1
|
Yu H, Lin Y, Lin J, Xie N, Liu L, Deng S, Sun Y. Causes of death analysis and the prognostic model construction in neuroendocrine carcinoma of the cervix: A SEER-based study. Cancer Med 2024; 13:e70066. [PMID: 39118477 PMCID: PMC11310552 DOI: 10.1002/cam4.70066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 07/13/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024] Open
Abstract
PURPOSE Neuroendocrine carcinoma of the cervix (NECC) is rare but results in poor prognosis. The causes of death (CODs) in NECC patients are rarely reported. Our study aimed to explore the distributions of death causes of NECC patients compared with squamous cell carcinoma (SCC) and adenocarcinoma (ADC) and to develop a validated survival prediction model. METHODS Patients diagnosed with NECC, SCC, or ADC were identified from the Surveillance, Epidemiology, and End Results Program database from 1975 to 2019. We analyzed the standardized mortality ratio (SMR) to determine each cause of death for each survival time category. The Kaplan-Meier method was used for survival analysis. Univariate and multivariate Cox regression analyses were used to establish a nomogram model. RESULTS A total of 358 NECC patients were included in this study, and 270 (75.4%) died during the follow-up period. Patients with NECC had 5.55 times (95% CI, 4.53-6.79, p < 0.0001) higher risk of death compared with patients with SCC and 10.38 times (95% CI, 8.28-13.01, p < 0.0001) higher compared with ADC. Cervical cancer is the main cause of death in NECC. As the diagnosis time increased, the risk of death from all causes and cervix cancer gradually decreased. While after at least 10 years of follow-up time, the highest and most dramatical SMR values were observed for metastasis (SMR, 138.81; 95% CI, 37.82-355.40; p < 0.05) and other cancers as the reason for death has an over 7-fold higher SMR (SMR: 7.07; 95% CI: 2.60-15.40, p < 0.05) more than 5 years after the cancer diagnosis. Race, FIGO stage, and surgery were independent risk factors for the overall survival (OS) of NECC patients. For the predictive nomogram, the C-index was 0.711 (95% CI: 0.697-0.725) and was corrected to 0.709 (95% CI: 0.680, 0.737) by bootstrap 1000 resampling validation. CONCLUSION Compared with SCC and ADC, NECC patients have an elevated risk of mortality due to cervical cancer and metastasis. We successfully constructed a prognostic nomogram for patients with NECC. Based on refractoriness and high mortality of NECC, targeted treatment strategies and follow-up plans should be further developed according to the risk of death and distribution characteristics of CODs.
Collapse
Affiliation(s)
- Haijuan Yu
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Yongtian Lin
- Department of EpidemiologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Jie Lin
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Ning Xie
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Linying Liu
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Sufang Deng
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| | - Yang Sun
- Department of GynecologyClinical Oncology School of Fujian Medical University, Fujian Cancer HospitalFuzhouFujianChina
| |
Collapse
|
2
|
Sonal S, Boudreau C, Lee GC, Cauley CE, Kunitake H, Goldstone RN, Francone TD, Bordeianou LG, Ricciardi R, Berger DL. Causes of death in patients operated for colorectal cancer. Surgery 2024; 175:1285-1290. [PMID: 38378348 DOI: 10.1016/j.surg.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Colorectal cancer remains the third leading cause of cancer-related mortality in the United States. This study evaluates the causes of death in patients operated on for colorectal cancer and their determinants. METHODS An Instructional Review Board-approved database containing patients who underwent surgical resection for colorectal cancer from 2004 to 2018 (last followed up in December 2020) in a tertiary care institution. Data on the underlying cause of death was extracted from the Registry of Vital Records and Statistics in Massachusetts. RESULTS A total of 576 deaths were recorded in the database, of which 290 (50.35%) patients died of colorectal cancer. Deaths from colorectal cancer gradually decreased over time, whereas deaths from other cancers increased, and deaths from cardiovascular diseases remained stable. Patients who died from colorectal cancer were younger, died earlier in the disease course, had fewer comorbidities, higher rates of stage IV disease, rectal cancer, neoadjuvant therapy, extramural vascular invasion, perineural invasion, R0 resection, and preserved mismatch repair protein status. On multivariate analysis, age (adjusted odds ratio for 10-year increase = 0.79, 95% confidence interval 0.65-0.95), American Society of Anesthesiologists score (adjusted odds ratio = 0.64, confidence interval 0.42-0.98), stage IV disease (adjusted odds ratio = 3.02, confidence interval 1.59-5.9), neoadjuvant therapy (adjusted odds ratio = 7.91, confidence interval 2.64-28.13), extramural vascular invasion (adjusted odds ratio = 2.3, confidence interval 1.36-3.91) & time from diagnosis to death (adjusted odds ratio = 0.76, confidence interval 0.68-0.83) predicted death due to colorectal cancer versus other causes, whereas tumor location, perineural invasion, R0 resection, and mismatch repair protein status did not. CONCLUSION There is a declining trend of deaths from colorectal cancer, presumably reflecting advances in colorectal cancer management strategies and better screening over time. However, younger patients disproportionately contribute to death due to colorectal cancer and need aggressive screening and management strategies.
Collapse
Affiliation(s)
- Swati Sonal
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA. https://twitter.com/Dr_SwatiSonal
| | - Chloe Boudreau
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Grace C Lee
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Christy E Cauley
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Hiroko Kunitake
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Robert N Goldstone
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Newton-Wellesley Hospital, Newton, MA
| | - Todd D Francone
- Department of Surgery, Newton-Wellesley Hospital, Newton, MA; Department of Surgery, Tufts University School of Medicine, Boston, MA
| | - Liliana G Bordeianou
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Rocco Ricciardi
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - David L Berger
- Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA.
| |
Collapse
|
3
|
Yuan C, Liu S, Yang K, Xie F, Li Y, Guo Y, Zhao W, Zhang J, Cheng Z. Causal association between colorectal cancer and Alzheimer's disease: a bidirectional two-sample mendelian randomization study. Front Genet 2024; 14:1180905. [PMID: 38250575 PMCID: PMC10797121 DOI: 10.3389/fgene.2023.1180905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Colorectal cancer and Alzheimer's disease are both common life-threatening diseases in the elderly population. Some studies suggest a possible inverse relationship between colorectal cancer and Alzheimer's disease, but real-world research is subject to many biases. We hope to clarify the causal relationship between the two through a bidirectional two-sample Mendelian randomization study. Methods: In our study, we used genetic summary data from large-scale genome-wide association studies to investigate the relationship between colorectal cancer and Alzheimer's disease. Our primary analysis employed the inverse-variance weighted method and we also used complementary techniques, including MR-Egger, weighted median estimator, and Maximum likelihood. We applied simex adjustment to the MR-Egger results. We also utilized the MRlap package to detect potential sample overlap and its impact on the bias of the results. In addition, we performed several sensitivity and heterogeneity analyses, to ensure the reliability of our results. Results: The combined effect size results of the inverse-variance weighted method indicate that colorectal cancer may decrease the incidence of Alzheimer's disease, with an odds ratio (OR) of 0.846 (95% CI: 0.762-0.929). Similar results were observed using other methods such as MR-Egger, weighted median estimator, and Maximum likelihood. On the other hand, Alzheimer's disease may slightly increase the incidence of colorectal cancer, with an OR of 1.014 (95% CI: 1.001-1.027). However, the results of one subgroup were not significant, and the results from MRlap indicated that sample overlap introduced bias into the results. Therefore, the results of the reverse validation are not reliable. The F-statistic for all SNPs was greater than 20. Four SNPs related to the outcome were excluded using Phenoscanner website but the adjustment did not affect the overall direction of the results. The results of these statistics were further validated by MR-PRESSO, funnel plots, leave-one-out analyses, Cochran's Q, demonstrating the reliability of the findings. Conclusion: According to the findings of this Mendelian randomization study, there appears to be a causal association between colorectal cancer and Alzheimer's disease. These results could have important implications for clinical practice in terms of how colorectal cancer and Alzheimer's disease are treated. To better understand the relationship between these two diseases, more research and screening are needed in clinical settings.
Collapse
Affiliation(s)
- Chunsheng Yuan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Saisai Liu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Kezhen Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Feiyu Xie
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Oncology Department, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yinan Li
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Oncology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medicine University, Beijing, China
| | - Yantong Guo
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Wenjun Zhao
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Jincheng Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Zhiqiang Cheng
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| |
Collapse
|
4
|
Lou T, Hu X, Lu N, Zhang T. Causes of Death Following Gastric Cancer Diagnosis: A Population-Based Analysis. Med Sci Monit 2023; 29:e939848. [PMID: 37218118 PMCID: PMC10224633 DOI: 10.12659/msm.939848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/06/2023] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND Causes of death (CODs) in patients with gastric cancer (GC) need to be studied. We examined the cancer-specific and non-cancer deaths among patients diagnosed with GC from 1975 to 2019. MATERIAL AND METHODS We obtained medical records from the Surveillance, Epidemiology, and End Results (SEER) database. We used SEER*Stat software to calculate standardized mortality ratios (SMRs) for specific CODs and performed a competing risk analysis to evaluate the cumulative mortality of specific CODs. RESULTS The final study cohort included 42 813 patients with GC, with a mean age at diagnosis of 67.7 years. As the end of 2021, a total of 36 924 (86.2%) patients died. Of these deaths, 24 625 (66.7%) were from GC, 6513 (17.6%) were from other types of cancers, and 5786 (15.7%) were from non-cancer causes. The most prevalent non-cancer CODs were heart diseases (2104; 5.7%), cerebrovascular diseases (501; 1.4%), and pneumonia/influenza (335; 0.9%). Among patients who survived over 5 years, non-cancer causes surpassed GC as the main CODs. Patients with GC had a higher risk of dying from many non-cancer causes than expected in the general population, particularly from suicide (SMR, 3.03; 95% CI, 2.35-3.85) and septicemia (SMR, 2.93; 95% CI, 2.51-3.4). The competing risk analysis showed that the cumulative mortality of GC gradually declined with a more recent diagnosis. CONCLUSIONS Although GC was the leading COD among patients with GC, non-cancer CODs accounted for a substantial number of deaths. These findings provide useful guidance on potential death risks among patients with GC.
Collapse
Affiliation(s)
- Ting Lou
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, Zhejiang, PR China
- Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, PR China
| | - Xueqian Hu
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, Zhejiang, PR China
- Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, PR China
| | - Ning Lu
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, Zhejiang, PR China
- Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, PR China
| | - Tingsu Zhang
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, Zhejiang, PR China
- Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, PR China
| |
Collapse
|
5
|
Chen Y, He L, Lu X, Tang Y, Luo G, Chen Y, Wu C, Liang Q, Xu X. Causes of death among early-onset colorectal cancer population in the United States: a large population-based study. Front Oncol 2023; 13:1094493. [PMID: 37168371 PMCID: PMC10166590 DOI: 10.3389/fonc.2023.1094493] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/30/2023] [Indexed: 05/13/2023] Open
Abstract
Background Early-onset colorectal cancer (EOCRC) has an alarmingly increasing trend and arouses increasing attention. Causes of death in EOCRC population remain unclear. Methods Data of EOCRC patients (1975-2018) were extracted from the Surveillance, Epidemiology, and End Results database. Distribution of death was calculated, and death risk of each cause was compared with the general population by calculating standard mortality ratios (SMRs) at different follow-up time. Univariate and multivariate Cox regression models were utilized to identify independent prognostic factors for overall survival (OS). Results The study included 36,013 patients, among whom 9,998 (27.7%) patients died of colorectal cancer (CRC) and 6,305 (17.5%) patients died of non-CRC causes. CRC death accounted for a high proportion of 74.8%-90.7% death cases within 10 years, while non-CRC death (especially cardiocerebrovascular disease death) was the major cause of death after 10 years. Non-cancer death had the highest SMR in EOCRC population within the first year after cancer diagnosis. Kidney disease [SMR = 2.10; 95% confidence interval (CI), 1.65-2.64] and infection (SMR = 1.92; 95% CI, 1.48-2.46) were two high-risk causes of death. Age at diagnosis, race, sex, year of diagnosis, grade, SEER stage, and surgery were independent prognostic factors for OS. Conclusion Most of EOCRC patients died of CRC within 10-year follow-up, while most of patients died of non-CRC causes after 10 years. Within the first year after cancer diagnosis, patients had high non-CRC death risk compared to the general population. Our findings help to guide risk monitoring and management for US EOCRC patients.
Collapse
Affiliation(s)
- Yuerong Chen
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lanping He
- Department of Gastroenterology, Fogang County People’s Hospital, Fogang, China
| | - Xiu Lu
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuqun Tang
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guanshui Luo
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuji Chen
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Chaosheng Wu
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qihua Liang
- Center of Digestive Endoscopology, The Second People’s Hospital of Luoding City, Luoding, China
| | - Xiuhong Xu
- Department of Acupuncture and Massage Rehabilitation, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| |
Collapse
|
6
|
Tominaga T, Nonaka T, Oyama S, Takamura Y, Hashimoto S, Shiraishi T, Sawai T, Nagayasu T. Efficacy of Neutrophil-to-Lymphocyte Ratio for Cancer-Specific Survival in Elderly Patients with Localized Colon Cancer: A Single Center Propensity Score-Matched Analysis. Clin Exp Gastroenterol 2023; 16:1-9. [PMID: 36636228 PMCID: PMC9830562 DOI: 10.2147/ceg.s385207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been studied for colorectal cancer. Elderly patients in general tend to have comorbidities and decreased organ function that potentially influence the NLR score. The aim of this study was to investigate the relationship between NLR and cancer-specific survival in elderly patients with colon cancer, using a propensity score-matched analysis. Patients and Methods A total of 203 patients aged over 75 years who underwent curative resection for colon cancer and were diagnosed pathologically with stage II/III disease were eligible for entry to the study. Patients were divided into two groups according to NLR score: NLR-High (NLR≥4.5) group (NLR-H, n=60) and NLR-Low (NLR<4.5) group (NLR-L, n=143). After propensity score matching, 57 patients in each group were matched. Results Before matching, Charlson comorbidity index was significantly higher in the NLR-H group (4 vs 2, p<0.001). After matching, all factors were similar between the groups. The median follow-up period was 43 months (range, 1-160 months). Five-year relapse-free-survival (69.8% vs 87.3%, p=0.030) and cancer-specific survival (83.0% vs 96.0%, p=0.042) were significantly lower in the NLR-H group. Conclusion NLR appears to be a cancer-specific prognostic marker in elderly patients with colon cancer.
Collapse
Affiliation(s)
- Tetsuro Tominaga
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan,Correspondence: Tetsuro Tominaga, Department of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, Tel +81-95-819-7304, Fax +81-95-819-7306, Email
| | - Takashi Nonaka
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shosaburo Oyama
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Yuma Takamura
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shintaro Hashimoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Toshio Shiraishi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Terumitsu Sawai
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| |
Collapse
|
7
|
Yan W, Tang X, Wang L, He C, Cui X, Yuan S, Zhang H. Applicability analysis of immunotherapy for lung cancer patients based on deep learning. Methods 2022; 205:149-156. [PMID: 35809770 DOI: 10.1016/j.ymeth.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/27/2022] [Accepted: 07/03/2022] [Indexed: 11/17/2022] Open
Abstract
According to global and Chinese cancer statistics, lung cancer is the second most common cancer globally with the highest mortality rate and a severe threat to human life and health. In recent years, immunotherapy has made significant breakthroughs in the treatment of cancer patients. However, only 30% of patients are applicable and may have immune-related adverse events. The traditional immunological inspection methods have limitations and often can not obtain the expected benefits. Deep learning is a typical representation learning method that can spontaneously mine the hidden feature of effective classification from seas of data. In order to alleviate medical resources and reduce costs, this paper proposes a deep learning-based method to predict patients best suited for immune checkpoint blocking therapy from patients CT images. The deep immunotherapy analysis method proposed in this paper is divided into three steps:(1) Using LUNA16 public dataset to develop a deep learning model for nodule detection. (2) Nodule detection was performed on the Anti-PD-1_Lung dataset, and the effectiveness of immunotherapy was determined by comparing the detection results of nodules before and after immunotherapy. (3) After the data set was processed, the deep learning method trained and analyzed the Lung images. According to the experimental results and comparative analysis, the proposed deep immunotherapy analysis method has a good performance in the detection of nodules. It works for the predictions for the applicability of immunotherapy for lung cancer.1.
Collapse
Affiliation(s)
- Wenjing Yan
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China
| | - Xiao Tang
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China
| | - Lidong Wang
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China
| | - Chao He
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China
| | - Xinran Cui
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China
| | - Shuai Yuan
- College of Software, Jilin University, Changchun 130000, PR China
| | - Hao Zhang
- College of Computer Science and Technology, Jilin University, Jilin 130000, PR China; College of Software, Jilin University, Changchun 130000, PR China.
| |
Collapse
|
8
|
Takeyama H, Noura S, Suzuki Y, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, Dono K. Higher Body Mass Index Is a Simple Favorable Non-cancer Prognostic Marker for Japanese Elderly Colorectal Cancer Patients after Curative Resection. J Anus Rectum Colon 2022; 6:134-142. [PMID: 35572483 PMCID: PMC9045859 DOI: 10.23922/jarc.2021-056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: In elderly colorectal cancer (CRC) patients, preoperative surgical indications can be controversial in some cases depending on the patient's physical condition. In comparison with younger patients, both cancer-specific survival (CSS) and non-CCS (NCSS) have an impact on the prognosis and both CSS and NCSS should be considered in the preoperative assessment. We aimed to investigate the impact of body mass index (BMI) on CSS and NCSS in Japanese elderly CRC patients. Methods: We retrospectively collected data from 471 Japanese elderly patients (≥80 years) with stage I-III CRC who underwent curative surgery from 1998 to 2017. A Kaplan-Meier survival analysis with propensity score matching (PSM) and a multivariate Cox regression analysis were performed. Results: After PSM, 123 higher BMI (≥23) and 123 lower BMI (<23) cases were matched. The higher BMI group had significantly better survival than the lower BMI group regarding NCSS and overall survival (OS; P < .001 and P < .001, respectively). The multivariate survival analysis further confirmed that the higher BMI group had significantly better survival than the lower BMI group regarding CSS, NCSS, and OS (P = .027, P < .001, and P < .001, respectively). Conclusions: In Japanese elderly patients with stage I-III CRC who underwent curative surgery, preoperative higher BMI was a significant and simple favorable prognostic predictor, especially for NCSS and OS.
Collapse
Affiliation(s)
| | - Shingo Noura
- Department of Surgery, Toyonaka Municipal Hospital
| | - Yozo Suzuki
- Department of Surgery, Toyonaka Municipal Hospital
| | | | | | | | | | | | | | | | | | - Keizo Dono
- Department of Surgery, Toyonaka Municipal Hospital
| |
Collapse
|