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Tao C, Hong W, Yin P, Wu S, Fan L, Lei Z, Yu Y. Nomogram Based on Body Composition and Prognostic Nutritional Index Predicts Survival After Curative Resection of Gastric Cancer. Acad Radiol 2024; 31:1940-1949. [PMID: 37981487 DOI: 10.1016/j.acra.2023.10.057] [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: 09/15/2023] [Revised: 10/17/2023] [Accepted: 10/29/2023] [Indexed: 11/21/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to identify independent prognostic factors for gastric cancer (GC) patients after curative resection using quantitative computed tomography (QCT) combined with prognostic nutritional index (PNI), and to develop a nomogram prediction model for individualized prognosis. MATERIALS AND METHODS This study retrospectively analyzed 119 patients with GC who underwent curative resection from January 2016 to March 2018. The patients' preoperative clinical pathological data were recorded, and all patients underwent QCT scans before and after curative resection to obtain QCT parameters: bone mineral density (BMD), skeletal muscle area (SMA), visceral fat area (VFA), subcutaneous fat area (SFA) and CT fat fraction (CTFF), then relative rate of change in each parameter (ΔBMD, ΔSMA, ΔVFA, ΔSFA, ΔCTFF) was calculated after time normalization. Multivariate Cox proportional hazards was used to establish a nomogram model that based on independent prognostic factors. The concordance index (C-index), area under the time-dependent receiver operating characteristic (ROC) curve and clinical decision curve were used to evaluate the predictive performance and clinical benefit of the nomogram model. RESULTS: This study found that ΔCTFF, ΔVFA, ΔBMD and PNI are independent prognostic factors for overall survival (OS) (hazard ratio: 1.034, 0.895, 0.976, 2.951, respectively, all p < 0.05). The established nomogram model could predict the area under the ROC curve of OS at 1, 3 and 5 years as 0.816, 0.815 and 0.881, respectively. The C-index was 0.743 (95% CI, 0.684-0.801), and the decision curve analysis showed that this model has good clinical net benefit. CONCLUSION The nomogram model based on body composition and PNI is reliable in predicting the individualized survival of underwent curative resection for GC patients.
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Affiliation(s)
- Chao Tao
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.)
| | - Wei Hong
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.)
| | - Pengzhan Yin
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.)
| | - Shujian Wu
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.)
| | - Lifang Fan
- School of Medical imaging, Wannan Medical College, Wuhu, China (L.F.)
| | - Zihao Lei
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.)
| | - Yongmei Yu
- Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, China (T.C., W.H., P.Y., S.W., Z.L., Y.Y.).
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Takayanagi-Hara R, Saito-Sasaki N, Okada E, Sawada Y. The Efficacy of Platinum Chemotherapy in a Japanese Malignant Melanoma Patient With a BRCA2 Mutation Identified by Gene Panel Testing. Cureus 2023; 15:e45572. [PMID: 37868454 PMCID: PMC10586885 DOI: 10.7759/cureus.45572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
A BRCA2 mutation increases the chance of developing cancer and has been linked to several diseases, including hereditary breast, ovarian, pancreatic, and prostate cancers. We present a case of advanced malignant melanoma treated with platinum-containing chemotherapy and demonstrate a momentarily favorable clinical outcome as determined by a Next Generation Sequencer (NGS) gene panel testing. A 54-year-old female with BRAF wild-type of anal primary melanoma received adjuvant immunotherapy with nivolumab following surgical resection. Novel distant lung metastasis was identified four months after the adjuvant therapy. Multi-gene panel testing figured out another potential treatment strategy using a sample from a distant metastatic tumor and identified a BRCA2 mutation in the tumor. Based on the sensitivity to platinum agents in BRCA2 mutation-positive tumors, DAC-Tam therapy (Dacarbazine, Nimustine, Cisplatin, and Tamoxifen) was administrated and showed tumor size reduction. After five rounds of DAC-Tam treatment, the metastatic lesion decreased from 17 mm to 5 mm. The parent was treated with platinum and Dacarbazine alone because of deteriorated renal function and grade 3 myelosuppression. In addition, the tumor showed resistance to the platinum plus Dacarbazine chemotherapy. Her chemotherapy-induced renal failure and bone marrow suppression did not improve well. Additionally, she felt significant weakness due to poor dietary intake and did not want to receive additional chemotherapy. To relieve her symptoms, she and her family desired the best supporting care and moved her to another hospital. The patient died 12 months after submitting the gene panel.
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Affiliation(s)
| | - Natsuko Saito-Sasaki
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
| | - Etsuko Okada
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
| | - Yu Sawada
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
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He T, Li H, Zhang Z. Differences of survival benefits brought by various treatments in ovarian cancer patients with different tumor stages. J Ovarian Res 2023; 16:92. [PMID: 37170143 PMCID: PMC10176927 DOI: 10.1186/s13048-023-01173-7] [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: 12/14/2022] [Accepted: 04/25/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE The current study aimed to explore the prognosis of ovarian cancer patients in different subgroup using three prognostic research indexes. The current study aimed to build a prognostic model for ovarian cancer patients. METHODS The study dataset was downloaded from Surveillance Epidemiology and End Results database. Accelerated Failure Time algorithm was used to construct a prognostic model for ovary cancer. RESULTS The mortality rate in the model group was 51.6% (9,314/18,056), while the mortality rate in the validation group was 52.1% (6,358/12,199). The current study constructed a prognostic model for ovarian cancer patients. The C indexes were 0.741 (95% confidence interval: 0.731-0.751) in model dataset and 0.738 (95% confidence interval: 0.726-0.750) in validation dataset. Brier score was 0.179 for model dataset and validation dataset. The C indexes were 0.741 (95% confidence interval: 0.733-0.749) in bootstrap internal validation dataset. Brier score was 0.178 for bootstrap internal validation dataset. CONCLUSION The current research indicated that there were significant differences in the survival benefits of treatments among ovarian cancer patients with different stages. The current research developed an individual mortality risk predictive system that could provide valuable predictive information for ovarian cancer patients.
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Affiliation(s)
- Tingshan He
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Guangdong, 528303, Shunde, China
| | - Hong Li
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Guangdong, 528303, Shunde, China
| | - Zhiqiao Zhang
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Guangdong, 528303, Shunde, China.
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Lan H, Yuan J, Zhang R, Jiang B, Li Q, Huang Z, Chen P, Xiang H, Zeng X, Xiao S. Pancancer analysis of SKA1 mutation and its association with the diagnosis and prognosis of human cancers. Genomics 2023; 115:110554. [PMID: 36587749 DOI: 10.1016/j.ygeno.2022.110554] [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: 10/14/2022] [Revised: 12/10/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
This study aims to explore the role of SKA1 in cancer diagnosis and prognosis and to investigate the mechanism by which SKA1 affects the malignant behaviors of ovarian cancer. Herein, we analyzed the oncogenic role of SKA1 at pan-cancer level by multiple informatics databases and verified the analysis by in vitro experiments. As a result, SKA1 was upregulated across cancers and was related to poor clinical outcome and immune infiltration. Specifically, the constructed nomogram showed superior performance in predicting the prognosis of epithelial ovarian cancer patients. Furthermore, the in vitro experiments revealed that silencing SKA1 significantly inhibited the proliferation, migratory ability and enhanced the cisplatin sensitivity of ovarian cancer cells. Therefore, we explored the oncogenic and potential therapeutic role of SKA1 across cancers through multiple bioinformatic analysis and revealed that SKA1 may promote ovarian cancer progression and chemoresistance to cisplatin by activating the AKT-FOXO3a signaling pathway.
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Affiliation(s)
- Hua Lan
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Gynecology and Obstetrics, Changsha Central Hospital of University of South China, Changsha, Hunan, China
| | - Jing Yuan
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rui Zhang
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Oncology, Huaihua Hospital of University of South China, Huaihua, Hunan, China
| | - Biyao Jiang
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiaofen Li
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zongyan Huang
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Peiling Chen
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huimin Xiang
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiangyang Zeng
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Songshu Xiao
- Department of Gynecology and Obstetrics, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Du J, Cheng Y, Hu D, Xing Y, Yue L, He R, Li H, Liu C, Liang X, Yang Y. A nomogram-based overall survival stratification to identify uterine sarcoma patients without distant metastases who may benefit from adjuvant radiotherapy. Gynecol Oncol 2023; 169:17-26. [PMID: 36469973 DOI: 10.1016/j.ygyno.2022.11.023] [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: 08/01/2022] [Revised: 11/11/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Adjuvant radiotherapy has been commonly performed in uterine sarcoma patients, but its role in overall survival (OS) remains controversial. Therefore, our study aimed to build a nomogram-based prognostic stratification to identify uterine sarcoma patients who might benefit from adjuvant radiotherapy. METHODS Uterine sarcoma patients without distant metastases between 2004 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The LASSO Cox regression was performed to identify essential prognostic predictors and a nomogram was built to predict the 1-, 3-, and 5-year OS. Receiver operating characteristic (ROC), calibration curves, and decision curve analysis (DCA) were used to validate the nomogram. Finally, prognostic stratification was performed by decision tree analysis based on the total points of the nomogram. RESULTS 2871 patients with uterine sarcoma were included. Preliminary analysis suggested that adjuvant radiotherapy failed to provide an OS benefit for the total population without our nomogram. The built nomogram showed good discrimination and calibration abilities to predict the OS in uterine sarcoma patients and the patients were stratified into three risk groups based on the nomogram. For patients in the high-risk group, adjuvant radiotherapy significantly improved the 5-year OS and median survival time by 26.4% and 17 months, respectively (P < 0.001); while radiotherapy failed to improve the survival outcomes of patients in the low- and intermediate-risk groups. CONCLUSIONS The nomogram-based prognostic stratification provides preliminary characterization of uterine sarcoma patients who may benefit from radiotherapy. The newly defined high-risk patients may gain significant OS benefit from adjuvant radiotherapy.
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Affiliation(s)
- Junhong Du
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yuemei Cheng
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Dan Hu
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yijuan Xing
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ling Yue
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ruifen He
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Hongli Li
- Department of Obstetrics and Gynecology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Chang Liu
- Department of Obstetrics and Gynecology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiaolei Liang
- Department of Obstetrics and Gynecology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China.
| | - Yongxiu Yang
- Department of Obstetrics and Gynecology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China.
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Zhang D, Li S, Zhang X, Peng J, Zhang S. What predicts the clinical benefits of PARP inhibitors in platinum-sensitive recurrent ovarian cancer: A real-world single-center retrospective cohort study from China. Front Oncol 2022; 12:955124. [PMID: 36059631 PMCID: PMC9433773 DOI: 10.3389/fonc.2022.955124] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
Objective This study assessed the real-world application, effectiveness, and safety of olaparib and niraparib as maintenance therapies in patients with platinum-sensitive recurrent ovarian cancer (PSROC) in China and investigated clinical factors associated with prolonged benefits of poly ADP-ribose polymerase (PARP) inhibitors to help guide clinician treatment-decision making in daily practice. Methods This real-world single-center retrospective cohort study was conducted at the Shandong Cancer Hospital and Institute. Archival data of consecutive patients diagnosed with PSROC who achieved a complete response (CR) or partial response (PR) after the last platinum-based chemotherapy and treated with olaparib or niraparib as maintenance therapy from August 2018 to September 2021 were collected. Results Overall, 106 women were included in the cohort. Seventy-two (68%) patients were treated with olaparib, while 34 (32%) received niraparib; 99.1% of the patients were diagnosed with high-grade serous carcinoma, and 73.6% had FIGO stages III–IV. Approximately 71.7% of the patients had received PARP inhibitors after the second platinum-based line and 44.3% of the patients achieved a CR in their last platinum-based therapy. The median platinum-free interval (PFI) after the penultimate platinum-based therapy was 10 (95% CI: 10–13.6) months. The median PFS was 21 (95% CI: 13–24.5) months and the median CFI was 22 (95% CI: 16–26.5) months. Consistent with the univariate analysis, the multivariate analysis identified three independent factors associated with prolonged progression-free survival (PFS) and chemotherapy-free interval (CFI): breast cancer susceptibility gene (BRCA) mutant type (p = 0.005 and p = 0.003); PFI ≥12 months (p = 0.01 and p = 0.006); and CR to last platinum-based therapy (p = 0.016 and p = 0.019). It was found that there was no appreciable difference in any grade 3–4 hematological AE between patients who received olaparib and niraparib. Conclusion Maintenance treatment with olaparib and niraparib is effective and well tolerated for PSROC patients in real-world clinical practice. Three clinical factors were identified that predicted prolonged survival under maintenance therapy with PARP inhibitors: BRCA mutant type, PFI ≥12 months, and CR to last platinum-based therapy. These findings should be further confirmed with an appropriately powered analysis in studies with larger sample sizes.
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Affiliation(s)
- Depu Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
- Department of Gynecology Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shuo Li
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xinxin Zhang
- Department of Gynecology Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jingwei Peng
- Department of Gynecology Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shiqian Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
- *Correspondence: Shiqian Zhang,
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Quesada S, Fabbro M, Solassol J. Toward More Comprehensive Homologous Recombination Deficiency Assays in Ovarian Cancer Part 2: Medical Perspectives. Cancers (Basel) 2022; 14:cancers14041098. [PMID: 35205846 PMCID: PMC8870335 DOI: 10.3390/cancers14041098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/19/2022] [Accepted: 02/20/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary High-grade serous ovarian cancer (HGSOC—the most frequent and aggressive form of ovarian cancer) represents an important challenge for clinicians. Half of HGSOC cases exhibit homologous recombination deficiency (HRD), mainly through alterations in BRCA1 and BRCA2. This leads to sensitivity to PARP inhibitors, a novel class of breakthrough molecules that improved HGSOC prognoses. To date, three companion diagnostic assays have received FDA approval for the evaluation of HRD status, but their use remains controversial. In this companion review (Part 1: Technical considerations; Part 2: Medical perspectives), we develop an integrative perspective, from translational research to clinical application, that could help physicians and researchers manage HGSOC. Abstract High-grade serous ovarian cancer (HGSOC) is the most frequent and aggressive form of ovarian cancer, representing an important challenge for clinicians. Half of HGSOC cases have homologous recombination deficiency (HRD), which has specific causes (mainly alterations in BRCA1/2, but also other alterations encompassed by the BRCAness concept) and consequences, both at molecular (e.g., genomic instability) and clinical (e.g., sensitivity to PARP inhibitor) levels. Based on its prevalence and clinical impact, HRD status merits investigation. To date, three PARP inhibitors have received FDA/EMA approval. For some approvals, the presence of specific molecular alterations is required. Three companion diagnostic (CDx) assays based on distinct technical and medical considerations have received FDA approval to date. However, their use remains controversial due to their technical and medical limitations. In this companion and integrated review, we take a “bench-to-bedside” perspective on HRD definition and evaluation in the context of HGSOC. Part 1 of the review adopts a molecular perspective regarding technical considerations and the development of CDx. Part 2 focuses on the clinical impact of HRD evaluation, primarily through currently validated CDx and prescription of PARP inhibitors, outlining achievements, limitations and medical perspectives.
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Affiliation(s)
- Stanislas Quesada
- Medical Oncology Department, Institut Régional du Cancer de Montpellier (ICM), 34298 Montpellier, France;
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France;
- Correspondence:
| | - Michel Fabbro
- Medical Oncology Department, Institut Régional du Cancer de Montpellier (ICM), 34298 Montpellier, France;
- Montpellier Research Cancer Institute (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, University of Montpellier, 34298 Montpellier, France
| | - Jérôme Solassol
- Faculty of Medicine, University of Montpellier, 34090 Montpellier, France;
- Montpellier Research Cancer Institute (IRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1194, University of Montpellier, 34298 Montpellier, France
- Department of Pathology and Onco-Biology, Centre Hospitalier Universitaire (CHU) Montpellier, 34295 Montpellier, France
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Zheng P, Zheng P, Chen G. Conditional Survival of Advanced Epithelial Ovarian Cancer: A Real-World Data Retrospective Cohort Study From the SEER Database. Front Med (Lausanne) 2021; 8:756401. [PMID: 34888325 PMCID: PMC8650058 DOI: 10.3389/fmed.2021.756401] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
Objective: To analyze conditional survival (CS) in patients with advanced epithelial ovarian cancer (EOC) and investigate prognostic factors that affect the CS rate to provide more accurate survival information. Methods: Patients with advanced EOC between 2004 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. CS analysis was performed to depict exact survival for patients who had already survived a specific number of years. Cox proportional hazards regression was performed to ascertain the individual contribution of factors associated with actuarial overall survival (OS) at diagnosis and CS at 1, 3, and 5 years after diagnosis. Results: Of 11,773 patients, OS decreased from 32.2% at 6 years to 25.1% at 8 years, while the corresponding 5 year CS (CS5) increased from 37.5% at 1 year to 43.9% at 3 years. Subgroup analysis stratified by clinicopathological characteristics showed that CS5 was always higher than the corresponding actuarial survival (all Δ > 0). Based on multivariate analysis at diagnosis, age, race, marital status, histological type, tumor grade, size, T stage, M stage, surgery, radiation therapy, and chemotherapy were independent prognostic factors for OS. Five years after diagnosis, however, only age, histological type, tumor grade, and laterality were persistently significant independent prognostic factors (all P <0.05). Furthermore, patients with poor pathological prognostic factors achieved greater improvements in CS5 rates, and the survival gaps between OS and CS were more obvious. Conclusion: CS of advanced EOC was dynamic and increased over time. Age, histology, tumor grade, and laterality were significant prognostic factors even 5 years after diagnosis. Thus, the availability of updated prognoses at various time points will allow clinicians to better guide their patients.
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Affiliation(s)
- Peng Zheng
- Department of Intensive Care Unit, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Ping Zheng
- Department of Osteology, Fuzhou Second Hospital, Xiamen University, Fuzhou, China
| | - Guilin Chen
- Department of Intensive Care Unit, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China.,Department of Osteology, Fuzhou Second Hospital, Xiamen University, Fuzhou, China.,Department of Gynecological Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
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