included testicular cancers with known therapeutic improvements but for the others large incidence changes probably implied that cancer stage (prostate) or etiology (oropharynx) changed into a more tractable form. Group 4 cancers included those with dismal survival 50 years ago but a clear tendency upwards. In 17 cancers 5-year survival reached between 50% and 100% while in only six cancers it remained at below 50%.
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Affiliation(s)
- Kari Hemminki
- Biomedical Center and Faculty of Medicine, Pilsen, Charles University in Prague, Pilsen, Czech Republic.,Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Asta Försti
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Vaclav Liska
- Biomedical Center and Faculty of Medicine, Pilsen, Charles University in Prague, Pilsen, Czech Republic.,Department of Surgery, University Hospital Pilsen, Charles University, Pilsen, Czech Republic
| | - Anna Kanerva
- Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland.,Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Otto Hemminki
- Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland.,Department of Urology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Akseli Hemminki
- Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland.,Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
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Cabasag CJ, Arnold M, Rutherford M, Ferlay J, Bardot A, Morgan E, Butler J, O'Connell DL, Nelson G, Høgdall C, Schnack T, Gavin A, Elwood M, Hanna L, Gourley C, De P, Saint-Jacques N, Mørch LS, Woods RR, Altman AD, Sykes P, Cohen PA, McNally O, Møller B, Walsh P, Morrison DS, Bray F, Soerjomataram I. Shifting incidence and survival of epithelial ovarian cancer (1995-2014): A SurvMark-2 study. Int J Cancer 2023; 152:1763-1777. [PMID: 36533660 DOI: 10.1002/ijc.34403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
The aim of the study is to provide a comprehensive assessment of incidence and survival trends of epithelial ovarian cancer (EOC) by histological subtype across seven high income countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the United Kingdom). Data on invasive EOC diagnosed in women aged 15 to 99 years during 1995 to 2014 were obtained from 20 cancer registries. Age standardized incidence rates and average annual percentage change were calculated by subtype for all ages and age groups (15-64 and 65-99 years). Net survival (NS) was estimated by subtype, age group and 5-year period using Pohar-Perme estimator. Our findings showed marked increase in serous carcinoma incidence was observed between 1995 and 2014 among women aged 65 to 99 years with average annual increase ranging between 2.2% and 5.8%. We documented a marked decrease in the incidence of adenocarcinoma "not otherwise specified" with estimates ranging between 4.4% and 7.4% in women aged 15 to 64 years and between 2.0% and 3.7% among the older age group. Improved survival, combining all EOC subtypes, was observed for all ages combined over the 20-year study period in all countries with 5-year NS absolute percent change ranging between 5.0 in Canada and 12.6 in Denmark. Several factors such as changes in guidelines and advancement in diagnostic tools may potentially influence the observed shift in histological subtypes and temporal trends. Progress in clinical management and treatment over the past decades potentially plays a role in the observed improvements in EOC survival.
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Affiliation(s)
| | - Melina Arnold
- International Agency for Research on Cancer, Lyon, France
| | - Mark Rutherford
- International Agency for Research on Cancer, Lyon, France
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jacques Ferlay
- International Agency for Research on Cancer, Lyon, France
| | - Aude Bardot
- International Agency for Research on Cancer, Lyon, France
| | - Eileen Morgan
- International Agency for Research on Cancer, Lyon, France
- Northern Ireland Cancer Registry, Center for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | - Dianne L O'Connell
- The Daffodil Center, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Gregg Nelson
- Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada
| | - Claus Høgdall
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tine Schnack
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Odense University Hospital, Odense, Denmark
| | - Anna Gavin
- Northern Ireland Cancer Registry, Center for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Mark Elwood
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Charlie Gourley
- Institute of Genetics and Cancer, Cancer Research UK Edinburgh Center, The University of Edinburgh, Edinburgh, Scotland, UK
| | | | | | - Lina Steinrud Mørch
- The Danish Cancer Society Research Center, Cancer Surveillance and Pharmacoepidemiology, Copenhagen, Denmark
| | - Ryan R Woods
- Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
| | - Alon D Altman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Manitoba, Canada
- CancerCare Manitoba Research Institute, Manitoba, Canada
| | - Peter Sykes
- University of Otago, Christchurch, New Zealand
| | - Paul A Cohen
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Perth, Western Australia, Australia
- Discipline of Obstetrics and Gynaecology, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Orla McNally
- Royal Women's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | - Paul Walsh
- National Cancer Registry Ireland, Cork, Ireland
| | | | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
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30
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Kraywinkel K, Flegar L, Huber J, Groeben C. [Cancer registries in Germany: what does the future hold for urology?]. Aktuelle Urol 2023; 54:208-212. [PMID: 37019141 DOI: 10.1055/a-2041-3063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Cancer registries are defined as systematically collected information in the form of a database on tumour diseases. They can provide information about the quality of oncological care or progress in the treatment of individual cancers over time. Since 1995, all German federal states have been required by law to establish and maintain a cancer registry. The Center for Cancer Registry Data (ZfKD) at Robert Koch Institute has collected this nationwide data since 2009 and compiled it into an annually audited dataset available for research purposes. By virtue of the Cancer Early Detection and Registry Act (KFRG), which was passed in 2013, the cancer registries were given a new perspective. Since then, they have made a central contribution to the quality assurance of oncological care. The cancer registries are mainly financed by the health insurance funds. An upcoming expansion of the dataset including clinical variables and earlier provision by the ZfKD starting next year offers new opportunities for the scientific use of cancer registry data. In particular, the course of the disease will now be mapped in considerable detail. Apart from the cancer registries, there are not many useful supplemental datasets in Germany for the assessment of the nationwide healthcare situation and treatment reality on a national level. The DRG database (case-based hospital statistics) of the Federal Statistics Office records all billing data of all German hospitals with few exceptions. Another interesting supplement to the cancer registry data are the datasets of the structured quality reports, which have been mandatory for hospitals since 2003. In the future, the scientific role of cancer registries is to be further enhanced by the Act on the Pooling of Cancer Registry Data, which was passed in 2021.
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Affiliation(s)
- Klaus Kraywinkel
- Zentrum für Krebsregisterdaten, Robert Koch Institut, Berlin, Deutschland
| | - Luka Flegar
- Klinik für Urologie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Marburg, Deutschland
| | - Johannes Huber
- Klinik für Urologie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Marburg, Deutschland
| | - Christer Groeben
- Klinik für Urologie, Universitätsklinikum Gießen und Marburg - Standort Marburg, Marburg, Deutschland
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31
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Nash SH, Wahlen MM, Meisner ALW, Morawski BM. Choice of Survival Metric and Its Impacts on Cancer Survival Estimates for American Indian and Alaska Native People. Cancer Epidemiol Biomarkers Prev 2023; 32:398-405. [PMID: 36723409 PMCID: PMC9992150 DOI: 10.1158/1055-9965.epi-22-1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/08/2022] [Accepted: 01/09/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Different survival metrics have different applicability to clinical practice and research. We evaluated how choice of survival metric influences assessment of cancer survival among American Indian and Alaska Native (AIAN) people relative to non-Hispanic Whites (NHW). A secondary objective was to present variations in survival among AIAN people by age, sex, stage, and Indian Health Service (IHS) region. METHODS Five-year survival was calculated using the North American Association of Central Cancer Registries Cancer in North America dataset. We calculated survival among AIAN people, compared with NHW using four approaches: (i) observed (crude) survival, (ii) cause-specific survival, (iii) relative survival using age- and sex-adjusted lifetables, and (iv) relative survival using lifetables additionally adjusted for race, geography, and socioeconomic status. For AIAN people, we evaluated how survival varied by age, stage at diagnosis, and IHS region. RESULTS Observed survival methods produced the lowest estimates, and-excepting prostate cancer-cause-specific methods produced the highest survival estimates. Survival was lower among AIAN people than NHW for all methods. Among AIAN people, survival was higher among those 20-64 years, females, and tumors diagnosed at local stage. Survival varied by IHS region and cancer sites. CONCLUSIONS These results support the assertion that using the same methodology to compare survival estimates between racial and ethnic groups is of paramount importance, but that the choice of metric requires careful consideration of study objectives. IMPACT These findings have the potential to impact choice of survival metric to explore disparities among AIAN people.
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Affiliation(s)
- Sarah H Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Madison M Wahlen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Angela L W Meisner
- New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Bożena M Morawski
- Cancer Data Registry of Idaho, Idaho Hospital Association, Boise, Idaho
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32
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Belot A, Camus V, Portugues C, Paget J, Chartier L, Cony-Makhoul P, Tilly H, Joubert C. Long-term excess mortality and net survival among elderly diffuse large B-cell lymphoma patients after front-line R-CHOP treatment. Br J Haematol 2023; 201:857-864. [PMID: 36813551 DOI: 10.1111/bjh.18705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023]
Abstract
In the era of immunochemotherapy, data on the long-term prognosis of elderly patients diagnosed with a diffuse large B-cell lymphoma (DLBCL) are scarce. In this population and on the longer term, other-cause mortality is an important competing risk that needs to be accounted for. Using clinical trial data and relative survival approaches, we estimated the 10-year net survival (NS) and we described the excess mortality hazard (EMH) due (directly or indirectly) to the DLBCL, over time and according to main prognosis factors using flexible regression modelling. The 10-year NS was 65% [59; 71]. Using the flexible modelling, we showed that the EMH decreases steeply after diagnosis. The variables 'performance status', 'number of extra-nodal sites' and the serum 'lactate dehydrogenase' were strongly associated with the EMH, even after adjustment on other important variables. EMH is very close to zero at 10 years for the whole population, so DLBCL patients do not experience an increased mortality compared to the general population in the long term. The number of extra-nodal sites was an important prognostic factor shortly after diagnosis, suggesting that it is correlated with an important but unmeasured prognostic factor that would lead to this selection effect over time.
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Affiliation(s)
- Aurélien Belot
- Biostatistics Department, LYSARC, Hôpital Lyon-Sud, Pierre-Bénite, France
| | - Vincent Camus
- Department of Hematology, Centre Henri Becquerel, Rouen, France.,INSERM U1245, Centre Henri Becquerel, University of Rouen, Rouen, France
| | - Cédric Portugues
- Biostatistics Department, LYSARC, Hôpital Lyon-Sud, Pierre-Bénite, France
| | - Jérome Paget
- Biostatistics Department, LYSARC, Hôpital Lyon-Sud, Pierre-Bénite, France
| | - Loic Chartier
- Biostatistics Department, LYSARC, Hôpital Lyon-Sud, Pierre-Bénite, France
| | | | - Hervé Tilly
- Department of Hematology, Centre Henri Becquerel, Rouen, France.,INSERM U1245, Centre Henri Becquerel, University of Rouen, Rouen, France
| | - Clémentine Joubert
- Biostatistics Department, LYSARC, Hôpital Lyon-Sud, Pierre-Bénite, France
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33
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Fujiwara M, Kitada F. Clinical Experience of Intra-tumoral Central-Dose Escalated Volumetric Modulated Arc Therapy for Lymph Node Metastases in Patients With Advanced Cancer. Cureus 2023; 15:e34995. [PMID: 36938256 PMCID: PMC10020031 DOI: 10.7759/cureus.34995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Background Lymph node metastases (LN mets) are radioresistant, and high-dose irradiation is preferred for their control. The volumetric-modulated arc therapy technique makes it possible to perform intra-tumoral dose escalation without increasing the total prescribed dose of fractionated irradiation. We report its clinical experiences with intra-tumoral central-dose escalated volumetric-modulated arc therapy (ICE-VMAT) for LN mets. Materials and methods This study retrospectively evaluated 31 patients with 50 LN mets from stage III and IV advanced cancers who received ICE-VMAT. The total described dose was 50 Gy, and the median intra-tumoral central dose was 66 Gy (range, 54-79 Gy). Results The median follow-up period was 21 months. The two-year local control and overall survival (OS) rates were 95% and 56%, whereas univariate analysis revealed that the KPS ≥ 80 group had a significantly better OS compared to the KPS < 80 group. Conclusion ICE-VMAT was effective for LN mets. Patients with good KPS may benefit from therapeutic intervention with ICE-VMAT, even if they have multiple distant LN mets.
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34
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Zammit AP, Hooper JD, Brown I, Clark DA, Riddell AD. In comparison with polypectomy, colorectal resection is associated with improved survival for patients diagnosed with malignant polyps. Colorectal Dis 2023; 25:261-271. [PMID: 36222394 DOI: 10.1111/codi.16369] [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] [Received: 07/06/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 02/08/2023]
Abstract
AIM Patients diagnosed with a malignant polyp generally have favourable overall survival (OS) and cancer-specific survival (CSS). However, it is unclear how choice in management for malignant polyps may affect survival. METHODS Data from the Queensland Oncology Repository was analysed to derive a population wide assessment of the impact of management strategy on OS and CSS for patients diagnosed with malignant polyps. Log-rank testing, Kaplan-Meier and Cox-regression models were performed. Patients were matched using propensity score and Mahalanobis distance matching. RESULTS A total of 1,646 patients were included with 240 deaths and 52 colorectal cancer related deaths until censor date. Following propensity score and Mahalanobis distance matching of patients undergoing polypectomy alone versus colorectal resection, there was no significant difference in the age groups (<60 years of age or ≥60 years of age), American Society of Anesthesiology score, comorbidity count or Association of ColoProctology of Great Britain and Ireland risk category. However, of note Log-rank testing demonstrated a significant difference in OS (p < 0.001) and CSS (p = 0.0061) between management strategies. Multivariable Cox-regression models in matched and un-matched patient cohorts demonstrated significantly lower hazards of death for OS with resection (p < 0.001). However, CSS was no longer significantly different between management groups in multivariable Cox-regression analysis (p = 0.073). CONCLUSION Patients who underwent colorectal resection had significantly improved OS and CSS compared with polypectomy alone. Improved OS was furthermore seen on multivariable analysis, and in matched cohorts. Future research should investigate why this unexpected finding may be the case and whether updates to guidelines should be considered.
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Affiliation(s)
- Andrew P Zammit
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - John D Hooper
- Mater Research, Translational Research Institute, Brisbane, Queensland, Australia
| | - Ian Brown
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Envoi Specialist Pathologists, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - David A Clark
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine and Health, University of Sydney and Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia.,St Vincent's Private Hospital Northside, Brisbane, Queensland, Australia
| | - Andrew D Riddell
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Redcliffe Hospital, Redcliffe, Queensland, Australia
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35
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Zaki TA, Liang PS, May FP, Murphy CC. Racial and Ethnic Disparities in Early-Onset Colorectal Cancer Survival. Clin Gastroenterol Hepatol 2023; 21:497-506.e3. [PMID: 35716905 PMCID: PMC9835097 DOI: 10.1016/j.cgh.2022.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Young adults diagnosed with colorectal cancer (CRC) comprise a growing, yet understudied, patient population. We estimated 5-year relative survival of early-onset CRC and examined disparities in survival by race-ethnicity in a population-based sample. METHODS We used the National Cancer Institute's Surveillance, Epidemiology, and End Results program of cancer registries to identify patients diagnosed with early-onset CRC (20-49 years of age) between January 1, 1992, and December 31, 2013. For each racial-ethnic group, we estimated 5-year relative survival, overall and by sex, tumor site, and stage at diagnosis. To illustrate temporal trends, we compared 5-year relative survival in 1992-2002 vs 2003-2013. We also used Cox proportional hazards regression models to examine the association of race-ethnicity and all-cause mortality, adjusting for age at diagnosis, sex, county type (urban vs rural), county-level median household income, tumor site, and stage at diagnosis. RESULTS We identified 33,777 patients diagnosed with early-onset CRC (58.5% White, 14.0% Black, 13.0% Asian, 14.5% Hispanic). Five-year relative survival ranged from 57.6% (Black patients) to 69.1% (White patients). Relative survival improved from 1992-2002 to 2003-2013 for White patients only; there was no improvement for Black, Asian, or Hispanic patients. This pattern was similar by sex, tumor site, and stage at diagnosis. In adjusted analysis, Black (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 1.36-1.49), Asian (aHR, 1.06; 95% CI, 1.01-1.12), and Hispanic (aHR, 1.16; 95% CI, 1.10-1.21) race-ethnicity were associated with all-cause mortality. CONCLUSION Our study adds to the well-documented disparities in CRC in older adults by demonstrating persistent racial-ethnic disparities in relative survival and all-cause mortality in patients with early-onset CRC.
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Affiliation(s)
- Timothy A. Zaki
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Peter S. Liang
- Department of Medicine, New York University Langone Health, New York, New York,Department of Medicine, VA New York Harbor Health Care System, New York, New York
| | - Folasade P. May
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Caitlin C. Murphy
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
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36
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Luijten JCHBM, Verstegen MHP, van Workum F, Nieuwenhuijzen GAP, van Berge Henegouwen MI, Gisbertz SS, Wijnhoven BPL, Verhoeven RHA, Rosman C. Survival after Ivor Lewis versus McKeown esophagectomy for cancer: propensity score matched analysis. Dis Esophagus 2023:6972913. [PMID: 36617230 DOI: 10.1093/dote/doac100] [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] [Received: 08/26/2022] [Revised: 11/08/2022] [Accepted: 11/28/2022] [Indexed: 01/09/2023]
Abstract
It is unknown whether Ivor Lewis (IL) or McKeown (McK) esophagectomy is preferred in patients with potentially curable esophageal or gastro-esophageal junction (GEJ) cancer. Patients with mid- and distal esophageal and GEJ cancer without distant metastases who underwent IL or McK esophagectomy in the Netherlands between 2015 and 2017, were selected from the Netherlands Cancer Registry. Patients were propensity score matched for sex, age, American Society of Anesthesiologist classification, comorbidity, tumor type, tumor location, clinical stage, neoadjuvant treatment and year of diagnosis. The primary outcome was a 3-year relative survival (RS). Secondary outcome parameters were number of lymph nodes examined, number of positive lymph nodes, radical resection rate, tumor regression grade, post-operative complications and mortality. A total of 1627 patients who underwent IL (n = 1094) or McK (n = 533) esophagectomy were included. Patient and tumor characteristics were balanced after propensity score matching, leaving 658 patients to be compared. The 3-year RS was 54% after IL and 50% after McK esophagectomy, P = 0.140. The median number of lymph nodes examined, median number of positive lymph nodes, radical resection rate and tumor regression grade were comparable between both groups. Recurrent laryngeal nerve palsy (2 vs. 5%, P = 0.006) occurred less frequently after IL esophagectomy. No differences were observed in post-operative anastomotic leakage rate, pulmonary complication rate and mortality rates. There was no statistically significant difference in the 3-year RS between IL and McK esophagectomy. Based on these results, both IL and McK esophagectomy can be performed in patients with mid to distal esophageal and GEJ cancer.
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Affiliation(s)
- J C H B M Luijten
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht 3501, The Netherlands.,Department of Surgery, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen 6525, The Netherlands
| | - M H P Verstegen
- Department of Surgery, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen 6525, The Netherlands.,Imperial College London, London SW7 2AZ, UK
| | - F van Workum
- Department of Surgery, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen 6525, The Netherlands.,Imperial College London, London SW7 2AZ, UK
| | | | - M I van Berge Henegouwen
- Department of Surgery, Amsterdam UMC-Location AMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam 1081, The Netherlands
| | - S S Gisbertz
- Department of Surgery, Amsterdam UMC-Location AMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam 1081, The Netherlands
| | - B P L Wijnhoven
- Department of Surgery, Erasmus MC, Rotterdam 3015, The Netherlands
| | - R H A Verhoeven
- Department of Research, Netherlands Comprehensive Cancer Organization, Utrecht 3501, The Netherlands.,Department of Surgery, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen 6525, The Netherlands
| | - C Rosman
- Department of Surgery, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen 6525, The Netherlands
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Doan LMT, Angione C, Occhipinti A. Machine Learning Methods for Survival Analysis with Clinical and Transcriptomics Data of Breast Cancer. Methods Mol Biol 2023; 2553:325-393. [PMID: 36227551 DOI: 10.1007/978-1-0716-2617-7_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Breast cancer is one of the most common cancers in women worldwide, which causes an enormous number of deaths annually. However, early diagnosis of breast cancer can improve survival outcomes enabling simpler and more cost-effective treatments. The recent increase in data availability provides unprecedented opportunities to apply data-driven and machine learning methods to identify early-detection prognostic factors capable of predicting the expected survival and potential sensitivity to treatment of patients, with the final aim of enhancing clinical outcomes. This tutorial presents a protocol for applying machine learning models in survival analysis for both clinical and transcriptomic data. We show that integrating clinical and mRNA expression data is essential to explain the multiple biological processes driving cancer progression. Our results reveal that machine-learning-based models such as random survival forests, gradient boosted survival model, and survival support vector machine can outperform the traditional statistical methods, i.e., Cox proportional hazard model. The highest C-index among the machine learning models was recorded when using survival support vector machine, with a value 0.688, whereas the C-index recorded using the Cox model was 0.677. Shapley Additive Explanation (SHAP) values were also applied to identify the feature importance of the models and their impact on the prediction outcomes.
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Affiliation(s)
- Le Minh Thao Doan
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK
| | - Claudio Angione
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK
- Centre for Digital Innovation, Teesside University, Middlesbrough, UK
- Healthcare Innovation Centre, Teesside University, Middlesbrough, UK
- National Horizons Centre, Teesside University, Darlington, UK
| | - Annalisa Occhipinti
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, UK.
- Centre for Digital Innovation, Teesside University, Middlesbrough, UK.
- National Horizons Centre, Teesside University, Darlington, UK.
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Gradel KO, Larsen TS, Frederiksen H, Vinholt PJ, Iachina M, Póvoa P, Zampieri FG, Nielsen SL, Dessau RB, Møller JK, Jensen TG, Chen M, Coia JE, Jelicic J. Impact of C-reactive protein and albumin levels on short, medium, and long term mortality in patients with diffuse large B-cell lymphoma. Ann Med 2022; 54:713-722. [PMID: 35238275 PMCID: PMC8896183 DOI: 10.1080/07853890.2022.2046287] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives and study design: In this population-based study of 602 patients, we amended C-reactive protein (CRP) and plasma albumin (PA) levels around the diagnosis of diffuse large B-cell lymphoma (DLBCL) to the International Prognostic Index (IPI) and assessed 0-90, 91-365, and +365-day survival.Results: The CRP did not contribute to the IPI's prognostic or discriminatory ability, regardless of time period, particularly not in models with PA. In contrast, the PA was an important contributor, especially in the 0-90 day period, but also up to one year after the diagnosis. For day 0-90, the model with the IPI only had an Area Under the Receiver Operating Characteristics (AUROC) of 0.742, whereas the IPI with PA as a continuous variable rendered an AUROC of 0.841. Especially the lower PA quartile (18-32 g/L) contributed to the worse prognosis.Conclusions: The amendment of PA to the IPI may significantly improve the short-term prognostic and discriminative ability.Key messagesThe amendment of the plasma albumin (PA) level to the International Prognostic Index significantly improved the prediction of mortality up to one year after the diagnosis of diffuse large B-cell lymphoma.It was especially the lower quartile of the PA level (18-32 g/L) that contributed to the worse prognosis.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.,OPEN - Odense Patient Data Exploratory Network, Odense University Hospital, Odense C, Denmark
| | - Thomas Stauffer Larsen
- Department of Haematology, Odense University Hospital, and Research Unit of Haematology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Henrik Frederiksen
- Department of Haematology, Odense University Hospital, and Research Unit of Haematology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Pernille Just Vinholt
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark
| | - Maria Iachina
- Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Pedro Póvoa
- Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.,The Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Estrada do Forte do Alto do Duque, Lisbon, and NOVA Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal
| | - Fernando Godinho Zampieri
- Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.,Research Institute, dHCor-Hospital Do Coração, São Paulo, Brazil
| | - Stig Lønberg Nielsen
- Department of Infectious Diseases, Odense University Hospital, and Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ram Benny Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - Jens Kjølseth Møller
- Department of Clinical Microbiology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Thøger Gorm Jensen
- Department of Clinical Microbiology, Odense University Hospital, and Department of Clinical Research, Research Unit of Clinical Microbiology, University of Southern Denmark, Odense C, Denmark
| | - Ming Chen
- Department of Clinical Microbiology, Hospital of Southern Jutland, Sønderborg, Denmark
| | - John Eugenio Coia
- Department of Clinical Microbiology, Hospital of South West Jutland, Esbjerg, Denmark
| | - Jelena Jelicic
- Department of Haematology, Odense University Hospital, and Research Unit of Haematology, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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Perez-de-Acha A, Pilleron S, Soto-Perez-de-Celis E. All-Cause Mortality Risk Prediction in Older Adults with Cancer: Practical Approaches and Limitations. Curr Oncol Rep 2022; 24:1377-1385. [PMID: 35648341 DOI: 10.1007/s11912-022-01303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The prediction of all-cause mortality is an important component of shared decision-making across the cancer care continuum, particularly in older adults with limited life expectancy, for whom there is an increased risk of over-diagnosis and treatment. RECENT FINDINGS Currently, several international societies recommend the use of all-cause mortality risk prediction tools when making decisions regarding screening and treatment in geriatric oncology. Here, we review some practical aspects of the utilization of those tools and dissect the characteristics of those most employed in geriatric oncology, highlighting both their advantages and their limitations.
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Affiliation(s)
- Andrea Perez-de-Acha
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas Y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Ciudad de Mexico, Mexico
| | - Sophie Pilleron
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas Y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Colonia Belisario Dominguez Sección XVI, Tlalpan, Ciudad de Mexico, Mexico.
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40
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Association of socioeconomic deprivation with life expectancy and all-cause mortality in Spain, 2011–2013. Sci Rep 2022; 12:15554. [PMID: 36114247 PMCID: PMC9481591 DOI: 10.1038/s41598-022-19859-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/06/2022] [Indexed: 11/08/2022] Open
Abstract
AbstractLife tables summarise a population’s mortality experience during a time period. Sex- and age-specific life tables are needed to compute various cancer survival measures. However, mortality rates vary according to socioeconomic status. We present sex- and age-specific life tables based on socioeconomic status at the census tract level in Spain during 2011–2013 that will allow estimating cancer relative survival estimates and life expectancy measures by socioeconomic status. Population and mortality data were obtained from the Spanish Statistical Office. Socioeconomic level was measured using the Spanish Deprivation Index by census tract. We produced sex- and age-specific life expectancies at birth by quintiles of deprivation, and life tables by census tract and province. Life expectancy at birth was higher among women than among men. Women and men in the most deprived census tracts in Spain lived 3.2 and 3.8 years less than their counterparts in the least deprived areas. A higher life expectancy in the northern regions of Spain was discovered. Life expectancy was higher in provincial capitals than in rural areas. We found a significant life expectancy gap and geographical variation by sex and socioeconomic status in Spain. The gap was more pronounced among men than among women. Understanding the association between life expectancy and socioeconomic status could help in developing appropriate public health programs. Furthermore, the life tables we produced are needed to estimate cancer specific survival measures by socioeconomic status. Therefore, they are important for cancer control in Spain.
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Jesan T, Sinha S. Modular organization of gene–tumor association network allows identification of key molecular players in cancer. J Biosci 2022. [DOI: 10.1007/s12038-022-00292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kirkham AA, Jerzak KJ. Prevalence of Breast Cancer Survivors Among Canadian Women. J Natl Compr Canc Netw 2022; 20:1005-1011. [PMID: 36075384 DOI: 10.6004/jnccn.2022.7028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The 49% decrease in breast cancer mortality since 1986 has increased the number of breast cancer survivors requiring survivorship care. The purpose of this analysis was to estimate the 2022 prevalence of breast cancer survivors diagnosed within the past 15 years among Canadian women. METHODS We extracted the projected female breast cancer cases from 2007 to 2021 and rates of net survival (competing noncancer causes of death removed) from the Canadian Cancer Society's statistical reports. Overall survival was extracted from published Ontario data. Using known survival rates for 1, 5, 10, and 15 years, we interpolated remaining years and applied the corresponding net and overall survival rates to the projected cases for each year from 2007 to 2021 to determine survivors in 2022. Prevalence for predefined age groups was also calculated. As an example of excess healthcare costs attributable to breast cancer, we calculated the excess costs of heart failure hospitalizations. RESULTS From 2007 to 2021, there were 370,756 breast cancer cases. Using net survival, 318,429 (85.9%) of these patients were projected to survive breast cancer by 2022, a prevalence of 2.1% of Canadian women. Using overall survival, prevalence was 1.8%. Prevalence increased with age group, from 0.01% of those aged 20 to 24 years to 12.7% of those aged ≥90 years, and from 1.0% among the working and/or child-raising (age 20-64 years) to 5.4% among elderly populations (age ≥65 years). Among these survivors, 24.9% of projected heart failure hospitalizations would be in excess of those among matched control subjects, with projected excess costs of $16.5 million CAD. Given the excess healthcare costs, potential for reduced contributions to the workforce, and reduced quality of life associated with long-term impairments and risk of excess non-breast cancer death, enhanced breast cancer survivorship care is warranted. CONCLUSIONS With an overall prevalence of 2% among Canadian women, breast cancer survivors represent an increasing segment of the working-age and elderly populations.
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Affiliation(s)
- Amy A Kirkham
- University of Toronto, Knowledge, Innovation, Talent and Everywhere (KITE), Toronto Rehabilitation Institute, University Health Network; and
| | - Katarzyna J Jerzak
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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43
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Loganathan A, Bharadwaj R, Srinivasan A, Scott JX. Cytogenetics and Molecular Genetics in Pediatric Acute Lymphoblastic Leukemia (ALL) and Its Correlation with Induction Outcomes. South Asian J Cancer 2022; 11:353-360. [PMID: 36756095 PMCID: PMC9902080 DOI: 10.1055/s-0042-1754337] [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] [Indexed: 10/15/2022] Open
Abstract
Arathi SrinivasanAims The aim was to study cytogenetics and molecular genetic profile in pediatric B-acute lymphoblastic leukemia (ALL) and correlate it with induction outcomes. Subjects and Methods A retrospective study of cytogenetics and molecular genetics of 98 children with B-cell ALL from January 2013 to May 2018 was done. Cytogenetics and molecular genetics were done in the bone marrow using multiplex reverse transcription polymerase chain reaction and G-banded karyotyping, respectively. Minimal residual disease (MRD) assessment was done at the end of induction by flowcytometry. Results Of the 98 children, 83 (84.6%) had evaluable cytogenetics, with 11 (13.25%) being abnormal karyotypes. Of the 11 abnormal karyotypes, seven children (8.4%) had hyperdiploidy, one had hypodiploidy, and three had miscellaneous findings. In molecular genetics, TEL-AML1 (ETV6/RUNX1)[t(12;21)] was the most common fusion gene abnormality (12.2% [12/98]), followed by E2A-PBX1 [t(1;19)] (5%), BCR/ABL1 [t(9;22)] (3%), and MLL-AF4 [t(4;11)] (1%). All the 98 children attained morphologic remission at the end of induction. All children with hyperdiploidy (7/7) attained remission and MRD negativity, but one expired during maintenance chemotherapy of disseminated tuberculosis. The child with hypodiploidy was MRD-positive. Three (25%) children with t (12;21) were MRD-positive. All children with Ph + ALL, t(1:19), and t(4;11) were MRD-negative. Fifty-two children had no detected abnormalities, six of whom had MRD positivity (11.5%). Conclusion Cytogenetic and molecular genetic subgrouping prognosticates ALL outcomes. Although 25% of TEL-AML + children had MRD positivity, larger studies are required to validate the same. End-of-induction MRD outcomes did not correlate with chromosomal aberrations.
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Affiliation(s)
- Ajeitha Loganathan
- Department of Pediatric Hematology and Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
| | - Rishab Bharadwaj
- Department of Pediatric Hematology and Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
| | - Arathi Srinivasan
- Department of Pediatric Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India,Address for correspondence Arathi Srinivasan, DNB Pediatrics, Post Doctoral Fellowship in Pediatric Hemato-oncology Department of Pediatric Hematology Oncology, Kanchi Kamakoti CHILDS Trust Hospital12-A, Nageshwara Road, Nungambakkam, Chennai 600034, Tamil NaduIndia
| | - Julius Xavier Scott
- Department of Pediatric Oncology, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
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Ulmer KK, Greteman B, McDonald M, Gonzalez Bosquet J, Charlton ME, Nash S. Association of Distance to Gynecologic Oncologist and Survival in a Rural Midwestern State. WOMEN'S HEALTH REPORTS 2022; 3:678-685. [PMID: 36147832 PMCID: PMC9436260 DOI: 10.1089/whr.2022.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Keely K. Ulmer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Breanna Greteman
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Megan McDonald
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jesus Gonzalez Bosquet
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Mary E. Charlton
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Sarah Nash
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
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Villumsen MD, Ahrenfeldt LJ, Christensen K, Ewertz M, Hjelmborg JB. Cancer-related reductions in survival: extent and duration evaluated using a large cohort study of twins, 1943-2011. Cancer Epidemiol Biomarkers Prev 2022; 31:1796-1803. [PMID: 35820201 DOI: 10.1158/1055-9965.epi-22-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/20/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The time during which there is an increased risk of death for cancer survivors was evaluated in a large twin study, which allows for matching on shared components such as age, genes, and socioeconomic factors in childhood. METHODS By use of data from Danish registers, time to death from initial cancer was studied prospectively in twins in two different settings. The twins were diagnosed with at least one cancer in the period 1943-2011. Setting I included 5,680 same-sex twin pairs aged six and over, while Setting II included 3,218 twin individuals from age 70 and over. The study provides comparisons within twin pairs and across birth cohorts, age at diagnoses, and time at diagnosis. RESULTS In 2001-2011, the five-year mortality risk for a twin surviving cancer after the age of 70 was twofold that of the co-twin, regardless of sex and zygosity, and it was 1.5-fold if the twin survived the initial nine months. After five to six years, the mortality risk corresponded to that of the co-twin. In previous decades, the excess hazard risk was considerably higher for both older and younger cohorts. There were no indications of change in relative survival across old birth cohorts. CONCLUSIONS This large twin study suggested that for a cancer-treatment survivor diagnosed at age 70 or later, the additional mortality risk was largely absent five years later, by which time the survival relative to the co-twin was 60%. IMPACT Elevated mortality risk after cancer is offset after five-six years.
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Affiliation(s)
- Martin Dalgaard Villumsen
- Danish Twin Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Linda Juel Ahrenfeldt
- Danish Twin Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Danish Twin Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Marianne Ewertz
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Jacob B Hjelmborg
- Danish Twin Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Net Survival in Survival Analyses for Patients with Cancer: A Scoping Review. Cancers (Basel) 2022; 14:cancers14143304. [PMID: 35884365 PMCID: PMC9322882 DOI: 10.3390/cancers14143304] [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] [Received: 04/11/2022] [Revised: 06/07/2022] [Accepted: 06/25/2022] [Indexed: 12/07/2022] Open
Abstract
Population-based net survival is an important tool for assessing prognostic advances. The unbiased Pohar Perme Estimator (PPE) was suggested in 2012 and soon established itself as the gold standard for estimating net survival. This scoping review aims to know in which context this estimator is being used in the oncology area, what the authors point out as a justification for its use, and the limitations found. We searched PubMed, and the grey literature to answer the question: Have studies involving patients diagnosed with cancer used the PPE to estimate cancer-specific survival? How do they justify the use of the PPE and what are the limitations pointed out? Out of 295 screened, 85 studies were included in this review. The two main characteristics of the PPE mentioned by the studies as justification were the fact that it is an unbiased estimator (83.5%) and that it produces comparable estimates among populations with different mortality rates from causes other than cancer (36.47%). No study pointed to a limitation due to the use of PPE. As a conclusion, the Pohar Perme Estimator is the gold standard for estimating net survival and should be more used in oncology, especially when dealing with population-based studies where the follow-up time is long, making high the probability of death from causes other than cancer.
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Nolin AC, Tian C, Hamilton CA, Casablanca Y, Bateman NW, Chan JK, Cote ML, Shriver CD, Powell MA, Phippen NT, Conrads TP, Maxwell GL, Darcy KM. Conditional estimates for uterine serous cancer: Tools for survivorship counseling and planning. Gynecol Oncol 2022; 166:90-99. [PMID: 35624045 DOI: 10.1016/j.ygyno.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/06/2022] [Accepted: 05/14/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Develop conditional survival and risk-assessment estimates for uterine serous carcinoma (USC) overall and stratified by stage as tools for annual survivorship counseling and care planning. METHODS Patients in the National Cancer Data Base diagnosed between 2004 and 2014 with stage I-IV USC were eligible. Individuals missing stage or survival data or with multiple malignancies were excluded. Five-year conditional survival was estimated using the stage-stratified Kaplan-Meier method annually during follow-up. A standardized mortality ratio (SMR) estimated the proportion of observed to expected deaths in the U.S. adjusted for year, age, and race. The relationships between prognostic factors and survival were studied using multivariate Cox modeling at diagnosis and conditioned on surviving 5-years. RESULTS There were 14,575 participants, including 43% with stage I, 8% with stage II, 29% with stage III, and 20% with stage IV USC. Five-year survival at diagnosis vs. after surviving 5-years was 52% vs. 75% overall, 77% vs. 81% for stage I, 57% vs. 72% for stage II, 40% vs. 66% for stage III, and 17% vs. 60% for stage IV USC, respectively (P < 0.0001). Incremental improvements in 5-year conditional survival and reductions in SMR tracked with annual follow-up and higher stage. The adjusted risk of death at diagnosis vs. after surviving 5-years was 1.15 vs. 1.40 per 5-year increase of age, 1.26 vs. 1.68 for Medicaid insurance, 3.92 vs. 2.48 for stage III disease, and 6.65 vs. 2.79 for stage IV disease, respectively (P < 0.0001). CONCLUSION In USC, the evolution of conditional survival permits annual reassessments of prognosis to tailor survivorship counseling and care planning.
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Affiliation(s)
- Angela C Nolin
- Department of Obstetrics and Gynecology, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Chunqiao Tian
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Chad A Hamilton
- Gynecologic Oncology Section, Women's Services and The Ochsner Cancer Institute, Ochsner Health, New Orleans, LA, USA
| | - Yovanni Casablanca
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Nicholas W Bateman
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John K Chan
- Palo Alto Medical Foundation, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA; Karmanos Cancer Institute, Population Studies, and Disparities Research Program, Detroit, MI, USA
| | - Craig D Shriver
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Matthew A Powell
- Division of Gynecologic Oncology, Siteman Cancer Center, Washington University, St Louis, MO, USA
| | - Neil T Phippen
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Thomas P Conrads
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - G Larry Maxwell
- Department of Obstetrics and Gynecology, Inova Fairfax Medical Campus, Falls Church, VA, USA; Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Kathleen M Darcy
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA.
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48
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Determinants of disease-specific survival in patients with and without metastatic pheochromocytoma and paraganglioma. Eur J Cancer 2022; 169:32-41. [DOI: 10.1016/j.ejca.2022.03.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 12/18/2022]
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Lee H, Singh GK. Disparities in All-cancer and Lung Cancer Survival by Social, Behavioral, and Health Status Characteristics in the United States: A Longitudinal Follow-up of the 1997-2015 National Health Interview Survey-National Death Index Record Linkage Study. J Cancer Prev 2022; 27:89-100. [PMID: 35864854 PMCID: PMC9271407 DOI: 10.15430/jcp.2022.27.2.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/04/2022] [Accepted: 05/23/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Hyunjung Lee
- Department of Public Policy and Public Affairs, John McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Gopal K. Singh
- The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., Riverdale, MD, USA
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50
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Abdel-Rahman O, Pham TM, Pokhrel A, Ruether D, Sawyer MB. Changes in Survival Outcomes of Patients With Neuroendocrine Neoplasms Over the Past 15 Years: A Real-World Study. Am J Clin Oncol 2022; 45:208-214. [PMID: 35383575 DOI: 10.1097/coc.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The past 2 decades have observed a number of advances in therapeutic approaches to patients with neuroendocrine neoplasms (NENs). This study aims to assess whether survival outcomes have changed among patients with NENs over the past 15 years, in a real-world, population-based study. MATERIALS AND METHODS We accessed administrative databases within the province of Alberta, Canada, and we reviewed patients with invasive NENs diagnosed 2004 to 2019. Patients were classified according to the year of diagnosis into 3 groups: 2004 to 2008; 2009 to 2013; and 2014 to 2019. Kaplan-Meier survival estimates were used to compare overall survival (OS) according to different baseline characteristics (including the year of diagnosis). Multivariable Cox regression modeling was used to examine factors associated with the risk of death in this cohort. RESULTS We included a total of 3431 patients in the study cohort. Using multivariable Cox regression analysis, the following factors were associated with worse survival: older age at diagnosis (hazard ratio [HR]: 3.45; 95% CI [confidence interval]: 2.74-4.35), male sex (HR: 1.38; 95% CI: 1.21-1.56), lung primary site (HR for lung vs. appendicular primary: 1.39; 95% CI: 1.01-1.92), Stage 4 disease (HR: 2.80; 95% CI: 2.38-3.30), South zone of the province (HR for South zone vs. Calgary zone: 1.85; 95% CI: 1.49-2.30), and higher comorbidity index (HR for ≥3 vs. 0: 2.66; 95% CI: 2.19-3.24). Although Kaplan-Meier method showed significant difference in OS according to diagnosis period, multivariable regression model showed that the period of diagnosis did not appear to impact OS (HR for diagnosis period 2004 to 2009 vs. 2014 to 2019: 1.04; 95% CI: 0.89-1.22). CONCLUSIONS Over the study period (2004 to 2019), patients diagnosed during later periods did not appear to experience better OS compared with patients diagnosed at an earlier time.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton
| | - Truong-Minh Pham
- Surveillance and Reporting, Cancer Research and Analytics, Cancer Care Alberta
| | - Arun Pokhrel
- System Performance and Innovation, Emergency Medical Services (EMS), Alberta Health Services
| | - Dean Ruether
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Michael B Sawyer
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton
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