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Zeng H, Zhong X, Liu W, Liang B, Xue X, Yu N, Xu D, Wang X, Lin S. Predicting treatment failure in stage III colon cancer patients after radical surgery. Front Oncol 2024; 14:1397468. [PMID: 38817900 PMCID: PMC11137277 DOI: 10.3389/fonc.2024.1397468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
Purpose The aim to assess treatment failure in patients with stage III colon cancer who underwent radical surgery and was analyzed using the nomogram. Methods Clinical factors and survival outcomes for stage III colon cancer patients registered in the SEER database from 2018 to 2019 were analyzed, with patients split into training and testing cohorts (7:3 ratio). A total of 360 patients from the First Affiliated Hospital of Longyan served as an external validation cohort. Independent predictors of treatment failure were identified using logistic regression analyses. The nomograms was evaluated by concordance index (C-index), calibration curves, and the area under the curve (AUC), decision curve analysis (DCA) and clinical impact curves (CIC) assessed the clinical utility of nomograms versus TNM staging. Results The study included 4,115 patients with stage III colon cancer. Multivariate logistic analysis age, tumor site, pT stage, pN stage, chemotherapy, pretreatment CEA levels, number of harvested lymph nodes, perineural invasion and marital status were identified as independent risk factors for treatment failure. The C-indices for the training and testing sets were 0.853 and 0.841. Validation by ROC and calibration curves confirmed the stability and reliability of the model. DCA showed that the net clinical effect of the histogram was superior to that of the TNM staging system, while CIC highlighted the potentially large clinical impact of the model. Conclusions The developed Nomogram provides a powerful and accurate tool for clinicians to assess the risk of treatment failure after radical surgery in patients with stage III colon cancer.
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Affiliation(s)
- Hao Zeng
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Xuejing Zhong
- Department of Science and Education, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Wenxin Liu
- Department of Anaesthesia, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Baofeng Liang
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Xueyi Xue
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Nong Yu
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Dongbo Xu
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
| | - Xiaojie Wang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shuangming Lin
- Department of Gastroenterology and Anorectal Surgery, Longyan First Hospital, Fujian Medical University, Longyan, China
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Fukai R, Nishida T, Sugimoto H, Hibino M, Horiuchi S, Kondo T, Teshima S, Hirata M, Asou K, Shimizu E, Saito Y, Sakao Y. Perioperative Evaluation of the Physical Quality of Life of Patients with Non-Small Cell Lung Cancer: A Prospective Study. Cancers (Basel) 2024; 16:1527. [PMID: 38672609 PMCID: PMC11048487 DOI: 10.3390/cancers16081527] [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: 02/25/2024] [Revised: 04/06/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Surgery is the most effective treatment for early-stage lung cancer; however, it poses a higher physical burden than other treatment options. Therefore, understanding the perioperative course of patients is important. Using the Short Form Health Survey 36, we prospectively measured the physical quality of life of patients who underwent anatomical pulmonary resection for non-small cell lung cancer at Shonan Kamakura General Hospital, Kanagawa, Japan (n = 87). In the preoperative setting, patients who had lower performance status and lived alone had significantly worse physical quality of life scores on multivariate analysis (regression coefficient (95% confidence interval), -9.37 (-13.43--5.32) and -10.22 (-13.74--7.40), respectively, p < 0.0001 for both). At 6 months postoperatively, patients who stopped smoking within 1 year preoperatively (stopped smoking within 1 year vs. remote or never smokers, 41.0 ± 10.5 vs. 48.6 ± 7.2, p = 0.002), had lower performance status (0 vs. 1-2, 49.3 ± 6.6 vs. 38.6 ± 9.6, p < 0.0001), lived alone (living alone vs. living with somebody, 41.6 ± 9.7 vs. 48.1 ± 7.9, p = 0.021), and had higher comorbid burden (Charlson comorbidity index <3 vs. ≥3, 48.2 ± 6.9 vs. 39.1 ± 14.7, p = 0.003) had significantly worse physical quality of life scores on univariate analysis. More recent smoking (regression coefficient (95% confidence interval), -4.90 (-8.78-1.0), p = 0.014), lower performance status (8.90 (5.10-12.70), p < 0.0001), living alone (5.76 (1.39-10.13), p = 0.01), and higher comorbid burden (-6.94 (-11.78--2.10), p = 0.006) were significant independent predictors of worse postoperative physical quality of life on multivariate analysis. Therefore, patients with these conditions might need additional support to maintain their physical condition after anatomical lung cancer surgery.
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Affiliation(s)
- Ryuta Fukai
- Department of General Thoracic Surgery, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura 247-8533, Kanagawa, Japan;
| | - Tomoki Nishida
- Department of General Thoracic Surgery, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura 247-8533, Kanagawa, Japan;
| | - Hideyasu Sugimoto
- Department of Respiratory Medicine, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10, Konandai, Konan-ku, Yokohama 234-0054, Kanagawa, Japan;
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, 1-5-1, Tsujidokandai, Fujisawa 251-0041, Kanagawa, Japan; (M.H.); (S.H.); (T.K.)
| | - Shigeto Horiuchi
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, 1-5-1, Tsujidokandai, Fujisawa 251-0041, Kanagawa, Japan; (M.H.); (S.H.); (T.K.)
| | - Tetsuri Kondo
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, 1-5-1, Tsujidokandai, Fujisawa 251-0041, Kanagawa, Japan; (M.H.); (S.H.); (T.K.)
| | - Shinichi Teshima
- Department of Pathology, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura 247-8533, Kanagawa, Japan;
| | - Masahiro Hirata
- Center for Clinical and Translational Science, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura 247-8533, Kanagawa, Japan;
| | - Keiko Asou
- Center for Clinical Research, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura 247-8533, Kanagawa, Japan;
| | - Etsuko Shimizu
- Clinical Research Center, Shonan Fujisawa Tokushukai Hospital, 1-5-1, Tsujidokandai, Fujisawa 251-0041, Kanagawa, Japan;
| | - Yuichi Saito
- Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-0003, Japan; (Y.S.); (Y.S.)
| | - Yukinori Sakao
- Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-0003, Japan; (Y.S.); (Y.S.)
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Bradley CJ, Liang R, Lindrooth RC, Sabik LM, Perraillon MC. Building Data Infrastructure for Disease-Focused Health Economics Research. Med Care 2023; 61:S147-S152. [PMID: 37963034 PMCID: PMC10635336 DOI: 10.1097/mlr.0000000000001904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Data infrastructure for cancer research is centered on registries that are often augmented with payer or hospital discharge databases, but these linkages are limited. A recent alternative in some states is to augment registry data with All-Payer Claims Databases (APCDs). These linkages capture patient-centered economic outcomes, including those driven by insurance and influence health equity, and can serve as a prototype for health economics research. OBJECTIVES To describe and assess the utility of a linkage between the Colorado APCD and Colorado Central Cancer Registry (CCCR) data for 2012-2017. RESEARCH DESIGN, PARTICIPANTS, AND MEASURES This cohort study of 91,883 insured patients evaluated the Colorado APCD-CCCR linkage on its suitability to assess demographics, area-level data, insurance, and out-of-pocket expenses 3 and 6 months after cancer diagnosis. RESULTS The linkage had high validity, with over 90% of patients in the CCCR linked to the APCD, but gaps in APCD health plans limited available claims at diagnosis. We highlight the advantages of the CCCR-APCD, such as granular race and ethnicity classification, area-level data, the ability to capture supplemental plans, medical and pharmacy out-of-pocket expenses, and transitions in insurance plans. CONCLUSIONS Linked data between registries and APCDs can be a cornerstone of a robust data infrastructure and spur innovations in health economics research on cost, quality, and outcomes. A larger infrastructure could comprise a network of state APCDs that maintain linkages for research and surveillance.
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Affiliation(s)
- Cathy J. Bradley
- University of Colorado Cancer Center Aurora, CO
- Colorado School of Public Health, Department of Health Systems, Management, and Policy Aurora, CO
| | - Rifei Liang
- University of Colorado Cancer Center Aurora, CO
| | - Richard C. Lindrooth
- Colorado School of Public Health, Department of Health Systems, Management, and Policy Aurora, CO
| | - Lindsay M. Sabik
- University of Pittsburgh School of Public Health, Department of Health Policy and Management, Pittsburgh, PA
| | - Marcelo C. Perraillon
- University of Colorado Cancer Center Aurora, CO
- Colorado School of Public Health, Department of Health Systems, Management, and Policy Aurora, CO
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Fiorella M, Alnemri A, Sussman S, Koka A, Johnson J, Cognetti D, Curry J, Mady L, Worster B, Leader AE, Luginbuhl A. Impact of Head and Neck Cancer Diagnosis and Treatment on Patient-Partner Intimacy. Otolaryngol Head Neck Surg 2023; 169:520-527. [PMID: 36125900 DOI: 10.1177/01945998221126068] [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: 06/15/2022] [Accepted: 08/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the effects of head and neck squamous cell carcinoma diagnosis and treatment on patient- and partner-perceived intimacy and to understand if a diagnosis of HPV-related head and neck squamous cell carcinoma influences patient-partner intimacy. STUDY DESIGN Prospective observational. SETTING Single tertiary care center. METHODS An investigator-developed questionnaire was used to prospectively survey patients and partners in 2 groups based on human papillomavirus (HPV) status: HPV+ and HPV- at diagnosis (visit 1) and after treatment (visit 2). Surveys were scored on a 60-point scale, and results were categorized as follows: loss of intimacy (0-30), stable relationship (31-41), or improvement in intimacy (42-60). Responses of couples who participated together were assessed for concordance. Responses were considered discordant if patient and partner scores equated to different levels of perceived intimacy. Median patient and partner scores were compared via Mann-Whitney U test, and concordance was assessed with a chi-square test. RESULTS Thirty-four patients and 28 partners completed surveys at visit 1 and 28 patients and 15 partners at visit 2. Median scores among patients and partners were similar at the first time point (HPV+, 45 vs 45, P = .64; HPV-, 42.6 vs 40.8, P = .29) and the second (HPV+, 44.5 vs 44, P = .87; HPV-, 40.2 vs 39.6, P = .90). Concordance rates between HPV+ and HPV- couples were 63% vs 44% (P = .43) for the first time point and 89% vs 50% (P = .24) for the second. CONCLUSION Patients and partners reported stable or improved intimacy at both time points, and most couples tended to agree on their levels of perceived intimacy. A diagnosis of HPV did not appear to significantly affect intimacy scores.
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Affiliation(s)
- Michele Fiorella
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Angela Alnemri
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sarah Sussman
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anusha Koka
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jennifer Johnson
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - David Cognetti
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joseph Curry
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leila Mady
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Brooke Worster
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Amy E Leader
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam Luginbuhl
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Wang X, Meng Q, Chen Y, Zhang Y, Huang X, Xiang L, Kong H, Wang C, Wang X, Zhang D. Prognostic immunogenic characteristics of iron pendant disease modifiers in colon cancer. Front Immunol 2023; 14:1100725. [PMID: 37304284 PMCID: PMC10251496 DOI: 10.3389/fimmu.2023.1100725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Background We explored the prognostic and immunogenic characteristics of iron pendant disease regulators in colon cancer to provide a scientific basis for the prediction of tumor prognosis-related markers and potential immunotherapeutic drug targets. Methods RNA sequencing and matched complete clinical information of colon cancer (COAD) were retrieved from the UCSC Xena database, and genomic and transcriptomic data of colon cancer from the TCGA database were downloaded. Then univariate and multifactorial Cox regression were used to process these data. The prognostic factors were analyzed by single-factor and multi-factor Cox regression, followed by Kaplan-Meier survival curves with the aid of R software "survival" package. Then we use FireBrowse online analysis tool to analyze the expression variation of all cancer genes, and draw a histogram according to the influencing factors to predict the 1, 3, and 5 year survival rates of patients. Results The results show that age, tumor stage and iron death score were significantly correlated with prognosis (p<0.05). Further multivariate cox regression analysis confirmed that age, tumor stage and iron death score were still significantly correlated with prognosis (p<0.05); The calibration curve results show that the deviation between the predicted values of 1 year, 3 years and 5 years and the diagonal of the figure is very small; the ROC curve results show that the AUC values of the 1-year and 5-year ROC curves of the bar graph are high; the DCA curve results show that the net yield of the bar graph is the largest; The scores of T cells and B cells in the high iron death score group were significantly lower than those in the low iron death score group, and the activities of immune related pathways were significantly reduced. There was a significant difference in the iron death score between the iron death molecular subtype and the gene cluster subtype. Conclusions The model showed a superior response to immunotherapy in the high-risk group, revealing a potential relationship between iron death and tumor immunotherapy, which will provide new ideas for the treatment and prognostic assessment of colon cancer patients.
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Affiliation(s)
- Xian Wang
- Department of Health Management, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qingyu Meng
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yawen Chen
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Graduate ,Medical School of Chinese PLA, Beijing, China
| | - Yanjun Zhang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaohui Huang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Health Management, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Longquan Xiang
- Department of Pathology, Jining NO.1 People’s Hospital, Shandong Jining, China
| | - Haiyang Kong
- Department of General Surgery, Qufu Hospital of Traditional Chinese Medicine, Qufu, China
| | - Chunxi Wang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Health Management, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xueyang Wang
- Department of Radiology, Yancheng Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Yancheng, China
| | - Dekang Zhang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Radiology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
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Hashim HT, Hashim AT, Nazir A, Afzaal U, Nazir A, Al‐Obaidi AD. Can the genes communicate with each other after birth? An international cross-sectional study. Health Sci Rep 2023; 6:e1084. [PMID: 36733667 PMCID: PMC9885756 DOI: 10.1002/hsr2.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
Background Various factors contribute to the pathogenesis of a disease. These include genetic factors, family history, and some idiopathic causes. Genetic makeup has an important role in the progression of disease. This is due to mutations in genetic material, that is, deoxyribonucleic acid (DNA). Methodology This is a cross-sectional study that involved 5000 participants distributed across 250 countries. All the participants were randomly selected and asked to fill out the online survey. All the participants were fully informed about the study's purpose before providing their consent. Results The participants were distributed among 250 countries. Their age mean (standard deviation) is 46.7 (12.4). We discovered a significant difference between those who have genetic or congenital diseases and those who have a family history of the disease. Also, there is a statistically significant difference between the recurrence of the disease and the duration of the visits of close relatives who have the same disease. Conclusion The study suggests that there might be some ways, through gene waves or the environment, in which a gene changes the expression of other genes of similar sequence in different individuals when the required period of contact is provided. In the future, this theory might explain the idiopathic nature of some diseases.
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Affiliation(s)
| | - Ali Talib Hashim
- Department of MedicineGolestan University for Medical SciencesGorganIran
| | - Abubakar Nazir
- Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Usama Afzaal
- Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Awais Nazir
- Department of MedicineKing Edward Medical UniversityLahorePakistan
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