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Li J, Yang YZ, Xu P, Zhang C. A Prognostic Model Based on the Log Odds Ratio of Positive Lymph Nodes Predicts Prognosis of Patients with Rectal Cancer. J Gastrointest Cancer 2024; 55:1111-1124. [PMID: 38700666 PMCID: PMC11347484 DOI: 10.1007/s12029-024-01046-2] [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] [Accepted: 03/17/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE This study aimed to compare the prognostic value of rectal cancer by comparing different lymph node staging systems, and a nomogram was constructed based on superior lymph node staging. METHODS Overall, 8700 patients with rectal cancer was obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The area under the curve (AUC), the C index, and the Akaike informativeness criteria (AIC) were used to examine the predict ability of various lymph node staging methods. Prognostic indicators were assessed using univariate and multivariate COX regression, and further correlation nomograms were created after the data were randomly split into training and validation cohorts. To evaluate the effectiveness of the model, the C index, calibration curves, decision curves (DCA), and receiver operating characteristic curve (ROC) were used. We ran Kaplan-Meier survival analyses to look for variations in risk classification. RESULTS While compared to the N-stage positive lymph node ratio (LNR), the log odds ratio of positive lymph nodes (LODDS) had the highest predictive effectiveness. Multifactorial COX regression analyses were used to create nomograms for overall survival (OS) and cancer-specific survival (CSS). The C indices of OS and CSS for this model were considerably higher than those for TNM staging in the training cohort. The created nomograms demonstrated good efficacy based on ROC, rectification, and decision curves. Kaplan-Meier survival analysis revealed notable variations in patient survival across various patient strata. CONCLUSIONS Compared to AJCC staging, the LODDS-based nomograms have a more accurate predictive effectiveness in predicting OS and CSS in patients with rectal cancer.
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Affiliation(s)
- Jian Li
- Department of General Surgery, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), Shenyang, China
| | - Yu Zhou Yang
- Department of General Surgery, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), Shenyang, China
- Jinzhou Medical University, Jinzhou, China
| | - Peng Xu
- Department of General Surgery, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), Shenyang, China
| | - Cheng Zhang
- Department of General Surgery, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), Shenyang, China.
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2
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Yang R, Yue W, Hu D, Wang G, Mao L, Huang J, Wang H, Liang G. Synthesis of compounds based on the active domain of cabotegravir and their application in inhibiting tumor cells activity. ChemistryOpen 2024; 13:e202300284. [PMID: 38315083 PMCID: PMC11230920 DOI: 10.1002/open.202300284] [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: 12/17/2023] [Revised: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
Structural modification based on existing drugs, which ensures the safety of marketed drugs, is an essential approach in developing new drugs. In this study, we modified the structure of cabotegravir by introducing the front alkyne on the core structure through chemical reaction, resulting in the synthesis of 9 compounds resembling 1,2,3-triazoles. The potential of these new cabotegravir derivatives as tumor suppressors in gastrointestinal tumors was investigated. Based on the MTT experiment, most compounds showed a reduction in the viability of KYSE30 and HCT116 cells. Notably, derivatives 5b and 5h exhibited the most significant inhibitory effects. To further explore the effects of derivatives 5b and 5h on gastrointestinal tumors, KYSE30 cells were chosen as a representative cell line. Both derivatives can effectively curtail the migration and invasion capabilities of KYSE30 cells and induce apoptosis in a dose-dependent manner. We further demonstrated these derivatives induce cell apoptosis in KYSE30 cells by inhibiting the expression of Stat3 protein and Smad2/3 protein. Based on the above results, we suggest they show promise in developing drugs for esophageal squamous cell carcinoma.
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Affiliation(s)
- Ruyue Yang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Wenhui Yue
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Dong Hu
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Guidan Wang
- School of Medical Technology and Engineering, Henan University of Science & Technology, Luoyang, 471023, China
| | - Longfei Mao
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Jiahe Huang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
| | - Huili Wang
- University of North Carolina Hospitals, 101 Manning Dr, Chapel Hill, Orange County, NC 27599, USA
| | - Gaofeng Liang
- School of Basic Medicine and Forensic Medicine, Henan University of Science & Technology, Luoyang, 471023, China
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Guo J, Xiong Z, Yin S, Wen Y, Jin L, Wang C, Chen H, Luo D, Deng Z, Huang D, Li X, Yi B, Mao C, Lian L. Elderly patients with stage II gastric cancer do not benefit from adjuvant chemotherapy. World J Surg Oncol 2023; 21:319. [PMID: 37821872 PMCID: PMC10566074 DOI: 10.1186/s12957-023-03185-5] [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: 06/21/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND With the aging of the population, the burden of elderly gastric cancer (EGC) increases worldwide. However, there is no consensus on the definition of EGC and the efficacy of adjuvant chemotherapy in patients with stage II EGC. Here, we investigated the effectiveness of adjuvant chemotherapy in defined EGC patients. METHODS We enrolled 5762 gastric cancer patients of three independent cohorts from the Sixth Affiliated Hospital of Sun Yat-sen University (local), the Surveillance, Epidemiology, and End Results (SEER), and the Asian Cancer Research Group (ACRG). The optimal age cutoff for EGC was determined using the K-adaptive partitioning algorithm. The defined EGC group and the efficacy of adjuvant chemotherapy for them were confirmed by Cox regression and Kaplan-Meier survival analyses. Furthermore, gene set variation analyses (GSVA) were performed to reveal pathway enrichment between groups. RESULTS The optimal age partition value for EGC patients was 75. In the local, SEER, and ACRG cohorts, the EGC group exhibited significantly worse overall survival and cancer-specific survival than the non-EGC group (P < 0.05) and was an independent risk factor. Stratified analyses based on chemotherapy showed that EGC patients derived little benefit from adjuvant chemotherapy. Furthermore, GSVA analysis revealed the activation of DNA repair-related pathways and downregulation of the p53 pathway, which may partially contribute to the observed findings. CONCLUSION In this retrospective, international multi-center study, 75 years old was identified as the optimal age cutoff for EGC definition, and adjuvant chemotherapy proved to be unbeneficial for stage II EGC patients.
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Affiliation(s)
- Jianping Guo
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhizhong Xiong
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shi Yin
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yue'e Wen
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Longyang Jin
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Caiqin Wang
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huaxian Chen
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dandong Luo
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zijian Deng
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dayin Huang
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xianzhe Li
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Biying Yi
- Follow-up office of the Sixth Affiliated Hospital, The Sixth Affiliated Hospital, Sun Yat-sen University, Guanzhou, China
| | - Chaobin Mao
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Lei Lian
- Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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Sharon CE, Wang M, Tortorello GN, Perry NJ, Ma KL, Tchou JC, Fayanju OM, Mahmoud NN, Miura JT, Karakousis GC. Impact of Patient Comorbidities on Presentation Stage of Breast and Colon Cancers. Ann Surg Oncol 2023; 30:4617-4626. [PMID: 37208570 PMCID: PMC10788153 DOI: 10.1245/s10434-023-13596-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND While patients with multiple comorbidities may have frequent contact with medical providers, it is unclear whether their healthcare visits translate into earlier detection of cancers, specifically breast and colon cancers. METHODS Patients diagnosed with stage I-IV breast ductal carcinoma and colon adenocarcinoma were identified from the National Cancer Database and stratified by comorbidity burden, dichotomized as a Charlson Comorbidity Index (CCI) Score of <2 or ≥2. Characteristics associated with comorbidities were analyzed by univariate and multivariate logistic regression. Propensity-score matching was performed to determine the impact of CCI on stage at cancer diagnosis, dichotomized as early (I-II) or late (III-IV). RESULTS A total of 672,032 patients with colon adenocarcinoma and 2,132,889 with breast ductal carcinoma were included. Patients with colon adenocarcinoma who had a CCI ≥ 2 (11%, n = 72,620) were more likely to be diagnosed with early-stage disease (53% vs. 47%; odds ratio [OR] 1.02, p = 0.017), and this finding persisted after propensity matching (CCI ≥ 2 55% vs. CCI < 2 53%, p < 0.001). Patients with breast ductal carcinoma who had a CCI ≥ 2 (4%, n = 85,069) were more likely to be diagnosed with late-stage disease (15% vs. 12%; OR 1.35, p < 0.001). This finding also persisted after propensity matching (CCI ≥ 2 14% vs. CCI < 2 10%, p < 0.001). CONCLUSIONS Patients with more comorbidities are more likely to present with early-stage colon cancers but late-stage breast cancers. This finding may reflect differences in practice patterns for routine screening in these patients. Providers should continue guideline directed screenings to detect cancers at an earlier stage and optimize outcomes.
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Affiliation(s)
- Cimarron E Sharon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - Michael Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gabriella N Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhita J Perry
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin L Ma
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Julia C Tchou
- Division of Breast Surgery, Department of surgery, The University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Philadelphia, PA, USA
| | - Oluwadamilola M Fayanju
- Division of Breast Surgery, Department of surgery, The University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Philadelphia, PA, USA
| | - Najjia N Mahmoud
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Colon and Rectal Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
| | - John T Miura
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Endocrine and Oncologic Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
| | - Giorgos C Karakousis
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Endocrine and Oncologic Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
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5
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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.
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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
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Gheybi K, Buckley E, Vitry A, Roder D. Associations of advanced age with comorbidity, stage and primary subsite as contributors to mortality from colorectal cancer. Front Public Health 2023; 11:1101771. [PMID: 37089488 PMCID: PMC10116414 DOI: 10.3389/fpubh.2023.1101771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/16/2023] [Indexed: 04/09/2023] Open
Abstract
BackgroundAlthough survival from colorectal cancer (CRC) has improved substantially in recent decades, people with advanced age still have a high likelihood of mortality from this disease. Nonetheless, few studies have investigated how cancer stage, subsite and comorbidities contribute collectively to poor prognosis of older people with CRC. Here, we decided to explore the association of age with mortality measures and how other variables influenced this association.MethodsUsing linkage of several administrative datasets, we investigated the risk of death among CRC cases during 2003–2014. Different models were used to explore the association of age with mortality measures and how other variables influenced this association.ResultsOur results indicated that people diagnosed at a young age and with lower comorbidity had a lower likelihood of all-cause and CRC-specific mortality. Aging had a greater association with mortality in early-stage CRC, and in rectal cancer, compared that seen with advanced-stage CRC and right colon cancer, respectively. Meanwhile, people with different levels of comorbidity were not significantly different in terms of their increased likelihood of mortality with advanced age. We also found that while most comorbidities were associated with all-cause mortality, only dementia [SHR = 1.43 (1.24–1.64)], Peptic ulcer disease [SHR = 1.12 (1.02–1.24)], kidney disease [SHR = 1.11 (1.04–1.20)] and liver disease [SHR = 1.65 (1.38–1.98)] were risk factors for CRC-specific mortality.ConclusionThis study showed that the positive association of advanced age with mortality in CRC depended on stage and subsite of the disease. We also found only a limited number of comorbidities to be associated with CRC-specific mortality. These novel findings implicate the need for more attention on factors that cause poor prognosis in older people.
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Affiliation(s)
- Kazzem Gheybi
- University of South Australia Allied Health and Human Performance, Adelaide, SA, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, SA, Australia
- Charles Perkins Centre, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Elizabeth Buckley
- University of South Australia Allied Health and Human Performance, Adelaide, SA, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, SA, Australia
| | - Agnes Vitry
- University of South Australia Clinical and Health Sciences, Adelaide, SA, Australia
| | - David Roder
- University of South Australia Allied Health and Human Performance, Adelaide, SA, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, SA, Australia
- *Correspondence: David Roder
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Afifi AM, Elmehrath AO, Ruhban IA, Saad AM, Gad MM, Al-Husseini MJ, Bekaii-Saab T, Sonbol MB. Causes of Death Following Nonmetastatic Colorectal Cancer Diagnosis in the U.S.: A Population-Based Analysis. Oncologist 2021; 26:733-739. [PMID: 34101294 DOI: 10.1002/onco.13854] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/01/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Because of the improved colorectal cancer (CRC) survival in the U.S., patients may live long enough after CRC diagnosis to the point where non-cancer-related comorbidities may considerably impact their overall survival. In this study, we perform a long-term analysis of causes of death (CODs) following nonmetastatic CRC with respect to different demographic and tumor-related criteria. MATERIALS AND METHODS We gained access to the Surveillance, Epidemiology, and End Results data to review patients diagnosed with nonmetastatic CRC during 2000-2015. We calculated standardized mortality ratios (SMRs) for each COD following CRC. SMRs represented the change of risk of a specific COD following CRC diagnoses when compared with the risk in the general U.S. POPULATION RESULTS We reviewed 302,345 patients, of whom 112,008 died during the study period. More deaths (68.3%) occurred within 5 years following nonmetastatic CRC diagnosis, with 76,486 deaths. CRC was the most common COD (51.4%) within 5 years of diagnosis followed by heart disease (15.2%) and other cancers (8.4%). As time passed after diagnosis, the number of CRC deaths decreased, and other noncancer causes increased to the point that after 10 years only 10.4% of deaths were attributed to CRC, 15.3% were attributed to other cancers, and 34.2% were secondary to heart disease. CONCLUSION Following nonmetastatic CRC diagnosis, most deaths remain secondary to CRC. Other causes, including other cancers and cardiovascular disease, represent a significant number of deaths, especially in the 5 years following initial CRC diagnosis. Our findings help guide counseling patients with CRC regarding future health risks. IMPLICATIONS FOR PRACTICE Most common causes of death following nonmetastatic colorectal cancer (CRC) are heart diseases, other cancers, chronic obstructive pulmonary disease, and cerebrovascular diseases. Physicians should counsel patients regarding survivorship with cancer screening and focus on prevention of noncancer deaths. These findings should be considered by physicians who give care for survivors of nonmetastatic CRC.
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Affiliation(s)
- Ahmed M Afifi
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Inas A Ruhban
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Anas M Saad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Mohamed M Gad
- Cleveland Clinic Foundation, Cleveland, Ohio, USA.,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Tanios Bekaii-Saab
- Mayo Clinic Cancer Center, Division of Hematology/Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Mohamad Bassam Sonbol
- Mayo Clinic Cancer Center, Division of Hematology/Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA
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8
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Michalopoulou E, Matthes KL, Karavasiloglou N, Wanner M, Limam M, Korol D, Held L, Rohrmann S. Impact of comorbidities at diagnosis on the 10-year colorectal cancer net survival: A population-based study. Cancer Epidemiol 2021; 73:101962. [PMID: 34051687 DOI: 10.1016/j.canep.2021.101962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND It is established that comorbidities negatively influence colorectal cancer (CRC)-specific survival. Only few studies have used the relative survival (RS) setting to estimate this association, although RS has been proven particularly useful considering the inaccuracy in death certification. This study aimed to investigate the impact of non-cancer comorbidities at CRC diagnosis on net survival, using cancer registry data. METHODS We included 1076 CRC patients diagnosed between 2000 and 2001 in the canton of Zurich. The number and severity of comorbidities was expressed using the Charlson Comorbidity Index (CCI). Multiple imputation was performed to account for missing information and 10-year net survival was estimated by modeling the excess hazards of death due to CRC, using flexible parametric models. RESULTS After imputation, approximately 35 % of the patients were affected by comorbidities. These appeared to decrease the 10-year net survival; the estimated excess hazard ratio for patients with one mild comorbidity was 2.14 (95 % CI 1.60-2.86), and for patients with one more severe or more than one comorbidity was 2.43 (95 % CI 1.77-3.34), compared to patients without comorbidities. CONCLUSIONS Our analysis suggested that non-cancer comorbidities at CRC diagnosis significantly decrease the 10-year net survival. Future studies should estimate net survival of CRC including comorbidities as prognostic factor and use a RS framework to overcome the uncertainty in death certification.
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Affiliation(s)
- Eleftheria Michalopoulou
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland
| | - Katarina Luise Matthes
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland; Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland
| | - Nena Karavasiloglou
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland
| | - Miriam Wanner
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland
| | - Manuela Limam
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland
| | - Dimitri Korol
- Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland
| | - Leonhard Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Sabine Rohrmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland; Cancer Registry Zurich, Zug, Schwyz and Schaffhausen, University Hospital Zurich, Vogelsangstrasse 10, 8091, Zurich, Switzerland.
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Lu L, Ma L, Zhang X, Susanne Mullins C, Linnebacher M. Analyzing non-cancer causes of death of colorectal carcinoma patients in the US population for the years 2000-2016. Cancer Med 2021; 10:2740-2751. [PMID: 33314795 PMCID: PMC8026921 DOI: 10.1002/cam4.3673] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/10/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) treatment and patient survival improved greatly. Consequently an increased incidence of non-cancer-related deaths is observed. This study analyzed the causes of non-cancer death for people suffering from CRC based on the year of diagnosis, follow-up time, and patient's age. METHODS The data from patients diagnosed with CRC in the years 2000-2016 were taken from the Surveillance, Epidemiology, and End Results 18 database. Patients were categorized according to: death from CRC, non-CRC cancer, and non-cancer. Constituent ratios and standardized mortality ratios (SMRs) were calculated to describe the death causes distribution and relative death risks. RESULTS Between 2000 and 2016, a stable and rapid drop for the original diagnosis as death cause for CRC patients was observed (70.19% to 49.35%). This was coupled to an increase in non-cancer-associated death reasons (23.38% to 40.00%). The most common non-cancer death cause was heart disease, especially for elderly patients. However, deaths from accidents and adverse effects were frequent in younger CRC patients. Patients died from septicemia more often within the first follow-up year; however, a 6-fold increase in death from Alzheimer's disease was found for after at least 180 months follow-up time. The SMRs of all 25 non-cancer death causes initially decreased in all CRC subgroups, followed by an increase with follow-up times. Gradually decreasing SMR values were observed with increasing age of CRC patients. CONCLUSIONS These findings could help modify and sharpen preventive measures and clinical management and raise physician's awareness to potential non-CRC death risk factors for CRC patients.
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Affiliation(s)
- Lili Lu
- Department of General Surgery, Molecular Oncology and ImmunotherapyRostock University Medical CenterRostockGermany
| | - Li Ma
- Department of EpidemiologyDalian Medical UniversityDalianChina
| | - Xianbin Zhang
- Department of General SurgeryShenzhen University General Hospital & Carson International Cancer Research CentreShenzhenChina
| | - Christina Susanne Mullins
- Department of General Surgery, Molecular Oncology and ImmunotherapyRostock University Medical CenterRostockGermany
| | - Michael Linnebacher
- Department of General Surgery, Molecular Oncology and ImmunotherapyRostock University Medical CenterRostockGermany
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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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Aoullay Z, Slaoui M, Razine R, Er-Raki A, Meddah B, Cherrah Y. Therapeutic Characteristics, Chemotherapy-Related Toxicities and Survivorship in Colorectal Cancer Patients. Ethiop J Health Sci 2020; 30:65-74. [PMID: 32116434 PMCID: PMC7036457 DOI: 10.4314/ejhs.v30i1.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Colorectal Cancer (CRC) is a major health problem around the globe. In Morocco, the disease ranks third after breast and lung cancers. This study is the first in Morocco to investigate epidemiological, clinical and therapeutic features while exhaustively describing toxic side-effects to chemotherapy of CRC and studying the 3-years survivorship. Methods This is a descriptive and analytical retrospective study of about 290 patients with CRC enrolled during the period of January-December 2013. Statistical analysis was performed to correlate clinicopathological data with chemotherapy toxicity and survivorship in patients, by Chi2 test. Overall Survival (OS) rate has been calculated by the Kaplan-Meier method and compared using Log-rank test. Results Fifty-five percent had a tumor localized in rectum, and 42,8% in colon. Mean age of these patients at diagnosis was 56,16 ± 14,6. incidence rate of adverse events (grade I to IV) was 85,6%. Diarrhea was the predominant toxicity (4.6%) occurring at a high grade (grade III–IV). The 3-years OS rate of patients with CRC was 71%. OS decreased by age, and patients with age subgroup between 40 to 59 years had a better OS than the other age subgroups (60 to 79 years and >80 years) with a p-value of 0.0001. Occurence of toxicity (all grades and types) was linked to a higher survival rates compared to the group who had no toxicity noticed (p-value of 0.001). Conclusion Our study shows that patients who had a polychemotherapy had a better OS than those who had monotherapy (p-value of 0.002).
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Affiliation(s)
- Zineb Aoullay
- Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi - BP, 6203 Rabat, Morocco
| | - Meriem Slaoui
- Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Avenue Mohammed Belarbi El Alaoui Souissi - BP, 6203 Rabat, Morocco
| | - Rachid Razine
- Laboratory of Biostatistics, Epidemiology and Clinical Research, Université Mohamed V-Souissi Faculty of Medicine and Pharmacy of Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi, BP 6203 Rabat, Morocco.,Department of Public Health, Université Mohamed V-Souissi Faculty of Medicine and Pharmacy of Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi, BP 6203 Rabat, Morocco
| | | | - Bouchra Meddah
- Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi - BP, 6203 Rabat, Morocco
| | - Yahia Cherrah
- Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy of Rabat, University Mohamed V Rabat, Avenue Mohammed Belarbi El Alaoui - Souissi - BP, 6203 Rabat, Morocco
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Baljit Singh, Kumar S, Rajneesh, Mohan M, Divya. Synthesis and Characterization of Psyllium Polysaccharide–Poly(2-hydroxypropyl methacrylate)−Poly(acrylamide) Hydrogels for Use in Sustained Drug Delivery Applications. POLYMER SCIENCE SERIES B 2020. [DOI: 10.1134/s1560090420330064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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Zhao X, Yang Y, Gu H, Zhou W, Zhang Q. New prognostic risk score for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer surgery: U.S. Nationwide Inpatient Sample analysis. J Geriatr Oncol 2020; 11:1250-1254. [PMID: 32376233 DOI: 10.1016/j.jgo.2020.04.003] [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] [Received: 02/15/2019] [Revised: 02/21/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To develop a new prognostic risk score index for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer resection. PARTICIPANTS AND METHODS A retrospective study included 111,976 patients with colorectal cancer who were ≥ 65 years of age and underwent resection. The records were extracted from the Nationwide Inpatient Sample (NIS) database between 2005 and 2014. Univariate and multivariate analyses were conducted to determine the associations of in-hospital mortality and demographics, number of comorbidities, clinical and hospital-related characteristics. A prognostic risk score index on in-hospital mortality was established based on the odds ratios of the significant factors. RESULTS 30 points were distributed across the identified predictors of in-hospital mortality. Emergent admission had the greatest impact on mortality (adjusted OR = 3.01) and received the highest ranking with 7 points. The odds were followed by age ≥85 years old and number of comorbidities ≥3 (adjusted OR = 2.58 and 1.99, respectively), which received a rank of 5 points. The other elements of the risk score index were age 75-84 (4 points), male (3 points), tumor located in the colon or with distant metastasis (2 points), and with two comorbidities or socioeconomic status <Q4 (1 point). CONCLUSION This study proposes a novel risk score index for predicting in-hospital mortality in geriatric colorectal cancer patients undergoing resection. This risk score may be helpful for clinicians in decision-making and risk stratification at the pre-surgical phase.
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Affiliation(s)
- Xiaohong Zhao
- Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
| | - Yunmei Yang
- Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
| | - Haifeng Gu
- Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
| | - Wenjing Zhou
- Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
| | - Qin Zhang
- Department of Geriatrics, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China.
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Lam CJK, Enewold L, McNeel TS, White DP, Warren JL, Mariotto AB. Estimating Chemotherapy Use Among Patients With a Prior Primary Cancer Diagnosis Using SEER-Medicare Data. J Natl Cancer Inst Monogr 2020; 2020:14-21. [PMID: 32412067 DOI: 10.1093/jncimonographs/lgaa005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/09/2020] [Accepted: 02/02/2020] [Indexed: 11/12/2022] Open
Abstract
Cancer treatment studies commonly exclude patients with prior primary cancers due to difficulties in ascertaining for which site treatment is intended. Surveillance, Epidemiology, and End Results-Medicare patients 65 years and older diagnosed with an index colon or rectal cancer (CRC) or female breast cancer (BC) between 2004 and 2013 were included. Chemotherapy, defined as "any chemotherapy" and more restrictively as "chemotherapy with confirmatory diagnoses," was ascertained based on claims data within 6 months of index cancer diagnosis by prior cancer history. Any chemotherapy use was slightly lower among patients with a prior cancer (CRC: no prior = 17.4%, prior = 16.1%; BC: no prior = 12.9%, prior = 12.0%). With confirmatory diagnoses required, estimates were lower, especially among patients with a prior cancer (CRC: no prior = 16.8%, prior = 13.6%; BC: no prior = 12.6%, prior = 11.0%). These findings suggest that patients with prior cancers can be included in studies of chemotherapy use; requiring confirmatory diagnoses can increase treatment assignment confidence.
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Affiliation(s)
- Clara J K Lam
- Data Analytics Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Lindsey Enewold
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | | | - Dolly P White
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Joan L Warren
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Angela B Mariotto
- Data Analytics Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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Adjuvant chemotherapy does not provide survival benefits to elderly patients with stage II colon cancer. Sci Rep 2019; 9:11846. [PMID: 31413354 PMCID: PMC6694195 DOI: 10.1038/s41598-019-48197-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/31/2019] [Indexed: 01/09/2023] Open
Abstract
To date, the effect of adjuvant chemotherapy after curative resection in patients with stage II colon cancer remains controversial. Still, little is known about the effects of adjuvant chemotherapy in patients with stage II colon cancer who are older than 70 years, as most studies did not focus on this population. This study aimed to investigate the oncologic outcomes of elderly patients with stage II colon cancer who underwent curative resection with or without postoperative adjuvant chemotherapy. We retrospectively reviewed medical records of patients older than 70 years who underwent curative resection of stage II primary colon cancer during 2002–2015. Patients were classified into surgery alone (SA) and adjuvant chemotherapy (AC) groups and propensity score-matched at a 1:1 ratio using a logistic regression. The end points were recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). Of the 623 patients who met the criteria, 145 were assigned to each arm after propensity score matching. The mean ages of the SA and AC groups were 74.3 and 74.0 years, respectively. A log-rank test revealed no significant inter-group differences in RFS (p = 0.202), CSS (p = 0.486) or OS (p = 0.299). In a Cox regression analysis, adjuvant chemotherapy was not found to be an independent factor affecting RFS (p = 0.206), CSS (p = 0.487) or OS (p = 0.301). Adjuvant chemotherapy does not appear to yield survival benefits in elderly patients with stage II colon cancer.
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Lorimer PD, Motz BM, Kirks RC, Han Y, Symanowski JT, Hwang JJ, Salo JC, Hill JS. Frequency of unplanned surgery in patients with stage IV colorectal cancer receiving palliative chemotherapy with an intact primary: An analysis of SEER‐Medicare. J Surg Oncol 2019; 120:407-414. [DOI: 10.1002/jso.25508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Patrick D. Lorimer
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Benjamin M. Motz
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Russell C. Kirks
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Yimei Han
- Department of Biostatistics, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - James T. Symanowski
- Department of Biostatistics, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Jimmy J. Hwang
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Jonathan C. Salo
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
| | - Joshua S. Hill
- Department of Surgery, Carolinas Medical CenterLevine Cancer Institute Charlotte North Carolina
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Risk prediction model for long-term heart failure incidence after epirubicin chemotherapy for breast cancer - A real-world data-based, nationwide classification analysis. Int J Cardiol 2019; 285:47-52. [PMID: 30905520 DOI: 10.1016/j.ijcard.2019.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/21/2019] [Accepted: 03/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) incidence during and after anthracycline therapy is highly dependent on anthracycline cumulative dose (CD), but its detailed risk factors remained unexplored. Our aim was to assess heart failure (HF) incidence after epirubicin therapy and construct a HF risk-prediction score. METHODS AND RESULTS A retrospective study was conducted by anonymized integration of nationwide healthcare databases. All the analysed patients were diagnosed with breast carcinoma confirmed by histology from 2007 to 2016. Participants did not undergo chemo- or radiotherapy or suffer HF/DCM during the preceding 3 years. The HF endpoint was established by assignment of I50 International Classification of Diseases (ICD) codes upon discharge from hospital or issuance of an autopsy report. 8068 patients treated with epirubicin were analysed. The 3-10-year HF cumulative incidence was 6.9%. Using binomial logistic regression the independent predictors were identified. A CD-dependent and significant effect on HF was revealed for epirubicin (threshold dose: 709 mg/m2, odds ratio (OR): 1.76) and docetaxel (CD: >510 mg/m2, OR: 1.59; CD ≤510 mg/m2, OR: 1.28, respectively). HF risk increased with age, even over 40. A risk-prediction score derived from regression coefficients consisting of age, diabetes mellitus, hypertension, coronary artery disease, stroke, epirubicin CD, docetaxel CD, capecitabine, gemcitabine, bevacizumab and cancer stage was able to classify HF risk over a wide range (2-30%). CONCLUSION Long-term HF risk for patients treated with epirubicin was stratified by our risk-prediction score with a nearly 15-fold difference between the lowest and highest groups.
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18
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Farrell C, Heaven C. Understanding the impact of chemotherapy on dignity for older people and their partners. Eur J Oncol Nurs 2018; 36:82-88. [DOI: 10.1016/j.ejon.2018.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022]
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Soares-Miranda L, Abreu S, Ruiz-Casado A, Lucia A. Physical activity and nutritional interventions and health-related quality of life in colorectal cancer survivors: a review. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23809000.2018.1503538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Luisa Soares-Miranda
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
| | - Sandra Abreu
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
- Faculty of Psychology, Education and Sport, Lusófona University of Porto, Porto, Portugal
| | - Ana Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Alejandro Lucia
- Research Institute of Hospital 12 de Octubre (‘i+12ʹ), Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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21
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Boakye D, Rillmann B, Walter V, Jansen L, Hoffmeister M, Brenner H. Impact of comorbidity and frailty on prognosis in colorectal cancer patients: A systematic review and meta-analysis. Cancer Treat Rev 2018; 64:30-39. [DOI: 10.1016/j.ctrv.2018.02.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/07/2018] [Indexed: 12/18/2022]
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Chen Y, Lairson DR, Chan W, Du XL. Risk of adverse events associated with front-line anti-myeloma treatment in Medicare patients with multiple myeloma. Ann Hematol 2018; 97:851-863. [PMID: 29333596 DOI: 10.1007/s00277-018-3238-4] [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] [Received: 05/18/2017] [Accepted: 01/02/2018] [Indexed: 11/30/2022]
Abstract
This study aims to examine the risks of adverse events associated with anti-multiple myeloma (MM) therapies in a large population-based cohort of elderly patients with MM. Patients diagnosed with advanced MM from 2005 through 2009 and receiving anti-MM therapy were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data. We compared safety outcomes between novel agents (proteasome inhibitor (PI) and immunomodulatory drugs (IMiD)) and other therapies and between PI- or IMiD-based regimens and PI plus IMiD combination regimens. Of 2587 patients with advanced MM, 2048 (79%) received novel agents and 539 (21%) received other therapies. Patients with preexisting anemia and thrombocytopenia were significantly more likely to receive novel agents (85.9 vs. 82.4%, P = 0.038; 13.8 vs. 10.4%, P = 0.036), while those with preexisting cardiovascular disease and hypertension were significantly less likely to receive novel agents (73.4 vs. 79.8%, P = 0.003; 81.3 vs. 85.2%, P = 0.035). The hazard ratios for anemia, peripheral neuropathy, and thromboembolic events for patients receiving novel agents compared with those receiving other therapies were 1.19 (95% CI, 1.06-1.32), 1.57 (95% CI, 1.15-2.15), and 1.31 (95% CI, 1.03-1.67). The hazard ratios for anemia, neutropenia, and thromboembolic events for patients receiving PI plus IMiD combination therapies compared with those receiving PI- or IMiD-based therapies were 1.31 (95% CI, 1.12-1.54), 1.66 (95% CI, 1.27-2.18, and 1.37 (95% CI, 1.02-1.86). Novel agents significantly increased the risk of anemia, peripheral neuropathy, and thromboembolic events. PI plus IMiD combination therapies were associated with significantly higher risk for anemia, neutropenia, and thromboembolic events.
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Affiliation(s)
- Ying Chen
- Department of Epidemiology, Human Genetics, and Environmental Science, School of Public Health, University of Texas Health Science Center in Houston, 1200 Pressler Street, RAS-E631, Houston, TX, 77030, USA
| | - David R Lairson
- Department of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center in Houston, Houston, TX, USA
| | - Wenyaw Chan
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center in Houston, Houston, TX, USA
| | - Xianglin L Du
- Department of Epidemiology, Human Genetics, and Environmental Science, School of Public Health, University of Texas Health Science Center in Houston, 1200 Pressler Street, RAS-E631, Houston, TX, 77030, USA.
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White A, Joseph D, Rim SH, Johnson CJ, Coleman MP, Allemani C. Colon cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5014-5036. [PMID: 29205304 PMCID: PMC6152891 DOI: 10.1002/cncr.31076] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 09/08/2017] [Accepted: 09/21/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND In the first CONCORD study (2008), 5-year survival for patients diagnosed with colon cancer between 1990 and 1994 in the United States was among the highest in the world (60%), but there were large racial disparities in most participating states. The CONCORD-2 study (2015) enabled the examination of survival trends between 1995 and 2009 for US states by race and stage. METHODS The authors analyzed data from 37 state population-based cancer registries, covering approximately 80% of the US population, for patients who were diagnosed with colon cancer between 2001 and 2009 and were followed through 2009. Survival up to 5 years was corrected for background mortality (net survival) using state-specific and race-specific life tables and age-standardized using the International Cancer Survival Standard weights. Survival is presented by race (all, black, white), stage, state, and calendar period (2001-2003 and 2004-2009) to account for changes in methods used to collect stage. RESULTS Five-year net survival increased by 0.9%, from 63.7% between 2001 and 2003 to 64.6% between 2004 and 2009. More black than white patients were diagnosed with distant-stage disease between 2001 and 2003 (21.5% vs 17.2%) and between 2004 and 2009 (23.3% vs 18.8%). Survival improved for both blacks and whites, but 5-year net survival was 9-10% lower for blacks than for whites both between 2001 and 2003 (54.7% vs 64.5%) and between 2004 and 2009 (56.6% vs 65.4%). The absolute difference between blacks and whites decreased by only 1% during the decade. CONCLUSIONS Five-year net survival from colon cancer increased slightly over time. Survival among blacks diagnosed between 2004 and 2009 had still not reached the level of that among whites diagnosed between 1990 and 1994, some 15 to 20 years earlier. These findings suggest a need for more targeted efforts to improve screening and to ensure timely, appropriate treatment, especially for blacks, to reduce this large and persistent disparity in survival. Cancer 2017;123:5014-36. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Arica White
- 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
| | - Sun Hee Rim
- 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 & Tropical Medicine, London, UK
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Yamano T, Yamauchi S, Kimura K, Babaya A, Hamanaka M, Kobayashi M, Fukumoto M, Tsukamoto K, Noda M, Tomita N, Sugihara K, Takemasa I, Hakamada K, Kameyama H, Takii Y, Hase K, Kotake K, Watanabe T, Takahashi K, Kanemitsu Y, Itabashi M, Yano H, Yasuno M, Hasegawa H, Hashiguchi Y, Masaki T, Watanabe M, Maeda K, Komori K, Sakai Y, Ohue M, Akagi Y. Influence of age and comorbidity on prognosis and application of adjuvant chemotherapy in elderly Japanese patients with colorectal cancer: A retrospective multicentre study. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Wu W, Wu F, Wang Z, Di J, Yang J, Gao P, Jiang B, Su X. CENPH Inhibits Rapamycin Sensitivity by Regulating GOLPH3-dependent mTOR Signaling Pathway in Colorectal Cancer. J Cancer 2017; 8:2163-2172. [PMID: 28819418 PMCID: PMC5560133 DOI: 10.7150/jca.19940] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/25/2017] [Indexed: 12/29/2022] Open
Abstract
Background: Centromere protein H (CENPH) is known as a fundamental component of the active centromere complex, and its overexpression is correlated with poor prognosis in various solid tumors. mTOR inhibitor rapamycin has been shown to possess antitumor activity, as well as prevent intestinal tumorigenesis. However, the prognostic value of CENPH in colorectal cancer (CRC) and the role of CENPH in rapamycin sensitivity remain unknown. Materials and methods: The effect of CENPH on the cell proliferation, clonogenicity, and cell response to rapamycin in CRC were evaluated by MTT and/or colony formation assays. For the underlying mechanisms, the interaction between CENPH and GOLPH3 were detected by co-immunoprecipitation, GST pull-down, and His-tag pull-down assays, as well as the laser scanning confocal microscopy. The status of kinases in mTOR signaling was determined by Western blot. Finally, the clinical significance of CENPH was analyzed using public CRC datasets with CENPH transcripts and clinical information. Results: CENPH inhibited CRC malignant phenotypes, conferred reduced sensitivity to rapamycin, and attenuated both mTORC1 and mTORC2 in mTOR signaling pathway through the interaction with golgi phosphoprotein 3 (GOLPH3), which has been identified as a potential oncogene and modulates the response to rapamycin. Moreover, elevated levels of CENPH were detected in CRC tissues, compared with normal colorectal tissues. High levels of CENPH expression gradually decreased according to CRC tumor stages. Patients with high CENPH expression had favorable survival. Conclusions: Our results suggest that CENPH inhibits rapamycin sensitivity by regulating GOLPH3 dependent mTOR pathway. High CENPH expression is associated with better prognosis in CRC patients. Taken together, CENPH may serve as a potential predictor for rapamycin sensitivity and therapeutic target for CRC patients.
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Affiliation(s)
- Wei Wu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Fan Wu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Zaozao Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jiabo Di
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jie Yang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Pin Gao
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Beihai Jiang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiangqian Su
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Joachim C, Godaert L, Dramé M, Véronique-Baudin J, Macni J, Smith-Ravin J, Novella JL, Mahmoudi R. Overall survival in elderly patients with colorectal cancer: A population-based study in the Caribbean. Cancer Epidemiol 2017; 48:85-91. [PMID: 28426981 DOI: 10.1016/j.canep.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/15/2017] [Accepted: 03/18/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Population-based Cancer registries (PBCR) play an important role in cancer surveillance and research. The aim of this study was to examine overall survival in elderly patients with colorectal cancer (CRC) by analysing data from the Martinique PBCR between 1993 and 2012. METHODS The log-rank test was used to assess the statistical differences of the survival curves by each categorical variable: age at diagnosis, sex, histology, zone of residence, subsite, stage at diagnosis, and chemotherapy. A multivariable Cox model was performed to identify independent prognostic factors for overall survival in elderly patients with colorectal cancer. RESULTS Among 2230 patients included in the study, 60.8% were aged≥65years; mean age at diagnosis of these patients was 75.7±7.2years. For the period 2008-2012, 532 elderly patients were analysed; mean age of those receiving chemotherapy was 73.0±0.4 versus 77.9±0.4years for those not receiving chemotherapy (p<0.0001). Stage at diagnosis was evaluated in 87.8% (467/532) of patients; 63.0% (294/467) had stage III-IV and 49.3% of these patients (145/294) received chemotherapy. Chemotherapy was less frequently prescribed in patients aged 75-84 and ≥85 years as compared to those aged 65-74 years (41.1% and 15.0% versus 64.6% respectively; p<0.0001). Stage III-IV at diagnosis (HR=5.25; 3.70-7.45; p<0.0001), and not receiving chemotherapy (HR=3.05; 2.23-4.16; p<0.0001), were independent prognostic factors for overall survival. CONCLUSION Our study highlights the role of PBCR in evaluating cancer survival and patterns of care in elderly people of the French West- Indies. Chemotherapy was less frequently prescribed among the elderly.
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Affiliation(s)
- Clarisse Joachim
- Registre Général des cancers de la Martinique, UF 1441 Registre des cancers, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU de Martinique, 97200 Fort-de-France, Martinique, France.
| | - Lidvine Godaert
- Pôle de Gériatrie, CHU de Martinique, 97200 Fort-de-France, Martinique, France
| | - Moustapha Dramé
- Faculté de Médecine, EA 3797, Université de Reims Champagne-Ardenne, 51095 Reims, France; Unité d'aide Méthodologique, Pôle Recherche et Santé publique, CHU de Reims, 51000 Reims, France
| | - Jacqueline Véronique-Baudin
- Registre Général des cancers de la Martinique, UF 1441 Registre des cancers, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU de Martinique, 97200 Fort-de-France, Martinique, France
| | - Jonathan Macni
- Registre Général des cancers de la Martinique, UF 1441 Registre des cancers, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU de Martinique, 97200 Fort-de-France, Martinique, France
| | - Juliette Smith-Ravin
- Université des Antilles, EA929 groupe BIOSPHERES, Campus de Schœlcher, 97200 Fort-de-France, Martinique, France
| | - Jean-Luc Novella
- Faculté de Médecine, EA 3797, Université de Reims Champagne-Ardenne, 51095 Reims, France; Département de Médecine Interne et Gériatrie, CHU de Reims, 51000 Reims, France
| | - Rachid Mahmoudi
- Faculté de Médecine, EA 3797, Université de Reims Champagne-Ardenne, 51095 Reims, France; Département de Médecine Interne et Gériatrie, CHU de Reims, 51000 Reims, France
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Lin J, Siegartel LR, Lingohr-Smith M, Menges B, Makenbaeva D. Using Health Care Claims Data to Assess the Prevalence of Hodgkin Lymphoma and Relapsed or Refractory Hodgkin Lymphoma in the United States. Clin Ther 2017; 39:303-310. [DOI: 10.1016/j.clinthera.2016.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/22/2016] [Accepted: 12/13/2016] [Indexed: 01/09/2023]
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van Eeghen EE, Bakker SD, van Bochove A, Loffeld RJLF. Impact of age and comorbidity on survival in colorectal cancer. J Gastrointest Oncol 2015; 6:605-12. [PMID: 26697191 DOI: 10.3978/j.issn.2078-6891.2015.070] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with colorectal cancer are often excluded from clinical trials based on age or a poor performance score. However, 70% of colorectal cancer is diagnosed in patients over 65. Evaluation on the influence of age and comorbidity on survival and cause of death in a non-selected population. METHODS Included were 621 consecutive patients with colorectal cancer. An extensive chart review was performed for 392 patients with colon cancer and 143 patients with rectal cancer. Analyses were performed separately for both groups. RESULTS Median survival of colon cancer patients was 5.13 years, 131 patients (34.3%) died from tumour progression. Age and comorbidity were significant predictors for overall survival (P<0.001). Age was also a significant predictor of cause of death (P=0.001). In rectal cancer patients median survival was 4.67 years, 51 (35.7%) of patients died from tumour progression. Neither age nor comorbidity was significant predictors of survival. Age was a significant predictor of cause of death (P<0.001). CONCLUSIONS In colon cancer patient age and comorbidity predict survival. This represents possible bias or a reduced survival benefit of treatment, and is an indication that colon cancer is not the prognosis defining illness in the majority of patients. In rectal cancer patients neither age or comorbidity significantly impacted survival.
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Relative impact of earlier diagnosis and improved treatment on survival for colorectal cancer: A US database study among elderly patients. Cancer Epidemiol 2014; 38:733-40. [DOI: 10.1016/j.canep.2014.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/06/2014] [Accepted: 10/12/2014] [Indexed: 01/26/2023]
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