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2.
Am Surg ; 85(9): 944-948, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638504

RESUMO

The incidence of esophageal cancer in the United States seems to have significantly increased since the 1970s. In undertaking this study, we sought to describe changes in the incidence, histologic type, and presenting stage of esophageal cancer over the past four decades. With Institutional Review Board approval, the Surveillance, Epidemiology, and End Results database of the National Cancer Institute was queried. Regression analysis was used to analyze data, and significance was accepted with 95 per cent probability. Forty-two thousand seven hundred thirty-nine patients had squamous cell carcinoma or adenocarcinoma located in their upper, middle, and/or lower esophagus from 1973 through 2010, reflecting a 7.5-fold annual increase from 1973 through 2010. Squamous cell carcinoma increased annually 2.5-fold (P < 0.001) and esophageal adenocarcinoma increased annually 57-fold from 1973 through 2010 (P < 0.001), whereas the overall population in the United States increased only 43 per cent (215,092,900 to 308,745,538) in the same period. From 1973 through 2010, there was a significant increase in the incidence of esophageal cancer in the United States. This increase was much greater than the increase in the population in the United States. The incidence of adenocarcinoma increased much more than that of squamous cell carcinoma of the esophagus from 1973 through 2010.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Adenocarcinoma/patologia , Idoso , Carcinoma de Células Escamosas/patologia , Comorbidade , Neoplasias Esofágicas/patologia , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Incidência , Masculino , Estadiamento de Neoplasias , Obesidade/epidemiologia , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia
3.
Medicine (Baltimore) ; 98(39): e17197, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574827

RESUMO

Controversies exist between the previous two prognostic nomograms for patients with bone metastatic prostate cancer (PCa), and a nomogram applied to western patients has yet to be established. Thus, we aimed to build a reliable and generic nomogram to individualize prognosis.The independent prognostic factors were identified in a retrospective study of 1556 patients with bone metastatic PCa registered in the Surveillance, Epidemiology and End Results (SEER) database. Besides, the prognostic nomogram was developed using R software according to the result of multivariable Cox regression analysis. Then, the discriminative ability of the nomogram was assessed by analyses of receiver operating characteristic curves (ROC curves). We also performed 1-, 2-, and 3-year calibrations of the nomogram by comparing the predicted survival to the observed survival. Furthermore, the model was externally validated using the data of 711 patients diagnosed at different times enrolled in the SEER database.Age ≥70 years, Gleason score ≥8, PSA value of 201 to 900 ng/ml, stage T4, stage N1, with liver metastases, and Asian/Pacific ethnicity were identified as independent prognostic factors. In the primary cohort, 1-, 2-, and 3-year area under the ROC curve (AUC) of the nomogram for predicting cancer-specific survival (CSS) were 0.71, 0.70, and 0.70, respectively. Besides 1-, 2-, and 3-year AUC were 0.70, 0.68, and 0.69, respectively, in the external validation cohort. Moreover, calibration curves presented perfect agreements between the nomogram-predicted and actual 1-, 2-, and 3-year CSS rate in both the primary and external validation cohorts. In other words, our nomogram has great predictive accuracy and reliability in predicting 1-, 2-, and 3-year CSS for patients with bone metastatic prostate cancer.This study established and validated a prognostic nomogram applied to not only Asian patients but western patients with bone metastatic PCa, which will be useful for patients' counseling and clinical trial designing.


Assuntos
Neoplasias Ósseas/mortalidade , Nomogramas , Neoplasias da Próstata/mortalidade , Medição de Risco/normas , Idoso , Neoplasias Ósseas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Modelos de Riscos Proporcionais , Próstata/patologia , Neoplasias da Próstata/secundário , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Programa de SEER , Taxa de Sobrevida
4.
Medicine (Baltimore) ; 98(40): e17214, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577711

RESUMO

The role of surgery in small cell lung cancer (SCLC) is controversial. This study explored whether surgery offered a survival benefits for patients with SCLC.Patients diagnosed with SCLC between 2010 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. The tumor, node, and metastasis (TNM) stage of SCLC in these patients was reclassified according to the 8th edition of the TNM classification for lung cancer. Overall survival (OS) was separately compared according to TNM stage between patients who underwent surgery and those who did not using Kaplan-Meier method. A Cox regression model was used to identify relevant variables affecting survival. Additional Kaplan-Meier curves were created to compare different types of surgery. Cox regression models and Forest plots were used to identify the predictors of survival in the surgery cohort.A total of 26,659 patients with SCLC were included, among which 627 (2.4%) patients underwent surgery. Surgery was associated with longer survival in patients with stage IA (45.0 vs 20.0 months, P < .001), stage IB (47.0 vs 19.0 months, P = .001), stage IIA (16.0 m vs NR, P = .007), stage III (18.0 vs 12.0 months, P < .001), and stage IV (9.0 vs 5.0 months, P < .001) disease, although the difference was not statistically significant for patients with stage IIB disease. Multivariate analysis identified surgery as an independent predictor of improved survival for all cohorts divided by stages except for stage IIB. Lobectomy was the most commonly performed procedure. Multivariate analysis in patients who underwent surgery identified lobectomy (hazard ratio [HR], 0.544; 95% confidence interval [CI], 0.341-0.869; P = .011) and chemotherapy (HR, 0.634; 95% CI, 0.487-0.827; P < .001) as independent predictors of improved survival in the surgery cohort.In a national analysis, surgery was performed in some patients for both early and advanced-stage SCLC. Surgery for SCLC was associated with improved survival except for patients with stage IIB disease. These results support an increased role of surgery in multimodal therapy for SCLC.


Assuntos
Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Carcinoma de Pequenas Células do Pulmão/mortalidade , Carcinoma de Pequenas Células do Pulmão/cirurgia , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Análise de Regressão , Programa de SEER , Carcinoma de Pequenas Células do Pulmão/patologia , Carcinoma de Pequenas Células do Pulmão/terapia , Análise de Sobrevida , Carga Tumoral
5.
Medicine (Baltimore) ; 98(40): e17332, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577727

RESUMO

To predict the survival of appendiceal mucinous adenocarcinoma (AMA) by prognostic nomogram.A total of 3234 patients with AMA were collected from the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2015. Univariate and multivariate Cox proportional hazards (PH) regression analyses were used to generate independent prognostic factors. These variables were included in the nomogram to predict overall survival (OS) and disease-specific survival (DSS) at 1-, 3-, and 5- years. These data are validated both internally and externally. The consistency index (C-index) and calibration chart were used to estimate the accuracy of the nomogram.The study cohort was randomly divided into the training (n = 2155) and validation group (n = 1799). According to univariate and multivariate analyses, age at diagnosis, marital status, sex, histological differentiation, SEER extent of disease, number of local lymph nodes examined, whether they were positive, and surgical methods were independent prognostic factors for OS and DSS. These factors were incorporated into the nomogram. Internal validation in the training cohort showed that the C-index values for nomogram predictions of OS and DSS were 0.73 (95% CI 0.70-0.76) and 0.77 (95% CI 0.73-0.81), respectively. Similarly, the corresponding C-index values in the external validation cohort were 0.76 (95% CI 0.70-0.81) and 0.75 (95% CI 0.71-0.80). The Calibration plots revealed that the actual survival and nomogram prediction had a good consistency.Build a nomogram in the SEER database to predict OS and DSS in patients with AMA. It can provide accurate and personalised survival prediction for clinicians and patients.


Assuntos
Adenocarcinoma Mucinoso/mortalidade , Adenocarcinoma Mucinoso/patologia , Neoplasias do Apêndice/mortalidade , Neoplasias do Apêndice/patologia , Nomogramas , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Modelos de Riscos Proporcionais , Programa de SEER , Fatores Sexuais , Fatores Socioeconômicos , Análise de Sobrevida
6.
Medicine (Baltimore) ; 98(40): e17367, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577736

RESUMO

There has been a steady increase in the incidence of signet ring cell (SRC) carcinoma, a distinct histological type with cells containing abundant intracytoplasmic mucin. We aimed to analyze the clinicopathological characteristics and prognostic value of patients with SRC gastric cancer (GC) who underwent gastrectomy.Clinical data of 10,312 GC patients who underwent D2 radical gastrectomy were obtained from the Surveillance, Epidemiology, and End Results database and were retrospectively analyzed. X-tile plots were constructed to illustrate the optimal cut-off points using the minimum P-value from the log-rank Chi-squared test. The Kaplan-Meier method was used for the analysis of the overall cumulative probability of survival. Their differences were evaluated using the log-rank test. The Cox multiple factors analysis was performed using the logistic regression method.In total, 946 (9.17%) SRC GC patients with pT1a-4bN0-3bM0 stage cancer were recruited. The optimal cut-off point for size was 49 mm. The 3-year overall survival (OS) rates of the SRC GC, large-size, and small-size groups were 35.89%, 30.63%, and 44.96%, respectively (P < .05). Cox multivariate analysis showed that tumor size (odds ratio [OR] = 2.032), T3 category (OR = 1.324), T4a category (OR = 1.945), and T4b category (OR = 2.163) were independent hazard prognostic factors.SRC GC has a distinct biological behavior, presents as a large-sized tumor (≥49 mm), and is associated with worse outcomes. SRC GC patients have 2.032 times risk of mortality. SRC patients with larger tumors are at higher risk for infiltrative growth, lymph node metastasis, and distant metastasis.


Assuntos
Carcinoma de Células em Anel de Sinete/mortalidade , Carcinoma de Células em Anel de Sinete/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrectomia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Programa de SEER , Carga Tumoral
7.
Anticancer Res ; 39(9): 4971-4975, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519603

RESUMO

BACKGROUND/AIM: We evaluated the incidence of uterine and breast cancer among women diagnosed with granulosa cell tumors (GCTs) of the ovary. PATIENTS AND METHODS: The US Surveillance, Epidemiology, and End Results (SEER) database was accessed and patients diagnosed with a GCT and had a known follow-up between 1973-2014 were identified. Personal tumor history was extracted and patients with a previous or subsequent malignant breast or uterine tumor were identified. The expected incidence of breast and uterine cancer was calculated based on the U.S age-specific rate of breast and uterine cancer per 100,000 women. Standardized incidence ratio (SIR) with 95% confidence intervals (95% CI) were calculated for each tumor. RESULTS: A total of 1908 cases of GCT were identified. Seventy- nine (4.14%) and 53 (2.78%) patients were diagnosed with a malignant breast and uterine malignancy. The cumulative expected number of malignant breast and uterine tumors was 27 (1.41%) and 6 (0.31%), respectively. The calculated SIR for breast and uterine malignancies was 2.96 (95%CI=2.34, 3.68) and 8.83 (95%CI=6.61, 11.56), respectively. CONCLUSION: An increased incidence of breast and uterine malignancies among patients diagnosed with GCTs was observed.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Tumor de Células da Granulosa/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia , Adulto Jovem
8.
Cancer Invest ; 37(9): 506-511, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31530035

RESUMO

With modern radiotherapy, stage I non-small cell lung cancer (S1NSCLC) cure is extended to nonsurgical candidates. Despite this, some S1NSCLC remains untreated. We aim to identify factors associated with no treatment. 62,213 S1NSCLC cases were identified (SEER: 2004-2012). Demographics were compared using Chi-squared. Multivariate analysis was performed using COX proportional HR. 11.9% of the 7373 patients lacked treatment. No insurance, Medicaid-dependence, unmarried status, advancing age, lower income, African American and Asian/Pacific Islander race, and male sex are associated with no treatment (p < .0001). No treatment portends a worse cancer-specific survival (21% vs 66% at 5Y, p < .0001) and OS (10% vs 50% at 5Y, p < .0001).


Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Conduta Expectante/estatística & dados numéricos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/etnologia , Feminino , Humanos , Neoplasias Pulmonares/etnologia , Masculino , Medicaid , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Programa de SEER , Fatores Socioeconômicos , Taxa de Sobrevida , Estados Unidos/etnologia
9.
Medicine (Baltimore) ; 98(36): e17025, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490388

RESUMO

Chest wall chondrosarcoma is a rare malignant tumor of the bone. This study is aimed to identify the prognostic determinants of chest wall chondrosarcoma. We used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients with chest wall chondrosarcoma from 1973 to 2015. Statistical analyses were performed using Kaplan-Meier method and Cox regression proportional hazards. A total of 779 patients were identified from the SEER database. The overall survival (OS) and cancer-specific survival (CSS) rates of the entire group at 10 years were 66.2% and 77.2%, respectively. On multivariate Cox regression, age ≤40 years, localized tumor stage, low tumor grade, surgery, and no radiotherapy were significantly associated with improved both OS and CSS. This study may help clinicians to predict survival of patients with chest wall chondrosarcoma and to provide appropriate treatment recommendations.


Assuntos
Neoplasias Ósseas/mortalidade , Condrossarcoma/mortalidade , Neoplasias Torácicas/mortalidade , Adulto , Feminino , Humanos , Masculino , Programa de SEER , Estados Unidos/epidemiologia
10.
Medicine (Baltimore) ; 98(36): e17083, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490413

RESUMO

There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine-Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020-0.177 and 0.021-0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Humanos , Lactente , Pessoa de Meia-Idade , Nomogramas , Medição de Risco , Programa de SEER , Estados Unidos/epidemiologia , Adulto Jovem
11.
Medicine (Baltimore) ; 98(31): e16684, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374051

RESUMO

The epidemiological and prognostic data focusing on clear cell renal cell carcinoma (ccRCC) are rarely presented. This study was aimed to define the frequency, incidence, and survival outcomes of ccRCC in the United States.The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients with ccRCC from 1973 to 2014. Two patient cohorts were utilized: patient cohorts of SEER 18 registries and 9 registries. Overall survival was determined with Kaplan-Meier method and compared across groups with log-rank test.The incidence rate of ccRCC increased with advancing age, peaked in individuals aged 60 to 79 years, and declined in individuals aged ≥80 years. The incidence rate of ccRCC was significantly higher in males than females (1.94: 1, P < .0001), in Whites than Blacks or others (1:0.79:0.91, P < .0001). The incidence rate of ccRCC with right side as primary origin was slightly but significantly higher than that with left side as primary origin (1:0.96, P = .0006). The incidence rate of ccRCC in Grade II was higher than other grades. Generally, the incidence rates of ccRCC in most circumstances started to surge in the middle 1990s. Survival outcomes of ccRCC worsened with advancing age at diagnosis, tumor grade, and stage. A better prognosis was observed in females than males, in Whites than Blacks, and in individuals diagnosed in 2006 to 2014 than 1973 to 2005.To the best of our knowledge, the present study firstly presented long-term and updated epidemiological and prognostic data concerning ccRCC in the United States. Significant differences in incidence rates and survival outcomes stratified by different variables were identified.


Assuntos
Carcinoma de Células Renais/mortalidade , Neoplasias Renais/mortalidade , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estudos Retrospectivos , Programa de SEER , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto Jovem
12.
Medicine (Baltimore) ; 98(33): e16727, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415366

RESUMO

Our study was designed to construct nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of lip carcinoma patients.A search of the Surveillance, Epidemiology, and End Results (SEER) database provided us with detailed clinical data of the 1780 lip carcinoma patients. On the basis of the credible random split-sample method, the 1780 patients were placed into 2 groups, with 890 patients in the modeling group and 890 patients in the counterpart's group (proportion = 1:1). By employing Kaplan-Meier univariate and Cox multivariate survival analyses based on the modeling cohort, the nomograms were developed and then used to divide the modeling cohort into low-risk cohort and high-risk cohort. The survival rates of the 2 groups were calculated. Internal and external evaluation of nomogram accuracy was performed by the concordance index (C-index) and calibration curves.With regard to 5- and 8-year OS and CSS, the C-indexes of internal validation were 0.762 and 0.787, whereas those of external validation reached 0.772 and 0.818, respectively. All the C-indexes were higher than 0.7. The survival curves of the low-risk cohort were obviously better than those of the high-risk cohort.Credible nomograms have been established based on the SEER large-sample population research. We believe these nomograms can contribute to the design of treatment plans and evaluations of individual prognosis.


Assuntos
Carcinoma/mortalidade , Neoplasias Labiais/mortalidade , Nomogramas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Programa de SEER , Taxa de Sobrevida , Adulto Jovem
13.
Medicine (Baltimore) ; 98(30): e16421, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348242

RESUMO

Cervical cancer is among the most frequent cancer types in women worldwide. Radiotherapy, including external beam radiation and brachytherapy, is one of the commonly used treatment options for cervical cancer. However, the adverse effects of radiation therapy on cervical cancer survival have been poorly investigated with inconclusive results. Therefore, the aim of this study was to determine the suitable radiotherapy modality according to patients' characteristics. A retrospective survival analysis of 44,602 patients was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate proportional hazard Cox model was used to evaluate the prognostic impact of different radiotherapy modalities, primary surgery, age, TNM stage, and tumor size. Our results indicated that patients without primary surgery, diagnosed at older age (≥45 years' old), at advanced TNM stages (III/IV) or with larger tumor size (≥3 cm) could benefit from radiotherapy. However, radiotherapy was detrimental in patients with primary surgery, diagnosed at younger age (<45 years' old), at earlier TNM stages (I/II) or with smaller tumor size (<3 cm). In addition, external beam radiation was in most cases less effective compared with combined external beam and brachytherapy. These results highlighted the necessity of realizing personalized radiotherapy treatments for patients with cervical cancer.


Assuntos
Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia , Adulto , Fatores Etários , Idoso , Braquiterapia/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Menopausa , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Prognóstico , Estudos Retrospectivos , Programa de SEER , Fatores Socioeconômicos , Carga Tumoral , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
14.
J Surg Oncol ; 120(4): 676-684, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31338834

RESUMO

BACKGROUND: The clinical relevance and general applicability of the 8th American Joint Committee on Cancer TNM gastric cancer staging system vs the 7th version have not been examined using datasets from both the East and West. METHODS: Patients (n = 29 984) treated for gastric adenocarcinoma at two high-volume centers (Severance Hospital [SH] and Gangnam Severance Hospital [GSH]) in Korea and data from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Survival curves, the performance of tumor staging, and the homogeneity of modified subgroups were compared. RESULTS: Minute changes were noted in the stage IIB subgroup; most changes were noted in stage III. Applying the 8th staging system facilitated better prediction of survival than applying the 7th version for SH data according to the log-rank test, C-index, and AIC (8444.5 vs 9263.8, 0.796 vs 0.798, and 104152 vs 103909, respectively). Its performance was also superior for GSH and SEER data. In a subgroup analysis of stages IIB to IIIC in SH, GSH, and SEER data, the 8th staging system showed similar or more homogeneous survival for each sub-classification than the 7th version. CONCLUSION: Compared with the 7th gastric cancer staging system, the newer version more accurately predicted prognosis and stratified subgroups more homogeneously.


Assuntos
Adenocarcinoma/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/mortalidade , Bases de Dados Factuais , Feminino , Seguimentos , Hospitais com Alto Volume de Atendimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Estudos Prospectivos , República da Coreia , Estudos Retrospectivos , Programa de SEER , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida
15.
Neoplasma ; 20192019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31305123

RESUMO

Preoperative radiation therapy has been regarded as the optional neoadjuvant treatment to decrease local recurrence of rectal cancer in addition to surgery. However, its benefit in survival remained obscure. This study was aimed to measure the efficacy of preoperative radiation therapy for survival in stage II and III rectal cancer patients. Retrospective cohort study used the database of Surveillance, Epidemiology and End Results program of the National Cancer Institute in the United States from 1988 to 2011. A total of 49439 patients diagnosed with primary rectal cancer who underwent surgery were included. Clinicopathological characteristics and rectal cancer-specific survival between surgery alone group and surgery plus preoperative radiation therapy group were compared. Rectal cancer patients in surgery plus preoperative radiation therapy group had significantly better survival than those in surgery alone group (72.70% vs. 66.61%, P < 0.001), as well as stratified by stages (stage II: 77.4% vs. 74.3%, P < 0.001; stage III: 68.3% vs. 58.6%, P < 0.001). However, this beneficial impact was only observed after 2000s (P < 0.001). Multivariate survival analysis revealed that preoperative radiation therapy was an independent predictor for better survival in stage III (hazard ratio, 0.795; 95% CI, 0.753-0.840; P < 0.001), but not in stage II (P = 0.70). Preoperative radiation therapy might bring a better survival in stage II and III rectal cancer patients, but only as an independent predictor for stage III patients. As time progressed, preoperative radiation therapy might yield more profit for stage II and III rectal cancer patients.


Assuntos
Recidiva Local de Neoplasia , Neoplasias Retais , Programa de SEER , Humanos , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Sistema de Registros , Estudos Retrospectivos , Estados Unidos
16.
Medicine (Baltimore) ; 98(28): e16436, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305469

RESUMO

The prognostic value and conflicting results of metastatic lymph node ratio (mLNR) on breast cancer have aroused an increasing concern. We aimed to evaluate the imperative of mLNR classification and prognostic factors in breast cancer with molecular subtypes.This study uses the database of surveillance, epidemiology, and end results (SEER) to investigate the imperative for reliable mLNR classification and critical prognostic factors in breast cancer with different molecular subtypes.The prognostic characteristics for disease-specific survival (DSS) of breast cancer were investigated in the SEER cohort (n = 3651). mLNR (P = .017) and histology grade (P < .001) were independent factors. A novel grade-lymph node ratio (G-R) staging system was proposed for breast cancer prognosis. The receiver operating characteristic curves revealed that the G-R staging system had an accurate 1-, 3-, and 5-year DSS prediction. Further stratification analysis with molecular subtypes of breast cancer (Luminal and TNBC) first proved robust prognostic values of the G-R staging system among molecular subtypes.The current population-based cohort demonstrated the capacity of mLNR serving as a critical prognostic factor. Also, G-R staging system has the potential to be regarded as reliable classification for breast cancer patients with different molecular subtypes.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Metástase Linfática/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Estudos Retrospectivos , Programa de SEER , Taxa de Sobrevida
17.
J Cancer Res Clin Oncol ; 145(9): 2397-2404, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31302755

RESUMO

INTRODUCTION: Surgery improves survival of small-cell lung cancer (SCLC) patients in early stage. However, the role of surgery in the elderly stage I SCLC patients is not well established. We designed this retrospective study to explore the efficacy of surgery on survival of this subset population. PATIENTS AND METHODS: Elderly patients aged ≥ 75 years with stage I SCLC diagnosed histologically from 1998 to 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Included patients were divided into surgery group (received surgery, accompanied by chemotherapy, radiotherapy, or both or neither), non-surgical group (only received radiotherapy, chemotherapy, or combination), and untreated group. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared among the three groups by the Kaplan-Meier analysis. Cox proportional hazards regression was used to identify factors associated with survival. RESULTS: A total of 983 patients were included. Among all of the patients, 24.0% patients received surgery, 46.6% patients received non-surgical treatment, and 29.4% patients received no treatment. The 5-year OS rates of surgery, non-surgical and untreated groups were 31%, 12% and 6%, respectively (P < 0.0001). In multivariable analysis, surgery was an important factor that improved OS when compared with non-surgical treatment (HR 0.554; 95% CI 0.458-0.670 [P < 0.0001]). In subgroup analysis, surgery remained an independent factor for OS among patients aged 75-79 years (HR 0.506; 95% CI 0.391-0.655 [P < 0.0001]) and 80-84 years (HR 0.544; 95% CI 0.388-0.763 [P < 0.0001]), while did not reach statistical significance when compared to non-surgical treatment for patients age ≥ 85 years (HR 0.914; 95% CI 0.507-1.650; [P = 0.766]). CONCLUSION: Surgical resection significantly improved OS in stage I SCLC patients aged 75-84 years in our study, but further exploration in larger prospective clinical trials is needed.


Assuntos
Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Carcinoma de Pequenas Células do Pulmão/mortalidade , Carcinoma de Pequenas Células do Pulmão/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Estadiamento de Neoplasias , Pneumonectomia/mortalidade , Pneumonectomia/estatística & dados numéricos , Estudos Retrospectivos , Programa de SEER , Carcinoma de Pequenas Células do Pulmão/patologia , Taxa de Sobrevida
18.
Medicine (Baltimore) ; 98(26): e16141, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261538

RESUMO

The aim of this study was to develop nomograms to predict long-term overall survival and cancer-specific survival of patients with osteosarcoma.We carried out univariate and multivariate analyses and set up nomograms predicting survival outcome using osteosarcoma patient data collected from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute (2004-2011, n = 1426). The patients were divided into a training cohort (2004-2008, n = 863) and a validation cohort (2009-2011, n = 563), and the mean follow-up was 55 months.In the training cohort, 304 patients (35.2%) died from osteosarcoma and 91 (10.5%) died from other causes. In the validation cohort, 155 patients (27.5%) died from osteosarcoma and (12.3%) died from other causes. Nomograms predicting overall survival (OS) and cancer-specific survival (CSS) were developed according to 6 clinicopathologic factors (age, tumor site, historic grade, surgery, AJCC T/N, and M), with concordance indexes (C-index) of 0.725 (OS) and 0.718 (CSS), respectively. The validation C-indexes were 0.775 and 0.742 for OS and CSS, respectively.Our results suggest that we have successfully developed highly accurate nomograms for predicting 5-year OS and CSS for osteosarcoma patients. These nomograms will help surgeons customize treatment and monitoring strategies for osteosarcoma patients.


Assuntos
Nomogramas , Osteossarcoma/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Osteossarcoma/mortalidade , Osteossarcoma/patologia , Osteossarcoma/terapia , Programa de SEER , Análise de Sobrevida , Adulto Jovem
19.
Medicine (Baltimore) ; 98(26): e16206, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261568

RESUMO

To develop clinical nomograms for prediction of overall survival (OS) and cancer-specific survival (CSS) in patients with stage IV tongue squamous cell carcinoma (TSCC) after surgery based on the Surveillance, Epidemiology, and End Results (SEER) program database.We collected data of resected stage IV TSCC patients from the SEER database, and divided them into the training set and validation set by 7:3 randomly. Kaplan-Meier analysis and Cox regression analysis were adopted to distinguish independent risk factors for OS and CSS. Clinical nomograms were constructed to predict the 3-year and 5-year probabilities of OS and CSS for individual patients. Calibration curves and Harrell C-indices were used for internal and external validation.A total of 1550 patients with resected stage IV TSCC were identified. No statistical differences were detected between the training and validation sets. Age, race, marital status, tumor site, AJCC T/N/M status, and radiotherapy were recognized as independent prognostic factors associated with OS as well as CSS. Then nomograms were developed based on these variables. The calibration curves displayed a good agreement between the predicted and actual values of 3-year and 5-year probabilities for OS and CSS. The C-indices predicting OS were corrected as 0.705 in the training set, and 0.664 in the validation set. As for CSS, corrected C-indices were 0.708 in the training set and 0.663 in the validation set.The established nomograms in this study exhibited good accuracy and effectiveness to predict 3-year and 5-year probabilities of OS and CSS in resected stage IV TSCC patients. They are useful tools to evaluate survival outcomes and helped choose appropriate treatment strategies.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Nomogramas , Período Pós-Operatório , Programa de SEER , Análise de Sobrevida , Neoplasias da Língua/mortalidade , Neoplasias da Língua/patologia , Adulto Jovem
20.
J Cancer Res Clin Oncol ; 145(8): 2115-2122, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31175463

RESUMO

PURPOSE: The survival of patients with IIIA-N2 non-small cell lung cancer after surgery followed by adjuvant chemotherapy is heterogeneous. The aim of this study is to form a prognostic system and a heat map method to visualize the overall survival rates in those patients. METHODS: Univariate and multivariate Cox hazards regression models and the associated Wald Chi square coefficient were used to form the prognostic score system. Recursive partitioning analysis was used to determine the cutoff values of lymph node ratio and prognostic score in SEER cohort and validated in FDUSCC cohort. Meanwhile, a heat map method was used to visualize the overall survival probabilities of 3, 5 and 10 years for individual patient of both cohorts. RESULTS: Lymph node ratio (with cutoff of 0.36) significantly correlates with overall survival of these patients. In addition, in patients with the same level of N2 disease, lymph node ratio still significantly affects survival. Also, after the multivariate analysis in SEER cohort, six factors were independent prognostic factors including age, sex, type of surgery, size, lymph node ratio and differentiation. A prognostic sore system with these factors (with cutoff of 12) was validated as a predictor for overall survival in FDUSCC cohort. CONCLUSIONS: This prognostic score system including lymph node ratio can predict the survival rates of IIIA-N2 patient after surgery and post-operative chemotherapy. Lymph node ratio could be a useful supplementation in TNM stage classification for IIIA-N2 patients. The heat map method can visualize the predicted overall survival of an individual patient.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Pneumonectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Quimioterapia Adjuvante , Terapia Combinada , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Programa de SEER , Taxa de Sobrevida , Resultado do Tratamento
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