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Yan J, Hester CA, Zhu H, Yan J, Augustine MM, Porembka MR, Wang SC, Mansour JC, Iii HJZ, Yopp AC, Polanco PM. Treatment and Survival Disparities of Colon Cancer in the Texas-Mexico Border Population: Cancer Disparities in Border Population. J Surg Res 2021; 267:432-442. [PMID: 34237628 DOI: 10.1016/j.jss.2021.05.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/12/2021] [Accepted: 05/27/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Previous studies have reported healthcare disparities in the Texas-Mexico border population. Our aim was to evaluate treatment utilization and oncologic outcomes of colon cancer patients in this vulnerable population. METHODS Patients with localized and regional colon cancer (CC) were identified in the Texas Cancer Registry (1995-2016). Clinicopathological data, hospital factors, receipt of optimal treatment, and overall survival (OS) were compared between Texas-Mexico Border (TMB) and the Non-Texas-Mexico Border (NTMB) cohorts. Multivariable analysis was performed to identify risk factors associated with decreased survival. RESULTS We identified 43,557 patients with localized/regional CC (9% TMB and 91% NTMB). TMB patients were more likely to be Hispanic (73% versus 13%), less likely to have private insurance (13% versus 21%), were more often treated at safety net hospitals (82% versus 22%) and less likely at ACS-CoC accredited hospitals (32% versus 57%). TMB patients were more likely to receive suboptimal treatment (21% versus 16%) and had a lower median OS for localized (8.58 versus 9.58 y) and regional colon cancer (5.75 versus 6.18 y, all P < 0.001). In multivariable analysis, TMB status was not associated with worse OS. Factors associated with worse survival included receipt of suboptimal treatment, Medicare/insured status, and treatment in safety net and non-accredited ACS-CoC hospitals (all P < 0.001) CONCLUSIONS: While TMB CC patients had worse OS, TMB status itself was not found to be a risk factor for decreased survival. This survival disparity is likely associated with higher rate of suboptimal treatment, Medicare/Uninsured status, and decreased access to ACS-CoC accredited hospitals.
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Affiliation(s)
- Justin Yan
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Caitlin A Hester
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Hong Zhu
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jingsheng Yan
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matthew M Augustine
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matthew R Porembka
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Sam C Wang
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - John C Mansour
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Herbert J Zeh Iii
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Adam C Yopp
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - Patricio M Polanco
- Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
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Zhang X, Xu R, Feng W, Xu J, Liang Y, Mu J. Autophagy-related genes contribute to malignant progression and have a clinical prognostic impact in colon adenocarcinoma. Exp Ther Med 2021; 22:932. [PMID: 34306201 PMCID: PMC8281215 DOI: 10.3892/etm.2021.10364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/15/2021] [Indexed: 12/23/2022] Open
Abstract
Autophagy has an important role in regulating tumor cell survival. However, the roles of autophagy-related genes (ARGs) during colon adenocarcinoma (COAD) progression and their prognostic value have remained elusive. The present study aimed to identify the correlation between ARGs and the progression of COAD, as well as the prognostic significance of ARGs. The transcriptome profiles and the corresponding clinicopathological information of patients with COAD were downloaded from The Cancer Genome Atlas and Genotype-Tissue Expression databases. A list of ARGs was obtained from the Human Autophagy Database and bioinformatics analysis was performed to investigate the functions of these ARGs. Statistical analyses of these genes were performed to identify independent prognostic markers. The selected prognostic markers were then validated in 15 patients with COAD via immunohistochemistry. Differentially expressed ARGs between normal and tumor tissues were identified. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses revealed that the differentially expressed ARGs were mainly enriched in toxoplasmosis and pathways in cancer. The ATG4B, DAPK1 and SERPINA1 genes were determined to be associated with COAD progression. In addition, a risk signature was proposed that may serve as an independent prognostic marker. In conclusion, ATG4B, DAPK1 and SERPINA1 are crucial participants in tumorigenesis of COAD. The present study may promote the development of novel treatment strategies for COAD.
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Affiliation(s)
- Xianyi Zhang
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Runtao Xu
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Wenjing Feng
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Jiapeng Xu
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Yulong Liang
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Jinghui Mu
- Department of General Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
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Brown JJ, Asumeng CK, Greenwald D, Weissman M, Zauber A, Striplin J, Weng O, List JM, Farley SM, Winawer SJ. Decreased colorectal cancer incidence and mortality in a diverse urban population with increased colonoscopy screening. BMC Public Health 2021; 21:1280. [PMID: 34193094 PMCID: PMC8247120 DOI: 10.1186/s12889-021-11330-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 06/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background Although colorectal cancer screening has contributed to decreased incidence and mortality, disparities are present by race/ethnicity. The Citywide Colon Cancer Control Coalition (C5) and NYC Department of Health and Mental Hygiene (DOHMH) promoted screening colonoscopy from 2003 on, and hypothesized future reductions in CRC incidence, mortality and racial/ethnic disparities. Methods We assessed annual percent change (APC) in NYC CRC incidence, stage and mortality rates through 2016 in a longitudinal cross-sectional study of NY State Cancer Registry, NYC Vital Statistics, and NYC Community Health Survey (CHS) data. Linear regression tested associations between CRC mortality rates and risk factors. Results Overall CRC incidence rates from 2000 decreased 2.8% yearly from 54.1 to 37.3/100,000 population in 2016, and mortality rates from 2003 decreased 2.9% yearly from 21.0 to 13.9 in 2016 at similar rates for all racial/ethnic groups. Local stage disease decreased overall with a transient increase from 2002 to 2007. In 2016, CRC incidence was higher among Blacks (42.5 per 100,000) than Whites (38.0), Latinos (31.7) and Asians (30.0). In 2016, Blacks had higher mortality rates (17.9), than Whites (15.2), Latinos (10.4) and Asians (8.8). In 2016, colonoscopy rates among Blacks were 72.2%, Latinos 71.1%, Whites 67.2%, and Asians, 60.9%. CRC mortality rates varied by neighborhood and were independently associated with Black race, CRC risk factors and access to care. Conclusions In a diverse urban population, a citywide campaign to increase screening colonoscopy was associated with decreased incidence and mortality among all ethnic/racial groups. Higher CRC burden among the Black population demonstrate more interventions are needed to improve equity.
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Affiliation(s)
- Jennifer J Brown
- Bureau of Chronic Disease Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA.
| | - Charles K Asumeng
- Bureau of Chronic Disease Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA
| | - David Greenwald
- Mount Sinai Beth Israel/Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew Weissman
- Mount Sinai Beth Israel/Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ann Zauber
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jared Striplin
- Bureau of Chronic Disease Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA
| | - Olivia Weng
- Bureau of Chronic Disease Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA
| | | | - Shannon M Farley
- Bureau of Chronic Disease Prevention, NYC Department of Health and Mental Hygiene, New York, NY, USA
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Johnston FM, Yeo HL, Clark C, Stewart JH. Bias Issues in Colorectal Cancer Management: A Review. Ann Surg Oncol 2021; 29:2166-2173. [PMID: 34142287 DOI: 10.1245/s10434-021-10232-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/02/2021] [Indexed: 12/11/2022]
Abstract
Based on census data, over one-third of the US population identifies as a racial or ethnic minority. This group of racial and ethnic minorities is more likely to develop cancer and die from it when compared with the general population of the USA. These disparities are most pronounced in the African American community. Despite overall CRC rates decreasing nationally and within certain racial and ethnic minorities in the USA, there continue to be disparities in incidence and mortality when compared with non-Hispanic Whites. The disparities in CRC incidence and mortality are related to systematic racism and bias inherent in healthcare systems and society. Disparities in CRC management will continue to exist until specific interventions are implemented in the context of each racial and ethnic group. This review's primary aim is to highlight the disparities in CRC among African Americans in the USA. For surgeons, understanding these disparities is formative to creating change and improving the quality of care, centering equity for all patients.
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Affiliation(s)
- Fabian M Johnston
- Division of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
| | - Heather L Yeo
- Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA
| | - Callisia Clark
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John H Stewart
- Department of Surgery, The University of Illinois at Chicago, Chicago, IL, USA.,University of Illinois Cancer Center, Chicago, IL, USA
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55
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Wang S, Liu Y, Shi Y, Guan J, Liu M, Wang W. Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer. J Int Med Res 2021; 49:3000605211015023. [PMID: 33990147 PMCID: PMC8127758 DOI: 10.1177/03000605211015023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To develop and externally validate a prognostic nomogram to predict overall survival (OS) in patients with resectable colon cancer. METHODS Data for 50,996 patients diagnosed with non-metastatic colon cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were assigned randomly to the training set (n = 34,168) or validation set (n = 16,828). Independent prognostic factors were identified by multivariate Cox proportional hazards regression analysis and used to construct the nomogram. Harrell's C-index and calibration plots were calculated using the SEER validation set. Additional external validation was performed using a Chinese dataset (n = 342). RESULTS Harrell's C-index of the nomogram for OS in the SEER validation set was 0.71, which was superior to that using the 7th edition of the American Joint Committee on Cancer TNM staging (0.59). Calibration plots showed consistency between actual observations and predicted 1-, 3-, and 5-year survival. Harrell's C-index (0.72) and calibration plot showed excellent predictive accuracy in the external validation set. CONCLUSIONS We developed a nomogram to predict OS after curative resection for colon cancer. Validation using the SEER and external datasets revealed good discrimination and calibration. This nomogram may help predict individual survival in patients with colon cancer.
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Affiliation(s)
- Shuanhu Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yakui Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yi Shi
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Jiajia Guan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Mulin Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Wenbin Wang
- Department of General Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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56
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Cole AP, Herzog P, Iyer HS, Marchese M, Mahal BA, Lipsitz SR, Nyambose J, Gershman ST, Kennedy M, Merriam G, Rebbeck TR, Trinh QD. Racial differences in the treatment and outcomes for prostate cancer in Massachusetts. Cancer 2021; 127:2714-2723. [PMID: 33999405 DOI: 10.1002/cncr.33564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Massachusetts is a northeastern state with universally mandated health insurance since 2006. Although Black men have generally worse prostate cancer outcomes, emerging data suggest that they may experience equivalent outcomes within a fully insured system. In this setting, the authors analyzed treatments and outcomes of non-Hispanic White and Black men in Massachusetts. METHODS White and Black men who were 20 years old or older and had been diagnosed with localized intermediate- or high-risk nonmetastatic prostate cancer in 2004-2015 were identified in the Massachusetts Cancer Registry. Adjusted logistic regression models were used to assess predictors of definitive therapy. Adjusted and unadjusted survival models compared cancer-specific mortality. Interaction terms were then used to assess whether the effect of race varied between counties. RESULTS A total of 20,856 men were identified. Of these, 19,287 (92.5%) were White. There were significant county-level differences in the odds of receiving definitive therapy and survival. Survival was worse for those with high-risk cancer (adjusted hazard ratio [HR], 1.50; 95% CI, 1.4-1.60) and those with public insurance (adjusted HR for Medicaid, 1.69; 95% CI, 1.38-2.07; adjusted HR for Medicare, 1.2; 95% CI, 1.14-1.35). Black men were less likely to receive definitive therapy (adjusted odds ratio, 0.78; 95% CI, 0.74-0.83) but had a 17% lower cancer-specific mortality (adjusted HR, 0.83; 95% CI, 0.7-0.99). CONCLUSIONS Despite lower odds of definitive treatment, Black men experience decreased cancer-specific mortality in comparison with White men in Massachusetts. These data support the growing body of research showing that Black men may achieve outcomes equivalent to or even better than those of White men within the context of a well-insured population. LAY SUMMARY There is a growing body of evidence showing that the excess risk of death among Black men with prostate cancer may be caused by disparities in access to care, with few or no disparities seen in universally insured health systems such as the Veterans Affairs and US Military Health System. Therefore, the authors sought to assess racial disparities in prostate cancer in Massachusetts, which was the earliest US state to mandate universal insurance coverage (in 2006). Despite lower odds of definitive treatment, Black men with prostate cancer experience reduced cancer-specific mortality in comparison with White men in Massachusetts. These data support the growing body of research showing that Black men may achieve outcomes equivalent to or even better than those of White men within the context of a well-insured population.
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Affiliation(s)
- Alexander P Cole
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter Herzog
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Maya Marchese
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brandon A Mahal
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Stuart R Lipsitz
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua Nyambose
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Susan T Gershman
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Mark Kennedy
- Boston Public Health Commission, Boston, Massachusetts
| | - Gail Merriam
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Colonic endoscopic submucosal dissection using a novel robotic system (with video). Gastrointest Endosc 2021; 93:1172-1177. [PMID: 32991869 DOI: 10.1016/j.gie.2020.09.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/20/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS One of the difficulties in performing endoscopic submucosal dissection (ESD) is the lack of retraction during submucosal dissection. The development of the EndoMaster EASE System (EndoMaster Pte Ltd, Singapore) aims to enhance the safety and efficacy of ESD through 2 flexible robotic arms for tissue retraction and dissection. This is a preclinical animal study to evaluate the performance of colorectal ESD using the latest version of the EndoMaster EASE System. METHODS The latest version of the EndoMaster EASE System consists of an independently designed, flexible platform with a built-in endoscopic imaging system and 3 working channels, 2 for the passage of robotic arms and 1 for accessories. In this animal study, the outcome measures were operating time (from starting incision to finishing dissection), completeness of resection, procedure-related adverse events, and limitations of arm manipulation in a narrow working space as assessed by counting the frequency of blind cutting. RESULTS Five ESD procedures were performed in a 66.7-kg porcine model with the animal under general anesthesia. The mean operative time was 73.8 minutes, and the mean size of the specimen resected was 1340 mm2. There was no perforation, although profuse bleeding was encountered during 1 robotic ESD procedure. CONCLUSIONS The current preclinical study confirmed the feasibility of performing colorectal ESD using the latest version of the EndoMaster EASE System. The system was also tested for the ability to manage adverse events including bleeding and perforation. This study provided important preclinical experience for clinical trial.
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Colorectal Cancer Screening Among Patients who Receive Medical and Dental Care at an Urban Community Health Center. J Community Health 2021; 45:626-634. [PMID: 31797302 DOI: 10.1007/s10900-019-00782-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Colorectal cancer (CRC) screening rates remain subpar, particularly among underserved populations. As the role of health care providers evolves, it has been suggested that dentists could play a larger role in preventive health. Building on this concept, dental visits could serve as an additional touchpoint for CRC screening outreach. The primary goal of this study was to compare CRC screening rates among patients who receive both dental and medical care to those who only receive medical care at an urban community health center in order to inform future CRC screening intervention development. We conducted a retrospective medical and dental record data abstraction of all patients meeting the criteria for CRC screening who had a medical and/or dental appointment within the last 2 years. A total of 1081 eligible patients were identified-250 in the dental and medical group and 831 in the medical only group. The patient population was largely black, female, and publicly insured. Among the dental and medical group patients, 36% were up to date on CRC screening compared to 22% among the medical only group (p < 0.001). In addition, the medical and dental group patients had higher screening rates in all other preventive health measures analyzed (p < 0.001). Despite higher screening rates among patients who received both dental and medical care, overall rates were very low. Further screening outreach is needed in this population, and engaging patients at dental visits may be one approach.
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Webster-Clark M, Keil AP, Sanoff HK, Stürmer T, Westreich D, Lund JL. Introducing longitudinal cumulative dose to describe chemotherapy patterns over time: Case study of a colon cancer trial. Int J Cancer 2021; 149:394-402. [PMID: 33729546 DOI: 10.1002/ijc.33565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/09/2021] [Accepted: 02/22/2021] [Indexed: 01/07/2023]
Abstract
Adjuvant chemotherapy regimens take months to complete. Despite this, studies evaluate chemotherapy adherence via measures assessed at the end of treatment (eg, number of patients missing any dose, relative dose intensity [RDI]). This approach ignores information like the timing of treatment delays. We propose longitudinal cumulative dose (LCD) to integrate impacts of dose reductions, missed doses and dose delays over time. We obtained data from the 2246 participants in the MOSAIC trial randomized to FOLFOX (all three agents) or 5-FU/LV (only 5-fluorouracil and leucovorin). We evaluated proportions of patients stopping treatment early and reducing, missing or delaying a dose in each arm for each chemotherapy agent at each cycle. We calculated LCD, the fraction of the final standard dose a participant reached by a given day, for each participant and each agent and compared it over time and at 24 weeks between treatment arms. Participants randomized to FOLFOX were more likely to stop treatment, reduce doses, miss doses or delay cycles; these differences increased over time. Median LCD for oxaliplatin in the FOLFOX arm at 24 weeks was 77%. The LCD for 5-fluorouracil differed between arms (FOLFOX arm median: 81%; 5-FU/LV arm median: 96%). Visualizing LCD highlighted the timing of deviations from standard administration in a way RDI could not, with major differences in 5-fluorouracil LCD across treatment arms beginning after the sixth dose. Further evaluation of LCD and its impacts on clinical outcomes may clarify mechanisms for heterogeneous patient outcomes.
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Affiliation(s)
- Michael Webster-Clark
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hanna K Sanoff
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Til Stürmer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel Westreich
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer L Lund
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Chiang SF, Huang HH, Tsai WS, Chin-Ming Tan B, Yang CY, Huang PJ, Yi-Feng Chang I, Lin J, Lu PS, Chin E, Liu YH, Yu JS, Chiang JM, Hung HY, You JF, Liu H. Comprehensive functional genomic analyses link APC somatic mutation and mRNA-miRNA networks to the clinical outcome of stage-III colorectal cancer patients. Biomed J 2021; 45:347-360. [PMID: 35550340 PMCID: PMC9250073 DOI: 10.1016/j.bj.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
Background Colorectal cancer (CRC) is a major health concern globally, but exhibits regional and/or environmental distinctions in terms of outcome especially for patients with stage III CRC. Methods From 2014 to 2016, matched pairs of tumor and adjacent normal tissue samples from 60 patients with stage I–IV CRC from Chang Gung Memorial Hospital in Taiwan were analyzed using next-generation sequencing. The DNA, mRNA, and miRNA sequences of paired tumor tissues were profiled. An observational study with survival analysis was done. Online datasets of The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC) were also integrated and compared. Results The gene that exhibited the highest mutation rate was adenomatous polyposis coli (APC) (75.0%), followed by TP53 (70.0%), KRAS (56.6%), and TTN (48.3%). APC was also the most frequently mutated gene in TCGA and ICGC datasets. Surprisingly, for non-metastatic cases (stages I-III), CRC patients with mutated APC had better outcome in terms of overall survival (p = 0.041) and recurrence free survival (p = 0.0048). Particularly for stage III CRC, the overall survival rate was 94.4% and 67.7%, respectively (p = 0.018), and the recurrence free survival rate was 94.4% and 16.7%, respectively (p = 0.00044). Further clinical and gene expression analyses revealed that the APC wt specimens to a greater extent exhibit poor differentiation state as well as EGFR upregulation, providing molecular basis for the poor prognosis of these patients. Finally, based on integrated transcriptome analysis, we constructed the mRNA-miRNA networks underlying disease recurrence of the stage III CRC and uncovered potential therapeutic targets for this clinical condition. Conclusion For stage III CRC, patients with mutated APC had better overall and recurrence free survival.
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Affiliation(s)
- Sum-Fu Chiang
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Heng-Hsuan Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Sy Tsai
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Bertrand Chin-Ming Tan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Yu Yang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Po-Jung Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ian Yi-Feng Chang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Jiarong Lin
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Shan Lu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - En Chin
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hao Liu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jau-Song Yu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Cell and Molecular Biology, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Jy-Ming Chiang
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsin-Yuan Hung
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jeng-Fu You
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsuan Liu
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Cell and Molecular Biology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Colon cancer survival in California from 2004 to 2011 by stage at diagnosis, sex, race/ethnicity, and socioeconomic status. Cancer Epidemiol 2021; 72:101901. [PMID: 33636581 DOI: 10.1016/j.canep.2021.101901] [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: 11/23/2020] [Revised: 02/02/2021] [Accepted: 02/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Disparities in cancer survival exist between groups. This study aims to examine these disparities in stage-, sex-, race/ethnicity-, and socioeconomic-specific colon cancer net survival in California for adults diagnosed between 2004 and 2011. METHODS We estimated age-standardized net survival using the Pohar Perme estimator for colon cancer by stage at diagnosis (localized, regional, and distant), sex, race/ethnicity (Non-Hispanic White, Non-Hispanic Black, and Hispanic), and socioeconomic status (SES). Data from the Surveillance, Epidemiology, and End Results database on adults diagnosed with malignant colon cancer during 2004-2011 in California were included (n = 78,285). County-level SES was approximated using quintile groupings based on the Federal Poverty Level. RESULTS Five-year survival for all included adults was 66.0 % (95 % CI: 65.6 %-66.4 %). The difference between Non-Hispanic White (White) adults and Non-Hispanic Black (Black) adults was 9.3 %, and between White adults and Hispanic adults was 3.4 %. A higher proportion of Black (24.5 %) and Hispanic (21.4 %) adults were diagnosed with distant disease compared to White adults (19.4 %). Differences in sex-specific survival were minimal, with only differences between Hispanic men (62.0 % [60.5 %-63.4 %]) and women (65.9 % [64.4 %-67.3 %]). SES differences were largest between the lowest quintile 63.0 % (62.3 %-65.2 %) and the highest quintile 67.8 % (66.8 %-68.8 %). SES-, stage-, and race/ethnicity-stratified analysis demonstrated improving trends for White adults with localized and regional disease, and Hispanic adults with regional disease. CONCLUSION Colon cancer survival in California is lower for Black and Hispanic adults than for White adults in all three categories: stage, sex, and SES, suggesting the need for improved health policy for Hispanic and Black adults.
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Early Elective Surgery After Colon Cancer Diagnosis has Higher Risk of Readmission and Death. Ann Surg 2021; 273:188-194. [PMID: 33086309 DOI: 10.1097/sla.0000000000004431] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE We hypothesized colon resection within 30 days of diagnosis of cancer would have higher rates of readmission and cancer specific mortality, unless there was demonstrated evidence of preoperative workup. SUMMARY BACKGROUND DATA Few studies have examined if negative consequences exist with expedited elective surgery after diagnosis of colon cancer. Surgery in a shorter time frame may result in a lack of appropriate preoperative care. METHODS Retrospective analysis of 25,407 patients in the Surveillance Epidemiology and End Results registry who underwent elective surgical resection for colon cancer from 2010 to 2015. Cohort stratified by age (66-75 vs >75 years). Primary outcomes of interest were 30-day readmission and 5-year colon cancer specific mortality. Relationships between timing of surgery and outcomes were assessed. RESULTS On unadjusted analysis, surgery before 20 days of diagnosis was associated with higher risk of 30-day readmission and colon cancer specific mortality in both age groups. Among those age 66 to 75 years old, adjusting for patient factors and preoperative workup eliminated the risk of 30-day readmission (risk ratio 1.5-0.9 for 0-10 days, risk ratio 1.3-0.9 for 11-20 days). However, the risk for colon cancer specific mortality, although reduced, persisted (hazard ratio 2.2-1.3 for 0-10 days, hazard ratio 2.0-1.2 for 11-20 days). In the cohort older than 75 years, adjusting for patient level factors and preoperative workup eliminated risk of surgery 20 days postop or sooner. CONCLUSIONS The risk associated with short time to surgery (within 30 days) may be mitigated if full oncologic workups are provided.
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Lv J, Yan L, Lu Y, Liu D, Niu J, Yin L. Sclonal architectures predict clinical outcome in colon adenocarcinoma. J Cell Mol Med 2021; 25:1796-1800. [PMID: 33369051 PMCID: PMC7875899 DOI: 10.1111/jcmm.16208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Ji Lv
- Department of surgeryThe First Hospital of QinhuangdaoQinhuangdaoChina
| | - Lili Yan
- Department of surgeryThe First Hospital of QinhuangdaoQinhuangdaoChina
| | - Yang Lu
- Department of surgeryThe First Hospital of QinhuangdaoQinhuangdaoChina
| | - Dongfeng Liu
- Department of surgeryThe First Hospital of QinhuangdaoQinhuangdaoChina
| | - Jia Niu
- Department of surgeryThe First Hospital of QinhuangdaoQinhuangdaoChina
| | - Liyong Yin
- Department of NeurologyThe First Hospital of QinhuangdaoQinhuangdaoChina
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Dibas M, Rajab AM, Atiah MJ, Aljundi S, Ghozy S, Phan K, Saquib N. Racial Disparities in the Incidence and Survival of Spinal Meningioma. Asian J Neurosurg 2020; 15:877-881. [PMID: 33708657 PMCID: PMC7869277 DOI: 10.4103/ajns.ajns_306_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: Race is a significant prognostic factor in various cancers, including the breast. Its prognostic association with spinal meningioma has not been established, although the incidence of spinal meningioma varies by race. In this retrospective cohort study, we aimed to investigate the association of race with the incidence and survival of spinal meningioma among a large population sample. Materials and Methods: A comprehensive search was done in the surveillance, epidemiology, and end results database between 2000 and 2016 to identify patients with spinal meningioma. Overall and race-specific incidence were calculated. The effect of race on overall survival among these patients was determined with Kaplan–Meier curve and Cox proportional hazard models. Results: Of 3502 spinal meningioma patients, 82.6% were Caucasian, 7.7% were African-American, 8.8% were Asian/Pacific Islander and 0.7% were American Indian/Alaska Native. The overall age-adjusted incidence was 0.239/100,000; it was highest among Caucasian (0.249) and lowest among American Indian/Alaska Native patients (0.137). There was a race effect in overall survival in the unadjusted analysis with the worst overall survival reported for Caucasian patients, and the best reported for American Indian/Alaska Native patients. However, this relationship was insignificant in the adjusted analysis. Conclusions: Race was not significantly associated with overall survival among these patients. Future studies should use spinal-meningioma-specific survival as outcome to see whether there is a racial difference in survival.
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Affiliation(s)
- Mahmoud Dibas
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Ahmad Mamoun Rajab
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Mohammad J Atiah
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Saadi Aljundi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Sherief Ghozy
- Department of Neurosurgery, El Sheikh Zayed Specialized Hospital, Giza, Egypt
| | - Kevin Phan
- Neurospine Surgery Research Group, Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
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Chen J, Zheng Y, Wang H, Zhang D, Zhao L, Yu D, Lin Z, Zhang T. Cause of death among patients with colorectal cancer: a population-based study in the United States. Aging (Albany NY) 2020; 12:22927-22948. [PMID: 33289707 PMCID: PMC7746372 DOI: 10.18632/aging.104022] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/19/2020] [Indexed: 12/20/2022]
Abstract
CRC (Colorectal cancer) is one of the most common causes of death worldwide and in the US (United States). In this study, we aim to perform a population-based analysis on the cause of death among patients with CRC in the US. A total of 834,510 CRC patients diagnosed between 1975 and 2016 in the US were selected from the SEER (Surveillance, Epidemiology, and End Results) program. Causes of death among CRC patients were characterized and SMRs (standardized mortality ratios) of death from non-cancer causes were calculated. Among all CRC patients included in this study, a total of 531,507 deaths were recorded, of which 51.3% were due to CRC, 10.3% were due to other cancers, and 38.4% were due to non-cancer causes. Recently, there has been a relative decrease in index-cancer deaths and an increase in non-cancer causes among CRC patients. The mortality risk from non-cancer rises with accumulating age and longer follow-up time. Cardiovascular diseases are the most prevalent non-cancer causes, accounting for 20.3% of all deaths among CRC patients. Compared with the general population, the mortality rate of non-cancer deaths among CRC patients is doubled (SMR, 2.02; 95% confidence interval, 2.01-2.03).
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Affiliation(s)
- Jiayuan Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yongqiang Zheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Sun Yat-Sen University, Guangzhou 510060, China
| | - Haihong Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dejun Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lei Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Dandan Yu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhenyu Lin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Fieber J, Goodsell K, Kelz RR, Ermer JP, Wirtalla C, Fraker DL, Wachtel H. Racial Disparities in Primary Hyperparathyroidism. World J Surg 2020; 45:180-187. [PMID: 32978665 DOI: 10.1007/s00268-020-05791-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Racial disparities in surgery are increasingly recognized. We evaluated the impact of race on presentation, preoperative evaluation, and surgical outcomes for patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT). METHODS We performed a retrospective cohort study of patients undergoing parathyroidectomy for PHPT at a single center (1997-2015). Patients were classified by self-identified race, as African-American or White. The primary outcome was disease severity at referral. The secondary outcome was completeness of preoperative evaluation. Operative success and surgical cure were evaluated. RESULTS A total of 2392 patients were included. The majority of patients (87.6%) were White. African-American patients had higher rates of comorbid disease as well as higher preoperative calcium (10.9 vs.10.8 mg/dl, p < 0.001) and PTH levels (122 vs. 97 pg/ml, p < 0.001). White patients were more likely to have history of bone loss documented by DXA and nephrolithiasis. African-American patients had lower rates of complete preoperative evaluation including DXA scan. Operatively, African-American patients had larger glands by size (1.7 vs. 1.5 cm, p < 0.001) and mass (573 vs. 364 mg, p < 0.001). We observed similar operative success (98.9 vs. 98.0%, p = 0.355) and cure rates (98.3 vs. 97.0%, p = 0.756). CONCLUSIONS At the time of surgical referral, African-American patients with PHPT have more biochemically severe disease and higher rates of incomplete evaluation. Operative success and cure rates are comparable.
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Affiliation(s)
- Jennifer Fieber
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA
| | - Kristin Goodsell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel R Kelz
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jae P Ermer
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA
| | - Chris Wirtalla
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA
| | - Douglas L Fraker
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Heather Wachtel
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street 4 Silverstein Pavilion, Philadelphia, PA, 19104, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Abstract
INTRODUCTION The purpose of this study was to examine colorectal cancer (CRC) malpractice suits over the past 20 years in the United States and evaluate the most common allegations, lawsuit outcomes, indemnity payment amounts, patient outcomes, and physician characteristics. METHODS The malpractice section of VerdictSearch, a legal database, was queried for cases in which CRC was a principle component of the lawsuit. Legal notes were used to characterize plaintiff allegations, verdict, financial compensation, and case year. Clinical history for each case were analyzed for patient demographics, medical outcomes, and physician characteristics. RESULTS A total of 240 CRC-related malpractice cases (1988-2018) were collected, resulting in defense (n = 101, 42.1%), plaintiff (n = 37, 15.4%), or settlement (n = 96, 40%) verdict. The primary defendants were often primary care physicians (n = 61, 25.4%) and gastroenterologists (n = 55, 22.9%). Most common plaintiff allegations are failure to perform diagnostic colonoscopy for patients with symptoms (n = 67, 27.9%), failure to perform screening colonoscopy according to screening guidelines (n = 46, 19.2%), or failure to detect CRC with colonoscopy (n = 45, 18.7%). A common alleged error in diagnosis before the median year of 2005 was failure to detect CRC by the noncolonoscopic methods (<2005: n = 22, 24.2%; >2005: n = 3, 3.09%). DISCUSSION Plaintiff-alleged errors in diagnosis are consistently the most common reason for CRC malpractice litigation in the past 20 years, whereas specific diagnostic allegations (i.e., failure to screen vs failure to detect) and methods used for surveillance may vary over time. It is important to identify such pitfalls in CRC screening and explore areas for improvement to maximize patient care and satisfaction and reduce physician malpractice litigations.
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Feng HT, Li Y, Duan X, Wang X, Qi C, Lam JWY, Ding D, Tang BZ. Substitution Activated Precise Phototheranostics through Supramolecular Assembly of AIEgen and Calixarene. J Am Chem Soc 2020; 142:15966-15974. [DOI: 10.1021/jacs.0c06872] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Hai-Tao Feng
- AIE Research Center, Shaanxi Key Laboratory of Phytochemistry, College of Chemistry and Chemical Engineering, Baoji University of Arts and Sciences, Baoji, Shaanxi 721013, China
| | - Yuanyuan Li
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong 999077, China
| | - Xingchen Duan
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, and College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Xiaoxuan Wang
- AIE Research Center, Shaanxi Key Laboratory of Phytochemistry, College of Chemistry and Chemical Engineering, Baoji University of Arts and Sciences, Baoji, Shaanxi 721013, China
| | - Chunxuan Qi
- AIE Research Center, Shaanxi Key Laboratory of Phytochemistry, College of Chemistry and Chemical Engineering, Baoji University of Arts and Sciences, Baoji, Shaanxi 721013, China
| | - Jacky W. Y. Lam
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong 999077, China
| | - Dan Ding
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, and College of Life Sciences, Nankai University, Tianjin 300071, China
| | - Ben Zhong Tang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong 999077, China
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou, Guangdong 510640, China
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Paredes AZ, Hyer JM, Tsilimigras DI, Moro A, Bagante F, Guglielmi A, Ruzzenente A, Alexandrescu S, Makris EA, Poultsides GA, Sasaki K, Aucejo FN, Pawlik TM. A Novel Machine-Learning Approach to Predict Recurrence After Resection of Colorectal Liver Metastases. Ann Surg Oncol 2020; 27:5139-5147. [PMID: 32779049 DOI: 10.1245/s10434-020-08991-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Surgical resection of hepatic metastases remains the only potentially curative treatment option for patients with colorectal liver metastases (CRLM). Widely adopted prognostic tools may oversimplify the impact of model parameters relative to long-term outcomes. METHODS Patients with CRLM who underwent a hepatectomy between 2001 and 2018 were identified in an international, multi-institutional database. Bootstrap resampling methodology used in tandem with multivariable mixed-effects logistic regression analysis was applied to construct a prediction model that was validated and compared with scores proposed by Fong and Vauthey. RESULTS Among 1406 patients who underwent hepatic resection of CRLM, 842 (59.9%) had recurrence. The full model (based on age, sex, primary tumor location, T stage, receipt of chemotherapy before hepatectomy, lymph node metastases, number of metastatic lesions in the liver, size of the largest hepatic metastases, carcinoembryonic antigen [CEA] level and KRAS status) had good discriminative ability to predict 1-year (area under the receiver operating curve [AUC], 0.693; 95% confidence interval [CI], 0.684-0.704), 3-year (AUC, 0.669; 95% CI, 0.661-0.677), and 5-year (AUC, 0.669; 95% CI, 0.661-0.679) risk of recurrence. Studies analyzing validation cohorts demonstrated similar model performance, with excellent model accuracy. In contrast, the AUCs for the Fong and Vauthey scores to predict 1-year recurrence were only 0.527 (95% CI, 0.514-0.538) and 0.525 (95% CI, 0.514-0.533), respectively. Similar trends were noted for 3- and 5-year recurrence. CONCLUSION The proposed clinical score, derived via machine learning, which included clinical characteristics and morphologic data, as well as information on KRAS status, accurately predicted recurrence after CRLM resection with good discrimination and prognostic ability.
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Affiliation(s)
- Anghela Z Paredes
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - J Madison Hyer
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Diamantis I Tsilimigras
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Amika Moro
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Fabio Bagante
- Department of Surgery, University of Verona, Verona, Italy
| | | | | | | | | | | | - Kazunari Sasaki
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Federico N Aucejo
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. .,Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
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Wiese D, Stroup AM, Maiti A, Harris G, Lynch SM, Vucetic S, Henry KA. Residential Mobility and Geospatial Disparities in Colon Cancer Survival. Cancer Epidemiol Biomarkers Prev 2020; 29:2119-2125. [PMID: 32759382 DOI: 10.1158/1055-9965.epi-20-0772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/24/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Identifying geospatial cancer survival disparities is critical to focus interventions and prioritize efforts with limited resources. Incorporating residential mobility into spatial models may result in different geographic patterns of survival compared with the standard approach using a single location based on the patient's residence at the time of diagnosis. METHODS Data on 3,949 regional-stage colon cancer cases diagnosed from 2006 to 2011 and followed until December 31, 2016, were obtained from the New Jersey State Cancer Registry. Geographic disparity based on the spatial variance and effect sizes from a Bayesian spatial model using residence at diagnosis was compared with a time-varying spatial model using residential histories [adjusted for sex, gender, substage, race/ethnicity, and census tract (CT) poverty]. Geographic estimates of risk of colon cancer death were mapped. RESULTS Most patients (65%) remained at the same residence, 22% changed CT, and 12% moved out of state. The time-varying model produced a wider range of adjusted risk of colon cancer death (0.85-1.20 vs. 0.94-1.11) and resulted in greater geographic disparity statewide after adjustment (25.5% vs. 14.2%) compared with the model with only the residence at diagnosis. CONCLUSIONS Including residential mobility may allow for more precise estimates of spatial risk of death. Results based on the traditional approach using only residence at diagnosis were not substantially different for regional stage colon cancer in New Jersey. IMPACT Including residential histories opens up new avenues of inquiry to better understand the complex relationships between people and places, and the effect of residential mobility on cancer outcomes.See related commentary by Williams, p. 2107.
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Affiliation(s)
- Daniel Wiese
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.
| | - Antoinette M Stroup
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, New Jersey.,Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey
| | - Aniruddha Maiti
- Department of Computer and Information Sciences, Temple University, Philadelphia, Pennsylvania
| | - Gerald Harris
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, New Jersey
| | - Shannon M Lynch
- Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Slobodan Vucetic
- Department of Computer and Information Sciences, Temple University, Philadelphia, Pennsylvania
| | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.,Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Booth S, Riley RD, Ensor J, Lambert PC, Rutherford MJ. Temporal recalibration for improving prognostic model development and risk predictions in settings where survival is improving over time. Int J Epidemiol 2020; 49:1316-1325. [PMID: 32243524 PMCID: PMC7750972 DOI: 10.1093/ije/dyaa030] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Prognostic models are typically developed in studies covering long time periods. However, if more recent years have seen improvements in survival, then using the full dataset may lead to out-of-date survival predictions. Period analysis addresses this by developing the model in a subset of the data from a recent time window, but results in a reduction of sample size. METHODS We propose a new approach, called temporal recalibration, to combine the advantages of period analysis and full cohort analysis. This approach develops a model in the entire dataset and then recalibrates the baseline survival using a period analysis sample. The approaches are demonstrated utilizing a prognostic model in colon cancer built using both Cox proportional hazards and flexible parametric survival models with data from 1996-2005 from the Surveillance, Epidemiology, and End Results (SEER) Program database. Comparison of model predictions with observed survival estimates were made for new patients subsequently diagnosed in 2006 and followed-up until 2015. RESULTS Period analysis and temporal recalibration provided more up-to-date survival predictions that more closely matched observed survival in subsequent data than the standard full cohort models. In addition, temporal recalibration provided more precise estimates of predictor effects. CONCLUSION Prognostic models are typically developed using a full cohort analysis that can result in out-of-date long-term survival estimates when survival has improved in recent years. Temporal recalibration is a simple method to address this, which can be used when developing and updating prognostic models to ensure survival predictions are more closely calibrated with the observed survival of individuals diagnosed subsequently.
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Affiliation(s)
- Sarah Booth
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Richard D Riley
- Centre for Prognosis Research, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Joie Ensor
- Centre for Prognosis Research, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Paul C Lambert
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark J Rutherford
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
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Quezada-Gutiérrez C, Álvarez-Bañuelos MT, Morales-Romero J, Sampieri CL, Guzmán-García RE, Montes-Villaseñor E. Factors associated with the survival of colorectal cancer in Mexico. Intest Res 2020; 18:315-324. [PMID: 32418415 PMCID: PMC7385577 DOI: 10.5217/ir.2019.09179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/AIMS Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment. METHODS A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012-2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis. RESULTS Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P= 0.026) and an advanced clinical stage of 22% (P< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (P= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1-54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2-4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1-2.9). CONCLUSIONS Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.
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Feng HT, Zou S, Chen M, Xiong F, Lee MH, Fang L, Tang BZ. Tuning Push–Pull Electronic Effects of AIEgens to Boost the Theranostic Efficacy for Colon Cancer. J Am Chem Soc 2020; 142:11442-11450. [DOI: 10.1021/jacs.0c02434] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Hai-Tao Feng
- Baoji AIE Research Center, Shaanxi Key Laboratory of Phytochemistry, College of Chemistry and Chemical Engineering, Baoji University of Arts and Sciences, Baoji 721013, China
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, and Institute of Molecular Functional Materials, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | | | - Ming Chen
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, and Institute of Molecular Functional Materials, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Feng Xiong
- Shenzhen Jinyu Biotechnology Co., Ltd., B1203 Compass Life Science Park, Julongshan B Road, Shenzhen 518118, China
| | | | | | - Ben Zhong Tang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration & Reconstruction, Institute for Advanced Study, Department of Chemical and Biomedical Engineering, Division of Life Science, State Key Laboratory of Molecular Neuroscience, and Institute of Molecular Functional Materials, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
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Scott A, Goffredo P, Ginader T, Hrabe J, Gribovskaja-Rupp I, Kapadia MR, Weigel RJ, Hassan I. The Impact of KRAS Mutation on the Presentation and Prognosis of Non-Metastatic Colon Cancer: an Analysis from the National Cancer Database. J Gastrointest Surg 2020; 24:1402-1410. [PMID: 32128676 DOI: 10.1007/s11605-020-04543-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/06/2020] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Approximately 40% of colorectal cancers have a KRAS mutation. The prognostic significance of KRAS mutations in patients with non-metastatic colon cancer has not been well elucidated. The National Cancer Database (NCDB) was used to analyze factors associated with KRAS mutation as well as its impact on the presentation and survival of patients with stages I-III colon cancer. METHODS The NCDB was queried to identify patients diagnosed with stages I-III adenocarcinoma of the colon from 2004 to 2015. RESULTS A total of 19,877 patients with known KRAS status were identified: mutation rates were 33% in stage I, 35% in stage II, and 38% in stage III patients (p < 0.01). On multivariable analysis, black race and right-sided location were independently associated with KRAS-mutated cancers (all p < 0.01). On univariate analysis for overall survival (OS), KRAS mutation was not significantly associated with a worse 5-year OS for stages I and II patients (p = 0.60 and 0.88, respectively). However, stage III KRAS-mutated colon cancers had a lower OS as compared with KRAS wild type cancers both on univariate and multivariable analysis. Right-sided colon cancers were independently associated with a worse prognosis compared with left-sided lesions (p < 0.01). CONCLUSIONS KRAS-mutated colon cancers were more frequently observed in black patients, right-sided locations, and higher-stage tumors. These mutations had a negative prognostic impact for stage III patients, suggesting that the incorporation of genotypic data into colon cancer staging may help to guide systemic therapy and prognostication of colon cancer patients.
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Affiliation(s)
- Aaron Scott
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Paolo Goffredo
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Timothy Ginader
- Holden Comprehensive Cancer Center Biostatistics Core, University of Iowa, Iowa City, IA, USA
| | - Jennifer Hrabe
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | | | - Muneera R Kapadia
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Ronald J Weigel
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Imran Hassan
- Department of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
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Freeman VL, Naylor KB, Boylan EE, Booth BJ, Pugach O, Barrett RE, Campbell RT, McLafferty SL. Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois. Cancer Med 2020; 9:3211-3223. [PMID: 32130791 PMCID: PMC7196057 DOI: 10.1002/cam4.2957] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Spatial access to primary care has been associated with late-stage and fatal breast cancer, but less is known about its relation to outcomes of other screening-preventable cancers such as colorectal cancer. This population-based retrospective cohort study examined whether spatial access to primary care providers associates with colorectal cancer-specific survival. METHODS Approximately 26 600 incident colorectal cancers diagnosed between 2000 and 2008 in adults residing in Cook County, Illinois were identified through the state cancer registry and georeferenced to the census tract of residence at diagnosis. An enhanced two-step floating catchment area method measured tract-level access to primary care physicians (PCPs) in the year of diagnosis using practice locations obtained from the American Medical Association. Vital status and underlying cause of death were determined using the National Death Index. Fine-Gray proportional subdistribution hazard models analyzed the association between tract-level PCP access scores and colorectal cancer-specific survival after accounting for tract-level socioeconomic status, case demographics, tumor characteristics, and other factors. RESULTS Increased tract-level access to PCPs was associated with a lower risk of death from colorectal cancer (hazard ratio [HR], 95% confidence interval [CI]) = 0.87 [0.79, 0.96], P = .008, highest vs lowest quintile), especially among persons diagnosed with regional-stage tumors (HR, 95% CI = 0.80 [0.69, 0.93], P = .004, highest vs lowest quintile). CONCLUSIONS Spatial access to primary care providers is a predictor of colorectal cancer-specific survival in Cook County, Illinois. Future research is needed to determine which areas within the cancer care continuum are most affected by spatial accessibility to primary care such as referral for screening, accessibility of screening and diagnostic testing, referral for treatment, and access to appropriate survivorship-related care.
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Affiliation(s)
- Vincent L. Freeman
- Division of Epidemiology and BiostatisticsSchool of Public HealthUniversity of Illinois at ChicagoChicagoILUSA
- University of Illinois Cancer CenterUniversity of Illinois Hospital and Health Sciences SystemChicagoILUSA
| | - Keith B. Naylor
- Division of Gastroenterology & HepatologyCollege of MedicineUniversity of Illinois at ChicagoChicagoILUSA
| | - Emma E. Boylan
- Division of Epidemiology and BiostatisticsSchool of Public HealthUniversity of Illinois at ChicagoChicagoILUSA
| | - Benjamin J. Booth
- Office of Community Health SystemsWashington State Department of HealthOlympiaWAUSA
| | - Oksana Pugach
- Division of Epidemiology and BiostatisticsSchool of Public HealthUniversity of Illinois at ChicagoChicagoILUSA
- Institute of Health Research and PolicySchool of Public HealthUniversity of Illinois at ChicagoChicagoILUSA
| | - Richard E. Barrett
- Department of SociologyCollege of Liberal and SciencesUniversity of Illinois at ChicagoChicagoILUSA
| | - Richard T. Campbell
- Institute of Health Research and PolicySchool of Public HealthUniversity of Illinois at ChicagoChicagoILUSA
| | - Sara L. McLafferty
- Department of Geography and Geographic Information ScienceUniversity of Illinois at Urbana‐ChampaignUrbanaILUSA
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Alharbi RA, Hakami R, Alkhayal KA, Al-Obeed OA, Traiki TAB, Zubaidi A, Al Homoud S, Ashari L, Abduljabbar A, Alsanea N. Long-term outcomes after complete mesocolic excision for colon cancer at a tertiary care center in Saudi Arabia. Ann Saudi Med 2020; 40:207-211. [PMID: 32493101 PMCID: PMC7270623 DOI: 10.5144/0256-4947.2020.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Data on long-term survival and recurrence of cancer after complete mesocolic excision (CME) for colon cancer has not been reported from our center and related to international data. OBJECTIVE Describe overall and disease-free survival, survival by surgery site and stage, and recurrence rates after curative surgery. DESIGN Retrospective chart review. SETTINGS Academic tertiary care center. PATIENTS AND METHODS The study included all patients who underwent either laparoscopic or open surgery for colon cancer with curative intent between 2001 and 2011. The colorectal database was reviewed for the following: demographic data, comorbidities, radiologic investigations, clinical stage, type of operation, complications, pathologic assessment, adjuvant treatment, recurrence and survival. Survival and recurrence rates were calculated, and survival curves were generated. MAIN OUTCOME MEASURES 5-year overall survival, secondary endpoints were 5-year disease-free survival, survival by surgery site and stage, and recurrence rates. SAMPLE SIZE 220. RESULTS The mean (SD) age at diagnosis was 57 (13) years (CI 95%: 55-59 years). There were 112 males. Mean (SD) body mass index was 27.6 (5.7) kg/m2 (CI 95%: 27-28). Pathological assessment revealed R0 (microscopically margin-negative) resection in 207 (94%). The overall 5-year survival and disease-free survival was 77.9% and 70%, respectively. The 5-year disease-free survival was 69% for the sigmoid/left colon and 69% for the right colon (difference statistically nonsignificant). Stages at the time of resection were stage 0 for 2 (0.01%) patients, stage I for 18 (8%), stage II for 92 (42%), stage III for 100 (46%), and stage IV for 6 (3%). The 5-year overall survival by stages I, II, III and IV was 94%, 80%, 75% and 50%, respectively (difference statistically non-significant). The overall 5-year recurrence rate was 23.4%. CONCLUSION The outcomes of surgical treatment for colon cancer at our institution are equivalent to international sites. No difference was noted between left and right colon in terms of survival after CME. LIMITATIONS Single center, retrospective, small sample size. CONFLICT OF INTEREST None.
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Affiliation(s)
- Reem A Alharbi
- From the Department of Clinical Surgery, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Riyadh Hakami
- From the Department of Surgery, King Fahad Central Hospital, Jazan, Saudi Arabia
| | - Khayal A Alkhayal
- From the Coloerectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Omar A Al-Obeed
- From the Coloerectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Thamer A Bin Traiki
- From the Coloerectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Zubaidi
- From the Coloerectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Samar Al Homoud
- From the Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Luai Ashari
- From the Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Alaa Abduljabbar
- From the Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nasser Alsanea
- From the Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Cusumano VT, Corona E, Partida D, Yang L, Yu C, May FP. Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy. BMC Gastroenterol 2020; 20:115. [PMID: 32306919 PMCID: PMC7168865 DOI: 10.1186/s12876-020-01262-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 04/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background The fecal immunochemical test (FIT) is the second most commonly used colorectal cancer (CRC) screening modality in the United States; yet, follow-up of abnormal FIT results with diagnostic colonoscopy is underutilized. Our objective was to determine patient-reported barriers to diagnostic colonoscopy following abnormal FIT in an academic healthcare setting. Methods We included patients age 50–75 with an abnormal FIT result between 1/1/2015 and 10/31/2017 and no documented follow-up diagnostic colonoscopy. We abstracted demographic data from the electronic health record (EHR). Study personnel conducted telephone surveys with patients to confirm colonoscopy completion and elicit data on notification of FIT results and barriers to colonoscopy. We also provided brief verbal education about diagnostic colonoscopy. We calculated frequencies of demographic data and survey responses and compared survey responses by interest in colonoscopy after education. Results We surveyed 67 patients. Fifty-one were aware of the abnormal FIT result, and a majority learned of the abnormal FIT result by direct communication with providers (19, 37.3%) or EHR messaging (11, 21.6%). Overall, fifty-three patients (79.1%) confirmed lack of colonoscopy, citing provider-related (19, 35.8%), patient-related (16, 30.2%), system-related (1, 1.9%), or multifactorial (17, 32.1%) reasons. Lack of knowledge of FIT result (14, 26.4%) was most common. After brief education, 20 (37.7%) patients requested colonoscopy. Conclusion Patients with an abnormal FIT reported various multi-level barriers to diagnostic colonoscopy after abnormal FIT, including knowledge of FIT results. When provided with brief education, participants expressed interest in diagnostic colonoscopy. Future efforts will evaluate interventions to improve colonoscopy follow-up.
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Affiliation(s)
- Vivy T Cusumano
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Edgar Corona
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Diana Partida
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Liu Yang
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Christine Yu
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Department of Gastroenterology, Southern California Permanente Medical Group, Los Angeles, California, USA
| | - Folasade P May
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. .,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. .,UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, Los Angeles, California, USA. .,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
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78
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Eaglehouse YL, Georg MW, Shriver CD, Zhu K. Racial Comparisons in Timeliness of Colon Cancer Treatment in an Equal-Access Health System. J Natl Cancer Inst 2020; 112:410-417. [PMID: 31271431 PMCID: PMC7156930 DOI: 10.1093/jnci/djz135] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 05/14/2019] [Accepted: 07/03/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Non-Hispanic black (NHB) adults with cancer may have longer time-to-treatment than non-Hispanic whites (NHW) in the United States. Unequal access to medical care may partially account for this racial disparity. This study aimed to investigate whether there were racial differences in time-to-treatment and in treatment delays for patients diagnosed with colon cancer in the equal-access Military Health System (MHS). METHODS Patients age 18-79 years diagnosed with colon adenocarcinoma between January 1, 1998, and December 31, 2014, were identified in the Department of Defense Central Cancer Registry and the MHS Data Repository-linked databases. Median time-to-treatment (surgery and chemotherapy) and 95% confidence intervals were compared between NHBs and NHWs in multivariable quantile regression models. Odds ratios and 95% confidence intervals of receiving delayed treatment defined by guidelines for NHBs relative to NHWs were estimated using multivariable logistic regression. RESULTS Patients (n = 3067) had a mean age at diagnosis of 58.4 (12.2) years and the racial distribution was 76.7% NHW and 23.3% NHB. Median adjusted time-to-treatment was similar for NHB compared to NHW patients. The likelihood of receiving delayed treatment was similar between NHB and NHW patients. CONCLUSIONS In the MHS, there was no evidence of treatment delays for NHBs compared to NHWs, suggesting the role of equal access to medical care and insurance coverage in reducing racial disparities in colon cancer treatment.
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Affiliation(s)
- Yvonne L Eaglehouse
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda
- Department of Surgery, Bethesda, MD
- F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda
| | - Matthew W Georg
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda
- F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda
| | - Craig D Shriver
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda
- Department of Surgery, Bethesda, MD
| | - Kangmin Zhu
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda
- Department of Preventive Medicine and Biostatistics, Bethesda
- F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda
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Yao Y, Li N. Effect of HtrA1 Polymorphism on Sensitivity to Chemotherapy in Patients with Colon Cancer. Med Sci Monit 2020; 26:e921933. [PMID: 32218415 PMCID: PMC7133446 DOI: 10.12659/msm.921933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/03/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study was performed to estimate the genetic effects of HtrA1 polymorphisms rs1049331 and rs11200638 on treatment response in stage III colon cancer patients receiving 5-FU-based chemotherapy. MATERIAL AND METHODS A total of 105 stage III colon cancer patients who received postoperative 5-FU based adjuvant chemotherapy were included in our study. Chemotherapy was performed in 3 cycles for the patients. HtrA1 rs1049331 and rs11200638 polymorphisms were genotyped via polymerase chain reaction with sequencing method. The treatment response was estimated according to the RECIST guidelines. RESULTS The response rate of the eligible patients was 53.33%. For rs1049331, the presences of TT genotype and T allele indicted reduced chemotherapy sensitivity (adjusted TT: OR=1.736, 95%CI: 1.001-3.011, P=0.049; T: OR=1.801, 95%CI: 1.054-2.932, P=0.039). The rs11200638 polymorphism had no significant association with chemotherapy sensitivity in the study population (P>0.05 for all). CONCLUSIONS HtrA1 rs1049331 polymorphism, but not rs11200638 polymorphism, can influence individual sensitivity to 5-FU-based treatment in stage III colon cancer patients.
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Affiliation(s)
- Yi Yao
- Medical School of Chinese PLA, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, P.R. China
- Department of Gastroenterology, Eighth Medical Center of People’s Liberation Army (PLA) General Hospital, Beijing, P.R. China
| | - Nan Li
- Medical School of Chinese PLA, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, P.R. China
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Issaka RB, Li L, Fedorenko C, Ko CW, Inadomi JM, Ramsey SD. Racial Disparities in Colorectal Cancer Mortality: the Role of Endoscopy Wait-Time and Stage at Diagnosis. J Racial Ethn Health Disparities 2020; 7:967-974. [PMID: 32052305 DOI: 10.1007/s40615-020-00721-x] [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: 11/18/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In Western Washington (WA), colorectal cancer (CRC) mortality between 2012 and 2016 was highest in American Indian/Alaska Natives (AI/AN) and African-Americans (AA) at 20.7 and 18.7, respectively, compared with non-Hispanic Whites at 14.1/100,000 people. We hypothesized that time from billed encounters for CRC-associated symptoms to endoscopy completion or CRC stage at diagnosis contributed to observed differences. METHODS Using administrative insurance claims linked to WA cancer registry data, we performed a retrospective cohort study of patients diagnosed with CRC between 2011 and 2017, with continuous insurance for 15 months prior to diagnosis and a billed encounter for CRC-associated symptoms. We determined the wait-time (days) and stage at diagnosis and conducted logistic regression analysis to identify the factors associated with endoscopy completion. RESULTS Of the 3461 CRC patients identified, 57% had stage 2 or 3 disease with no differences in stage by race, and 84% completed an endoscopy after a billed encounter for CRC-associated symptoms. The median wait-time to endoscopy was 52 days (IQR 14-218) without differences by race. Compared with patients diagnosed with stage 1 CRC, patients with stage 4 CRC were more likely to complete an endoscopy within the first quartile of time (22.2% vs. 17.4%, p < 0.01). Living arrangement, insurance type, and comorbidity, but not race, were significant factors associated with endoscopy completion. CONCLUSIONS We found no statistically significant differences in time from billed CRC-associated symptoms to endoscopy completion or in CRC stage among AA and AI/AN compared to Whites. This suggests that other factors are more likely to contribute to observed mortality disparities.
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Affiliation(s)
- Rachel B Issaka
- Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA. .,Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA. .,Division of Gastroenterology, University of Washington School of Medicine, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA.
| | - Li Li
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - Catherine Fedorenko
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - Cynthia W Ko
- Division of Gastroenterology, University of Washington School of Medicine, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - John M Inadomi
- Division of Gastroenterology, University of Washington School of Medicine, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - Scott D Ramsey
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
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Alese OB, Jiang R, Zakka KM, Wu C, Shaib W, Akce M, Behera M, El-Rayes BF. Analysis of racial disparities in the treatment and outcomes of colorectal cancer in young adults. Cancer Epidemiol 2019; 63:101618. [PMID: 31600666 DOI: 10.1016/j.canep.2019.101618] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The incidence of colorectal cancer (CRC) in young adults is increasing. Minority populations with CRC are known to have worse survival outcomes. The aim of this study is to evaluate adults under age 50 years with CRC by race and ethnicity. METHODS Data were obtained from all US hospitals that contributed to the National Cancer Database (NCDB) between 2004 and 2013. Univariate and multivariable testing was done to identify factors associated with patient outcome. Kaplan-Meier analysis and Cox proportional hazards models were used for association between patient characteristics and survival. RESULTS A total of 83,449 patients between 18 and 50 years of age were identified. Median age was 45 years (SD ± 6), with male preponderance (53.9%). 72% were non-Hispanic Whites (NHW), Blacks (AA) were 15.1% and Hispanics (who did not identify as Blacks) were 8.3% of the study population. Distribution across stages IIV was 15.6%, 22.4%, 33.9% and 27% consecutively. 41.8% of NHW and 28.4% of AA had rectal cancers (p < 0.001). Despite equally receiving standard of care (SOC) as per national guidelines, AA had significantly lower 5-year survival rates (58.8%) compared to Hispanics (64.8%) and NHW (66.9%; HR 1.42; 1.38-1.46; p < 0.001). Furthermore, NHW (HR 0.85; 0.81-0.88; p < 0.001) and Hispanics (HR 0.75; 0.70-0.79; p < 0.001) were more likely to benefit from chemotherapy compared to AA. SOC utilization was associated with improved survival across all racial groups, especially in AA (HR 0.64; 0.60-0.69; p < 0.001). CONCLUSION Despite comparable rates of SOC utilization, AA young adults had worse survival outcomes compared to other races. More colon (compared to rectal) cancers in AA may have contributed to their worse outcomes.
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Affiliation(s)
- Olatunji B Alese
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
| | - Renjian Jiang
- Winship Research Informatics, Emory University, Atlanta, GA, USA
| | - Katerina M Zakka
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Christina Wu
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Walid Shaib
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Mehmet Akce
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Madhusmita Behera
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA; Winship Research Informatics, Emory University, Atlanta, GA, USA
| | - Bassel F El-Rayes
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Karstensen JG, Burisch J, Pommergaard HC, Aalling L, Højen H, Jespersen N, Schmidt PN, Bülow S. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry. Clin Gastroenterol Hepatol 2019; 17:2294-2300.e1. [PMID: 30743005 DOI: 10.1016/j.cgh.2019.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/10/2019] [Accepted: 02/03/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Familial adenomatous polyposis (FAP) is an autosomal dominant disorder that increases risk for colorectal cancer (CRC). We assessed changes in the incidence and prevalence of CRC, and survival times, of patients with FAP participating in the Danish follow-up study. METHODS We collected data from the Danish Polyposis Registry, a nationwide, complete registry of patients with FAP that includes clinical information, surgical procedures, follow-up findings, and pathology reports. We compared data between the periods of 1990-1999 and 2000-2017. In 2017, the registry contained 226 families with 721 individuals with FAP. Probands were defined as patients diagnosed based on bowel symptoms, without any knowledge of hereditary bowel disease. Call-up patients were defined as those found to have FAP during screening and due to a diagnosis of FAP in first-degree relatives. RESULTS Although the mean incidence rate of FAP was stable from 1990-1999 (0.19/100,000/year) to 2000-2017 (0.32/100,000/year) (P = .91), the point prevalence increased from 4.86/100,000 in 1999 to 6.11/100,000 by the end of 2017 (P = .005). During 2000-2017, 25 of 72,218 CRC cases were associated with FAP (0.03%)-this was a significant decrease from 1990-1999 (26/30,005 cases; 0.09%) (P = .001). The risk of CRC was significantly higher for probands (n = 191; 61.6%) than call-up cases (n = 5; 1.9%) (P < .001). All CRCs in call-up patients were detected at the diagnosis of FAP (no cases were identified in the follow-up program). The median life expectancy for call-up patients was 72.0 years (95% CI, 63.3-80.7), compared to 55.0 years for probands (95% CI, 51.2-58.8) (P < .001). Therefore, the tracing and follow-up program increased life expectancy by 17.0 years for first-degree family members. CONCLUSION The Danish Polyposis Registry enables close monitoring of patients with FAP, reducing risk of CRC and prolonging life.
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Affiliation(s)
- John Gásdal Karstensen
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
| | - Johan Burisch
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Lisa Aalling
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Helle Højen
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Niels Jespersen
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Palle Nordblad Schmidt
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Steffen Bülow
- Danish Polyposis Registry, Gastro Unit, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Alawadhi E, Al-Awadi A, Elbasmi A, Coleman MP, Allemani C. Cancer Survival by Stage at Diagnosis in Kuwait: A Population-Based Study. JOURNAL OF ONCOLOGY 2019; 2019:8463195. [PMID: 31662756 PMCID: PMC6754911 DOI: 10.1155/2019/8463195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/31/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the distribution of stage at diagnosis for 12 cancers in Kuwait, to estimate stage-specific net survival at 1 and 5 years after diagnosis, and to assess differences in stage-specific survival between Kuwait and the United States. MATERIAL AND METHODS Data were obtained from the Kuwait Cancer Registry, for Kuwaiti patients diagnosed during 2000-2013, with follow-up to 31 December 2015. The distribution of Surveillance Epidemiology and End Results (SEER) Summary Stage for 12 malignancies was examined. We estimated net survival by stage up to 5 years after diagnosis, controlling for background mortality with life tables of all-cause mortality in the general population by single year of age, sex, and calendar period. Survival estimates were age-standardised using the International Cancer Survival Standard (ICSS) weights. RESULTS Only 14.2% of patients were diagnosed at a localised stage and 38.9% at the regional stage. The proportion of patients with known stage was 88.9% during 2000-2004 but fell to 59.4% during 2010-2013. During 2005-2009, 1- and 5-year survival for colon, rectal, breast, cervical, and prostate cancer was about 90% or higher for patients diagnosed at the localised stage. During 2004-2009, the proportion of patients diagnosed at a localised stage was lower in Kuwait than in the US for colon, breast, and lung cancer. Age-standardised 5-year net survival for all stages combined was lower in Kuwait than the US for colon, lung, and breast cancer, but stage-specific survival was similar. CONCLUSION Since stage-specific survival is similar in Kuwait and the US, late stage at diagnosis is likely to be a major contributing factor to the overall lower survival in Kuwait than in the US. Increasing public awareness of cancer risk factors and symptoms and investment in early detection will be vital to reduce the proportion of patients diagnosed at a late stage and to improve survival.
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Affiliation(s)
- E. Alawadhi
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - A. Al-Awadi
- Kuwait Cancer Control Center, Ministry of Kuwait, Kuwait City, Kuwait
| | - A. Elbasmi
- Kuwait Cancer Control Center, Ministry of Kuwait, Kuwait City, Kuwait
| | - M. P. Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - C. Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
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84
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Adenocarcinoma in the transposed colon: High grade active inflammation versus low grade chronic inflammation. Eur J Surg Oncol 2019; 45:1536-1541. [DOI: 10.1016/j.ejso.2019.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/12/2019] [Indexed: 01/16/2023] Open
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Low colorectal cancer survival in the Mountain West state of Nevada: A population-based analysis. PLoS One 2019; 14:e0221337. [PMID: 31425558 PMCID: PMC6699684 DOI: 10.1371/journal.pone.0221337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 08/05/2019] [Indexed: 12/16/2022] Open
Abstract
Colorectal cancer (CRC) is the third greatest cancer burden in the United States. The remarkably diverse Mountain West state of Nevada has uncharacteristically high CRC mortality compared to other Western states. We aimed to study the determinants of the CRC excess burden by using data from the Nevada Central Cancer Registry from 2003-2013. Five-year cause-specific age-adjusted survival from colorectal cancer was calculated and stratified by sex, race/ethnicity and region of Nevada. Cox Proportional Hazards regression modelling was used to study the impact of demographic, social, and clinical factors on CRC survival in Nevada, assessing follow-up as accurately as possible. The extent to which differences in survival can be explained by receipt of stage-appropriate treatment was also assessed. 12,413 CRC cases from 2003-2013 in Nevada were analyzed. Five-year CRC survival was low: 56.0% (95% CI: 54.6-57.5) among males and 59.5% (95% CI: 58.0-61.1) among females; significantly lower than national 5-year survival of 65.1% and 66.5%, respectively. Low survival was driven by populous Southern Nevada; after adjustment for all covariates, Southern Nevadans were at 17% higher risk of death than their counterparts in Northwestern Nevada (HR:1.17; 95% CI:1.08-1.27). Many patients did not receive stage-appropriate treatment, although this only partly explained the poor survival, uniformly low for every race/ethnicity in Nevada. The observed disparity for this one state within a single nation merits public health attention; regardless of the state or region of residence, all Americans deserve equal opportunity for optimum health outcomes in the face of a cancer diagnosis. The current study provides baseline information critical to clinicians, public health professionals, and all relevant stakeholders as they attempt to discern why Nevada's outcomes are vastly divergent from its neighboring Western states and make plans for remediation.
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86
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Huang QR, Pan XB. Prognostic lncRNAs, miRNAs, and mRNAs Form a Competing Endogenous RNA Network in Colon Cancer. Front Oncol 2019; 9:712. [PMID: 31448228 PMCID: PMC6691151 DOI: 10.3389/fonc.2019.00712] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/17/2019] [Indexed: 01/09/2023] Open
Abstract
Purpose: To develop a multi-RNA-based model to provide survival risk prediction for colon cancer by constructing a competing endogenous RNAs (ceRNAs) network. Methods: The prognostic information and expression of the lncRNAs, miRNAs, and mRNAs in colon cancer specimens from The Cancer Genome Atlas (TCGA) were assessed. Constructing prognostic models used the differentially expressed RNAs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses and Gene Ontology were used to identify the functional role of the ceRNA network in the prognosis of colon cancer. Results: Five lncRNAs (AC007384.1, AC002511.1, AC012640.1, C17orf82, and AP001619.1), 8 miRNAs (hsa-mir-141, hsa-mir-150, hsa-mir-375, hsa-mir-96, hsa-mir-107, hsa-mir-106a, hsa-mir-200a, and hsa-mir-1271), and 5 mRNAs (BDNF, KLF4, SESN2, SMOC1, and TRIB3) were highly correlated with tumor status and tumor stage. Three prognostic models based on the 5 lncRNAs, 8 miRNAs, and 5 mRNAs were constructed. The prognostic ability was 0.850 for the lncRNA-based model, 0.811 for the miRNA-based model, and 0.770 for the mRNA-based model. Patients with high-risk scores revealed worse overall survival. The KEGG pathways were significantly enriched in the “neuroactive ligand-receptor interaction.” Conclusion: This study identified several potential prognostic biomarkers to construct a multi-RNA-based prognostic model for colon cancer.
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Affiliation(s)
- Qian-Rong Huang
- Department of Neurosurgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Xin-Bin Pan
- Department of Radiation Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
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Gootee JM, Curtin CE, Aurit SJ, Randhawa SE, Kang BY, Silberstein PT. Treatment Facility: An Important Prognostic Factor for Dedifferentiated Liposarcoma Survival. Fed Pract 2019; 36:S34-S41. [PMID: 31507311 PMCID: PMC6719806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A National Cancer Database study of on survival outcomes for patients with dedifferentiated liposarcomas found that insurance status, median household income, and treatment facility were associated with differences in median survival and 5- and 10-year survival probabilities.
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Affiliation(s)
- Jonathan Michael Gootee
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
| | - Christina E Curtin
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
| | - Sarah J Aurit
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
| | - Saboor E Randhawa
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
| | - Bianca Y Kang
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
| | - Peter T Silberstein
- , and are Medical Students; is a Statistician in the Division of Clinical Research and Evaluative Sciences; is a Second Year Resident in the Department of Internal Medicine; and is Chief of Hematology/Oncology and Associate Professor in the Department of Internal Medicine, all at Creighton University School of Medicine in Omaha, Nebraska. Peter Silberstein also is Chief of Oncology at VA Nebraska-Western Iowa Healthcare System in Omaha
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88
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Xie F, Dong D, Du N, Guo L, Ni W, Yuan H, Zhang N, Jie J, Liu G, Tai G. An 8‑gene signature predicts the prognosis of cervical cancer following radiotherapy. Mol Med Rep 2019; 20:2990-3002. [PMID: 31432147 PMCID: PMC6755236 DOI: 10.3892/mmr.2019.10535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 05/10/2019] [Indexed: 02/07/2023] Open
Abstract
Gene expression and DNA methylation levels affect the outcomes of patients with cancer. The present study aimed to establish a multigene risk model for predicting the outcomes of patients with cervical cancer (CerC) treated with or without radiotherapy. RNA sequencing training data with matched DNA methylation profiles were downloaded from The Cancer Genome Atlas database. Patients were divided into radiotherapy and non‑radiotherapy groups according to the treatment strategy. Differently expressed and methylated genes between the two groups were identified, and 8 prognostic genes were identified using Cox regression analysis. The optimized risk model based on the 8‑gene signature was defined using the Cox's proportional hazards model. Kaplan‑Meier survival analysis indicated that patients with higher risk scores exhibited poorer survival compared with patients with lower risk scores (log‑rank test, P=3.22x10‑7). Validation using the GSE44001 gene set demonstrated that patients in the high‑risk group exhibited a shorter survival time comprared with the low‑risk group (log‑rank test, P=3.01x10‑3). The area under the receiver operating characteristic curve values for the training and validation sets were 0.951 and 0.929, respectively. Cox regression analyses indicated that recurrence and risk status were risk factors for poor outcomes in patients with CerC treated with or without radiotherapy. The present study defined that the 8‑gene signature was an independent risk factor for the prognosis of patients with CerC. The 8‑gene prognostic model had predictive power for CerC prognosis.
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Affiliation(s)
- Fei Xie
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Dan Dong
- Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Na Du
- Department of Infections, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Liang Guo
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Weihua Ni
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hongyan Yuan
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Nannan Zhang
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Jiang Jie
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Guomu Liu
- Department of Nephrology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Guixiang Tai
- Department of Immunology, College of Basic Medical Science, Jilin University, Changchun, Jilin 130021, P.R. China
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89
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The role of socioeconomic disparity in colorectal cancer stage at presentation. Updates Surg 2019; 71:523-531. [DOI: 10.1007/s13304-019-00632-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/12/2019] [Indexed: 12/16/2022]
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90
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Hunleth JM, Gallo R, Steinmetz EK, James AS. Complicating "the good result": narratives of colorectal cancer screening when cancer is not found. J Psychosoc Oncol 2019; 37:509-525. [PMID: 30714858 DOI: 10.1080/07347332.2018.1563581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES In this paper, we analyze narratives from a Photovoice project on colorectal cancer screening that was carried out with people who had undergone screening and were found to not have cancer. METHODS Three groups, totaling eighteen participants, took part in the project, meeting multiple times over the course of approximately 10 weeks, and discussing photos they took about colorectal cancer screening. RESULTS A common way in which the participants conveyed their screening experiences was through reflection on their own or other people's illnesses. Our findings highlight the multiple meanings of receiving a "good" or noncancerous screening result after undergoing cancer screening. CONCLUSION Such findings suggest that framing noncancerous results only in terms of relief or other positive emotions may ignore the realities people and their families face and their remaining concerns. This paper has broader implications for policies to reduce cancer disparities as well as public health and patient-provider communication about screening.
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Affiliation(s)
- Jean M Hunleth
- a Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine , St. Louis , Missouri , USA
| | - Robert Gallo
- a Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine , St. Louis , Missouri , USA
| | - Emily K Steinmetz
- b Department of Anthropology, Washington College , Chestertown , Maryland , USA
| | - Aimee S James
- a Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine , St. Louis , Missouri , USA
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91
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Affiliation(s)
- Beverly B Green
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle
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92
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Hall MJ, Morris AM, Sun W. Precision Medicine Versus Population Medicine in Colon Cancer: From Prospects of Prevention, Adjuvant Chemotherapy, and Surveillance. Am Soc Clin Oncol Educ Book 2018; 38:220-230. [PMID: 30231337 DOI: 10.1200/edbk_200961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
With the advances of technologic revolution that provides new insights into human biology, genetics and cancer, as well as advantages of big data which amasses large amounts of information for us to approach cancer treatment and prevention, we are facing challenges of organically combining data from studies based on general population and information from individual testing and setting out precisional recommendations in cancer diagnosis, prevention, and treatment. We are obligated to accelerate the adaptation of new scientific discoveries into effective treatments and prevention for cancer. In this review, we introduce our opinions on bringing knowledge of precision and population medicine together to guide our clinical practice from the prospects of colorectal cancer prevention, stage III colon cancer adjuvant therapy, and postsurgery surveillance.
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Affiliation(s)
- Michael J Hall
- From the Fox Chase Cancer Center, Philadelphia, PA; Stanford University, Stanford, CA; University of Kansas, Kansas City, KS
| | - Arden M Morris
- From the Fox Chase Cancer Center, Philadelphia, PA; Stanford University, Stanford, CA; University of Kansas, Kansas City, KS
| | - Weijing Sun
- From the Fox Chase Cancer Center, Philadelphia, PA; Stanford University, Stanford, CA; University of Kansas, Kansas City, KS
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93
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Mirza AS, Pabbathi S, Lu Y, Ayoubi N, Ewing A, Jaglal M, Roetzheim R. Comorbidities, risk, and socioeconomic factors of uninsured cancer survivors. Medicine (Baltimore) 2018; 97:e13121. [PMID: 30461610 PMCID: PMC6393034 DOI: 10.1097/md.0000000000013121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/12/2018] [Indexed: 01/19/2023] Open
Abstract
Cancer patients can be well-connected to resources during treatment but become lost to follow-up and subsequently may receive treatment in free clinics for chronic morbidities. Few studies have examined outcomes for uninsured patients with cancer histories in free clinics, but research examining socioeconomic determinants emphasizes poor cancer outcomes for patients with lower socioeconomic statuses (SES).Demographic data and chronic disease measures were extracted from medical charts of patients treated in 8 free clinics in 2016 in Tampa Bay. Descriptive statistics and Pearson correlation coefficients were used to demonstrate relationships between socioeconomic factors, cancer diagnoses, and comorbidities. Charlson Comorbidity Index (CCI) was used to assess mortality risk and severity of disease burden.The histories of 4804 uninsured patients were evaluated, identifying 86 (1.7%) as having had cancer. They were predominantly female (65.1%) and significantly older than those without cancer histories. Average duration from initial diagnosis was approximately 8.53 years (standard deviation [SD] 7.55). Overall, cancer patients had higher CCI scores (3.04 [1.928 SD] versus 0.90 [1.209 SD]; P <.001); thus reflecting more weighted comorbidities than patients without cancer (P <.001). Other factors of chronic disease including obesity and substance abuse correlated with cancer history.Among uninsured patients, those with cancer histories had greater mortality risk by CCI than those without. Chronic conditions such as diabetes, cerebrovascular disease, and chronic pulmonary disease existed in patients with cancer histories, affecting their mortality risk. Uninsured patients with a history of cancer are in greater need for chronic disease management and prevention.
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Affiliation(s)
| | - Smitha Pabbathi
- Department of Internal Medicine, Moffitt Cancer Center, Survivorship Clinic
| | - Yuanyuan Lu
- College of Public Health, University of South Florida
| | - Noura Ayoubi
- Morsani College of Medicine, University of South Florida
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Ramamoorthy A, Knepper TC, Merenda C, Mendoza M, McLeod HL, Bull J, Zhang L, Pacanowski M. Demographic Composition of Select Oncologic New Molecular Entities Approved by the FDA Between 2008 and 2017. Clin Pharmacol Ther 2018; 104:940-948. [PMID: 30218447 PMCID: PMC6220929 DOI: 10.1002/cpt.1180] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/06/2018] [Indexed: 01/13/2023]
Abstract
Race, ethnicity, sex, and age are demographic factors that can influence drug exposure and/or response, and can consequently affect treatment outcome. We evaluated demographic subgroup enrollment patterns in new therapeutic products approved by the US Food and Drug Administration (FDA) for the treatment of select cancers-breast, colorectal, lung, and prostate-that have comparative differences in morbidity and/or mortality among some demographic subgroups. In submissions of products approved between 2008 and 2013, participants (n = 22,481) were white (80%), from outside the United States (74%), between 17 and 64 years old (59%), and men (56% and 53%, including and excluding sex-specific indications, respectively). In pivotal trials of products approved between2014 and 2017, participants (n = 3,612) were white (71%), between 17 and 64 years old (61%), and men (48% and 63%, including and excluding sex-specific indications, respectively). The US-relevant minority populations were under-represented. A broader representation of patient subgroups in clinical trials may contribute to better understanding of exposure and/or response variability, and consequently help personalize drug therapy.
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Affiliation(s)
- Anuradha Ramamoorthy
- Office of Clinical PharmacologyOffice of Translational SciencesCenter for Drug Evaluation and Research (CDER)U.S. Food and Drug Administration (FDA)Silver SpringMarylandUSA
| | | | - Christine Merenda
- Office of Minority HealthOffice of the CommissionerFDASilver Spring, MarylandUSA
| | - Martin Mendoza
- Office of Minority HealthOffice of the CommissionerFDASilver Spring, MarylandUSA
| | | | - Jonca Bull
- Office of Minority HealthOffice of the CommissionerFDASilver Spring, MarylandUSA
- Pharmaceutical Product Development (PPD)LLCBethesdaMarylandUSA
| | - Lei Zhang
- Office of Clinical PharmacologyOffice of Translational SciencesCenter for Drug Evaluation and Research (CDER)U.S. Food and Drug Administration (FDA)Silver SpringMarylandUSA
- Office of Research and StandardsOffice of Generic DrugsCDERFDASilver Spring, MarylandUSA
| | - Michael Pacanowski
- Office of Clinical PharmacologyOffice of Translational SciencesCenter for Drug Evaluation and Research (CDER)U.S. Food and Drug Administration (FDA)Silver SpringMarylandUSA
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Evaluation of the contribution of demographics, access to health care, treatment, and tumor characteristics to racial differences in survival of advanced prostate cancer. Prostate Cancer Prostatic Dis 2018; 22:125-136. [DOI: 10.1038/s41391-018-0083-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 01/05/2023]
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96
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White A, Rim SH, Joseph D, Johnson CJ, Coleman MP, Allemani C. Reply to Colon cancer survival in the US Department of Veterans Affairs by race and stage: 2001 through 2009. Cancer 2018; 124:2859-2860. [PMID: 29710371 PMCID: PMC6368182 DOI: 10.1002/cncr.31523] [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: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Arica White
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sun Hee Rim
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Djenaba Joseph
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Michel P. Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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98
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Zhu C, Hou X, Zhu J, Jiang C, Wei W. Expression of miR-30c and miR-29b in prostate cancer and its diagnostic significance. Oncol Lett 2018; 16:3140-3144. [PMID: 30127906 PMCID: PMC6096223 DOI: 10.3892/ol.2018.9007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022] Open
Abstract
This study aimed to investigate the expression of miR-30c and miR-29b in prostate cancer (PCa) and its clinical significance. The expression of miR-30c and miR-29b was detected by RT-qPCR in 187 cases of PCa and their adjacent tissues. Combined with clinical information, the correlation between the expression of miR-29b and miR-30c and the clinical features of PCa was analyzed, and ROC curve was plotted. The expression of miR-30c and miR-29b detected by RT-qPCR showed that the expression of miR-29b and miR-30c in PCa tissues was significantly lower than that in adjacent cancerous tissues (p<0.05). By comparing the expression and clinical data of miR-29b and miR-30c in the cancer tissues of PCa patients, it was observed that age, smoking, and TNM staging were not related to miR-29b and miR-30c expression (p>0.05), while lymph node metastasis, bone metastasis, and Gleason score were related to the expression of miR-29b and miR-30c (p<0.01). The ROC curve showed that miR-29b AUC, 0.924; 95% CI, 0.824–0.967, and miR-30c AUC, 0.944; 95% CI, 0.798–0.972. miR-30c and miR-29b are clinically relevant to PCa. In conclusion, detecting the expression of miR-30c and miR-29b not only can differentiate between PCa and paracancerous tissues, but it is also anticipated to become a new biomarker for the diagnosis of PCa.
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Affiliation(s)
- Chuanan Zhu
- Department of Clinical Laboratory, Jining First People's Hospital, Jining, Shandong 272000, P.R. China
| | - Xiumei Hou
- Nursing Department, Jining Psychiatric Hospital, Jining, Shandong 272051, P.R. China
| | - Jiabin Zhu
- Department of Neurology, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, P.R. China
| | - Chunxiao Jiang
- Department of Clinical Laboratory, Jining First People's Hospital, Jining, Shandong 272000, P.R. China
| | - Wei Wei
- Department of Clinical Laboratory, Jining First People's Hospital, Jining, Shandong 272000, P.R. China
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99
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Al-Ameri M, Persson M, Bergman P, Franco-Cereceda A, Sartipy U. Surgery for pulmonary metastases from colorectal cancer: survival and prognostic factors. J Thorac Dis 2018; 10:3372-3380. [PMID: 30069332 DOI: 10.21037/jtd.2018.05.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background This study aimed to describe overall survival following pulmonary metastasectomy for colorectal cancer (CRC) in Sweden, and to assess the discrimination of a recently proposed risk prediction model. Methods Individual-level data of 756 patients who underwent resection of pulmonary metastases from CRC between 2009 and 2015 were obtained from ThoR, a Swedish national quality register for thoracic surgery. We classified patients into three risk categories according to the number of preoperative risk factors [age, disease-free interval (DFI), presence of extrathoracic lesions, number of pulmonary metastases] established in a prior study. We estimated the hazard ratios (HRs) and 95% confidence interval (CI) by Cox regression and the restricted mean survival time difference as group contrast measures. Results During a median follow-up time of 2.9 years, 35% (268/756) patients died. At 5 years, overall survival was 56% (95% CI: 51-60%). In a Cox regression model with risk category as the only independent variable, the HR for all-cause mortality was 1.94 (95% CI: 1.38-2.72, P<0.001) and 4.35 (95% CI: 2.49-7.62, P<0.001) in the moderate- (n=558) and high-risk categories (n=32), respectively, versus the low-risk category (n=166). At 5 years, the differences in restricted mean survival time were 6 months (P<0.001) and 1.5 years (P<0.001) in the moderate- and high-risk categories, respectively, versus the low-risk category. Conclusions Five-year survival after surgery for pulmonary metastases from CRC in Sweden was similar or higher compared with contemporary reports. A prognostic model, initially developed in Japanese patients, had excellent discrimination in an external validation cohort of Swedish patients.
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Affiliation(s)
- Mamdoh Al-Ameri
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Michael Persson
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Per Bergman
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anders Franco-Cereceda
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ulrik Sartipy
- Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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100
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Colon cancer survival in the US Department of Veterans Affairs by race and stage: 2001 through 2009. Cancer 2018; 124:2858. [DOI: 10.1002/cncr.31525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/06/2018] [Indexed: 11/07/2022]
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