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Rahouma M, Khairallah S, Baudo M, Al-Thani S, Dabsha A, Shenouda D, Mohamed A, Dimagli A, El Sherbiny M, Kamal M, Villena-Vargas J, Chow OS. Epidemiological Study of Adenoid Cystic Carcinoma and Its Outcomes: Insights from the Surveillance, Epidemiology, and End Results (SEER) Database. Cancers (Basel) 2024; 16:3383. [PMID: 39410002 PMCID: PMC11476411 DOI: 10.3390/cancers16193383] [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: 08/07/2024] [Revised: 09/26/2024] [Accepted: 10/01/2024] [Indexed: 10/20/2024] Open
Abstract
OBJECTIVE Adenoid cystic carcinoma (ACC) is a rare malignant tumor that mainly arises in the head and neck area. We aimed to compare the long-term survival of patients with ACC based on their geographic regions within the United States using the Surveillance, Epidemiology, and End Results (SEER) registry data. METHODS We queried the SEER database to evaluate the geographic distribution of ACC patients based on inpatient admissions. The states included in the study were divided into four geographical regions (Midwest, Northeast, South, and West) based on the U.S. Census Bureau-designated regions and divisions. Demographic and clinical variables were compared between the groups. Kaplan-Meier curves and Cox regression were used to assess late mortality. RESULTS A total of 5150 patients were included (4.2% from the Midwest, 17.2% from the Northeast, 22.5% from the South, and 56.1% from the West regions). The median follow-up was 12.3 (95% CI: 11.6-13.1 years). Median overall survival was 11.0 (95% CI: 9.2-NR years), 14.3 (95% CI: 12.4-16.4 years), 11.3 (95% CI: 9.7-14.8 years), and 12.0 (95% CI: 11.3-13.0 years) for Midwest, Northeast, South, and West regions, respectively. In multivariable analysis, older age, male sex, thoracic cancer, the presence of regional and distal disease, receiving chemotherapy, not undergoing surgical resection, and being treated in the West vs. Northeast region were found to be independent predictors of poor survival. We identified a significant survival difference between the different regions, with the West exhibiting the worst survival compared to the Northeast region. CONCLUSIONS In addition to the well-known predictors of late mortality in ACC (tumor location, stage, and treatment modalities), our study identified a lack of social support (being unmarried) and geographic location (West region) as independent predictors of late mortality in multivariable analysis. Further research is needed to explore the causal relationships.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt; (A.M.); (M.E.S.)
| | - Sherif Khairallah
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt; (A.M.); (M.E.S.)
| | - Massimo Baudo
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
- Cardiac Surgery Department, Spedali Civili di Brescia, University of Brescia, 25121 Brescia, Italy
| | - Shaikha Al-Thani
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
| | - Anas Dabsha
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt; (A.M.); (M.E.S.)
| | - David Shenouda
- Biology Department, New York Institute of Technology, New York, NY 11568, USA;
| | - Abdelrahman Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt; (A.M.); (M.E.S.)
| | - Arnaldo Dimagli
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
| | - Magdy El Sherbiny
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt; (A.M.); (M.E.S.)
| | - Mona Kamal
- Symptom Research Departments, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Jonathan Villena-Vargas
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
| | - Oliver S. Chow
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, Box 110, New York, NY 10065, USA; (S.K.); (M.B.); (A.D.); (A.D.); (J.V.-V.); (O.S.C.)
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Appiah D, Goodart CR, Kothari GK, Ebong IA, Nwabuo CC. Reduced Risk of All-Cause, Cancer-, and Cardiovascular Disease-Related Mortality among Patients with Primary Malignant Cardiac Tumors Receiving Chemotherapy in the United States. Curr Oncol 2023; 30:8488-8500. [PMID: 37754533 PMCID: PMC10529023 DOI: 10.3390/curroncol30090618] [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: 08/19/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Primary malignant cardiac tumors (PMCTs) are rare but lethal neoplasms. There are limited evidence-based treatment guidelines for PMCTs. We evaluated the relation of chemotherapy with mortality outcomes in patients with PMCTs in the United States. Data were from patients aged ≥ 20 years from the Surveillance, Epidemiology, and End Results program who were diagnosed with PMCTs from 2000 to 2020. Cox regression, competing risk, and propensity score analyses were performed to estimate hazard ratios (HR) and confidence intervals (CI). About 53% of the 563 patients with PMCTs received chemotherapy as the first course of treatment. During a mean follow-up of 24.7 months (median: 10), 458 deaths occurred with 81.7% and 9.4% due to cancer and cardiovascular disease (CVD), respectively. In models adjusted for sociodemographic and clinico-pathophysiological factors including histology, receipt of chemotherapy was associated with low risk for all-cause (HR: 0.56, 95%CI: 0.45-0.69), cancer (HR: 0.63, 95%CI: 0.50-0.80) and CVD mortality (HR: 0.27, 95%CI: 0.12-0.58). Patients who had both chemotherapy and surgery had the lowest risk for all-cause and cancer mortality. This study suggests that the subpopulations of patients with PMCTs who receive chemotherapy may have better prognosis than those who do not receive this therapy regardless of histology.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Carina R. Goodart
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Grishma K. Kothari
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Imo A. Ebong
- Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA 95616, USA
| | - Chike C. Nwabuo
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Ronin Institute, Montclair, NJ 07043, USA
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Wang W, Kang L, Zhang J, Li H, Cao T, He S. Age and treatment disparities in survival of primary malignant cardiac tumors: an analysis of over 40 years and 500 patients. J Thorac Dis 2023; 15:4434-4444. [PMID: 37691678 PMCID: PMC10482641 DOI: 10.21037/jtd-23-1054] [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: 07/05/2023] [Accepted: 08/13/2023] [Indexed: 09/12/2023]
Abstract
Background Primary malignant cardiac tumors (PMCTs) are rare and tend to have a poor prognosis, due to their aggressive biological behavior and the inadequate expertise with the disease. This article compares the survival of patients with PMCT subtypes in the United States across age and treatment groups. Methods Data of 529 patients diagnosed with PMCTs were analyzed. Chi-squared test was used to assess significance of the differences between proportions in demographic and tumor characteristics by age and treatment. Cox regression analysis was used to estimate survival from the Surveillance, Epidemiology, and End Results (SEER) follow-up data. Results Survival rates for PMCTs differed significantly between age groups, with patients younger than 20 years surviving significantly longer than those older than 80 years. The median survival times of all patients with PMCTs were 22.5, 11, 5, and 1 month for ages less than 20, 20-50, 51-80, and greater than 80 years, respectively (global log-rank P=0.0026). In the treatment cohort, for all tumors [hazard ratio (HR) 1.52, P<0.001], sarcomas (HR 1.83, P=0.002), and other tumors (HR 2.24, P=0.017), survival was lower in patients who did not receive treatment than in those who received only surgery. Survival after diagnosis of sarcoma was lower in patients who received radiotherapy only than in those who received surgery only (HR 1.49, P=0.046). However, there was no significant association between treatment and survival for lymphoma and mesothelioma. Conclusions This study confirms that PMCTs have limited treatment options and poor patient survival, especially for elderly patients and patients who receive no treatment. And patients with PMCTs of any age, whether treated or not, have poor survival rates. Techniques for early diagnosis and treatment may be necessary. Surgical treatment should have a higher priority for future treatment of patients with sarcomas.
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Affiliation(s)
- Wenmiao Wang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, China
- Graduate School, Shandong University, Ji’nan, China
| | - Li Kang
- School of Public Health, Nantong University, Nantong, China
| | - Jiaxin Zhang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, China
- Medical School of Nantong University, Nantong, China
| | - Houqiang Li
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Tiegang Cao
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Shuai He
- Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, China
- School of Public Health, Nantong University, Nantong, China
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Rahouma M, Khairallah S, Dabsha A, Baudo M, El-Sayed Ahmed MM, Gambardella I, Lau C, Esmail YM, Mohamed A, Girardi L, Gaudino M, Lorusso R, Mick SL. Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis. Front Oncol 2023; 13:1071770. [PMID: 36761976 PMCID: PMC9902931 DOI: 10.3389/fonc.2023.1071770] [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: 10/16/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Primary malignant cardiac tumors (PMCTs) are rare. Geographical distribution has been demonstrated to affect cancer outcomes, making the reduction of geographical inequalities a major priority for cancer control agencies. Geographic survival disparities have not been reported previously for PMCT and the aim of this study is to compare the prevalence and the long-term survival rate with respect to the geographic location of PMCTs using the Surveillance, Epidemiology, and End Results (SEER) research plus data 17 registries between 2000 and 2019. Methods The SEER database was queried to identify geographic variation among PMCTs. We classified the included states into 4 geographical regions (Midwest, Northeast, South and West regions) based on the U.S. Census Bureau-designated regions and divisions. Different demographic and clinical variables were analyzed and compared between the four groups. Kaplan Meier curves and Cox regression were used for survival assessment. Results A total of 563 patients were included in our analysis. The median age was 53 years (inter-quartile range (IQR): 38 - 68 years) and included 26, 90, 101, and 346 patients from the Midwest, Northeast, South, and West regions respectively. Sarcoma represented 65.6% of the cases, followed by hematological tumors (26.2%), while mesothelioma accounted for 2.1%. Treatment analysis showed no significant differences between different regions. Median overall survival was 11, 21, 13, and 11 months for Midwest, Northeast, South and West regions respectively and 5-year overall survival was 22.2%, 25.4%, 14.9%, and 17.6% respectively. On multivariate Cox regression, significant independent predictors of late overall mortality among the entire cohort included age (Hazard Ratio [HR] 1.028), year of diagnosis (HR 0.967), sarcoma (HR 3.36), surgery (HR 0.63) and chemotherapy (HR 0.56). Conclusion Primary malignant cardiac tumors are rare and associated with poor prognosis. Sarcoma is the most common pathological type. Younger age, recent era diagnosis, surgical resection, and chemotherapy were the independent predictors of better survival. While univariate analysis revealed that patients in the South areas had a worse survival trend compared to other areas, geographic disparity in survival was nullified in multivariate analysis.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt,*Correspondence: Mohamed Rahouma, ;
| | - Sherif Khairallah
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Anas Dabsha
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Massimo Baudo
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Cardiac Surgery Department, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Magdy M. El-Sayed Ahmed
- Cardiothoracic Surgery Department, Mayo Clinic, Jacksonville, FL, United States,Department of Surgery, Zagazig University Faculty of Medicine, Zagazig, Egypt
| | | | - Christopher Lau
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Yomna M. Esmail
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Abdelrahman Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Leonard Girardi
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Mario Gaudino
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Stephanie L. Mick
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
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Aloysius MM, Shrivastava S, Rojulpote C, Naseer R, Hanif H, Babic M, Gentilezza K, Boruah PK, Pancholy S. Racial and ethnic characteristics and cancer-specific survival in Primary Malignant Cardiac Tumors. Front Cardiovasc Med 2022; 9:961160. [PMID: 36093161 PMCID: PMC9453391 DOI: 10.3389/fcvm.2022.961160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background There is limited insight into the epidemiological characteristics and effect of race and ethnicity on Primary Malignant Cardiac Tumors (PMCTs). Objectives Comparison of clinical characteristics and cancer-specific survival outcomes of major races in the United States from the Surveillance, Epidemiology and End-Result (SEER) registry. Methods ICD-O-3 codes were used to identify PMCTs for the years 1975 to 2015. Three major races were identified—“White”, “Black”, and “Asian/Pacific Islander”. Cancer-specific survival outcomes were compared using Kaplan-Meier analysis across and amongst races, based on tumor histology. A subgroup analysis of cancer-specific survival was performed between “Hispanics” and “non-Hispanics.” Results Seven hundred and twenty patients were identified−47% females and 79% White, mean age at diagnosis (47 ± 20 years). Black patients were significantly younger (39 ± 18 years) and presented more commonly with angiosarcomas (53%). Non-angiogenic sarcomas and lymphomas were the most common tumors in the White (38%) and Asian/Pacific Islander (34%) cohorts. For a median follow-up period of 50 (IQR3-86) months, cancer-specific survival (mean ± SD, in months) was worse in Blacks (9 ± 3) as compared to Whites (15 ± 1) and Asian/Pacific Islander (14 ± 1) (p-value; Black vs. White <0.001; Black vs. Asian/Pacific Islanders = 0.017, White vs. Asian/Pacific Islanders = 0.3). Subgroup analysis with 116 (16%) Hispanics (40% females; mean age of 40 ± 20 years) showed a longer mean cancer-specific survival of 16.9 ± 2.4 months as compared to 13.6 ± 1.1 months in non-Hispanics (p = 0.011). Conclusion Black and non-Hispanic patients have poorer cancer-specific survival in PMCTs.
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Affiliation(s)
- Mark M. Aloysius
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Sanskriti Shrivastava
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
- *Correspondence: Sanskriti Shrivastava ;
| | - Chaitanya Rojulpote
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Raza Naseer
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Hamza Hanif
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Milos Babic
- Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Kenneth Gentilezza
- Department of Physical Medicine and Rehabilitation, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Pranjal K. Boruah
- Department of Cardiovascular Diseases, The Wright Center for Graduate Medical Education, Scranton, PA, United States
| | - Samir Pancholy
- Department of Cardiovascular Diseases, The Wright Center for Graduate Medical Education, Scranton, PA, United States
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